Executive function: what is it, and how do we support it in those with autism? Part I
Executive function is a term that is widely used in autism circles to describe a broad array of skills that have to do with an individual’s cognitive function . Some sources say that up to 80% of those with autism suffer from executive function disorder, leading to difficulties managing time, completing tasks, and making what for many of us would be simple tasks – like cleaning our rooms – very complicated or seemingly impossible.
For some people with ASD, social and communication difficulties are not the primary issue. They are socially engaged and are doing their best to communicate frequently, but they are unable to respond in a timely and organized way to the requests of parents and teachers, or to organize and initiate sophisticated play because they have considerable difficulty with executive function.
What is executive function?
The technical definition of executive function is: the cognitive processes that help us regulate, control and manage our thoughts and actions. It includes planning, working memory, attention, problem solving, verbal reasoning, inhibition, cognitive flexibility, initiation of actions and monitoring of actions. But what does that look like in real life?
Cynthia Kim, in her blog Musings of an Aspie says:
In practice, executive function is a slippery concept. Sometimes it looks like responsibility. Sometimes it looks like self-discipline. Sometimes it looks like being a competent adult.
If you have poor EF, people might mistake you for being disorganized, lazy, incompetent, sloppy, or just plain not very bright. Why? Because executive function encompasses so many essential areas of daily living. Nearly everything we do calls on areas of executive function. Cooking. Cleaning. Parenting. Work. School. Self-care.
One of our contributors, Rebecca Moyes, described executive function this way:
(Executive function deficits) can be likened to an employee who works for a company where the supervisor is unorganized and inefficient. Nothing seems to go right, things get misplaced, and general chaos seems to be the operational rule. It’s a lot like that for children with autism spectrum disorders. The executive in charge of their brain is not effective, and because of this, planning processes suffer.
What are the aspects of our executive function
It’s important to know that not all people with ASD have issues with all the aspects of executive function. For instance, an individual might have the ability to plan, but lack the initiation to follow through. They might be able to problem solve once they realize there is actually a problem, but are unable to verbalize it. Here is a list of our executive functions and their basic descriptions.
Planning is the ability to forward-think and choose the necessary actions to reach a goal, decide the right order, assign each task to the proper cognitive resources, and establish a plan of action. Those on the spectrum can have difficulty formulating plans to get through their days and organize tasks into completable sections.
To problem solve, an individual must identify a problem and then formulate a strategy to solve the problem. Problem solving uses almost all the other executive functions including reasoning, attention, planning, initiation, working memory, and monitoring. Depending on which of the executive functions the individual struggles with, that is where the problem solving chain will get broken.
Individuals on the spectrum notoriously have specific memory deficits and strengths. They can seemingly remember every Jedi name, rank and serial number in all ten Star Wars movies, but have trouble remembering to eat, or what day it is, or what the order of the steps are when brushing teeth. Working memory is the ability to remember specific short term memories needed to execute a function or daily task.
Attention is closely tied to working memory, and again those on the spectrum can show great strengths in some areas and severe challenges in others. Individuals with ASD often have a keen ability to focus, but directing that focus can be challenging. If the person with ASD has sensory issues, then it’s possible all they will be able to focus their attention on is the sound of the lights buzzing or the smells of the other people in the room. An individual’s ability to focus directly affects what they can keep in and recall from their short term memory
Reasoning, or verbal reasoning, is the ability to understand, analyze and think critically about concepts presented in words, and then relay them back or integrate them successfully. Many of those on the spectrum struggle with verbal acuity. Verbal reasoning can also be hindered by social meanings that are not obvious to those with autism.
Initiation is the ability to start an activity, plan, or task. For those with executive function difficulties with initiation, they may want to play a certain game, do their homework, or play an instrument, but unless the activity is initiated by someone else it doesn’t happen. It has nothing to do with desire, or “want” – it is about lacking the function of “just doing it”.
Inhibition is impulse control; the ability to have emotional, cognitive or physical reactions that aren’t acted upon in the moment. So when a person with ASD starts “information downloading” all the names and songs of their favourite 500 K-pop groups, this would be a lack of cognitive impulse control. Emotional outbursts, hand flapping, or stimming can be emotional and physical ways that impulse control aren’t in place, (although some stimming can be soothing and help concentration if controlled and non-harmful). Some children with ASD simply cannot control their impulses sufficiently to participate in structured situations.
Cognitive flexibility in simple terms is the ability to roll with the punches. Those with autism are well known to need structure and predictability, and change can be very challenging. This can also lead to rigidity of thoughts and opinions, as well as schedules and routines.
Monitoring is normally an unconscious process that kicks in when we are on auto pilot doing normal tasks. For instance, if you are walking down the street and talking to someone at the same time, normally only a small part of your brain is engaged in walking. You already know how to walk, so the monitoring part of the brain takes over and keeps you from bumping into things while you have your chat. For someone with executive function issues, if they were tired or overloaded, they would suddenly have problems with the “auto pilot” settings on basic activities, dropping or bumping into things, or simply not being able to pay attention in ways that could be hazardous like walking out onto a busy street.
How do we help individuals with autism overcome executive function challenges?
Executive function is something that most of us take for granted. We might have challenging areas here and there, maybe we aren’t as organized as we would like, or maybe we lack some initiative, or self-control, but for those with executive function disorder even the basics can be hard. So how can he help? We will go over some ideas for how to help in our next blog post.
For further reading:
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