Ida Sue Baron, Ph.D., ABPP
Board Certified in Clinical Neuropsychology
Board Certified Subspecialist in Pediatric Neuropsychology
American Board of Professional Psychology
Clinical Professor Emeritus in Pediatrics
The George Washington University School of Medicine and Health Sciences, Washington, DC

Newsletter: Executive Function

June 2014

Past newsletters are posted at Questions/comments should be emailed to

Q. What is Executive Function?

Executive function (EF) is an overarching or “umbrella” term that covers a number of very different but related cognitive functions, some broad and some specific.

EFs emerge at different times in the course of a child’s early development, beginning in infancy and continuing to develop throughout childhood and into young adulthood.

EFs are linked to different or overlapping regions in the brain. There are close associations between different EFs and the frontal lobes - the large portions of the front part of the human brain. For example, EFs may be designated as to whether they are “Hot” or “Cold” aspects of cognition:

“Cold” EFs, such as working memory, executive attention, and organizational skills, are often mediated by one region of the frontal lobe (dorsolateral prefrontal cortex).

“Hot” EFs, such as impulse control, response inhibition, and social cognition, are related to emotional and social skills, and often mediated by other frontal lobe areas (orbitofrontal or dorsomedial regions).

The influence of EF on a person’s overall functioning is arguably more important and fundamental to cognitive efficiency and real-world success than is an individual’s IQ. For example, very intelligent individuals can have very poor EFs and thus fail to succeed in important ways personally and in society, while less intelligent individuals who have exceptionally good EFs can function and succeed better than someone who has higher measured intelligence.

There are a number of commonly researched EFs that are also an important part of a clinical neuropsychological evaluation. Examples of some types of EF that are easily measurable using specific tests and experimental paradigms include:

Inhibitory Control: ability to hold back and not demonstrate a behavior inappropriate to the situation, and the ability to avoid distraction

Working Memory: ability to briefly hold information in mind briefly in order to take some action using that information. Working memory capacity and executive function share a common underlying executive attention component that is strongly predictive of higher-level cognition

Cognitive Flexibility: ability to shift ideas and actions in response to immediate circumstances

Verbal Fluency: ability to retrieve words on command from one’s internal dictionary of words

Planning and Organization: These later developing EFs enable a person to demonstrate a higher level of efficient processing and overall integration of information from all sensory modalities and deeper emotional circuits in the brain

Application of EF: A Real-world Example

Let’s imagine you have reserved a seat on an airplane and you are at the airport working on your laptop device while you wait to board when you hear an announcement that your flight has been cancelled. The EFs you must enlist to help you through this scenario include the following:

Inhibitory Control: the ability to refrain from inappropriate behavior in order to take appropriate and constructive action

Emotional Control: the ability to not lose your temper and argue with an unhelpful gate agent who will not assign you to another flight

Shifting Mental Set: the ability to make the change from working on your laptop to taking active and effective next steps that will enable you to reach an alternative solution and make the trip

Initiation of Action: the ability to begin a logical search for a customer service representative or ticket agent who can re-book your flight on the next available plane

Plan/Organize: the ability to take steps in an appropriate order, and efficiently pack up your laptop and move your luggage to the new departure gate

Working Memory: Once given new flight departure information, the ability to retain the new flight and gate numbers as you run to catch a plane just about to leave

Self-Monitor: the ability to keep track of your emotional and behavioral responses despite the unexpected stress

Advance online publication this month:

Gerner, G. and Baron, I. S. (online) Pregnancy Complications and Neuropsychological Outcomes: A Review. Child Neuropsychology. DOI: 10.1080/09297049.2014.910301.

Pregnancy complications elevate risk of associated adverse medical, socioenvironmental, and behavioral outcomes in children and have a substantial impact on neuropsychological functioning and mental health across the child’s lifespan. This review summarizes prevalent pregnancy complications and the associated psychological and neuropsychological findings, highlighting methodological challenges that have restricted investigations of these outcomes and identifying opportune areas for future study. The common pregnancy complications reviewed are: hypertensive disorders, diabetes, infection, and behavioral and environmental risk factors such as obesity and nutritional factors.

Scientific Presentation:

A PETIT Study poster entitled “Phonological Processing and Rapid Naming Differences in Late-Preterm Children at Age 6” first-authored by one of our student research volunteers, Kaitlin Riegler, is to be presented this month at the 12th Annual American Academy of Clinical Neuropsychology Conference in New York, NY.