Executive function can be surprisingly hard to explain in speech therapy. In this post, I share a clearer, evidence-based way to talk about executive function, moving beyond potentially misleading analogies like “CEO of the brain” and focusing on core executive functions that are integral in everyday functioning. This discussion draws heavily from the teaching of Lauren Schwabish, supplemented by my own review of the research literature.
Free DIRECT download: Executive Function for SLPs – cheat sheet. (Email subscribers get free access to all the resources in the Free Subscription Library.)
Outline:
- What is executive function?
- Why is executive function hard to explain?
- Why the CEO analogy for executive function can be misleading.
- A clearer way to explain executive function.
- The three core executive function skills that SLPs may overlook.
- A patient-friendly way to talk about core executive function skills.
- Watch a short video summary.
- Learn more from the Speech Scope podcast.
- Explore Lauren Schwabish’s Medbridge courses.
- Share your favorite analogies for executive function.
- Related Eat, Speak & Think posts.
- References.
What is executive function?
Executive function (EF) has been described many ways. When taking a bird’s eye view of EF, it’s not hard to understand. For instance:
Executive function “enables individuals to plan, organize, and complete everyday tasks.”
-Blakemore and Choudhury, 2006, as cited in Gilbert et al., 2025
Or:
Executive function is “involved in flexible, goal-directed behavior.”
-Hackman et al., 2015, as cited in Gilbert et al. 2025
But how do we use this to teach patients and families about the challenges that they are seeing?
Why is executive function hard to explain?
Executive function is an abstract cognitive function that depends on other abstract cognitive functions to work well.
So not only are EF skills abstract, but we don’t completely agree on what they are.
If you search online for a list of executive function skills, you’ll probably find different lists. For instance, Dawson & Guare identify eleven EF skills and Strosnider & Sharp identify five EF skills (as discussed here).
The situation gets more complicated when we think about how EF interacts with other cognitive functions. Experts don’t agree on how EF relates to “fluid intelligence, self-regulation, executive attention, and effortful control, and the relation between working memory and inhibition and attention” (Diamond 2012).
We often turn to analogies, which can be helpful. But maybe some analogies are less helpful than others.
Why the CEO analogy for executive function can be misleading
SLPs may use analogies like EF skills are “the CEO of the brain” or “the air traffic control center” to help patients and families understand executive function.
Lauren Schwabish (SLP) recommends moving away from analogies like these, as they give an inaccurate impression of how EF skills actually work (Baar, 2025). The problems with these specific metaphors are that they:
- Imply that EF is separate and monitors other cognitive functions from above.
- Suggest that EF directs the rest of the brain’s functions, like a manager.
- Miss the point that EF is at the heart of everything we do.
A clearer way to explain executive function
Lauren Schwabish described her own analogy for cognition in an earlier discussion with Sarah Baar (Baar, 2024, 25:40). In the more recent podcast episode, Lauren refines her metaphor for executive functions by separating out the higher level EF skills from the three core EF skills (Baar, 2025, 16:58).
Cognition is like a multi-story building.
- The foundation of the building is attention. If there are cracks in attention, all the other floors will be shaky.
- The lobby is processing. Information from the world is walking in and stepping onto the elevator.
- Next floor is memory. Memory depends on the lower levels: attention and processing.
- Higher floors = organization, problem solving, reasoning, etc.
- Penthouse = higher level EF skills. They rely on all the other skills to function well.
- Elevator = working memory. Limited space, constantly moving. Picks up information and takes it to the level it needs to go to. Nothing lives in the elevator. Information goes in and comes out.
- Maintenance crew = the 3 core EF skills. They know every inch of the building and do what’s necessary to make it work smoothly.
Lauren Schwabish (Baar, 2024; Baar, 2025)
I wanted to share Lauren’s analogy because I think it is highly understandable. Everyone knows what happens to a building when the foundation crumbles, how unpleasant things can get when the toilets back up, or how hard it is to get around when the elevator is out of order.
Of course, there are other great analogies. The best analogy is the one that makes sense to our patient! Listen to the podcast to hear other good ways to talk about executive function skills, including one that Lauren “steals” from a grad student.
So, what are the 3 core EF skills that make up the brain’s maintenance crew?
The three core EF skills that SLPs may overlook
According to the literature, research supports three core executive function skills (Diamond, 2013; Gilbert et al., 2025; Miyake et al., 2000). They are:
- Inhibitory control:
- Response Inhibition – behavioral self-control.
- Interference control – selective attention and cognitive inhibition.
- Ability to control one’s own attention, behavior, thoughts, and emotions.
- Working memory:
- Monitoring and updating information.
- Temporary storage and manipulation of information for tasks like reasoning, learning, and language comprehension.
- Cognitive flexibility:
- Shifting perspective or mental set.
- Creative thinking.
- Adapting to changed circumstances.
These core EF skills support higher level skills like planning, sequencing, problem solving, organization, time management, etc.
If we think about speech therapy using Lauren’s building analogy, it makes sense why we would want to make sure that the core EF skills are working properly.
