Using Executive Function Coaching in School-Based Occupational Therapy to Facilitate Performance of Students with ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental difference that impacts the development of self regulation and executive functions. Difficulties in executive functions significantly impact classroom performance . Research has shown that coaching executive functions can be a successful intervention in improving the academic performance of children with ADHD.

This article will discuss the use of “executive function coaching” along with “ ADHD coaching” and “ADHD caregiver coaching” to improve the school performance of students with ADHD. We will provide multiple continuing education choices for OTP’s looking to add coaching to their toolbox.

Coaching emerges as a potent evidence-based tool for Occupational Therapy Practitioners (OTPs), with a surge in supporting research over the past decade (Dunn et al., 2012; Graham et al., 2010).

Coaching is strengths-based, collaborative, client-led approach in which the coach facilitates clients’ progress toward self-identified goals through skillful questions (Boney et al., 2019; Harrington et al., 2021). The core concepts of coaching are so closely aligned with the professional paradigm of occupational therapy, that I questioned the difference.  

Coaching and occupational therapy share a fundamental objective: delving into a client’s daily routines, habits, and roles within their distinct contextual, physical, and social contexts. The ultimate goal is to create interventions that optimize participation in activities that hold genuine significance (AOTA, 2020).

While coaching is evidenced based approach, what are all these new titles…. read on to learn more aboutthe different types of coaching.

What is Executive Function Coaching?

An “ executive function coach” is an individual that specializes in helping people develop and improve their executive functioning skills. In most school districts, providers including special education teachers, OTs, SLPs and counselors utilize a coaching approach to support executive functions as part of their school based services. While there is no specific degree required to become an “executive function coach”, continuing education is highly recommended for specialization and fidelity. 

Numerous studies highlight executive function coaching’s efficacy in enhancing ADHD children’s academic performance, particularly when tailored for functional cognition. Best practice promotes the integration of cognitive interventions within occupation-relevant contexts to enhance occupational performance. These interventions encompass awareness strategies, task training, task engagement, environmental modifications, and assistive technology. Evidenced demonstrates that utilizing cognitive interventions detached from occupational performance leads to less optimal patient outcomes (AOTA 2020).

What is ADHD Coaching? 

ADHD coaching is an emerging field in evidence. According to the ADHD Coaching Organization (ACO) ,  ADHD Coaches are International Coach Federation (ICF) trained coaches with specific training and expertise in coaching people and/or groups affected by ADHD.

ADHD coaching is a supportive, collaborative, goal-oriented process that addresses the specific needs of clients who have ADHD. Coaches support the client in creating systems and strategies tailored to the client’s needs and to strengthen the client’s ability to manage the pragmatic aspects of life. The coach helps to educate the client about ADHD and how it affects them across a lifetime, provides information regarding tools and resources as well as research-based information relevant to the client’s needs and interests. 

Parent / Caregiver Training/Coaching

Parent/caregiver training and coaching represent well-established, frontline approaches for addressing ADHD. The American Academy of Pediatrics consistently endorses evidence-based parent training for young children. Parent coaching stands out as a primary Early Intervention strategy that aligns closely with the Individuals With Disabilities Education Improvement Act of 2004 (IDEA). According to IDEA, Early Intervention services should be delivered within the child’s natural environment, focusing on family needs and preferences through a family-centered, routines-based approach.

Many individualized education plans (IEPs) include provisions for “parent training.” The specific providers of this service can vary based on the school and child. Taking a coaching perspective can be highly effective in enhancing the caregiver’s capabilities.

It is important to understand that “Executive function coaching” is an unregulated industry meaning anyone can call themselves an executive function coach. 

While promoting classroom performance in executive function skills is well within the OT scope of practice, OTPS have an ethical responsibility to ensure competency to deliver the service.(AOTA)  Therefore using coaching techniques to improve participation and performance of executive function in school requires learning beyond what most accredited institutions provide. 

Students with ADHD will have difficulties with executive function development, but it is not restricted to ADHD.  Many neurodiverse learners have executive function differences including students with dyslexia, DCD and autistic students. Therapists can add this approach to their toolkit by obtaining continuing education and certifications  to practice within our code of ethics. 

Below we describe available continuing education, certifications and micro credentials that can improve your confidence across your unique practice areas. This post contains affiliate discount links for courses I have taken, fully endorse therefor applied for a discount code for OT4ADHD readers. 

