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Older Teens and Executive Functioning Issues

This post follows on from my earlier post "Young Teens and Eecutive Functioning Issues" If you haven't read that post, you might want to read it before continuing here as it provides a useful introduction to the topic.

In my earlier post I defined lack of executive function and talked about the problems it can cause in day-to-day scenarios involving simple tasks, like getting dressed.  As children get older however, executive functioning difficulties become more pronounced because they're expected to be able to take responsibility for more far-reaching decisions.

Decisions made by older teens can affect lives and can result in legal action, injury and even death.

An Example;

Take, as an example, the problem of driving home after a night out.

The simplified executive functioning would probably flow as follows but each component would have a myriad of ordered sub-tasks as well;

  1. Decide - Am I ok to drive home?  
    This would require both a knowledge of the drink-driving laws as well as a reasonably accurate count of one's own consumption.  Of course, if there's a tester machine handy, this simplifies things but someone with defective executive functioning could easily miss this step and not even consider their own suitability to drive. Of course, if they're well over the limit, then their executive functioning is probably even more impaired than usual and the decision will not be made without outside involvement.

  2. Decide - Are my friends ok
    Chances are, this decision would probably not even occur to an individual on the spectrum. It's not that they don't care but simply that it takes work to put themselves in someone else's shoes and they won't pick up on subtleties. If someone's speech is slurred or if they're a little unsteady on their feet, it probably won't register but of course, if they fall over - or better still, ask directly for a lift home, they'll be helped.  Even without executive functioning difficulties, this step will probably be missed.

  3. Drive Home
    Driving is an executive functioning nightmare. There are so many sequenced tasks to perform that little things, like putting a seat belt on may be missed.  There's also the constant distraction of one's driving surroundings.  Headlights from oncoming traffic, noise from the radio or passengers, street lights, traffic lights etc. You'd be surprised at how these things can further impair executive functioning.
So far, I've hardly mentioned the worst parts of executive functioning difficulties, distractions and unexpected change but both of these can be deadly..  Driving aged teens rarely seem to drive alone and the distraction of their passengers can be enough to have serious consequences.

Change is just as bad.  You might be wondering what exactly constitutes change on the road since since everything there is in motion but I can tell you that both of my worst teenage driving accidents were the result of cars being in "unexpected places".  Simply driving at different times of the day can put parked vehicles in previously moving lanes.

In the days before mobile phones, street-side telephone boxes used to be a big issue too because cars would be unexpectedly parked there when their owners were on the phone. Although these are less of a worry now, a car turning at a rarely used intersection or some unexpected road work is enough change to cause an accident.

Image by Free-Photos from Pixabay

Encounters with Police

The problems of teenagers with executive functioning difficulties don't end with cars.  Unless they have extremely strong personalities, it's hard for them to make appropriate choices when peer pressure is applied. It's also more likely that they will react incorrectly under pressure.

For example, a person involved in a low-level crime, such as underage smoking, drinking or loitering, may not realise that the crime isn't serious enough for them to be hauled off to jail.  Instead of standing their ground and accepting a lecture from the law, they may try to run or even worse, may react violently.

This is one of the reasons why so there are so many stories about autistic people being assaulted by police. It's not so much police brutality (although sometimes that comes into play), it's simply that these young adults react inappropriately by either becoming overly defensive or by fleeing. Autistic body language is very different and police will often pick up on this and think that it's suspicious behaviour or drug/alcohol influenced.

Social Problems

Finally, the problems are not limited to legal and driving issues. They also have social consequences. For example. a female with impaired executive functioning may go too far in flirting with someone.  In particular, flirting without a clear plan or intentions.  This can lead to unsavoury or dangerous responses. 

It would be wrong to suggest that a female is responsible for an aggressive reaction but at the same time, an inability to read warning signals and a failure to plan for safety significantly increases her risk.

When it comes to males on the spectrum, there are potential social disasters here too. A male may try to
"flirt" but come off as aggressive. In social gatherings with lots of other young people, it doesn't take much for these behaviours to escalate into fights or accusations. 

It's very easy for a male with executive functioning issues to cross a line and say or do something inappropriate that will have legal repercussions and/or make them a social pariah. 

What can be done?

It's hard to know exactly what can be done to improve executive functioning skills in young adults and the problem is twofold;
  1. How to recognise a lack of executive functioning?
    If this has been picked up in a young child, and taught constantly, then there's an easy answer.  Unfortunately however most doctors talk about autism, adhd or aspergers in general terms rather than the specifics of executive functioning.

  2. How to teach a young adult to plan more effectively
    If it wasn't difficult enough to pass on the skills of successful planning and awareness to young adults, there is also the problem that young adults are not interested in this sort of "training" from their parents. While role-playing these scenarios could be helpful, it's unlikely that it could be accomplished at home. It really needs to be done as part of their formal education.
What these young adults really need is to have role-playing (and social stories) about real-life teen situations included as part of the school curriculum.  I know that it sounds a bit "sleazy" suggesting that we teach our teenagers to flirt or to prepare to depart a drunken party but role-playing these scenarios is probably the most effective means of combating the problem.  

There is also the suggestion that teens with differences that could get them into trouble should be registered with their local police station (or at least wear a medical band) in case their condition leads to police action.

I'll be very interested to hear what my readers feel could be appropriate solutions.


Anonymous said…
Thanks, good post, our girls are still quite young and fairly responsible considering their challenges, but this post gets me thinking ahead. It's rather heartening that there is a presumption that our AS kids are going to be driving and attending social, age appropriate activities such as drinking with friends....good stuff!!
Maddy said…
Unfortunately I have nothing helpful to add at this stage - I'm just looking ahead to the future - anticipating some of the inevitable complications. For the moment mine are both adamant that they never want to drive, however, I suspect that may change.
Quite chilling reading.... a lot to factor in for the 14 year old's next few years.
Stephanie said…
I would suggest not starting with the assumption that there is an appropriate level of alcohol consumption for teenagers to drink and drive. The difficulties of that decision are entirely avoidable. Decide beforehand not to drink, or at the very least not to drink and drive.

The best strategies I've read about concerning executive functioning have to do with preparing for a situation--role-playing is one of those strategies, but there are others like social stories that are less involved in acting things out.

But I do wonder if there is a way to approach the process so that it can be generalized into a skill.
thehatguy said…
I'm working on a blog that I've just started, I'm going to be posting a lot and I was wondering if you would like to take a look, any suggestions are helpful. This blog is and will be about transitioning to adulthood and how to live life with or as an adult on the spectrum. This is a very complex topic to be blogging about, but I'm hoping that it will be very helpful. I feel that I can help in a unique way, because I have Asperger's, with co-morbid conditions. Anyways, here is the blog: Adult Asperger's.
thehatguy said…
I too have executive functioning issues, I'm addressing those and other issues in my New Blog.
!!Chaos!! said…
I've never had the issue really, tho for me it's a rather simple question of "have I had even a single beer in this awake cycle?" if the answer is yes, then I don't drive. Period. If I haven't had a good long sleep between drinking and driving driving ain't happening, and i can't actually go by days cuz I don't have anything even remotely resembling a normal sleep schedule, having been awake for far far too long is often a reason not to drive.

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