Welcome. My name is Cindy Lopez, the host of this CHC podcast, Voices of Compassion. We hope you find a little courage, feel connected and experience compassion every time you listen. 

Executive function is the brain’s management system helping us plan, organize, manage emotions, and adapt to change, but for neurodivergent youth these skills develop differently. In this episode, psychologists, Dr. Mayra Quezada and Rosinel Ermio break down what executive function really means. Learn to recognize the difference between defiance and genuine executive function struggles, discover practical strategies for supporting youth, and understand when to seek professional help. Our experts share insights on time management challenges, task initiation difficulties, and the role technology can play in building independence, whether it’s struggling with homework completion, keeping track of schedules, or adapting to routine changes. This episode offers compassionate, actionable guidance. Discover how to balance scaffolding independence as your youth prepared for adulthood and learn to celebrate progress no matter how small.

So, welcome Rosenel and Mayra. We’re so glad that you were able to join us today for this important conversation about executive functioning. Before we dive into the conversation, I’d love it if you could take a minute to tell our listeners a little bit more about yourselves.

Mayra Quezada, PsyD: Hi. Thanks for having us, Cindy. So my name is Dr. Mayra Quezada. I’m a licensed clinical psychologist. I received my degree in clinical community psychology from the University of Laverne. And I really appreciated that clinical community emphasis because of the emphasis it puts on multicultural training and cultural humility. I also have two pets. I have a dog named Yuzu and a cat named Banks because I’m a millennial and grew up loving Hocus Pocus. I’ve been working with the SLC for about a year and a half. And also have a private practice where I do individual therapy with adults.

Rosinel Ermio, MS: And I am Rosinel Ermio. I’m one of the senior learning specialists at the Schwab Learning Center. And I work one-to-one with teens and adults who suspect or have been diagnosed with ADHD or learning disabilities. I have a degree in communicative disorders and sciences with a minor in art education and a master’s in assistive technology studies and human services. It took some time for me to figure out what I wanted to do when I grew up, but all throughout my love for learning has been present. It started at a young age and I’ve always had an interest in tinkering in or learning about all kinds of subjects. And I love to tell people about how I was voted as most likely to be a Sesame Street character for my eighth grade class.

Cindy Lopez: Love that.

Rosinel Ermio, MS: And when I’m not learning or working with clients, I love spending time with my husband and my daughters who are 17 and 19 years old, and our dog Kelly.

Cindy Lopez: Thank you both for sharing a little bit more about yourselves. As we think about this conversation about executive function, let’s take a minute to first define it. So, what is it exactly?

Mayra Quezada, PsyD: Executive function is an umbrella term that covers a wide range of abilities that help us to get things done. It’s like our brain’s management system for planning and organization, working memory, impulse control, getting started on task, staying on task, and time management. It also helps with our emotional regulation, meaning, how we manage our feelings so that they don’t overwhelm us and derail our plans. And it also helps us with our cognitive flexibility or how well we can shift between tasks and adapt to change. I recently heard another psychologist describe it as all of the skills it takes to help us to be successful that you can’t learn in a book or a classroom.

Rosinel Ermio, MS: As Mayra described, the executive function as an umbrella term, I also like using the analogy of an umbrella to describe the experience too. So, I picture an umbrella with the executive function skills as the different panels of the umbrella. And so geared with these skills, we can handle processing and responding to incoming information, making decisions, planning, monitoring what we say and do, and then keeping focus and completing different tasks. And so working together, these skills help us navigate through the day as information and tasks are coming at us, like variable rain levels in different directions. And sometimes we may have a light sprinkle and it may be easier to move through the day. However light or heavy the stream may be, there may be areas of the umbrella such as time management or working memory that may not be as strong or may need more reinforcement or support to help manage the rain and varying levels.

Cindy Lopez: It’s so interesting because I’ve heard so many different metaphors for executive function, so I haven’t heard the umbrella, but other ones like the conductor of an orchestra, the air traffic controller. Somebody else said it’s more like the football game and coach analogy, but in any case, really appreciate the fact that these executive function skills really help us with our everyday life.

