349. Q&A: What’s the difference between executive function coaching and tutoring—and how do I know which my child needs?

Dr. Sarah (00:02):

Ever wonder what psychologists moms talk about when we get together, whether we’re consulting one another about a challenging case or one of our own kids, or just leaning on each other when parenting feels hard, because trust me, even when we do this for a living, it’s still hard. Joining me each week in these special Thursday shows are two of my closest friends, both moms, both psychologists, they’re the people I call when I need a sounding board. These are our unfiltered answers to your parenting questions. We’re letting you in on the conversations the three of us usually have behind closed doors. This is Securely Attached: Beyond the Sessions.

(00:41):

Hello, we’ve got Dr. Emily Upshur here on the Beyond the Sessions segment of the Securely Attached podcast, and we are going to answer a listener question. Emily, good to see you.

Dr. Emily (00:53):

Good to see you as always.

Dr. Sarah (00:56):

So are you ready every day? Yes. I know. I see you every day, but I like seeing you multiple times a day.

Dr. Emily (01:02):

Always.

Dr. Sarah (01:03):

All right, so this one I think you’re going to like this question. You ready?

Dr. Emily (01:08):

Yep.

Dr. Sarah (01:09):

Okay. My 12-year-old son has been having a tough time in school this year, especially with writing and keeping up with assignments. I set him up with a tutor to help with English, and that’s been going okay, but now his teacher is recommending we also start executive function coaching. I’m a little confused if he’s already getting help with the schoolwork itself. Is coaching really necessary too? I’m also wondering, should I maybe stop tutoring and just focus on the coaching instead? I don’t want to overwhelm him or be throwing time and money at something he doesn’t really need. I’d love to hear what you’d do if this was your own kid and really appreciate any guidance you can offer. Thanks so much.

Dr. Emily (01:46):

Great question.

Dr. Sarah (01:47):

I know, I feel like we field this a lot.

Dr. Emily (01:50):

And also, I mean I think it’s a really commonly unknown thing, so I really appreciate the ask. Right. I guess we should start with the difference between regular tutoring and executive functioning tutoring.

(02:03):

She’s calling it coaching, executive functioning tutoring or executive functioning coaching are basically one and the same. So just to dispel that, and I guess I can just jump right in and say the difference between executive function tutoring and sort of a subject based or academic tutor is that executive functioning tutors don’t actually get into content material of each subject. The goal is actually to create organizational systems and systems for learning. So just to sort of ground this listener and what that might look like is an executive functioning tutor might really focus on helping your child write their assignments in a planner or create a folder system for their backpack. So if you look in your 12 year old’s backpack and it’s exploding with paper, an executive functioning tutor might say like, Hey, let’s maybe take a look at this. Let’s get an accordion folder. Let’s get a binder that organizes by subject or by color and helps your child create, or a hand in folder that helps your child create a system.

(03:17):

They also might help you with, okay, your child says they have an assignment due on Thursday and your kid is doing it on Wednesday night at 8:00 PM and maybe that’s not enough time to sort of execute that to the best and highest quality that your child can. So an executive functioning tutor might say, Hey, let’s do a little bit each day and divide that assignment up and just really try to teach the child planning organization and chunking of material. And I think that’s the difference because they’re looking at all your subjects. A 12-year-old is going to have multiple subjects that they’re learning. I mean even in elementary school you do, but it’s really looking at all your subjects and saying, what system works for you to hand in work to accomplish your work and complete it to hand it in. That’s another thing that happens commonly at this age. I did all the work, but I forgot to hand it in.

Dr. Sarah (04:10):

Oh my God, that was me in fifth grade. I remember having a teacher parent meeting where they were like, your daughter’s not doing her homework. And I was like, oh, I am. Hold on. And I ran my locker and I got all my homework that I’ve been doing for weeks and brought it in and they were like, oh, wait, what? And I was like, yeah, I just forget to turn it in and then I forget that I forgot and then I keep forgetting.

Dr. Emily (04:34):

Exactly. So an executive pumpkin tutor for you would’ve been like, how can we create reminders even before tech? Could it be that it’s an assignment? Could there be a homeschool collaboration? Could it be that there’s a parent checks in every night and reminds in the morning? Don’t forget to hand in your assignment, but an executive functioning tutor really takes this sort of parachute view and says, what’s the big landscape of what’s falling between the cracks for you? It’s handing it in, it’s not doing the, and how can we make systems that sort of are more efficient, accurate and getting the job done.

Dr. Sarah (05:10):

And I think a really good, I don’t mean to cut you off, but I think a really good tutor is also going to focus on helping the child craft some of these things. Because how many times do we have, especially with Neurodiverse kids, but kind of all kids who are working on executive functioning skills where the parents see this bird’s eye view and we know what we need to do, but if we tell you to do it, you dig your heels in more and it just creates this power struggle where it’s like if we can help the child identify the challenge, identify what their goal is and how they want to solve it, and then work backwards to create a plan that they kind of are going to have so much more agency and buy into actually executing on that when, so it’s also like how do you construct a solution, not just how do you identify what the solution is and then make a plan to do it. It’s like there is a lot of motivational support.

