Several years ago, I was asked what “areas” I typically trained in. I replied that I had done a lot of training on Executive Function Skills and Augmentative and Alternative Communication (AAC). The person I was talking with then asked me if I had ever thought about doing a training on Executive Functioning and AAC, and that they thought this would be an interesting topic. I agreed, and before I knew it, I had committed to creating a training for seven months later on this topic. I kept pushing off my “work time” to do this because I was not sure there was really a connection. In fact, I questioned why I had agreed to this. As I finally started tackling the planning of this training, it clicked.
Executive Function Skills are the skills we all need to be independent in our daily lives. They allow us to make sure we are acting in a way that is appropriate to the setting. They enable us to inhibit our responses, guide our emotional control, sustain our attention to the task, initiate what we need to do, manage our time, plan and prioritize all aspects of our lives, think in a flexible manner, and set goals. We pull from previous experiences as we learn and increase our executive functioning. To do this, we need vocabulary and language skills. Even if we are not able to express words to others, we need an understanding of language and vocabulary. I also started thinking about how we select vocabulary to teach to AAC users.
I want to note that there are a number of evidence-based ways people teach AAC systems and vocabulary, and you want to use those. As we move forward, consider how the vocabulary you choose to focus on is selected. Regardless of whether you are using a motor plan, category-based, partner-assisted scanning, etc., someone (SLP, parents, care team, etc) decides what words you will focus on and in what order. When I thought of needing language/vocabulary to increase Executive Function Skills, the words used with those skills must be focused on.
We know that we learn language based on our experiences with language. We can not learn a language or use words we have not been exposed to. Ding, ding, ding. This was the connection. There is no developmental order to word learning. Everyone learns different words at different times, that is why when parents of young children get together, they talk about what their child’s “first words” are. There may be similar functions to the words, but the words are different.
“The order of learning words resides in children’s environments and experiences: what they hear, see, are told, and read”
–Choosing Words to Teach– Beck, McKeown, and Kucan
With this thought in mind, I had my connection. Doing a crosswalk with the Communication Matrix and an Executive Function by Age chart created by Life Skills Advocate, I put them together.
There are seven levels on the Communication Matrix. The first six levels happen during the ages of 0-24 months. The seventh level is from age 24 months when children typically have language skills of combining 2-3 symbols to create a message.
Below is a chart that explains the ages and what you see communicatively at each level of the Communication Matrix.
Looking at the Executive Function Skills Chart by Age (Life Skills Advocate), we see these skills developing between the ages of 0 and 24 months, listed below.
- Planning
- Pointing and grabbling
- Acting on environment
- Organization
- Begin Matching skills
- Colors, shapes, early categories
- Overgeneralize categories (all 4-legged animals are dogs)
- Working Memory
- Simple Recall Games (peek-a–boo)
- Participates and enjoys simple familiar rhymes and songs
- Begins to fill in the blank when pausing in familiar songs
Once someone is aged 2-4, the chart shows us that executive function skills begin to increase in complexity and number. Considering the Communication Matrix and what happens during this time, you see an increased language ability.
- Planning
- Simple Instructions
- Time Management
- Time concepts
- Follows Visual Schedule
- Waiting- emerging
- Task Initiation
- Start and complete tasks up to 10 minutes
- Organization
- Categories, patterns
- Cleans up with assistance
- Working Memory
- Follows along with songs/finger play with multiple steps
- Sings familiar songs/ rhymes
- Emotional Control
- Able to label own emotions
- Able to label emotions of others
- Has tantrums when upset, frustrated, or overwhelmed and requires support to overcome
How do we use this information to help us connect Executive Function learning and AAC vocabulary? We consider what words you need to increase purposeful use of different areas of Executive Functioning.
Typical Response Inhibition is being able to:
- Sharing toys and materials
- Wait for a period of time (starting with a short period and increasing in length)
- Keep hands, feet, and materials to yourself
- Follow directions (initially simple, then becoming more complex)
- Follow classroom and house rules
- Calm yourself when you are upset
What language is needed to do these things?
| Task | Language |
| Sharing toys and materials | Mine, yours, share, turn |
| Wait for a period of time | Wait, time words (numbers, minutes, days, etc) later, soon, next |
| Keep hands, feet, and materials to yourself | Self, yours, stop, keep, names of body parts/ materials, away |
| Follow directions (initially simple, then becoming more complex) | First, second, next, then, after, prepositions (on, under, in, behind), item names. locations |
| Follow classroom and house rules | Time words, self, object names, then, next, preposition words |
This is a sampling of words you may need for these tasks. The point is, have you been purposeful in selecting these words to teach, model, and use repeatedly? Again, use what we know is best practice with AAC implementation and lay on top of that purposeful selection of words that connect with an executive function skill you want to focus on. Maybe the student is struggling with a specific skill. Target those words to make sure they have the experiences and exposure to learn those words. Even if the student does not use the words back to you, use them with the student. Remember, we can’t learn words we have never been exposed to.
Do a similar activity to this with different executive function areas to identify words to target with the student. Keep your data before, during, and after you have targeted the words to see if the executive function skill has changed and hopefully improved to allow the individual to become more independent.
Want to learn more? Contact Paige to do a full or half-day training on this topic for your agency. Email pbuckingam.kansas@gmail.com for details.
Buckingham Educational Services & Training, LLC 