Executive Functioning and Deaf Children

The issue

“Executive functioning” (EF) is a term used increasingly in educational, clinical, and other settings to explain why some children seem to be able to focus, work consistently, and finish things, while other children struggle to put in consistent effort and stay on task.  EF refers to mental abilities that are responsible for actively, purposefully regulating thought, behavior, and emotion, in order to stay on-task and achieve goals.  It can be thought of as the brain’s oversight and self-control processing to be sure that thoughts and behaviors occur according to plan.  Therefore, EF is important for many areas of daily functioning.

Deaf children might have fewer opportunities to develop EF skills because they have less exposure to auditory experience and language early in life.  Cochlear Implants (CIs) alone may not fully resolve this issue because reduced hearing and language experiences have already occurred before implantation and because CIs do not fully restore normal hearing. Because early hearing and language experiences provide valuable learning and practice of EF skills, about one-third of children with CIs may show EF delays. On the other hand, more than half of children with CIs do not have EF delays, in many cases because they have found ways to develop EF that supplement early auditory and language deprivation.

What we know

EF is not just one mental function or ability, but rather is a group of abilities that work together to regulate and direct thinking and behavior.  Three core abilities that make up EF are inhibition (holding back on behavior so that it can be carefully considered), working memory (holding and updating information in memory even when other mental processes are happening), and flexibility (shifting attention or mindset in order to better achieve goals).  Other abilities involved in EF are planning, organization, controlled attention, initiating and sustaining mental effort, self-monitoring, and emotional control. These abilities are involved in guiding social behavior as well as formal and informal learning.

Like any human trait, EF varies from person to person, and a range of EF skill is seen across the population.  At the low end of this range, people with poor EF encounter problems with attention, concentration, self-control, impulsivity, hyperactivity, distractibility, and carrying out plans.  Some types of disorders, such as Attention-Deficit/Hyperactivity Disorder (ADHD), are characterized by deficits in EF.  Also, exposure to or deprivation from some kinds of experiences and learning, including auditory experience, language, and environmental experiences, also can increase or decrease the risk of EF delays.  For example, children need to learn EF at home and school, and they benefit from practice, reinforcement, and encouragement of EF from adults.

What we don’t know

We are learning more about how to improve EF in children, by integrating EF-learning and EF-practice experiences into education and home settings and by setting up the environment to shape and encourage positive EF.  For example, demonstrating organization, planning, and self-monitoring as children complete tasks can provide children with EF practice opportunities.  However, the effectiveness of some learning/treatment programs for EF is still being tested.  Some treatments to improve EF might produce temporary results or might only help the child in one specific situation.  One factor that might be important in producing a long-lasting, broad improvement in EF is the amount of practice involved in learning EF.  Programs that teach EF skills in a few weeks probably need to be accompanied by ongoing practice for months or even years for the improvements to continue.  Additionally, programs that teach EF using a variety of methods – from practice in a simulated setting (e.g., on a computer) to application in real-world situations – are more likely to be effective.  Good EF “coaching” programs have these characteristics, with a period of learning from the “coach” and an extended period of practice and application in the real-world.  Embedding the child in a family environment that promotes EF also provides extensive teaching and practice of EF skills.


EF is important for maintaining focus, carrying out plans, finishing tasks, and achieving goals at home, school, and in other environments.  Although many deaf children with CIs are at risk for EF delays, even more children with CIs are able to compensate for early hearing and language deprivation and achieve normal EF.  By identifying what EF is, measuring it in individual children, and providing education and treatments to improve it, we can improve quality of life, success, and goal attainment.

Posted on April 2, 2018 by
William G. Kronenberger
Indiana University School of Medicine
wkronenb {at} iupui.edu


Further reading

Figueras, B., Edwards, L., & Langdon, D. (2008). Executive function and language in deaf children. Journal of Deaf Studies and Deaf Education, 13, 362-377. view details

Kronenberger, W. G., Colson, B. G., Henning, S., & Pisoni, D. B. (2014). Executive functioning and speech-language skills following long-term use of cochlear implants. Journal of Deaf Studies and Deaf Education, 19, 456-470. view details

Kronenberger, W. G., & Pisoni, D. B. (in press). Neurocognitive functioning in deaf children with cochlear implants. In H. Knoors & M. Marschark (Eds.), Evidence-based practice in deaf education. New York, NY: Oxford University Press. view details

Pisoni, D. B., Conway, C. M., Kronenberger, W., Henning, S., & Anaya, E. (2010). Executive function, cognitive control, and sequence learning in deaf children with cochlear implants. In M. Marschark & P. E. Spencer (Eds.), The Oxford handbook of deaf studies, language, and education, Vol 2. (pp. 439-457). New York, NY: Oxford University Press. view details