Dr. Emily (06:07):

Totally. I love that because I’ll tell you, I have a child who struggles with executive functioning and he will tell you he does not struggle with executive, which is a telltale sign that you have problems with executive, but he really was like, I have a system, mommy, I have one.

Dr. Sarah (06:28):

And it’s not working for you.

Dr. Emily (06:31):

It’s not working all the time. And he’s like, but it works most. So again, it’s really about, I love when you said co-creating. I think that’s really helpful. But there are things that I do think are helpful to really make routine. An executive functioning coach will really emphasize having a learning center. It could be your dining room table. It don’t have to go buy anything or do anything big, but it’s like you sit at the dining room table, maybe you have a little pencil caddy with all of an eraser calculator, whatever you might need to do your work.

Dr. Sarah (07:06):

So that you don’t keep getting up and then getting distracted, then forgetting to come back. We’re really stress testing all of the challenges that show up when we have to do X task.

Dr. Emily (07:17):

Exactly. So I think some of those things we sort of do have to impose in a routine kind of way and just sort of be a little bit disciplined about, nope, every day we come home we check your planner or we populate your planner and we work in this place. And then I think you co-create and solve, I think.

Dr. Sarah (07:35):

Yeah, it’s a balance for sure, and I think a well-executed executive functioning coaching or tutoring will definitely have a balance of that, but the child isn’t going to constantly feel like they’re pushing up against someone telling them what to do all the time.

Dr. Emily (07:52):

Exactly. Yeah, and I think what’s really hard, I do want to name this as if you are a parent that is neurodivergent yourself, this could be really hard too because it might be really hard for you to see the steps or because you’ve maybe scaffolded your own life or created your own solutions, but it so makes sense to you. And if you don’t struggle with executive functioning as a parent, it’s so hard to understand. You’re like, why can’t you just do it? I just don’t understand why you just don’t do it. Do it and hand it in, do it and hand it or whatever it is. So I just want to name that as a parent, this can be hard to understand because it can be either really foreign or you could struggle with some of the similar things that are going on. And creating your own systems might be helpful part of this too.

Dr. Sarah (08:42):

Yeah, and one other thing I’ll say too about the parent child piece, because whether I think when you a kid has executive functioning challenges and you are a parent who also does, or like you were saying, you’re a parent who absolutely doesn’t get why this is so hard because it just clicks in their mind they don’t have the same struggles. Both of those scenarios can be legit really difficult in parenthood.

(09:12):

But one way that I think to utilize executive function coaching to address that piece too, so it’s not just about child skill building, but family system support is to make sure that you are working with an executive function coach who is utilizing family systems, right? So they’re not just working with the child, but at least a couple sessions or a part of every session includes looping you into what we’re doing, why we’re doing it, and what’s your role in maintaining and supporting this. Because especially with little kids, but even 12 year olds and even high schoolers, the more there is whole family system buy-in and adoption of these systems, like these executive functioning support systems that we’re building the absolute easier this ends up being, and I think you’ll find that executive function coaching that’s addressing school related academic related challenges, a lot of these strategies that you guys are building can be extrapolated and reused for other things outside of the academic system. Like, oh, putting your laundry in the laundry basket or helping with chores or a lot of these sort of executive function skills do not exist exclusively inside of academia, their life skills. And so you usually see these challenges show up all over the place. And so creating systems that help organization planning, time management, noticing when I’m getting distracted so I can bring myself back to and identify my original goal. Those are all objectives of executive function coaching that can also be non-academic, though usually people start it for academic reasons.

Dr. Emily (11:13):

And I do want to address this, listeners, do I have to do all the things? Because I think that’s a really overwhelming and costly, honestly endeavor. There’s a couple of things I just wanted to point out. One is if you can find an executive functioning tutor that’s also a licensed clinician, that can be something that’s really helpful because you can get reimbursed for that potentially if you have out of network benefits through insurance, whereas a tutor is just out of pocket expenses. So I just want to name that as a parent who’s going through this, it’s really important for me to find executive functioning tutors that might also be able to be reimbursed through my, because they’re also working on other psychological needs and that type of thing. It’s really helpful. But I think if as a parent, I think it’s really important to talk to the teacher about what they’re seeing as the deficit because if this child really is struggling with reading and writing or English and writing as the listener noted that that might be really important to keep your subject-based tutor and maybe you can just introduce one or two routines.