So, I’m wondering if typical development of executive function differs in more neurodivergent teens compared to their, I’m going to call it neurotypical peers.

Mayra Quezada, PsyD: Yeah, so, when we’re using the term neurodivergent or talking about some conditions like ADHD or autism, these are neurodevelopmental disorders. So, this neurodevelopmental and neurodivergent means that there is a true physiological difference in the structure, the functioning, and the development of the brain. And so some of these differences that we might see that are different in someone with ADHD, for example, are differences in the prefrontal cortex and that’s the area closest to our forehead in the brain – that is where we find most of these executive functioning abilities.  And so what we’ve noticed is that there could be like a three to five year delay in the development of the prefrontal cortex in the ADHD brain depending on the severity. We also see some differences in the limbic system. It tends to be a bit smaller in folks with ADHD and when we’re talking about the limbic system that’s going to be the emotional center of the brain. It also deals with memory. So, that’s why we might see some difficulties with emotional regulation and working memory. And then we might also see some less activation in the anterior cingulate part of the brain, which helps us make social and emotional decisions. So we also might see some differences in risk taking, or, you know, just reading social cues and deciding on how to respond to different social situations.

One interesting thing though and something to keep in mind is that all of these parts of the brains and systems that we’ve mentioned continue to grow and develop throughout life. And we tend to see more of a difference in younger brains. Once folks reach adulthood, we don’t really see a significant difference in these structures anymore.

Cindy Lopez: That’s interesting because in my life as an educator, learned more and more about executive function through the years, I know that last part of the brain to develop is that prefrontal cortex, and that’s where all the executive function sits, as you just described. So, is this correct, like whether you’re a typically developing child or neurodivergent, that prefrontal cortex is just going to take a longer time to develop?

Mayra Quezada, PsyD: Yeah, so I’ve read that about the age of 25 is when we typically see that reach full maturity in that prefrontal cortex, but despite that, just the rate of maturity there is going to be that slight delay.

Rosinel Ermio: So, as neurodivergent teens grow and develop their executive function skills, we might find that they also bring in different perspectives, find different ways to engage other skills, and leverage their strengths to optimize their learning and daily function. So, while the strengths and approaches are unique to each individual, there are some commonly noted strengths such as innovative thinking and creativity, problem solving skills, big picture thinking, and pattern recognition, curiosity and interest in new things, resourcefulness, observational skills and empathy. And so recognizing the areas of development and strength can help teens realize their potential in different ways and identify what supports they need to create opportunities for success.

Cindy Lopez: I really like that you brought up the strengths piece because I think it’s so important, especially as we talk about neurodiversity because we all have different brains, but I really like the fact that you brought up strengths because it is important to consider the whole person. Even with neurodivergent kids, like as you think about some of the areas where they might be challenged, how can you help them identify, cultivate those strengths that they can leverage as they go through life?

As we think about these neurodivergent teens, are there specific executive function skills that tend to be the most challenging for these teens? And how might they manifest differently across different conditions like ADHD or dyslexia or other learning differences?

Mayra Quezada, PsyD: So, the folks I’ve worked with, I’ve mostly noticed that getting started on difficult, boring, or cognitively demanding tasks tend to be the most difficult, especially for younger adults. This is especially true if they have a hobby that they find a lot more interesting or if they spend a lot of time on their phones or social media. These other activities tend to be more rewarding in the short-term and can be especially difficult to pull away from to do work that’s not as interesting. I’ve heard this example of attention as being like a huge kind of cargo ship in the ocean. A lot of teens or young adults with attention challenges or executive functioning challenges, they can keep their attention on something that they really like, but like these big cargo ships, it’s going to be a lot harder to kind of switch directions in a snap. And so just that pulling away or shifting task or shifting our attention is one of those executive functioning skills that is really hard for a lot of neurodiverse folks.

