Why this age is so important
This is one of my favourite age groups to work with as an occupational therapist. Children are becoming more independent and curious. They’re developing their own interests, managing more responsibilities and beginning to think ahead in ways they couldn’t when they were younger. But they’re also navigating an enormous increase in expectations.
Parents often tell us:
“She knows exactly what she needs to do, but she never gets started.”
“He’s so bright, but he forgets everything.”
“She spends twenty minutes looking for her shoes every morning.”
“He leaves every project until the night before it’s due.”
“I feel like I’m constantly reminding him.”
If you’ve found yourself saying any of these things, you’re certainly not alone. Many parents begin to notice executive functioning challenges during these years—not because something has suddenly gone wrong, but because children’s worlds have become much more complex.
Executive functions are expected to do much more
When children were younger, adults naturally provided most of the planning and organisation. We reminded them to brush their teeth. We packed their school bags. We organised play dates. We managed their time. By middle childhood, many of these responsibilities begin to shift towards the child.
Without us always noticing, children are now expected to:
- Remember sporting equipment
- Manage homework across different subjects
- Organise longer school projects
- Keep track of multiple belongings
- Follow changing timetables
- Manage friendships
- Regulate emotions during increasingly complex social situations
- Organise extracurricular activities
- Think ahead
- Prioritise tasks
- Solve problems independently
That’s a remarkable amount of executive functioning. It’s also why children who seemed to be coping well in the early school years can suddenly begin to struggle. Research consistently shows that executive functions continue developing throughout childhood and adolescence as the prefrontal cortex matures (Best & Miller, 2010; Diamond, 2013; Zelazo, 2015). In other words, we are asking children to use brain networks that are still very much under construction.
Brain Builder
One helpful way to think about executive functions is to imagine the brain’s “chief executive officer.” At this age, that CEO is becoming much more capable—but they’re still learning the job. Sometimes they make excellent decisions. Other times they lose the meeting agenda, forget what they were supposed to do next, and become overwhelmed by too many competing demands.
That isn’t failure. That’s development.
The OT Lens
As occupational therapists, we don’t just ask:
“Can this child complete the task?”
We ask:
“What is helping—or preventing—the child from participating successfully?”
Participation is at the heart of occupational therapy. A child who can complete homework only with constant reminders may not yet have developed the executive function skills needed to participate independently.
Rather than simply increasing expectations, we explore how to build the skills while adapting the environment to support success. This approach reflects the Person–Environment–Occupation (PEO) Model, which recognises that successful participation depends not only on the child’s abilities but also on the demands of the task and the environment (Law et al., 1996).
“But they can organise their Lego for hours…”
One of the most confusing things for parents is inconsistency. A child who forgets their homework every week may be able to spend hours creating an elaborate Lego city, organising Pokémon cards or planning an intricate Minecraft world. How can both things be true?
The answer lies in understanding how executive functions interact with motivation, interest and emotion. When children are deeply interested in an activity, their brains often access executive function skills more effectively.
They may:
- Plan ahead
- Persist through challenges
- Solve complex problems
- Remember detailed information
- Remain focused for long periods
When the task is less motivating—or places demands on skills that are still developing—they may need significantly more support. This is particularly relevant for many neurodivergent children, whose executive functioning may vary considerably depending on context (Diamond, 2013; Dawson & Guare, 2018).
OT Tip
Instead of saying:
“If you can organise your Lego, you can organise your homework.”
Try saying:
“Let’s think about what makes Lego easier to organise. How could we use some of those same ideas for your homework?”
Perhaps it’s having clearly labelled storage, visual reminders, a predictable routine or breaking a large task into smaller parts. Occupational therapists often help families identify strengths in one occupation and transfer those strategies into another.
Planning Becomes More Complex
Planning in middle childhood extends far beyond deciding what game to play.
Children are now expected to:
- Estimate how long tasks will take
- Gather everything they need before beginning
- Complete work over several days
- Prepare for tests
- Manage competing priorities
- Balance school, hobbies and family life
These are sophisticated skills that continue developing throughout adolescence. Many children need explicit teaching and guided practice rather than assuming they’ll “just pick it up.”
Parent Reflection
Think about one task your child finds difficult.
Now ask yourself:
“Is the task difficult because they don’t know what to do… or because organising themselves to do it is the difficult part?”
That simple shift in thinking often changes how we support children.
In Part 2, we’ll explore organisation, time management, emotional regulation, friendships, technology, and how everyday occupations continue to shape executive functions during middle childhood. We’ll also discuss practical OT strategies for fostering independence, signs that additional support may be beneficial, and include a full evidence-informed reference list.
by Nicola Van Zyl