(12:24):

If the teacher says, well, they’re not handing in their homework, maybe you as the parent can supplement that kind of executive functioning routine and just start small, start just with a planner and just with checking in with your child and maybe doing a homeschool connection, checking with the teacher and checking at home if that’s the main concern of the teacher. So I think I do want to be really sensitive to not spreading your resources too thin and feeling overwhelmed and paralyzed by this process. I think there are multiple ways to tackle this where you don’t have to do it all at the same time.

Dr. Sarah (12:57):

Right, because I will acknowledge that her instinct to say I don’t want to overwhelm him is on point. Right? Totally. Especially if your kid struggles with executive functioning, that sense of I am overwhelmed by all the things I have to do. It can put a lot of stress on a system and create friction that we don’t need to put extra friction on. So I would say I think your point is really well taken, Emily, that if I would just kind of say let’s triage, try to figure out what’s the true core challenge that’s causing the most difficulty. Is it organizational skills, planning, time management, short-term memory, all that kind of stuff. Emotion regulation is a piece of this too. Are they getting super frustrated and it’s getting that is derailing, getting things done or staying focused on a task? Then I would say if that seems like it’s the primary, I’d go with that first. If you’re seeing a little executive dysfunction, but there is a learning disability or there’s truly a knowledge gap or a skill gap in a specific domain of academics, then maybe that’s the primary focus for now. And then trying to supplement in ways that you can do on your own, which we kind of gave you some ideas to start with, but there’s lots of other resources for deepening this if you want to try to do it yourself.

Dr. Emily (14:32):

So one thing though, I do want to throw out there to consider, certainly the case in my own household is you if you don’t want to be the parent or if you’re getting a lot of pushback and there’s a lot of tension in the home around you being the one trying to implement some of the executive functioning structures, that’s a really time to get a tutor too, if you have the ability to do that. Because I know for myself that actually my child is more accepting of recommendations by, I’m always like, oh, I just said that and they just said that, but somehow you weren’t so mad at them. I think it’s really an important resource if you’re able to do it. I just want to be sensitive to everybody’s different where they’re putting their resources, but if you’re able to sort of supplement with external, or even if it’s just a few times, I think you might find that there’s less tension in your home and maybe your child is more receptive or is able to tolerate a little bit more feedback from other people.

Dr. Sarah (15:34):

No, that’s a very good point. When it’s coming from someone else besides you, the mom, somehow it’s just all the other stuff isn’t thrown in the mix.

Dr. Emily (15:45):

I’m always like, my mom’s sandwich tastes better than my sandwich. I want you to do it, not me. So I think that’s helpful.

Dr. Sarah (15:55):

Yeah, it’s okay to outsource that.

Dr. Emily (15:57):

Yeah. Yeah, it can even be beneficial. Yeah, I just wanted to add that one. I don’t want to diagnose from afar or anything like that, but I do think a lot of kids with executive functioning difficulties have trouble with writing because writing requires a ton of executive functioning skills. You have to plan what you’re writing, you have to outline it. There’s all these steps that are entailed in it. So I think when you’re triaging maybe, I don’t know, but again, I think it’s really important to use your resources, speak to the teacher and figure out what are the variables? Does this child really have a problem writing or do they really have a trouble with executive functioning? We don’t really know.

Dr. Sarah (16:43):

And sometimes it’s not always clear, and I don’t know, obviously if this kid has had any diagnosis or a neuropsych or anything to identify if there’s a learning disability or an executive function challenges that are measurable and documentable, but some things that you could do if you’re trying to figure out like, okay, I actually just really want to get to the bottom of what is the thing that’s actually driving the issue, then a neuropsych evaluation might be worth exploring. I think at 12, if you haven’t yet, and this is impairing his functioning at academics or these executive functioning challenges are impairing his functioning in other areas of his life, it’s worth at least getting a consultation with someone who does these types of evaluations. We do this at our practice at extra friend psychology group, but you can find this anywhere you are in your local area. A lot of places who do neuropsych valves will do one-off consultations just to say, yes, this is worth exploring deeper, or I don’t think that you have to take this step yet, and here’s a couple of things you can do in the interim first. But I do think that’s a resource, especially if, again, I don’t know if this kid specifically is having, if these challenges are starting to really get in the way of functioning on a global scale, but if that is happening for a child, especially as academics get more demanding and systems that kids might have developed on their own, like compensatory strategies might start to crack under the pressure of the academic demands as they get more complex,

(18:29):

Then it’s worth at least getting a consultation with somebody and perhaps getting a neuropsych eval. Because the reason why a neuropsych eval would be helpful is it will be able to tell you, is this due to a learning disability? Is this due to A DHD or an executive functioning deficit that we can measure? And it can also within that because a lot of different executive functioning skills inside of that bucket, and you might be good at some and struggle with others. So neurop cycle testing will also identify which executive functioning skills are the true areas of weakness or areas of strength. So you can index on the strengths and then you can scaffold the weaknesses. So getting that map is helpful. Again, I don’t think that’s first line, but if you’ve done some work to figure out and try to support your kid and you’re not making progress and areas of functioning are dropping, then I would say consider that.