Time management is another big pain point for folks with executive functioning challenges. I’ve noticed that they often tend to wait until the last minute to figure out plans or they might under or overestimate how much time something will take to complete. And also in terms of what challenges might manifest across various conditions like ADHD or even autism or learning differences, I know for at least in ADHD, we might see more difficulty with inhibition and impulse control, getting started on tasks, issues with working memory or time management. We might see someone jumping between a lot of tasks or maybe starting many different projects or tasks, but then finishing very few of them. We might also notice chronic lateness or stronger performance on tasks that they tend to find more interesting or urgent. 

For individuals that might have autism, we might see folks struggling more with cognitive flexibility or switching between a lot of different tasks or being okay with last minute changes to their routines.

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Cindy Lopez: So, we’ve mentioned this term, cognitive flexibility. So, for our listeners, again, cognitive flexibility is just the ability to shift or make changes, adapt to things when they don’t go the way that you’ve planned. So, that cognitive flexibility helps you flex and manage those changes so you can, I’m going to call it, roll with the punches. And I think that’s such an important piece of executive function. We tend to focus at least in my experience in education a lot on the organizational strategies or time management, but this idea of cognitive flexibility of emotional regulation, that’s also part of our executive function skills. And Rosinel, I think you had something else you wanted to say too.

Rosinel Ermio, MS: I think most people today would agree that our modern world has so much going on and it seems like there’s just so much to do and things that grab our attention while we have so little time. And so for teens, this can be particularly challenging as they juggle multiple classes, activities and sports, jobs, hobbies and interests, and just, you know, time with friends and family. And so time management is important for understanding how much time they need for completing things and how much time they actually have in a day, but I think it’s also important to note that executive function challenges can really vary from person to person and depend on different situations. And a teen may not recognize the specific executive function challenge they’re experiencing nor have the awareness to say, “I’m having trouble with time management, working memory, or task initiation.” Instead, you might hear them say that they can’t study or they’re having trouble completing homework, or you might observe that they’re having trouble keeping up with chores.

So, these types of activities or task involve multiple steps and executive function skills. So, for example, studying involves time management and planning to have a set time, the ability to break down information and tasks, organization of thoughts and class materials to identify and sort through relevant information, working memory to hold relevant information, prioritization, and task initiation to do each required step for studying and the ability to focus and avoid distractions on top of the actual content they need to learn. And so to support teens in gaining a better understanding of their specific challenges, it helps to encourage metacognition, which is the ability to look at the big picture and think about and reflect on their thinking and processes. And they could develop a check-in system for themselves and use guiding questions such as, what do I need to do before getting started on a task or what is my goal right now? And other questions like, how much time is needed?

Cindy Lopez: Rosinel, you mentioned studying and the ability to focus and avoid distractions and stay on top of the content. Sometimes, I think that might look like a student who looks like they’re being defiant or non-compliant or just not wanting to finish the assignment or kind of being lazy, but I wonder, so the things that we see on the outside may not be indicative of what’s really going on. How can parents, how can they distinguish between a teen who’s being non-compliant versus one who’s really struggling with executive function challenges?

Mayra Quezada, PsyD: Yeah. There won’t be any one thing that you’re looking for, but there are several data points of a person’s function in different situations and contexts that might clue a parent in. For example, how does their teen’s performance change when it involves a subject or a task that they’re really interested in? If a person has interest in one or two school subjects and is pretty good about completing the homework or projects for that class or doesn’t mind spending time studying the material, but then neglects or avoids classes or subjects that they don’t really enjoy, that might be a sign it’s more related to executive function than to defiance. With defiance, we see pushback across the board on all tasks, even some subjects that they do well in or prefer. Also, if a teen or young adult doesn’t complete tasks or chores that you might assign to them or ask them to do – but maybe they do it after being reminded because they genuinely forgot – or instead, if you remind them, do they throw a tantrum or fit because they just really don’t feel like doing it. So, that might be another clue, if it’s related to executive functioning and their memory or just ability to keep the tasks that they need to do in mind.

