Does your child forget instructions, lose focus easily, or struggle to answer simple questions?
You’re not alone — and it may be related to something called working memory. 

What Are Executive Functions?

Executive functions are the brain skills that help your child focus, remember, and get things done. When children have difficulty focusing, remembering, learning, and processing information, we need to take a closer look at their executive functions. We can sort these skills into two main categories:  

1. Organization: attention, planning, sequencing, problem-solving, working memory and processing, time-management or following a schedule, cognitive flexibility, and abstract thinking including perspective taking, and connecting new information to learned information 
2. Regulation: task initiation, impulse control, self-regulation, self-monitoring behaviours and thoughts, decision-making, accepting change, and task completion 

Speech-Language Pathologists (SLPs) assess the skills above and recommend supports and strategies considering an individual’s areas of strength and weakness. For example, perhaps a child can follow routines easily but has difficulty starting new tasks; or, a child has strong attention skills when asked to focus on one task, but difficulty diving attention across tasks. This child may benefit from a ‘first-then’ board in which they focus on two small parts of the new task at a time. 

What is Working Memory?

This article would be very long if we looked at each of the skills above, so let’s take a closer look at one of the skills above – working memory. Working memory helps us hold on to a piece of information and use it to complete a task. Processing speed refers to the amount of time we take to respond or process information. Children with difficulty in working memory often have trouble following directions, paying attention, answering questions, and having conversations. 

For example, if I ask, “What did you do today?”, you need to

1. understand and process the question,
2. decide what type of information answers my question,
3. choose information to share,
4. ignore irrelevant information, and
5. share your response using vocabulary and sentence structure a listener could understand. 

You need to hold onto the question in your memory (i.e., information) while you go through all these steps (i.e., the task). At school, a teacher may say, “Everyone clean up the toys and go to your desk”. Children need to remember both parts of these instructions and act on them. If a child forgets the second part, they may only clean up the toys. If something interesting catches their attention, like a pattern on the carpet or a picture book, they may stay on the floor instead of going to their desk. In both of these instances, the child may have understood the directions (i.e., the knowledge to complete the task) but could not complete them. 

How can I know if my child has working memory difficulties? 

One way to gain insight into your child’s working memory skills is to observe how they follow directions. Can they follow a one-step direction (e.g., touch your feet)? What about two steps (e.g., touch your feet, then clap your hands)? How about three steps (e.g., touch your feet, then clap your hands, then touch your ears)? Can they follow directions that require more time in between them (e.g., clean up the shapes then put your shoes on)? Children with working memory difficulties may need multiple repetitions of an instruction before they follow it. Another way to see working memory in action is to monitor how your child answers questions and has conversations – do they have difficulty following with following the conversation? Forming responses? Focusing – needing repetition or additional time to respond? These are some ways working memory skills interfere with language tasks.  

When children have these difficulties, their behaviour may be viewed as defiant or uncooperative. For example, when children do not follow directions right away or as instructed, it may seem like they are choosing not to listen. While this is sometimes true, it is important to figure out whether working memory difficulties play a role as well. Understanding a child’s strengths and weaknesses helps inform individualized supports to help a child hold information and complete the required tasks.  

What does SLP support look like? 

In some circumstances, children with working memory challenges have language challenges since the two skills are closely related. Research shows us how working memory challenges can affect language task performance, not necessarily language knowledge. This means, if asked “what did you do today”, a child may understand all the words in the question but have difficulty completing the task of answering the question. If asked to complete three directions, “put your pencil on the table, close your water bottle, and push in your chair”, a child may understand each question and all the vocabulary words, but have difficulty completing the task of following all three directions. SLPs are not the only profession with training to support working memory difficulties. We often collaborate with teachers, Occupational Therapists or psychologists to provide holistic care. We also collaborate with you – caregivers! 

In SLP intervention, what do we do? Focus on memory, language knowledge, task performance, or all three?  

Current research tells us that practicing memory tasks can improve memory, but these improvements may not generalize to language tasks. Therefore, SLP intervention needs to focus on:  

• Supporting a child’s working memory depending on the tasks or demands of their environment and academics 
• Providing supports to decrease these demands or make the tasks more manageable 
• Building language skills 

Strategies to Support Working Memory

Supports to decrease these demands may include: 

• Visual and written supports. Visuals decrease working memory demands since they help us hold onto information with less effort. A child may have difficulty following a spoken direction but can follow a written direction. A child may have a much easier time understanding a schedule when visuals are used to represent each item or answering a question when visual choices are given. 
• Repeated directions and rehearsal. A child may benefit from hearing directions 2-3 times to allow for more processing time and help the child hold onto the information. A child may have better task performance if they rehearse or repeat the directions they hear.  
• Shorter directions and slower pace. A child may have better task performance if directions are given in shorter phrases and at a slower speed to allow for more processing time. 
• Detailed instructions. Details decrease working memory demands in some cases because it requires less decision-making. For example, if I say “Please clean up your desk”, you need to decide what it means to clean up your desk. What tasks do you need to complete? In which order? How do you know when you have finished cleaning up your desk? You need to answer these questions as you complete the tasks. However, what if I said, “Please put your books and papers in your desk.” Then once this task was finished, I added “Now, put your homework in your backpack. Then you’re all done!” These details narrow our focus decreasing working memory. 

Get Support For Your Child

If you’re noticing these challenges, our Speech-Language Pathologists at Developing Hands Pediatric & Family Therapy can help assess your child and provide personalized strategies. 

For more information about our Speech-Language Therapy, click here!

Ready to get started? Connect with us using the information below:

• Email: inquiries@developinghands.com
• Phone: 416-576-6842
• Get In Touch!