Dr. Emily (19:35):

Yeah, no, I think that’s a really good point. And I will say one of the things that we see a lot in clinical work in our practices, I love it when I love that this parent is sort of early on the, I don’t think it’s ever too late, but I love that the younger the child and when you’re giving them these skills, the more they can build on them and they don’t develop kind of bad habits too. So it’s really nice to have that early intervention, as you might suggest, just to have set up systems that can be repeatable, that are good in healthy systems that are helping the child build on top of their skills.

Dr. Sarah (20:18):

Yesh, especially as school is getting more and more and more digital in their assignment tracking and the way that does not work for all kids. Even though schools are like Google Classroom and all these different digital platforms that teachers are using to assign, assign things. For a lot of kids, especially kids who are neurodiverse or struggle with cognitive organizational skills, those digital spaces are a lot harder to conceptualize in a concrete way, which makes time management in particular a little bit difficult. So moving away from the paper planner can actually be really hard for kids. They don’t want to do it. They love the digital landscape better, but they’re skipping some really important foundational skills that come from physically writing it out, mapping it out, seeing the time blocks, all those things. Being able to say, this assignment is due in three pages, not some date. It’s very, whenever you can, especially for younger kids who are just starting to have the complexity of tracking multiple assignments is starting to come online for the first time in school, starting them out with paper planners, I think it feels like it’s dying out in schools. And I really urge people…

Dr. Emily (21:46):

It’s coming back though. I’ll say, sorry to interrupt you, Sarah, but I will say I have a 10th grader, a seventh grader and a fourth grader, and for the first time in years, my 10th grader asked me for a planner, like a paper and pencil planner.

Dr. Sarah (22:00):

But did the teacher say, here is a planner? You need to have this?

Dr. Emily (22:04):

No.

Dr. Sarah (22:05):

Schools aren’t doing it.

Dr. Emily (22:06):

No, but my seventh graders homeroom teacher suggested it. I thought that that was, and then my fourth grader, they got it through their school packet. It is part of it. I do think it does remind me if your child’s a little bit older, you might have to reinforce that, right? Because you might be like, oh, you remember what? I used to get you a planner every year or when you were little, you use this and it really helped utilize it. And it’s what’s really nice is my 10th grader now, I can just get him a nice little one. My fourth grader, I have an eight and a half by 11 big giant so they can see the whole thing. But my 10th grader, it still helps to see a week’s view. Really it does help. So I would completely reinforce that. I think some of those skills are really important to teach and introduce and then sort of maintain throughout their…

Dr. Sarah (23:01):

Right. And if your school has moved away from that, don’t feel like you can’t say, we’re going to do this anyway. It’s okay if it’s a Google classroom or it’s going to be here too. Some kids really don’t like it. Redundancy. It’s already there. I don’t want to do much.

Dr. Emily (23:17):

So the routine for my seventh grader is he has a planner and we sit down as an adult in the household and him every night and look and double check, and he gets super annoyed, but it’s, guess how many times we miss something? Quite often. I’ve already done it. I didn’t think that was due. It was a big deal, but it’s really a nice routine. So I think if this parent wants to start somewhere, that’s a nice place to start.

Dr. Sarah (23:44):

Yeah. If you have other questions like anyone listening about this sort of executive functioning versus executive function coaching versus therapy versus tutoring versus when do I get a neuropsych? We have other episodes. We’ll link those in the show notes, but you can also always reach out to our practice at upshurbren.com. We do neuropsych evaluations. We do consultations, just like one-off consultations just to say these are what’s going on and this is our recommendations. So if you don’t live in New York State, you can just do a one-off consultation too, or we can help orient you to what your options are based on the information that you’re dealing with. And we also offer executive function tutoring and support. Alright, well thank you so much for writing in and good luck to you and your son and we will talk again soon. Bye, Emily.

Dr. Emily (24:46):

Bye.

Dr. Sarah (24:46):

Thank you so much for listening. As you can hear, parenting is not one size fits all. It’s nuanced Thank you so much for listening. As you can hear, parenting is not one size fits all. It’s nuanced and it’s complicated. So I really hope that this series where we’re answering your questions really helps you to cut through some of the noise and find out what works best for you and your unique child. If you have a burning parenting question, something you’re struggling to navigate or a topic you really want us to shed light on or share research about, we want to know, go to drsarahbren.com/question to send in anything that you want, Rebecca, Emily, and me to answer in Securely Attached: Beyond the Sessions. That’s drsarahbren.com/question. And check back for a brand new securely attached next Tuesday. And until then, don’t be a stranger.