Empirical status regarding the remediation of executive skills

Abstract

As has been discussed in previous chapters, EdF is a frequent consequence of neurodevelopmental and acquired neurological conditions, and often warrants intervention. At this time, there are several approaches available for the treatment of EdF. Treatment can involve cognitive, behavioral, or pharmacologic approaches. While there is a paucity of research on the efficacy of interventions to address EdF in children, there is a solid literature describing the theoretical considerations and models for remediation of EF in children. In this chapter, the current empirical literature describing cognitive and behavioral interventions for EdF are reviewed, with a brief discussion of the efficacy of pharmacologic treatments for EdF. Examining efficacy of interventions It has been proposed that the best context for EdF intervention is through everyday functional activities, using everyday people and routines. According to this theoretical model, teaching cognitive processes in an entirely decontextualized manner is not likely to be effective. Instead, it is believed necessary to teach and support EF skills in the context of everyday routines. These skills emerge through a process of sequential mastery; slowly introducing new EF demands into daily routines (such as expecting the child to initiate each step independently) or alternating the sequence of steps to achieve a goal more efficiently is the typical approach taken to ensure successful acquisition. As such, interventions should be integrated into the child's home routine and educational program and implemented by caregivers, teachers, and therapists.

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