22 Executive Functioning Activities for Adults

In this post, you’ll find executive functioning activities for adults, plus free PDF worksheets! These functional, step-by-step activities are organized by severity, from severe to moderate to mild executive dysfunction.

Bookmark this page and open it during treatments. Or feel free to copy and print anything you find useful.

For ready-made materials that will save you hours of time and stress, check out our bestselling Adult Speech Therapy Starter Pack and the Adult Speech Therapy Roadmap Course.

How to Treat Executive Functioning

Executive functioning treatment involves helping your patient solve problems and gain more control of their behavior.

In this post, we’ll focus on problem-solving.

There are 3 steps to problem-solving treatment:

1. Choose functional, meaningful goals with your patient
2. Improve awareness of their cognitive impairments
3. Teach a strategy

Let’s go over these steps!

1. Keep it Functional

Keep treatment functional! This will make your sessions practical and motivating for your patients.

Functional tasks are often ADLs and IADLs. That said, interview the patients and caregivers to understand their goals and what matters to them.

How to Set Functional Goals

When setting goals, consider the following patient factors:

• The patient’s goals, wants, and needs
• Previous level of functioning
• Current level of functioning
• Amount of support available
• Motivation
• Awareness of impairments

See our Goal Bank and Guide To Writing Excellent Goals for more help.

2. Work on Awareness (‘Metacognition’)

For executive functioning treatment to be most effective, patients need to have at least some awareness of their executive dysfunction.

Steps to Improve Awareness:

• Predict. Before the task, have the patient predict how they’ll do
• Assess. After the task, have them assess how they did
• Compare. Discuss how their prediction compared to how they actually did

The goal is for self-assessment to become a habit.

Get a free Self-Awareness Worksheet in the Executive Functioning Worksheets PDF bundle. For more on the topic, read How To Improve Awareness.

3. Teach An Executive Functioning Strategy

Teach your patient a step-by-step process or ‘strategy’ for how to solve problems. You’ll use these strategies with the executive functioning activities below.

For all severity levels, the goal is for your patients to internalize the strategy so they can better solve problems in their daily lives.

Patients with milder impairments will fill out a worksheet that helps them break down their goals into steps.

For moderate to severe impairments, you’ll modify this process to help them learn how to think in a structured way.

Now let’s review the strategies!

Executive Functioning Strategies for Adults PDF

Below are 6 executive functioning strategies for adults, plus our free Executive Functioning PDF bundle.

In the executive functioning activities below, you’ll find recommendations for when to use each strategy.

1. Game Plan Worksheet

Download the free Game Plan Worksheet to teach your patients a step-by-step process for how to solve problems.

It’s appropriate for milder executive dysfunction.

Read Executive Functioning Strategies for detailed instructions on how to use the worksheets.

2. Improve Self-Awareness

Use a self-awareness process like the Self-Awareness Worksheet (above) to help your patient become more aware of their cognitive deficits.

For mild to moderate executive dysfunction.

3. Errorless Learning

For moderate to severe executive dysfunction.

Errorless learning helps patients learn a skill with as few errors as possible. This is so they don’t practice and encode the wrong skill.

Steps To Errorless Learning:

• Choose a specific skill or answer
  • “When you eat, you take small bites. What should you do when you eat?”
  • Correct answer: “Take small bites.”
• First, model the skill or answer.
  • “When you eat, you take small bites. What should you do when you eat? You take small bites.”
• Then, have the patient practice the correct skill or answer many times
• If the patient makes an error, correct it right away
• Emphasize not guessing by giving the cues needed to get the right answer
• Pair with chaining as appropriate

If your patient has a memory impairment, spaced retrieval is another great strategy.

4. Task Analysis

Task analysis is breaking down a task into smaller steps. This makes it easier for your patient to learn a multi-step skill.

Teach the patient each smaller step, then ‘chain’ them together.

5. Chaining

Use chaining to teach patients a multi-step task. You can use forward or backward chaining.

Teach the entire task first, then gradually decrease cues, step-by-step, until the patient can do the task independently.

Be sure to use errorless learning and to give immediate feedback as needed throughout.