Also, some individuals with executive function challenges often struggle to complete complex verbal instructions with multiple steps and keeping this mental to-do list. So, if they eventually get it done, it might be due to not be able to do it initially. Because as Rosinel spoke, you know, spoke to earlier, there’s a different process that has to happen to kind of get into these steps and figure out what the steps are to getting the goals completed. And they might just be taking that extra time to figure out what those steps are. Again, not because they don’t want to do it, but because they just need that extra support or time.

We’ll also see day-to-day variability in challenges with executive functioning, like, it could be influenced by sleep, stress, feelings of being overwhelmed or just other lifestyle habits can impact a teen’s executive function. So, if we see that maybe some days of the week they’re pretty consistent in getting things done and getting their schoolwork done, they might have some off days compared to just consistent daily avoidance or neglect of responsibilities then that variability might again give us another clue that it’s more due to executive function challenges than something like defiance. 

And then finally another point I want to make is that noticing a teen’s response to the challenges. We talked about, you know, the difference in the structures of the brain. And this being something that is a true challenge for a lot of teens and it can cause genuine struggle and an underlying lack of the ability to get things done despite a strong desire to. So, we might see someone try to make amends or make efforts to improve their behavior with neurodiverse teens versus just blowing it off or trying to not make it as big of a deal or not making efforts to address the problem in someone who’s just more defiant.

Rosinel Ermio, MS: As Mayra said, teens act or react and respond and communicate about the challenges in different ways and specifically for communication. You may find that how a teen communicates their thoughts about different tasks clues you into what’s going on. So, if someone’s struggling with executive function, maybe they’re having trouble doing the task because they don’t know how or they don’t know where to start or there are too many steps to it. They might say that they have a lot to do or they don’t have the time for it all or can’t keep track of everything. They might ask for help too. And so, kind of listening for these types of clues or cues can be helpful and what the teen may need support with or need help with.

Cindy Lopez: Yeah both what you are saying Rosinel and Mayra, there’s probably a difference between the effort it takes to really produce something, and I think that teens who are challenged with executive function, they’re really probably going to try to make efforts to like improve. And as you noted, Mayra, versus someone who just blows it off, is not a big deal. So, I think that’s really important too, to understand and for our parents and caregivers and even educators who are seeing that kind of thing, that it could point to some more executive function challenges than behavioral kinds of challenges.

On that note, what are some practical strategies that you might recommend that parents could implement at home to support their teen’s executive function development without creating more conflict? And especially I think we’re looking at that transition age from high school, which can be tricky for parents and teens to navigate.

Rosinel Ermio, MS: So, working with teens on their awareness of their specific challenges, how it affects them can help with identifying practical strategies. As I mentioned earlier, the metacognitive approach and just really thinking and reflecting on how they think and learn and go about their day-to-day and being able to work on that based on their reflection. And so in general, you may find that it takes some time for them to find the best strategy and for them to implement it regularly. It helps to have some type of check in with them to understand how they are managing,how it’s going and listening to their personal insight and reflection. And giving your feedback can help with the process. And so to start, it helps to take a big picture look at all of the things, tasks, and events the teen is managing in their daily life. As I mentioned earlier, they have busy lives and are managing a lot of details throughout the day. So, a few things to consider: How are they currently getting the information about their schedule or due dates and events? How are they keeping track of the information? Are they trying to just keep mental notes of their schedule and are they just trying to mentally organize the information or is there something they can refer to when needed? Like a list or calendar? So, for many people it does help to have a visual method of tracking tasks and deadlines. This could be on paper or a digital calendar or a planner. If you use a shared family calendar, it helps to keep the teen aware about appointments, any events and tasks that are added. And it can be helpful to have conversations about deadlines, time estimates needed and the importance of tasks to guide them on ways to prioritize their time. Setting a regular time to review schedules and plans can help them anticipate what’s ahead. Your teen might need help with developing and keeping routines for before and after school, and so you can assist them by helping them identify and create a list of the tasks and things that they need to do to complete or things they need to complete as they get ready in the morning and to close out the day in the evening. Have them time it so they can plan their time out. And it could be helpful to use timers or alarms to keep on track.

