Executive Function Domains in OT – The Project Manager (IITOGA Model)

Executive functions are the brain’s management system. They help us plan, organize, initiate tasks, monitor progress, and regulate behavior when executive function is impaired—whether due to brain injury, aging, or neurodevelopmental conditions—making daily life quickly unravel.

Table of Contents

This final post in the Memory Tools series uses the Project Manager analogy and the acronym IITOGA to help you understand and recall the key domains of executive functioning.

The Project Manager Analogy

Imagine your brain is running a busy project—your day. The executive functions are like a skilled project manager, juggling timelines, tasks, resources, and feedback. When this manager is out sick, things go wrong: tasks are forgotten, time is misjudged, and priorities are confused.

The IITOGA Acronym

This acronym summarizes six core domains of executive function:

I = Initiation

Definition: Starting a task or activity without undue procrastination.
Example: Getting started on cooking dinner or paying bills.

I = Inhibition

Definition: Controlling impulsive behavior and resisting distractions.
Example: Not interrupting someone or resisting the urge to check your phone constantly.

T = Task Persistence

Definition: Staying on task until completion.
Example: Following through on laundry from start to finish without giving up.

O = Organization

Definition: Arranging steps, materials, and information in a logical, efficient order.
Example: Laying out ingredients before cooking or sorting paperwork by category.

G = Generative Thinking (Cognitive Flexibility)

Definition: Thinking of new solutions and switching strategies as needed.
Example: Taking a different route when traffic is heavy or solving a problem in a new way.

A = Awareness (Self-Monitoring)

Definition: Recognizing errors, adjusting behavior, and reflecting on performance.
Example: Realizing you’ve made a mistake mid-task and correcting it.

Clinical and Care Applications

For OTs:

Use IITOGA domains to guide performance-based assessments like the EFPT or MET
Document executive function impairments with clarity for rehab teams and caregivers
Match interventions to specific breakdowns (e.g., visual checklists for initiation, timers for task persistence)

For Students:

Use the project manager metaphor in case discussions and presentations
Apply IITOGA to identify deficits and write functional goals

For Caregivers:

Understand that what looks like laziness or forgetfulness may actually be poor initiation or task persistence
Break tasks into smaller steps and offer gentle cues or structure

Conclusion

Executive function isn’t just one thing—it’s a coordinated system that lets us navigate complex, multi-step life activities. Using the Project Manager analogy and the IITOGA framework makes it easier to identify where the breakdown is—and how to rebuild it, one task at a time.

This concludes the Memory Tools for Smart Learning series. Revisit any part of the series to reinforce your understanding and apply these tools in practice, study, or daily caregiving.