Steps to Backward Chaining:

1. Use task analysis to break down a task into key steps
2. Fully prompt the patient through each step
3. Fade prompts for the last step only
   • Go through the entire task then decrease cues for the last step
   • Keep fading cues until the patient can do the last step independently
4. Fade prompts for the 2nd-to-last step
   • Go through the entire task, but this time decrease cues for the 2nd-to-last step and last step
   • Keep fading cues until the patient can do these last 2 steps independently
5. Keep fading prompts for the entire task
   • Keep backward chaining until the patient does the entire task independently

6. Make Modifications

Modifying a patient’s environment or tasks can improve executive functioning. They can also compensate for impairments.

Modify the Environment

• Reduce clutter. Remove extra stuff
• Remove distractions. Reduce excess noise and visual distractions
• Organize the space. Assign specific places for specific things (a key rack by the door)

Modify the Task

• Make tasks easier
• Give cues and prompts
• Use task analysis
• Identify other factors that may be impacting the patient’s ability to problem-solve
  • Physiological: issues with sleep, medication side effects, pain, etc.
  • Psychological: depression, anxiety, etc.
  • Refer out as appropriate

Add External Aids

Add in external aids to support your patient’s executive functioning goals. For example, checklists and alarms to prepare a meal.

• Smartphone
• Calendars
• Checklists

Read External Memory Aids for TBI for more ideas.

22 Executive Functioning Activities for Adults!

Below, you’ll find 22 executive functioning activities for your adult speech therapy patients.

These functional treatment ideas focus on problem-solving and are organized into severe, moderate, and mild impairments.

Activities for Severe Executive Dysfunction

You will teach patients with severe impairments to think in a structured way. The goal is often basic safety.

These patients likely can’t generate the steps to a goal by themselves. But you can still teach them how to think methodically.

Executive Functioning Strategies For Severe Impairments

1. Errorless Learning
2. Tasks Analysis
3. Chaining
4. Make Modifications

1. Using the Call Light

Below are examples of how to use executive functioning strategies to teach a patient to use the call light.

Task Analysis. Break down “using the call light” into three steps

1. Feel the need to use the bathroom
2. Find the call light
3. Push the button

Errorless Learning. “What do you do when you need to use the bathroom? Use the call light.” Focus on accuracy.

Chaining. Teach patients the steps to calling the nurse with backward chaining.

Make Modifications. Declutter the room. Train caregivers to always keep the call light in the same place. Post a printed image of the call light next to the bed.

2. Follow Precautions

Turn any precautions that the patient has into an executive functioning activity. For example, fall precautions, activity limitations, etc.

3. Transfer From A Wheelchair

If your patient uses a wheelchair or walker, use task analysis, errorless learning, chaining, and modifications to teach them how to safety transfer to and from their wheelchair or walker.

4. Sequencing Tasks

Use simple, structured tasks to practice executive functioning strategies.

Have patients place the steps of the following tasks into the correct order:

Brush My Teeth

☐ Spit out the toothpaste

☐ Put toothpaste on my toothbrush

☐ Brush my teeth

Take A Picture With My Phone

☐ Open the camera app

☐ Unlock my phone

☐ Press the button to take the picture

☐ Aim the camera

Visit our shop for sequencing worksheets designed for speech therapy patients.

5. Simple Pen & Paper Math

Use simple math tasks to practice executive functioning strategies.

The point isn’t math. The point is to practice the strategies in a structured environment.

Once they’ve improved, expand treatment. Keep scrolling to learn how!

Activities for Moderate Executive Dysfunction

Patients with moderate problem-solving impairments are ready to expand beyond basic safety goals. They can now work on ADLs and IADLs, increase independence, and set and attain their own goals.

At the moderate level, they’re also ready to try self-awareness strategies. At the mild-moderate level, you can introduce the Game Plan Worksheet.

Executive Functioning Strategies For Moderate Impairments

1. Self-Awareness Worksheet
2. Game Plan Worksheet (Mild-moderate)
3. Errorless Learning
4. Tasks Analysis
5. Chaining
6. Make Modifications

6. Avoid Falls

At the moderate level, have at-risk patients problem-solve how to avoid falls.

Have them use task analysis, errorless learning, and chaining to come up with steps and then learn the following tasks.

• Use assistive devices
• Make your home safer
• Get your vision checked
• Get your hearing checked

7. Remember Your Medications

Use task analysis, errorless learning, and chaining to help patients become more independent with medication management

You can also use a worksheet to help teach the steps.

8. Use a Smartphone

Use executive functioning strategies to help patients learn how to use their smartphones to reach their goals.

