Wednesday, November 30, 2011

How a Lack of Executive Functioning May Appear in Young Adults



You'll often hear that people with Aspergers syndrome have problems with "executive functioning" but what does it mean and how does it manifest in young adults?  In this post, I hope to give you some answers.


Put simply, executive functions are higher level functions such as planning, reasoning, problem solving, multi-tasking, attention span, inhibition, flexibility, self monitoring, self-initiation and self guidance.  I'm sure I've left out quite a few.

Executive functions are important but in an animal sense, a lack of them is usually not life threatening.  Eating, sleeping, moving and toileting for example, aren't classed as "executive functions".  While executive functioning provides many advantages, it's not so critical in the pure "animal" sense.  It's people and society that has made executive functioning critical in humans.


How a Lack of Executive Functioning Could Manifest in Young Adults
The remainder of this post will focus on an example, in this case; getting ready for school. This may seem like a single task but it is actually an objective made up of many different tasks.

A parent of a child with good executive functioning might expect to be able to say "get yourself ready for school" or even have their child realise that because it's Tuesday, they need to get ready and wear their sports uniform.  This would imply self initiation of tasks.

The getting ready for school task includes sub-tasks such as;

  1. Getting your pyjamas off 
  2. Putting your pyjamas under the pillow ready for "after school"
  3. Putting underpants on
  4. Deciding whether to wear a sports or normal uniform
  5. Putting pants on
  6. Putting a shirt on
  7. Putting a tie, headband, ribbons etc on 
  8. Putting socks on
  9. Washing Hands
  10. Having Breakfast
  11. Washing hands and face
  12. Brushing Teeth
  13. Putting Lunch in the school bag
  14. Putting Books/Diary in the school bag
  15. Putting Shoes on
  16. Getting outside on time.

A child with poor executive functioning will see these all as entirely separate tasks.  They know that "going to school" is part of the big picture but they won't be able to sequence the tasks and they won't self-start or self-monitor.  If there are any distractions available they will quickly become distracted and will fail to complete the task.

If anything changes, for example, if their favourite breakfast cereal isn't available, then they will not have the flexibility to be able to cope with change. They will not be able to do tasks out of order; for example getting their bags packed before breakfast and the entire "getting ready for school" process will stop. The inflexibility may even trigger a meltdown.

Then there is the matter of lack of inhibition. You might feel that this simply refers to states of undress, and in this example it could.  The lack of Inhibition however refers to a much wider issue.  In particular, it refers to a control mechanism which tells us when "enough is enough" or when certain behavior is unwarranted.  For example, a child lacking in inhibition may not realise when a parent is dangerously overwhelmed and may continue to "push buttons" way past a point of safety.


The Big Picture
This may sound like your child but I'm not necessarily here to offer solutions to the problems of getting ready for school. This post wasn't about that. It was about the lack of executive functioning.  Take any sequence of tasks or anything for which good planning and "common sense" is required and you'll spot the executive functioning issues.

This is what we need to be addressing with children on the spectrum.

17 comments:

Anonymous said...

So what's the best way to address this? This is what we face with our very intelligent AS daughter age 8. She is making improvement in OT, but we so worry about her ability to care for her needs and be productive as she gets older. She has so much to offer, but can't seem to get her "ducks in a row" so to speak. Have you yourself faced these issues? Do you face them now as a professional adult and parent? We often joke that our daughter will have the amazing idea that brings in a fortune. The rest of the family will run the business and serve as her personal assistants! Any futher input?

Aspergeek said...

In terms of both work and social life, this is one of the most difficult things for NT people to understand and get past.

People are often amazed I get utterly lost and confused when I have to do paperwork, while when asked to write up an summary of the physics behind the formation of black holes, I can do that in minutes.

I've had bosses that forced me to do menial tasks aside my work and found I spent a ridiculous amount of time finishing those supposed small tasks, leaving no time for me to do my actual work.

Then being angry at me for taking so long doing those.


Thats a point where there exists a breakdown of understanding in both ways and where often, in my case, friction and dislike of my current job springs from.

The people I work for are informed in advance that I have these problems yet always end up forcing me to do these things I'm wholly unsuited for anyway.

Then they don't understand why It takes so long and I can't understand why they force me to do these things, while they've known all along they shouldn't.

Anonymous said...

And NT wives of aspie males are "Executive Assistants" who take care of SO MANY 'menial tasks' for him. Because if she didn't, the family would never get out the door! :)

Good post! Describes my kiddos to a "t", too.

aspmom
"Aspie Wife, Aspie Mom"

Marita said...

So so true and very frustrating as a parent.

I asked my husband to 'move the washing around' - which to me means,
1. move dry washing off the line into basket to be folded.
2. move clean washing from machine to the now empty washing line.
3. move dirty clothing into machine to be washed.
4. turn on washing machine then go fold the dry washing in the basket.

I found my husband lifting the washing machine and moving it around because he is that literal.

So I emailed him my breakdown of what moving the washing around meant to me - ie moving it from one place to the next.

