The Executive Function Institute

Many kids have difficulty with having a bowel movement in the toilet. It’s a frequently asked question from caregivers and therapists.
It’s all about access and Interoception. This post contains a FREE handout.

Toileting Starts with Access: A Body-First Approach to Support Toileting depends on much more than learning a routine. Interoception, regulation, sensory processing, nervous system state, and body awareness all influence how children access toileting participation. This body-first, neurodiversity-affirming approach helps caregivers and professionals better unde...

We often wonder why the same child can compete a skill one day but struggles the next day. There’s plenty we can do to help!

Why Skills Don’t Always Show Up: Understanding Access in Children A child completes a task one day… and struggles with the same task the next.They follow directions in one setting… and seem unable to in another.This pattern is often described as inconsistency. It can be confusing for caregivers, educators, and clinicians alike.But this is not a loss of skill. ...

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The top 10 most-downloaded OTJR: Occupational Therapy Journal of Research articles of 2025 are now available — most with open access!

📖Explore the most-downloaded articles of 2025: https://www.aotf.org/About-AOTF/News/top-10-most-downloaded-otjr-articles-of-2025

In clinical and educational settings, we often focus on whether a child can perform a skill.

Judging behavior as 'good' or 'bad' OR punishing children when they do not have access is absolutely detrimental.

A more useful question is:
Can the child access the systems required to perform that skill in this moment?
Skills do not simply disappear.

However, access to those skills can fluctuate based on state, environment, and support.

When access is limited:
-regulation is impacted
-executive function is reduced
-participation decreases

This shift, from skill to access, changes how we assess, intervene, and support children across settings.

It moves us away from behavior-first approaches and toward understanding capacity in context.

🌳 From Roots to Fruit, The Integrated Interoception Model™

It’s not about forcing children to meet milestones, it’s about meeting them where THEY ARE. If a child cannot access what they need, we should see how we can support them or accommodate their comfort. Stress responses can quickly cut off access. How to help? Check out our new program. https://www.executivefunctioninstitute.com/product-page/from-roots-to-fruit-complete-clinical-toolkit

Now available! The Roots to Fruit 🍎 Integrated Interoception Model assessment tool and treatment planning kit. Supports ALL levels of support needs and neurodiversity. It’s not about forcing milestones, it’s about meeting kids where they are and looking at ACCESS. So much more to come 😊 https://www.executivefunctioninstitute.com/product-page/from-roots-to-fruit-complete-clinical-toolkit

We say, "we are leaving in 5 minutes" or "finish your game in 5 minutes," and our kids meltdown despite the verbal warning. Time management is an abstract part of executive function. Here are strategies to help and an explanation of WHY our kids may struggle.

Why Time Is Abstract for Kids With Executive Function Challenges? Time is abstract for many children with executive function challenges. “Five minutes” has no shape, sound, or internal signal—and when time disappears suddenly, stress responses often follow. This post explains why time feels invisible to kids at home and school and shares practical, train-the...

Another fantastic resource