Task ideas include:

• Setting an alarm
• Setting a timer
• Using the calculator
• Checking the weather
• Texting a family member
• Using a voice recorder

9. Organize Bills

Use executive functioning strategies to help patients with basic financial management.

Modify the activities below for each patient.

• Get organized. Organize paper bills. Set a weekly alarm to sort through mail.
• Make a list. Create a list of important financial websites and phone numbers. Bookmark important websites.
• Set up automatic payments. Set up automatic payments for all recurring payments.
• Make a schedule. For bills where you can’t set up auto pay. Mark due dates on a calendar. Decide when to pay each bill. Set up recurrent reminders.

10. Practical Math Worksheets

Use simple but practical math problems to help your patient internalize their executive functioning strategies.

Once they’ve learned the strategy, move beyond worksheets to real-life activities.

Ideas for practical math worksheets:

• Calculate the cost of eating at a local cafe or restaurant
• Calculate how much you’ll save with a coupon code
• Calculate how many days are between events on your calender
• Calculate what time to leave the house to get to school or work on time
• Calculate when to make an online purchase to receive the item by a certain date
• Calculate how to split a bill between you and 2 friends

Visit our shop for premade practical math worksheets and treatment ideas.

11. Math in Everyday Life

Once your patient is ready, move on to multi-step, everyday math tasks.

Watch A Movie.

• Check the movie times at your local theater
• Decide what movie and time to watch
• Calculate what time the movie will end
• Calculate what time you need to leave home to get to the movie on time
• Calculate the cost of a movie ticket and snacks

Buy Groceries.

• Decide on a budget for a week’s worth of groceries
• Write a list of all the items you need
• Using a weekly ad or website, write down the price of all the items you need
• Calculate the total cost

12. Meal Planning

Use meal planning to practice executive functioning strategies. If you’re patient is ready, introduce The Game Plan Worksheet!

Meal planning treatment ideas:

• Make a grocery budget
• Make a grocery shopping list
• Create a grocery shopping schedule and set alarms so you don’t run out of food
• Plan a meal that fits into your diet or health goals (for example, low sodium diet or Mediterranean diet)
• Plan a dinner party
• Use a meal delivery service to save time on shopping, meal prep, and cleaning. Set reminders for when to choose meals and when to start cooking every day

13. Set Goals

Once your patients are ready, help them set personal goals.

This is more general than The Game Plan Worksheet as you’re helping them create a list of goals that they’d like to work towards.

Questions to ask:

• What is your daily routine right now?
• What did a normal day use to look like (pre-injury)?
• What things are missing that you’d like to do again?
• Are there other things you’d like to do?
• Which of these things can you make progress towards in the next 2 weeks?
• These will become your goals!

14. Real Life Problem-Solving

As the patient progresses, help them become more independent in other multiple-step, real-life tasks.

These include their daily activities and the goals they set.

Example treatment activities:

• Planning their own schedule
• Making their own appointments
• Increased independence with ADLs and IADLs

Activities for Mild Executive Dysfunction

Patients with mild executive dysfunction will work on tasks that further increase their independence and quality of life.

Do a more in-depth patient interview. What do they want their life to look like? And how can your executive functioning treatment sessions help them get there?

Continue to improve self-awareness by having patients predict how they’ll do, assess how they did, then compare the two.

For more treatment ideas, read How To Treat Mild to Moderate Executive Dysfunction and How To Treat Working Memory.

Problem-Solving Strategies To Use: Mild Impairment

1. Game Plan Worksheet
2. Self-Awareness Worksheet
3. Tasks Analysis
4. Make Modifications

15. Math in Everyday Life: Road Trip

Patient Instructions:

1. Choose a road trip destination. Have fun with this! Maybe it’s to visit family or to go on a beach vacation
2. Use an atlas or Google Maps to map out your journey
3. Calculate the total distance
4. Calculate how many days/hours the trip will take
5. Calculate how much you’ll spend on fuel or tickets
6. Calculate the difference in time and cost if you add a stop

16. Math in Everyday Life: Shopping

To keep this activity functional, choose stores that fits your patient’s interest.

For example, if they love gardening, use a garden center’s website to plan next spring’s garden. Or if it’s around the holidays and they plan to host family or friends, use a weekly ad from a local grocery store to plan a meal.

We’ll use the example of planning a holiday feast.