Gavin Bollard said...

@Marita,

I'd probably have done the same thing with those instructions.

They're best given one line at a time and if possible, incorporated into a regular routine.

Amy said...

Good article.

We have dealt with the before school routine for many years now and finally have a semi-workable solution (semi-workable because both parents need to be on top of re-enforcing, in my opinion).

Our son has an online chart which he checks off in the morning and in the evening (before it gets to late...I prefer 7:30am and 7:30pm). Instead of us nagging him about getting dressed, brushing his teeth, etc., we tell him to check his chart.

I don't know if it works because it's online or because he sees tangible rewards, but so far for the most part it has worked very well.

We're still working on him bringing up the chart himself when he comes down in the morning. That will be a big one.

Anonymous said...

Greetings.
I, personally, was diagnosed with Asperger's around 5-6 mo ths ago, which I acknowledged immediately, yet acceptance came about a week ago, where I found your blog (thank you!) but that is irrelevant.

When, as with the washer scenario, I get a certain task given ("move the washing around" for instance) I usually think "what's the point in moving the machine?" and ask why I should do that and ask for clear instructions on what to actually do. If they're not understanding as to why I need the instructions or they find it too obvious, it is usually enough to get me close, if not past the meltdown point.

Morten, 17.

Debra said...

I agree with Gavin Bollard regarding the manifestion of a lack of executive functioning in young adults with Aspergers. I suggest taking a look at this video to be helping with Aspergers and daily life: http://www.onlineceucredit.com/youtube/asperger-skills-ep5.html

asperger said...

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Joanna said...

I have 2 special needs chidlren one diagnosed with PDD-NOS who is 9 and my oldest officillay had Anxiety but I am sure she has high functioning Autism. The scary thing for me is she is my little twin and I have been diagnosed with Asperger traits and executive functioning problems I believe I have Aspergers and I am trying to work through a diagnosis for my oldest. I wanted to thank you for this post as it helps me to better see what myself and my oldest are dealing with.

Angie said...

I have a 10 yr old stepson (here full time) who has Aspie and ADHD, and his executive function is like nonexistent. Same with my 9 yr old bio son (autism/MR/Bi polar), and 8 yr old stepdaughter (pdd-nos, adhd). It's like simply telling them to get ready for school is not in their whole line of know how. Simply taking a shower requires that someone stand in the bathroom and guide them through each task. Same with dressing with the boys (of course they are farther up in the autism area than stepdaughter). Reading this article makes a lot more sense out of what we see each morning now...and throughout most of the day actually...it's not because they won't, it's because they CAN'T.

Anonymous said...

WOW! My son is 4 and was diagnosed with Asperger's a year ago. This has completely described what I go through on a daily basis with him. I also have a 2 year old at home and mornings are horendous! I ask my oldest to get dressed....it takes him over half an hour to put on his underwear, socks, shirt and pants! I even lay them out for him so he doesn't have to choose. Some mornings I have to even be there in his room with him or he doesn't get dressed because he gets distracted as he is supposed to get dressed. This happens for other tasks throughout the day also.

Thank you so much for explaining this!

vhudi said...

i am South Africa and was close to giving up on life, have a 10year old who was diagnosed with aspie and adhd, i have been struggling with support but this blog isjust an answer from heaven

Anonymous said...

As an aspie woman I face stuff like this all the time. Usually the biggest complain I get is that I do not prioritize right. If I can memorize "useless" information and make time to draw or engage in special interests and follow instructions in a game, why can I not remember to wash my hands or close a door or organize my schedule? It is kind of impossible to describe to someone who does not have that sort of dysfunction how lost and confused most of my days are spent.

Chester Vanderpool said...

Yeah, that was me as a kid. To a t! Not only was I not able to follow instructions, but I couldn't pick up on subtle things. Of course, I didn't get diagnosed until I was older so it was hell.

Anonymous said...

Those with "Asperger's" actually have better executive function. The only reason it seems like they do not is because modern fast paced life does not suite them.
If you give them a task they will see all variables. So say for example a modern tyrant (boss) orders them to find out how a piston what works. They will go and figure how the piston and engine work together. The boss does not understand this because their brain does not work. So they will think the aspergers person did not complete the task, when in fact they went above and beyond what they were supposed too. You see they are called disordered because the fucking retard they are talking too cant stand being made a fool of.
If they are placed in an environment, such as Pleistocene Europe, that is normal (modern feminized life is not normal) they would kick the shit out of Neurocrazies.
Oh also they are not good at following instructions because instructions don't take into account instincts. Thats what they are doing when they break the instructions (societies instincts).
Also they are so easily distracted because they following their instincts. In the environment these traits evolved in there was no public school. Your parents taught you. Nowadays parents ship their kids off to school and follow the orders of their government masters. The author of this blog might want to check out www.koanicsoul.com

annakindt said...

I have Asperger Syndrome and I've found it helpful to read books aimed at people with AD/HD to help with my executive function problems. I've found some techniques that help me tame my personal chaos which gives me more time to geek out with my special interests.