EXECUTIVE
FUNCTIONING:
A HOME VISITOR PERSPECTIVE
Luke Quinn, MSW
Learning Objectives



Understand basics of Executive Functioning as it
applies to infants and toddlers
Learn practical activities to enhance Executive
Functioning in early childhood
Develop ideas for supporting Executive Function
development with families
First: our own Executive Functioning
Instructions: circle numerical answers and total each section
Strongly
Tend to Tend to
Disagree
Disagree
Disagree Agree
Agree
Strongly
Agree
I don't jump to conclusions
1
2
3
4
5
6
I think before I speak
I make sure I have all the facts
before I take action
1
2
3
4
5
6
1
2
3
4
5
6
Section A Total:
13
Adapted from Executive Skills Questionnaire for Adults by Peg Dawson & Richard Guare
Executive Skills Questionnaire





Your EF Strengths (highest totals)
Your EF Challenges (lowest totals)
Any Surprises?
Thoughts?
Implications for our work with families and children?
Executive Function
Our very own air traffic control system
Executive Function Skills
Working Memory - the ability to hold
and manipulate information in our
heads over short periods of time
Inhibitory Control- the ability to master
and filter our thoughts and impulses to
resist temptations and distractions
Marshmallow Experiment
Mental Flexibility – the ability to
switch gears and adjust to changing
demands, priorities, or perspectives
Working Memory (to hold)
7-9 MONTHS Develops ability to remember that unseen objects
are still there and learns to put two actions together in a
sequence
9-10 MONTHS Can execute simple means-to-ends tasks and twostep plans; also able to integrate looking one place and acting
at another place
3 YEARS Can hold in mind two rules and act on those rules
ADULT Can remember multiple tasks, rules, and strategies that
vary by situation
from Center on Developing Child, Working Paper 11
Inhibitory Control (to wait)
6 MONTHS Rudimentary response inhibition
8-11 MONTHS Begins to maintain focus despite distractions
during brief delays in a task; also able to inhibit reaching
immediately for a visible but inaccessible object
4-5 YEARS Can delay eating a treat; also can begin to hold an
arbitrary rule in mind and follow it
ADULT Consistent self-control; situationally appropriate
responses
from Center on Developing Child, Working Paper 11
Mental Flexibility (to switch)
9-11 MONTHS Develops ability to seek alternate methods to
retrieve objects beyond directly reaching for what’s in view
2-5 YEARS Succeeds at shifting according to changing rules
based on different settings or circumstances
ADULT Able to revise actions and plans in response to changing
circumstances
from Center on Developing Child, Working Paper 11
EF Skill proficiency
The Opportunity: Circuits for Executive Function Skills Are
Located in Brain Regions that Exhibit an Extended Period
of Plasticity
Birth
3
5
10
15
25
30
Age (Years)
Slide courtesy of the Center on the Developing Child at Harvard University
50
70
80
Weintraub, et al., (2011)
How to share this with families?
How could you start the conversation?
 How to continue the conversation?
 Questions you might ask
 Observations you could make
 How to make it practical?
 How do you feel about the term “Executive
Function” – do you have a better term for
parents?

Activities to build EF Skills
http://developingchild.harvard.edu/resources/
Working Memory (to hold)

For INFANTS (birth to 18 months)
 Peekaboo
 Hide-and-Find
 Rhymes,
Songs, Fingerplays
 Imitation Games

For TODDLERS (18 to 36 months)
 Matching
and Sorting
 Conversations and Storytelling
Inhibitory Control (to wait)

For INFANTS (birth to 18 months)
 Back
and Forth Activities
 Peekaboo
 Naming for your baby

For TODDLERS (18 to 36 months)
 Freeze
Dance
 Active Songs
 Talking about Feelings
Mental Flexibility (to switch)

For INFANTS (birth to 18 months)
 Rattle
Play
 Symbolic Play

For TODDLERS (18 to 36 months)
 Pretend
Play
 Silly Sorting
Spotlight on Game Play


A Game has at least one rule to remember (Working
Memory) and requires waiting and/or turn-taking
(Inhibitory Control). As they play, children may need
to try new tactics (Mental Flexibility) to be successful.
All sorts of games
 Home-made,

Songs, Imitation, Active
Support parents to support their children
ThinkFun Games
Ages: 18 months and up
ThinkFun Games
Ages: 18 months and up
Improvement on test of Mental Flexibility
Age-adjusted Score
110
Average for
normed sample
100
NIH toolbox
Card Sort Test
90
Pre
80
Post
70
60
Trained
Untrained
How to encourage EF activities?
What are families already doing?
 Where could this fit into your home visit?
 Does this fit with other models you are using?
 Will parents care?

Resources
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Activity Cards
Android and
iPhone App
Online Resources
http://www.joinvroom.org/tools-and-activities
*scroll to bottom of page for link to printable cards in Spanish and English
Resources
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
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Activities Guide
Working Papers and InBriefs
Videos
A
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few in Spanish and Portuguese
Online Training Modules
 EF
and Building Brain Architecture (WA DEL)
http://developingchild.harvard.edu/resources/
Resources

Videos


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Brain Architecture, EF, Serve and Return, Toxic Stress
Learning Cards
PowerPoint Presentations
http://www.albertafamilywellness.org/building-better-brains
Thank You!
Luke Quinn, MSW
Children’s Home Society of WA
lukeq@chs-wa.org