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The work of the Family Futures Consortium has been increasingly informed by neurodevelopmental psychology and a consideration of how environmental trauma can affect the physiological development of the brain. This has led to the view that the extreme pre- and post-birth experiences of some accommodated children will affect their development in a more complex way than had been hitherto thought, and will require specific remedial therapeutic help. Richard Lansdown , Alan Burnell and Marion Allen outline how they came to realise that many of the children they see show behaviour patterns consistent with weakness in executive functioning. Data collected on 86 referred children revealed that all had significant difficulties in this area, a finding of considerable clinical importance for people working with such families. The basic concepts underlying executive functioning are outlined and hypotheses on the aetiology of the difficulties are discussed. The article concludes with a discussion of the ways in which the authors' therapeutic approaches have been modified.