Testing a child for
executive functioning issues
can be tricky. That’s because executive function is the management system of the brain, and it involves a wide range of skills. Individual tests may look at a number of areas to pinpoint where the trouble spots are. So there can appear to be overlap between tests in what they measure.
It’s important that testing for executive function be done as part of a
. Looking at all areas of a child’s learning can reveal any other challenges that might be having an impact.
Here are examples of skills that tests for executive function can assess:
There are many tests that can evaluate executive function in children. And a lot of them look at more than one skill at a time. Here are types of tests, and some of the most common examples of each.
Tests that assess attention
Example: Test of Variables of Attention (TOVA) (ages 4 and up)
Similar tests include: Integrated Visual and Auditory CPT (IVA-2) (ages 6 and up); Conners Continuous Performance Test II (CPT II) (ages 6 and up)
Why it’s important: The ability to pay attention is a key executive function. Trouble with attention is a hallmark of
. While this test isn’t an assessment for ADHD, it might signal that a child struggles with attention. Learn more about the
link between ADHD and executive functioning issues
How it works: In the classic version, different letters flash on a computer screen. The child is asked to press the space bar whenever the letter A appears. The test lasts for 15 to 20 minutes. (With CPT II, kids press the bar when they don’t see the letter.)
Kids who miss targets may be “zoning out” because they have trouble paying attention. But this test also looks at other skills that can impact attention. Missing targets might be the result of slow processing speed, for instance. Responding to the wrong targets might be a problem with focus or with inhibitory control. And a child who was doing well up to a certain point but then made mistakes may have trouble sustaining attention.
Tests that assess inhibitory control
Example: Stroop Color and Word Test (ages 5 to 14; adult version starts at 15)
Similar tests: The Color-Word Interference Test of Delis-Kaplan Executive Function System (D-KEFS) (ages 8 and up)
What it measures: A child’s ability to hold back on giving an automatic response, or the ability to think through something before acting.
Why it’s important: Inhibitory control is tied to
. It allows kids to think before they act. It also allows them to assess each new situation and consider the correct or most effective way to respond.
How it works: The evaluator shows a child the words for different colors written out. But the color of the ink doesn’t match the word that’s spelled out. For example, the word red might be written in green ink. As quickly as possible, the child must say the name of the color, as opposed to the word. The test is usually timed, so it also looks at processing speed.
Kids who haven’t learned to read yet may perform a similar task with shapes instead of words. In this case, there might be a circle in red ink. The child has to say the color, not the shape.
Tests that assess working memory
Example: Digit Span and Spatial Span subtests of the Wechsler Intelligence Test for Children (WISC) (ages 6 to 16)
Similar tests include: Working memory tasks in the WJ-III Cognitive battery (ages 2 and up)
What they measure: The Digit Span test measures verbal
(the ability to store information that’s heard). The Spatial Span test measures visual working memory (the ability to store information that’s seen).
Why they’re important: Working memory is an executive function that allows kids to hold onto new information in order to put it to use. (It’s also
affected by attention
How it works: With digit span, the evaluator dictates a series of numbers, and the child has to repeat them back in reverse order. If the examiner says “9, 6, 3,” the child has to repeat the sequence back as “3, 6, 9.” When working with younger kids, the evaluator might list a series of animals in size order, such as bee, dog, and cow. The child repeats them back saying the biggest to the smallest animal.
With spatial span, the evaluator touches a series of blocks in a certain order. The child has to touch the blocks in the reverse order that the evaluator touched them.
If a child does poorly on the digit span version but well on the spatial span, it might point to trouble with working memory that is more language related. If it’s the other way around, it might mean that the child is struggling with working memory just for visual-spatial tasks.
Tests that assess organization and planning skills
Example: Tower of Hanoi (ages 5 and up)
Similar tests include: The Tower Test of D-KEFS (ages 8 and up); Rey–Osterrieth Complex Figure Test (ages 6 and up)
What it measures: The ability to plan, sequence, and organize information for problem-solving. It can also assess working memory and inhibitory control.
Why it’s important: Planning,
, and organizational skills are key to following directions and completing tasks efficiently. They’re also important when it comes to participating in complex discussion. Kids who have trouble with executive function often struggle with these skills.
How it works: A child must rearrange beads or disks to match a model while following specific rules. A rule might be that the child can’t place a larger bead on top of a smaller one. The goal is to complete the task in as few moves as possible.
Tests that assess concept formation
Example: Matrix Analogies Test (ages 5 to 17)
Similar tests: Naglieri Nonverbal Ability Test (ages 4 to 18), WISC-V Matrix Reasoning (ages 6 to 16)
What it measures: The ability to form classes of items based on what they have in common; the ability to figure out patterns or relationships between objects.
Why it’s important: Concept formation allows kids to see relationships between things and develop ideas based on what they already know about them. It’s important for abstract thinking.
How it works: A child sees a grid of four boxes with pictures in them. The top row might have a big house next to a big apple. The box below the big house has a little house. The box under the big apple is empty. The child has to pick what logically belongs there (a little apple) from five choices. (The analogies are more complex for older kids.)
Tests that assess set shifting
Example: Wisconsin Card Sorting Test (ages 7 and up)
Similar tests include: The Sorting Test of D-KEFS (ages 8 and up); Minnesota Executive Function Scale (MEFS) (ages 2 and up; measures other executive functions as well); Trail Making Tests
What it measures: A child’s ability to shift from one task to another. It also measures concept formation.
Why it’s important: This executive function allows kids to shift their attention and move from one task or situation to another. This type of flexible thinking helps kids see new ways of doing things, or try something else when the first approach doesn’t work.
How it works: A child is shown a set of five cards. Each card has a different figure on it. The figures switch around with each problem. For example, in one problem the figures on the cards might be: three green stars, one red circle, two yellow blocks, four yellow crosses, and two red crosses.
The child sees four of the cards lined up in a row, and one by itself below. The child is told to match that card to one of the four above, but not told the rule for matching. (In other words, the child doesn’t know whether to match by shape, color, number, etc.)
The child only gets feedback on whether the match was right or wrong. So through trial and error, the child needs to figure out the rule. Scoring is based on the number of correct sorts.
See the Minnesota Executive Function Scale, a virtual card-sorting task, in action:
Tests that assess word and idea generation
Example: Controlled Oral Word Association Test (ages 5 to 16)
Similar tests: Verbal Fluency Test in the D-KEFS (ages 8 and up); Word Generation subtest in the NEPSY-II (ages 3 to 16)
What it measures: The ability to think of words and generate ideas. (It also looks at set shifting and processing speed in some versions.)
Why it’s important: Kids rely on executive functioning to solve problems. Being able to quickly come up with words and ideas is key to problem-solving.
How it works: The child names as many words as possible, based on a certain letter. For example, they might have to come up with words that start with M. Or, on a harder version of the test, they may have to name as many kinds of fruit and furniture as possible, in pairs. They might start with apple/chair or banana/couch, and so on.
It’s important to know that results of a single test aren’t enough to identify trouble with executive function. The evaluator has to look at all of the test results together. That allows the evaluator to pinpoint which areas are a struggle and develop a plan to help your child succeed.