And if your teen struggles with time management, it could help to have a visible clock in each of the rooms that they use as they complete their routines and so they can see it and to support your teen’s success with getting things done, there are a few things to consider. So, they might need to find an ideal workspace, and time depending on the task. So, thinking, are they working in a distraction-reduced space? Are they working at a time free of distractions or any competing tasks before they start their work? It would help for them to set their goals, review and break down what needs to be done and gather all necessary materials first. If you give them instructions for any specific tasks that you’re asking them to do, it does help to break it up and give one step at a time instead of all at once. And this is something they can build on and then also encouraging them to write things down so they don’t have to rely on their working memory if they need some support for that. And then remember, they should plan out some time for breaks just as much as the time that they’re working to help increase their focus, attention, and motivation, and to avoid any fatigue from working.

Cindy Lopez: Rosinel, I think it’s so important what you’ve just said, and I’m also thinking as one of our listeners, who is probably a parent about how these are all really great strategies and at what point in time do I support them and keep them accountable without like stepping in and taking over or enabling them. What do you think about that?

Rosinel Ermio, MS: Yeah. As the teens are building their skills and working on their executive function, parents can provide supportive accountability by being a part of the process as the teen sets their goals and for themselves, for things that they’re asking of the teens, giving clear expectations, having the regular check-ins that I mentioned earlier and then providing encouragement and celebrating their successes. And as they try different things, different tools or strategies and make progress and succeed, celebrate those successes in some way, it could be a big or small way. And then help them to identify what is working well and help them to reinforce continued use of those strategies or tools. If they do need to improve in different areas, continue to talk about what isn’t working and what can be changed.

Cindy Lopez: A lot of good ideas for our listeners in terms of working with their teens. I’m also aware that there’s so much technology now. There’s so much technology that our teens are using in terms of social media, but more than that, there are so many technology tools that have been developed to support executive function. So, what do you think about technology and how can our teens use technology effectively versus using them as a crutch or being overly dependent on them.

Rosinel Ermio, MS: Yeah, I think all of us would say that technology plays an integral and prevalent part of our daily life. So, in general we find that different tools support our learning and performance, especially for executive function.

So, the goal of using technology is to provide external scaffolding and support to help the teens understand and address their needs, while experiencing the development of their internal systems and skills for executive function. So, these different tools can provide individuals with visual or auditory cues. Our alarms and reminders, meaningful feedback, ways to keep notes and information and just having helpful data of like what they’re doing, how they’re doing. So, I think there’s thoughtful and individualized consideration while selecting a technology. And so I encourage starting with tools that are not too complicated, and those that won’t become an added distraction. And so, considering what device you’re using or uploading the different tools on and when they’re used is important when using the technology too. And so many apps and technology can be customized to the individual needs and their uses. The consistency and mobile accessibility available now with technology are great benefits. And so as the individual’s needs change or as they adapt to just their development with executive function, they can consider changes in the settings or maybe using different tools that allow them to work more independently.

Cindy Lopez: Yeah, I think the goal for parents is always about like, how can I foster independence in my child, my teen, you know, I don’t want to take over, but I want to foster independence. So, I think that’s always, kind of, the fine line that parents walk. And if parents and caregivers are finding that there are continued challenges with executive function and that perhaps what they’re doing is not helping that much what would you tell parents or when should parents consider seeking additional professional support? How could they advocate effectively for their teen’s executive function needs in school settings?

Mayra Quezada, PsyD: So, I think if a young adult is noticing that despite their own efforts to improve, they are continuing to face struggles at school or work such as falling grades and increasing missed assignments and deadlines, maybe even missing social or other appointments, and their performance is not really reflecting their knowledge, then it’s worth seeking, maybe further evaluation, you know, potentially learning services or additional professional support to address what they’re noticing. And then also anyone noticing any big gaps between their ability and output, that they can’t seem to close no matter what they try on their own. They can also benefit from additional supports and interventions. However, with that said, it is important to note that it shouldn’t only rely on output, right? Like you might be getting the good grades, you might be getting good reviews at work, but we might be noticing how much more effort is going into producing that output. So, they might again be staying organized, doing well on tests, but if it comes at such a great cost that other areas of that person’s life are being sacrificed, you know, maybe they are not developing friendships or they’re not sleeping well because they’re up all night getting work done, then that also merits seeking consultation with a professional. So, it’s not just about are you checking the boxes, but how much work and effort is going into getting that work done.

