Assessing for problems with executive functioning is more complex than one might think, because despite the fact that there are specific tests that look at skills for executive functioning the most important thing to understand is that in the context of testing we are sometimes artificially imposing a structure and so it may help the child who has trouble with executive functioning and they look better on testing than they do in real life.
There is good reason to do in office, one-on-one assessment, but it has to be also a process of looking at some of the observational rating scales. We want to know how the child is functioning daily at home, at school, and the observations of what the child does well, what the child doesn’t do well, you want to look at the history over time.
Someone who is anxious can have trouble with executive functioning, but sometimes once that anxiety is addressed the child returns to their previous good level of executive functioning. We would know that if we have a good history. Other kids from the moment they started school were just having trouble managing the demands.
All of that sort of soft data is very important. And then there are specific tests that can look at say how someone organizes an essay, how they are at remembering visual material, visual working memory, auditory working memory. We have tests for all of those things. And they’re very important.
Testing is also really important to rule out some of the lookalike disorders. So the purpose of testing for a child with executive functioning is to determine their specific profile of weaknesses and of strengths so we know what we can use to move the development along, rule out lookalike disorders and to determine if there is a diagnostic category that helps us to understand the child better.
