Executive functions, self-regulation, and learned optimism in paediatric rehabilitation: a review and implications for intervention.

Abstract

Success for children and adults alike in educational, vocational, and social pursuits depends heavily on effective self-regulation of cognitive and social behaviour. Our goal in this article has been to summarize recent literature on executive self-regulatory functions, their importance, their development during childhood, the types of disability associated with EF impairment, and intervention approaches that have been shown to be useful for related disability groups. We also examined the literature on learned helplessness and learned optimism for clues to a comprehensive approach to helping children with EF impairment, in particular those with acquired brain injury. The central rehabilitation-relevant themes that we have derived from these reviews are: (a). although brain injury can directly impair executive self-regulation, aspects of the environment and the presence or absence of support behaviours of others can reduce or amplify the neurologic impairment; (b). interventions need to be context sensitive; (c). everyday routines of instruction and parent-child interaction are the ideal context within which to provide EF facilitation; and (d). a primary role for rehabilitation specialists is to help everyday people effectively organize and modulate their support for and everyday interactions with children with disability. In an ideal world, competent and optimistic rehabilitation professionals work collaboratively with children and their parents, teachers and others to ensure an optimistic vision of the future that includes an increasingly autonomous child with the executive self-regulatory skill needed to succeed in adult life.