Cindy Lopez: Yeah, that makes so much sense. And Rosinel, I’m wondering if maybe you could speak to the school piece. What can parents and families do to support their students in school settings?

Rosinel Ermio, MS: Yeah, so individuals and families can work with their schools to determine what supports are available to students. There may be specific documentation and information that’s needed in order to support these requests. And so, if a student does have an individualized education program or IEP, a 504 plan, or other accommodation plan, they can work with their schools and teachers to set up the appropriate accommodations, support and solutions based on the individual needs and limitations. In addition to classroom support, some schools may have learning specialists or other resource specialists to address diverse, learning needs and individuals and families can also find support in centers like the Schwab Learning Center, where they can work one-to-one with a learning specialist or other coach on the specific goals of the teen.

And I encourage as individuals and the family gain an understanding of the student’s needs and strengths that it’s important for them that the teen or individual is actively involved and is a part of the discussion. This allows them to really build their awareness and their understanding of what they need, what they need to ask for, and how to work with others in building solutions. And just building that self-advocacy for themselves.

Cindy Lopez: Yeah, thanks for mentioning the Schwab Learning Center. And for our listeners, you can learn more about the Schwab Learning Center at chconline.org/schwab-learning-center. There, you can register to get started with a learning specialist like Rosinel, who could help and support with coaching and developing important executive function skills. So, Mayra and Rosinel, thank you so much for joining us today and for sharing some of your time and expertise with us. Before we wrap it up, I’m wondering, what you are really hoping that our listeners would hear from you today.

Mayra Quezada, PsyD: Thanks again for having us, Cindy. I think something I’d like folks to take home with them and thinking back to a previously asked question, I’ve seen a lot of neurodiverse folks with executive function challenges internalize the message that this is a personal flaw and they might even label themselves as lazy or is having a problem with willpower. But I really hope that, you know, any of our listeners who have these struggles or who know somebody with these struggles really hear that it’s not always a matter of effort or character. And that it is a genuine difference in how the brain manages these tasks and the efficiency of our brains to carry out those set of skills. And so it takes the right kind of support and intervention to help.

Cindy Lopez: Thank you for reiterating that. I think that’s a really important point. Rosinel, did you have any last thoughts?

Rosinel Ermio, MS: Yes. Like Mayra, I’m so thankful, happy to be here to share what I’ve learned through the years. I would say, some key takeaways for me are that executive function skills are utilized and built throughout our lives. And the demand on these skills, like an umbrella may change at different life stages and the teen years in particular are a prime time of development and adaptation. And so, continuously working on these skills and challenging them in different ways. If someone’s having difficulty with daily life and executive function, they can use that metacognitive approach to understand their strengths and challenges and then tailor the strategies and tools that fit them best. It’s okay to ask for support and accountability when needed. You know, that could be from parents or at schools or friends. And it’s important to remember that progress can take time and it’s unique to the individual. And so I always say celebrate the successes no matter how big or small.

Cindy Lopez: Yeah, I love that and I love ending on that note to celebrate successes no matter how big or how small, and just know that it’s an imperfect journey. It’s going to look different with every person, and there’s going to be three steps forward, two steps back, but celebrate the successes. So, thank you Rosinel and Mayra for everything that you’ve shared with us today. To our listeners, thank you for joining us. If you need help, CHC is here for you. You can reach out to our care team via email at [email protected], or you can call 650-688-3625. You can find out more about the Schwab Learning Center, either through them or through the website at chconline.org. So, thank you everyone. 

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