Continuing Education for ADHD/ Executive Function 

ADHD and Executive Functions

Current continuing education for advancing skills and knowledge in ADHD and executive functions by AOTA approved providers.

Certified ADHD Professional Intensive Training Course

Executive Function Mastery Course, Evidence-Based Strategies to Improve Attention, Memory & Self-Regulation , George McCloskey, Ph.D. | Lynne Kenney, Psy.D. | Kathy Morris, M.Ed., B.S. 18.5 Hours, AOTA Provider

Certificate Course in Neurological Approaches for Self-Regulation: Techniques for Kids with Autism, ADHD & Sensory Disorders, Varleisha Gibbs, PhD, OTD, OTR/L, AOTA approved provider , PESI 13.75 CE

ADHD: Intervention Strategies for School-Based OTs and SLPs Lori Benson Adams , by Sensational Brain AOTA Provider .15 CEUS

Executive Function And Its Application To Occupational Therapy In School Based Treatment -Jocelynn Wallach

Cognition and Executive Function: Evidence-Based Assessment and Intervention Tools to Improve Participation – LIVE WEBINAR – Four Sessions– Jeryl Benson AOTA Provider  .15 CEUS

Professional ADHD Coach

In order to be recognized as a Professional ADHD Coach, one must either have completed a fully integrated ADHD Coach Training Program, or completed at least 60 hours of ICF-compliant life coach training plus at least 35 hours of ADHD coach training from recognized sources. International Coaching Federation (ICF)- ICF offers the most globally recognized, independent credentialing program for coach practitioners.  

In addition, there are two governing bodies that help keep ADHD coaches accredited and up to best practice. 

• Professional Association of ADHD Coaches (PAAC) The primary mission of PAAC is to independently credential coaches who want to work with people impacted by ADHD. PAAC also accredits organizations that train people to become ADHD coaches. 
• ADHD Coaches Association  (ACO)The ACO is a worldwide professional membership organization for ADHD coaches. 

Fully Integrated ADHD Coach Training Programs

The following are the recognized sources of ADHD Coach training, these are considerably large investments of time and money. They earn you the credential of a Certified ADHD Life Coaches (CALC) and can include the mentoring hours required. These courses are not AOTA approved providers of CE.

• JSTcoaching.com Specializes in Students with ADHD –Jodi Sleeper-Triplett
• ADD Coach Academy (ADDCA) – David Giwerc, Barbara Luther, and staff
• ADHD Coach Training Center (IACTCenter) -Laurie Dupar and team

Specialty Track ADHD Coach Training Programs 

The following courses are both AOTA approved providers of CE and ICF approved hours to be used towards your ICF certification.

• PTS Coach Academy – Parent ADHD Coaching, Cindy Goldrich- This is the training I took and is now an AOTA approved provider . I recommend it highly if you will be leading group or individual parent coaching sessions. AOTA Approved Provider .
• Dive Into a Coach Approach™ Certification Training Program–Hélène Thériault- BScOT, MAdEd, PCC Function First Coaching Inc.-. approved for both CCE and AOTA Approved Provider

Continuing Education for OT by OT

The following is a list of evidenced based coaching programs and workshops offered for OTP’s run by OT’s. 

Coaching stands as an evidence-based method for enhancing occupational performance in students facing ADHD and functional cognition challenges. Its integration into the school environment mirrors the current best practices of both occupational therapy and education. Coaching aligns closely with occupational therapy professional paradymn, illustrates the standards for functional cognition and also operates within the least restrictive environment. Moreover, it resonates with the multimodal treatment guidelines for ADHD, employing collaborative techniques that involve families, teachers, and caregivers. This approach serves as an evidence-backed pillar for the chronic care model.

Contrasting a conventional occupational therapy approach, coaching hinges on reflective responding and skillful questioning instead of merely providing solutions. This strategy empowers clients to generate their own solutions and formulate actionable plans, thereby enhancing generalization and capacity.

For occupational therapy practitioners (OTPs) to effectively utilize coaching, advanced training is advisable to ensure fidelity. Whether applying coaching techniques to empower students, parents, or educators, dedicating time to continued education in the coaching approach proves to be a worthwhile investment.

References

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