1. Use the weekly ad for a local grocery store
2. Decide on a budget for the holiday meal
3. Write a list of all the items you’ll need to make the meal. Don’t forget fun decor and desserts!
4. Using the weekly ad, write down the price of all the items you’ll need
5. Calculate what the total cost will be
6. Problem solve what to do if you go above the budget

17. Math in Everyday Life: Restaurant Menu

Plan take-out from a local restaurant or maybe even a date night!

1. Open the restaurant’s menu (physical or online)
2. Set a budget
3. Make a list of all the items you want
4. Calculate tax and tip
5. Calculate how much the total will be
6. Problem solve what to do if you go above the budget

18. Math in Everyday Life: Reading a Receipt

Below is an example activity from our shop:

Patient Instructions:

1. Ask the patient to review a receipt and then answer questions
2. Let them know that they can use the calculator and pen and paper as needed

1. How much is each mango?
2. How much is each avocado?
3. How much are apples per pound?
4. How much is whipped topping?
5. What is your grand total?

19. Construction Task

Choose a motivating and relevant construction task for your patient.

This may be putting together a small piece of furniture, a birdhouse, origami, or even a Star Wars Lego set!

As appropriate, use the Game Plan Worksheet to help plan out the task and the Self-Awareness worksheet to improve metacognition.

1. Open the instructions
2. Read step 1
3. Complete step 1
4. Cross out step 1
5. Repeat for each step until the construction task is complete

20. Make A Presentation

If your patient wants to return to school or the office, have them make a presentation on Google Slides, Powerpoint, Canva, or another platform.

As appropriate, use The Game Plan Worksheet to help plan out the task and Self-Awareness worksheet to improve metcognition.

Let’s use the example of making a product review presentation:

1. Choose a product that’s interesting or relevant to the patient (software, skin care product, etc.)
2. Research the product
3. Make a list of 3 pros and 3 cons for the product
4. Make a slide for each of the 6 items (3 pros and 3 cons)
5. Add an image to each slide
6. Write a script for each slide
7. Present the slides

21. Savings Goal

Have patients choose a motivating savings goal. Maybe it’s holiday gifts for the kids, a new cell phone, a rainy day fund, or anything else.

Use The Game Plan Worksheet as appropriate to help them plan the task.

Here’s an example savings goal of saving up for holiday gifts for the kids:

1. Calculate how much holiday gifts will cost
2. Set a savings goal
3. Calculate how many months there are until the holidays
4. Calculate how much you need to save each month
5. Problem solve what to do if you can’t meet your savings goal on time

22. Set Up A Digital Calendar

Digital calendars, such as Google Calendar, can be a game-changer for people with mild executive dysfunction.

Use The Game Plan Worksheet as appropriate to help them plan the tasks.

Let’s use the example of managing a son’s baseball schedule:

1. Set up a family Google calendar account. Invite your son and spouse so that the events and reminders are synced to their phones
2. Input the times of all weekly practices. For example, every Monday and Wednesday at 4 pm
3. Set up a reminder 30 minutes before each practice so you can leave the house on time
4. Input the times and locations of baseball games. For example, Saturday at 8 am at City Park
5. Set up a reminder 1 hour before each game so you can leave the house on time
6. Set up a weekly reminder to wash their baseball uniform

More Executive Functioning PDFs

Visit our shop and online course for bestselling PDFs, lessons, and treatment guides—designed for patients with executive dysfunction!

References

• Weightman, M., Vining Radomski, M., Mashima, P., & Roth, C. (2014). Mild Traumatic Brain Injury Rehabilitation Toolkit. Borden Institute. https://medcoe.army.mil/borden-tb-tbi
• Brewer, C., Aparo, M. (2021) The Adult Speech Therapy Starter Pack. Harmony Road Design Publishing.
• Center on Budget & Policy Priorities, Global Learning Partners, & Annie E. Casey Foundation. (n.d.). Goal Plan Do Review/Revise: An Executive Skills-Informed Goal Achievement Framework for use in human services programs. GPDR/R. https://www.gpdrr.org/
• Cicerone, K. D., Dams-O’Connor, K., Eberle, R., Fraas, M., Ganci, K., Langenbahn, D., Shapiro-Rosenbaum, A., Tate, R. L., Trexler, L. E., & American Congress Of Rehabilitation Medicine. (2022). ACRM Cognitive Rehabilitation Manual & Textbook Second Edition: Translating evidence-based recommendations into practice.