Executive Functioning Deficit in Autism

Source: VeryWell Health

Imagine you’re the executive in charge of a project team. Your job is to think about the overall goals of the project and the objectives required to achieve the goals. Then, you’ll have to work with your team to put together a timeline and put your plans into action. It will be up to you to have all the supplies and personnel in place when you need them so that the process will flow seamlessly — meeting deadlines on time and on budget. If something goes wrong (someone gets sick, a delivery is late, you need more of something than you anticipated, etc.), you’ll need to manage the process of troubleshooting and remediation.

To meet your goals, you’ll need to:

• Understand and articulate both the larger goals and the objectives required to meet the goals
• Anticipate and develop a timeline to implement all the steps along the way
• Manage the people and processes involved in meeting the goals
• Anticipate and plan for the unexpected
• Calmly and intelligently cope with setbacks and problems
• Flexibly change the process, people, or timeline so as to cope with the reality that you just have to expect the unexpected.

Incredibly, this is what we expect our children to do when we ask them to “work collaboratively on a school project that you’ll be presenting in three weeks,” or “work with the other kids to sell these cookies so you can raise enough money for your band trip.”

Even more incredibly, most kids — by the time they’re in middle school — are capable of managing such complex, multi-faceted, time-sensitive, collaborative projects. They may not be perfect, but they understand what’s needed to be successful.

At a simpler level, younger children are capable of managing the complex process of “cleaning up the playroom and getting ready for dinner.” They can respond to the big-picture goal by thinking through the steps required to straighten up the room, wash hands, dry hands, and help set the table — and then by putting those steps into action.

They have developed (or are in the process of developing) the set of skills known as “executive functioning.”

Why Is Executive Functioning So Tough for People With Autism?

Autism spectrum disorder is characterized by certain personal abilities and deficits. Most (though not all) people with autism:

• Are great at seeing details clearly, but have a hard time seeing a big picture and understanding which details are most relevant to that big picture.
• Are good at following schedules and routines, but have a difficult time flexibly changing those schedules or routines.
• Can understand and follow rules, but get upset when rules are broken or bent.
• May have difficulty sustaining focus and motivation when engaged in something that isn’t intrinsically interesting to them.
• Have a hard time switching from one activity to the next.
• Have a difficult time effectively communicating wants and needs to others.
• May not imitate others’ behaviors without being directly instructed to do so (for example, unlikely to look around, notice that everyone else is getting ready to go, and do the same).
• Have challenges with “working memory” (the ability to conceptualize and manipulate multiple pieces of information and expectations at the same time).
• Can work with concrete objects and expectations more readily than with abstract ideas.
• Have difficulty with “theory of mind” (understanding that others’ do not know, share, feel, or understand what’s inside your own mind).

Looking at this list, you’ll probably notice that most of these qualities are in direct conflict with the qualities required for good executive functioning. If you don’t see the big picture, are not a flexible problem solver, and have poor “people skills,” you’re unlikely to be a good project manager. You’ll also have a hard time planning for and executing multiple steps at the same time — especially if those steps are abstract (thinking about time as opposed to building a model).

Building (and Working Around the Need for) Executive Functioning Skills

Some people with autism will never have good executive functioning skills. That said, however, it is possible to build and work around the need for such skills — in some cases, making it possible to manage complex situations without much difficulty.

Building Executive Functioning Skills

Here are a few techniques that can help to increase and strengthen executive functioning:

Direct Instruction: Certain aspects of executive function can be taught through ordinary instruction and drilling. For example, it is possible to teach the skills of thinking through the steps required for an outcome; to complete certain tasks before others; to use time management tools such as calendars; to complete the same tasks at the same time each day or week, etc. While most people seem to internalize these skills without direct instruction, there are plenty of people — autistic or not — who can benefit from ordinary time management instruction.
Role Play: What should you do when presented with a multi-step challenge? By role-playing and talking through such challenges, many autistic people can practice and become more skilled at planning and take logical action.
Setting Up Practice Challenges: At home or in the classroom, it’s possible to set up low-stress situations that require executive functioning skills. Ordinary tasks like washing, drying, folding, and putting away clothes require multi-step planning, time management, and tenacity.
Developing Social Stories for Flexibility: What can I do if an unexpected problem arises while I’m attempting to complete a task (for example — I run out of detergent, someone else is using the dryer, I forgot the laundry basket upstairs, etc.)? Social stories, particularly when written together, can provide answers to such questions so that anxiety doesn’t interfere with getting the task done.

Workarounds

While it’s possible to build some executive functioning skills, chances are that people with autism will find such skills tough to master. For that, there are workarounds like these:

Use apps to manage time. Alarms, visual timekeepers, and other tools can keep autistic people on track, even when they are not thinking about time.
• Use visual reminders and schedules. What are the steps required to get that laundry done? A laminated photo-based step-by-step poster in the laundry room can keep you on task.
Break it down. Instead of “get ready for school,” consider breaking tasks into smaller chunks such as “brush teeth,” “get dressed,” and so forth.
Try carrots rather than sticks. Failing to complete a task can result in intended or natural consequences: dirty or wet underwear, for example. But when the job is done right, no one notices. Consider offering small, tangible rewards for a job done well and completely.
Use a buddy system. It can be hard to stay on track when you’re easily distracted or not especially focused on the task. With a buddy — especially one who is focused on the process — you may be more successful.
Simplify the process. Yes, you probably SHOULD separate before you wash, and fold after you dry — but if you wash everything together and just keep your clean undies in the laundry basket, you can cut two steps out of the process and STILL arrive at the same goal (clean, dry undies).