Supporting a Child with Executive Functioning Challenges

Ethan is a 10-year-old child who was referred to occupational therapy due to concerns related to organization, task completion, attention, and independence with daily routines. His parents reported that homework often took much longer than expected, he frequently forgot materials needed for school, and he required repeated reminders to complete everyday tasks.

Service

Occupational Therapy

Setting

Clinic

Approach

Executive Functioning Skills Focus

Background

Ethan is a 10-year-old child who was referred to occupational therapy due to concerns related to organization, task completion, attention, and independence with daily routines. His parents reported that homework often took much longer than expected, he frequently forgot materials needed for school, and he required repeated reminders to complete everyday tasks.

At school, Ethan’s teachers noted that he had difficulty following multi-step instructions, organizing assignments, managing his time, and transitioning between activities. While academically capable, these challenges were impacting his performance, confidence, and participation in the classroom.

His family wanted support to help him develop the skills needed to become more independent and successful at home and school.

Assessment

An occupational therapist completed a comprehensive assessment to better understand Ethan’s executive functioning abilities and how they were affecting daily activities. This included:

What the assessment included

Parent interview
Observation during structured and unstructured activities
Assessment of organization, planning, working memory, attention, and task completion skills
Review of school routines, homework demands, and daily living tasks
Identification of strengths, challenges, and functional goals

What We learned

The assessment identified difficulties with planning, organization, working memory, task initiation, and self-monitoring. Ethan often knew what he needed to do but had trouble organizing his thoughts, remembering instructions, and completing tasks efficiently without support.

Intervention Plan

A personalized occupational therapy plan was developed to improve executive functioning skills and increase independence across environments.
Organization and Planning Skills
  • Teaching strategies to organize school materials, assignments, and personal belongings
  • Creating visual systems and checklists to support task completion
  • Practicing breaking larger tasks into smaller, manageable steps
Working Memory Supports
  • Using visual reminders and cueing systems
  • Teaching strategies to improve recall of instructions and routines
  • Practicing note-taking and self-monitoring techniques
Time Management and Task Completion
  • Introducing timers and visual schedules
  • Teaching strategies to estimate task duration and manage workload
  • Developing routines to support homework and daily responsibilities
Self-Regulation and Attention
  • Identifying factors that contributed to distraction and reduced focus
  • Incorporating movement breaks and environmental modifications
  • Teaching strategies to improve attention and task persistence
Parent and School Collaboration
  • Providing parents and teachers with practical strategies to support executive functioning
  • Developing consistent systems across home and school environments
  • Monitoring progress and adjusting supports as needed

We offer flexible support options to meet you and your family's individual needs

Results

Following occupational therapy intervention:
Ethan demonstrated improved ability to follow multi-step instructions independently
Homework completion became more efficient and required fewer reminders
Organization of school materials and assignments improved significantly
Teachers reported increased independence during classroom tasks
Ethan became more successful at managing routines and transitions. This significantly reduced the amount of parent reminders in the morning and the time needed to get ready for school on time.
Confidence increased as he experienced greater success at home and school
His parents reported less frustration during homework and daily routines, and Ethan expressed feeling more capable of managing responsibilities on his own.

Conclusion

Executive functioning skills play a critical role in a child’s ability to learn, stay organized, manage time, and participate successfully in daily activities. Occupational therapy can help children develop practical strategies to improve planning, organization, attention, working memory, and self-regulation.

 

By building these foundational skills, children can increase their independence, confidence, and success at home, at school, and in the community.

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