Otherwise, if we jump right in to treating the higher-level EF skills, our patients may show improvement during structured activities with our support, but they may be unable to generalize to their life.
So Lauren Schwabish suggests that focusing on the core EF skills first can help us understand and more effectively treat many cognitive challenges we see in our practice. (Baar, 2025)
A patient-friendly way to talk about core executive function skills
The core EF skills are pretty abstract and technical: inhibitory control, working memory, and cognitive flexibility.
Lauren shared a great way to frame this when talking to clients and families (Baar, 2025):
- Self-awareness.
- Self-monitoring.
- Self-management.
These concepts don’t map 1:1 onto the core EF skills, but they describe how the core skills show up in people’s lives. When people understand the problem they are having, they may feel more empowered to solve them!
Watch a short video summary
I made a short video summary, highlighting the top-level takeaways from Lauren and Sarah’s conversation.
Learn more from the Speech Scope podcast
You can watch Lauren and Sarah discuss executive functions with each other and others at the ASHA Convention on this special Speech Scope podcast episode.
Or check out the conversation on Spotify or Apple podcasts!
Explore Lauren Schwabish’s Medbridge courses
I’m a big fan of Lauren’s insights and teaching style! Check out these Medbridge courses (first chapter is free):
- Creative Approaches to Delivering Skilled Person-Centered Rehabilitation* – Lauren Schwabish
- The Role of the SLP in Persistent Postconcussion Syndrome Management *- Lauren Schwabish
- Working Memory: How Can I Address This in a Meaningful Way?* – Sarah Baar & Lauren Schwabish
*As an affiliate of Medbridge, I may earn a small commission on qualifying new subscriptions. There is no extra charge to you, and it will help keep Eat, Speak, & Think sustainable.
Share your favorite analogies for executive function
I think that the best analogies are the ones that are understood by our patients! There isn’t one right way to describe executive function skills. Even Lauren is “stealing” an analogy from a graduate student (Baar, 2025, 23:36).
I love learning about different analogies, because we never know what might help a patient in the future. Do you have a favorite analogy for executive function? Have you used a unique analogy for executive function that was helpful to a patient? If so, please share in the comments!
Related Eat, Speak, & Think posts
- An easy way to write participation-level speech therapy goals.
- Quick guide to self-management training in Parkinson’s.
- Soft skills for SLPs: Taking your practice to new heights.
- 10 ideas for the speech therapy patient we’re not sure how to help.
References
- Baar, S. (Host). (2024, October 14). Working memory: How can I address this in a meaningful way [Podcast episode]. In Speech Scope: A MedBridge podcast. MedBridge. https://www.medbridge.com/educate/courses/working-memory-how-can-i-address-this-in-a-meaningful-way-sarah-baar-lauren-schwabish [Free to listen/watch on YouTube, Spotify, Apple Podcasts, and other podcast apps]
- Baar, S. (Host). (2025, December 15). Making sense of executive functions: What’s missing from our explanations (No. 22) [Podcast episode]. In Speech Scope: A Medbridge podcast. MedBridge. https://www.medbridge.com/educate/courses/making-sense-of-executive-functions-whats-missing-from-our-explanations-lauren-schwabish-sarah-baar [Free to listen/watch on YouTube, Spotify, Apple Podcasts, and other podcast apps]
- Diamond A. (2013). Executive functions. Annual review of psychology, 64, 135–168. https://doi.org/10.1146/annurev-psych-113011-143750 [open access]
- Gilbert, L. M., Williams, R. A., Morris, J. G., Dunn, A., Boat, R., Dring, K. J., Nevill, M. E., & Cooper, S. B. (2025). Chronological age and biological maturity are separately positively associated with inhibitory control and working memory in boys and girls. Frontiers in Cognition, 4, Article 1565625. https://doi.org/10.3389/fcogn.2025.1565625 [open access]
- Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., Howerter, A., & Wager, T. D. (2000). The unity and diversity of executive functions and their contributions to complex “Frontal Lobe” tasks: a latent variable analysis. Cognitive psychology, 41(1), 49–100. https://doi.org/10.1006/cogp.1999.0734 [available from ResearchGate]
Free DIRECT download: Executive Function for SLPs – cheat sheet. (Email subscribers get free access to all the resources in the Free Subscription Library.)
Featured image by Helena Lopes from Pexels, found on Canva.com.
Lisa earned her M.A. in Speech-Language Pathology from the University of Maryland, College Park and her M.A. in Linguistics from the University of California, San Diego.
She participated in research studies with the National Institute on Deafness and other Communication Disorders (NIDCD) and the University of Maryland in the areas of aphasia, Parkinson’s Disease, epilepsy, and fluency disorders.
Lisa has been working as a medical speech-language pathologist since 2008. She has a strong passion for evidence-based assessment and therapy, having earned five ASHA Awards for Professional Participation in Continuing Education.
She launched EatSpeakThink.com in June 2018 to help other clinicians be more successful working in home health, as well as to provide strategies and resources to people living with problems eating, speaking, or thinking.
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