Monthly Archives: January 2014

Tools for Families: Two Key Strategies for Treating Executive Dysfunction

Treatment for executive dysfunction is primary a process of structured skill building. There is no medication that “fixes” or improves executive weaknesses. Behavior plans, rewards and consequences do not improve weak executive functioning either.

So what can you do to help your child better organize, plan and meet their goals?

Let’s start with the basic requirements to support your child in developing executive functioning skills.

The two most important approaches to remember when parenting a child with executive dysfunction are: Consistent Routines and Breaking Down Multistep Tasks.

Consistent routines are what allow your child to get through the day as smoothly as possible. Routines are grounding and help people make sense of the seemingly overwhelming number of tasks they must do in a day. Routines are especially important for your child in the morning before school, during homework time, and before settling down for bed at night. These times of day require a lot of transitions and organzation. Without solid routines, children with executive dysfunction can get overwhelmed, lost and distracted. They can look like they are spinning in circles, getting nothing done. This happens because they do not see how individual tasks help them to complete a larger goal.

Multistep tasks are another area of major struggle for kids with executive dysfunction. For instance, when you ask your child to “Get dressed and ready for school,” you probably mean that he needs to put on underclothes, shirt, pants, socks and shoes. You may also mean for him to brush his teeth, comb his hair and grab his backpack as he heads out the door. The child with executive functioning weaknesses does not intuitively understand that all those little steps equal “getting dressed and ready for school.” A concrete routine that you directly teach your child will help him to understand all the small steps necessary to “get ready for school.”

Routines must be implemented and reinforced consistently. Changing a routine from day-to-day will only confuse and frustrate your child. The more consistent you are with your routines, the faster your child will catch on and be able to implement the routines independently.

Many families minimize the need to keep routines consistent and misunderstand how they must break down multistep tasks to help their child be successful. For many this approach sounds simplistic…until they start to implement it.

Honestly, being consistent and breaking down tasks isn’t easy. The task breakdown can be time consuming and laborious. And consistency is harder than you imagine if you’re not one to stick to a routine.

However, these two strategies taken together will make your child feel more in control,have more success and minimize stress for everyone in the family.

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Come on In, The Water’s Fine!

I believe psychologists have an important role to play in bringing about health care change. And I am so very excited to be partnering with innovative thinker and psychologist Dr. Susan Giurleo to begin exploring how that might happen.

After a discussion in which several psychologists were sharing frustration over our wish to contribute more and our sense that our voices aren’t heard in other spaces, we realized that we could do something about that. We could build a space and reach out to others from that platform. I talked about this a bit more in my post “Why #InnoPsy?

Now it’s time to actually get it started.

The Medicine and Psychology Tweetchat started January 7th 2014 as the #InnoPsy chat, and continues every Tuesday at 9 pm ET/6 pm PT. Why a Tweetchat? Because Twitter is a platform that allows for global conversations–and it’s where I met most of the innovators that I admire and respect.

You’ve never participated in a Tweetchat, you say? No problem. First of all, you need a Twitter account. They are free and easy to establish. If you’re starting your first account, you’ll be prompted to follow some folks. You could start with Susan Giurleo (@SusanGiurleo) and I (@DrBeckerSchutte). You can also follow the @MedPsychChat account for chat topics and moderation.

Once you have your Twitter account up and running, I would recommend using another tool to participate in the chat. My favorites are Tweetchat or Either of these tools allows you to enter a hashtag (ours is #MedPsych) and you will see the chat in a full screen window, which makes it easy to follow along.

So, if you want to join a #MedPsych chat, then pull up your device of choice at 9:30 pm ET on a Tuesday night.  Open your Tweetchat,, or other Twitter interaction tool.  Type the #MedPsych hashtag into the search bar, and jump on into the conversation.  We’ll ask for introductions, and then be off and running on our topic of the night.

Not a psychologist or a doctor? No problem! #MedPsych is open to all stakeholders (and if you live in a body, you are a healthcare stakeholder).  We believe that a big-tent community is how we will truly find solutions to the challenges that we face in healthcare.

The first chat included some community brainstorming about topics we wanted to explore in a discussion about innovation in psychology.  Now, we’ll introduce a new topic each week.

I hope we see you there! I’m excited to explore new ideas in psychology, medicine, and integrated healthcare.

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