Executive Function Difficulties

Many individuals on the autism spectrum have great memories for facts and details, but they have trouble organizing their thoughts and accessing and integrating the information they have to make it useful for them. This is called "Executive Function" (EF) difficulty.

Executive Function can be considered the "epi-center" of the brain; it controls the integration of cognitive processes such as planning and prioritizing, accessing working memory, directing attention, problem solving, verbal reasoning, inhibiting extraneous ideas, mental flexibility or shifting thoughts, multi-tasking, time management, and initiating and monitoring one's actions (metacognition). Together, these skills allow all individuals to solve problems, organize a plan of action, and control emotions and behaviors throughout the day.

Individuals with EF difficulties can look very different from one another. Here are some examples of how EF difficulties may affect individuals on the autism spectrum:

• Some people notice small details but have difficulty seeing how these all fit into a larger picture, unless outside support is available to help them structure the pieces.
• Others might have trouble with holding onto a thought, and this may lead to problems with following simple two-step directions. For example, instructions like "go to your room and put on your shoes" may be forgotten by the time a person reaches his or her bedroom.
• Many times individuals with EF difficulties have trouble planning, organizing, and/or sequencing their thoughts as well as maintaining their attention. This can lead to problems with completing daily chores, such as getting dressed, grooming, or cooking.
• Some individuals with EF issues struggle to shift gears from one thing to another. This can lead to the appearance of 'stubborn' behavior, because a person gets stuck on a tiny detail or routine and will not move on unless the routine is satisfied. For example, one individual may have trouble with an unexpected change in the school routine, such as replacing gym with a school assembly, or another person may struggle to finish a meal if he or she cannot eat from his or her favorite blue plate.
• EF difficulties may make it difficult for someone working on a "team" or with others on a project. If one individual has an idea and cannot take the advice or feedback from others, or if it is difficult for the person to integrate these thoughts, then it will be very difficult for the individual to be a contributing member of the team.
• Others with EF issues may have difficulty controlling impulses or regulating behavior when they are upset or frustrated.

There are many ways to help individuals compensate for EF deficits. Many individuals use Assistive Technology to help them stay organized and on track. These can include assignment notebooks or checklists, annotated calendars, picture schedules, and color-coded information to distinguish subjects or projects. Electronic aides can be wonderful tools for those who enjoy technology.

Besides Assistive Technology, there are other strategies to help compensate for EF difficulties. Students may benefit from sitting closer to the teacher. Employees may benefit from working out of the main flow of traffic, where distractions are minimized.

When faced with a large project (either in school or at work), individuals can benefit from having the project broken down into manageable pieces so that the project doesn't feel so overwhelming. The project can be completed one piece at a time. Some individuals benefit from intermediate deadlines. For example, instead of making a large assignment due in a month, the first part can be due in one week, the second part the second week, etc., until the project is completed. In fact, with help, many individuals can learn how to do this for themselves.

Executive Functioning strategies and accommodations can be included in Individualized Education Programs (IEPs) and 504 Plans. As in any situation, the IEP or 504 Plan needs to address the individual's deficits and incorporate the strategies and goals that will specifically work for that particular student. They may also be provided as an employment accommodation.

Some psychologists and speech-language pathologists specialize in Executive Functioning training. Adults may also want to consult a job coach to determine how accommodations can be made in the workplace.

Additional Resources

• Executive Functioning, from Autism Speaks®

Suggested Books

 A Parent's Guide to Asperger Syndrome and High Functioning Autism; Sally Ozonoff, Geraldine Dawson, and James McPartland. The Guildford Press 2002

Smart but Scattered; Peg Dawson and Richard Guare. The Guilford Press 2009

Unstuck and on Target! An Executive Function Curriculum to Improve Flexibility for Children With Autism Spectrum Disorders; Lynn Cannon, Lauren Kenworthy, Katie Alexander, Monica Werner, Laura Anthony, Research Edition. Paul H Brookes Publishing Company, 2011