Executive Functioning Disorders – not just kid stuff


 by Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC
Part 4 in a Series (click HERE for Part 3)

EFD – the gift that keeps on giving

graphic image of lady in formal dress and long gloves“The more you know about EFD challenges, the better you’ll be able
to help your child build her executive skills
and manage the difficulties.”

~ from a fairly comprehensive – albeit misleading article:
Understanding EFDs – Executive Functioning Disorders.

In fact, MUCH of what you will read about EFD is misleading — UNLESS it makes it clearer than clear that difficulties with Executive Functions are NOT exclusively – or even primarily – a childhood problem.

NOR are the problems rare

In my [25-year] experience with ADD and it’s “sibling” disorders (including TBI, anxiety and depression – among many others), the number of people struggling with EFDs is grossly under-estimated and under-reported.

EVEN an excellent article in a published in the well-respected Journal of Attention Disorders, “Executive Dysfunction in School-Age Children With ADHD” reports that “An estimated 30 percent of people with ADHD have executive functioning issues.” ~ Lambek, R., et al.

AND YET, many ADD experts like Dr. Thomas E. Brown from Yale, who has spent his entire career studying ADD/ADHD, position it AS a condition of Impaired Executive Functions.  
[A New Understanding of Attention Deficit Hyperactivity Disorder (ADD/ADHD)]

So, wouldn’t that place the best estimate of
the percentage of ADD/ADHDers
challenged with impaired executive functioning
at 100 percent?

But wait!  There’s more

MORE folks on Team EFD than folks with ADD/ADHD

image source: addwithease.com

For the most part, the executive functions are mediated through a particular region of the brain called the prefrontal cortex [PFC].

Implication: any individual with a disorder, stroke or other brain damage affecting the prefrontal cortex is highly likely to experience brain-based executive functioning challenges of one sort or another.

That includes individuals OF ANY AGE with mood disorders, autistic spectrum disorders, TBI/ABI, and more than a few neurological conditions such as sensory integration disorders, Parkinson’s, dyslexia — in fact, almost all of what I refer to as the alphabet disorders.


BY THE WAY . . . if you already suspect that YOU are probably a member of Club EFD, unless your reading skills are EXCELLENT and you are already a voracious reader, enroll a friend, loved one or coach to help you work through the EFD articles.

Don’t forget that you can always scroll up the sidebar
for a reminder of how links work on this site, they’re subtle ==>

A Review of a few EF Basics:

ABOUT Executive Functions – a brief introduction & overview
What ARE executive functions? – several experts attempt to answer
Executive Functioning, Focus and Attentional Bias

While,  unfortunately, impaired executive functions are not yet fully accepted as an “official” disability, most scientists, doctors, therapists understand what Executive Functions ARE (along with a comparatively small subset of life coaches who received comprehensive brain-based training).

  • Some of those professionals know enough to understand how EF’s operate and the implications of impaired executive functioning skills: that they impact life success negatively.
  • Some are able to recognize problems stemming from impaired executive functions through observation of a patient in his or her individual practice.
  • Only a few know how to help you effectively overcome what they identify.

Executive Functioning Self Defense

If you’ve read the three articles above, by the time you finish this article YOU will know more about executive functions and executive functioning than most of the helping professionals you are likely to encounter.

If you’ve also read the articles linked throughout this article, you will be well on your way to knowing how to work around kludgy executive functioning.

Your final task will be to develop the the systems and standardize the habits you will need to be able to systematize as many repeatedly challenging tasks as possible.  You want to put them on autopilot, bypassing PFC involvement for the most part.

(You can also hire me to make sure you work on that – but I’ve made the information available on ADDandSoMuchMore.com for anyone who is ready-willing-and-able to do whatever it takes to be able to benefit from it).

It’s quite possible to learn to defend your life from what you do! 

Understanding what’s going on – and what you need to put in place to accomplish your goals and run your life – makes ALL the difference.

So let’s get started. Don’t short-change yourself or your loved ones.

Many Executive Functions – probably more than you realized

Image Source: thestudyacademy

As you reviewed above, “Executive Functions” are what we call the integrated set of mental skills that make effective management of the cognitive tasks of daily living possible — including, among others:

  • tasks with intensive working and short-term memory requirements
  • anything that necessitates an inner awareness of the passage of TIME
  • activities where a reliable sense of direction is important
  • ALL tasks requiring adequate attentional skills, which means a relatively strong ability to:

1-focus on the intended object,
2-sustain the focus, and/or
3-shift focus at will

They are all brain-based abilities that allow one to be ABLE to do things like:

  • self-monitor
  • ride herd on impulse control and emotional regulation
  • plan, sequence, prioritize, schedule, and activate to task-completion
  • estimate time to completion and monitor time elapsed
  • retain cognitive focus despite everyday distractions
  • switch gears and get back on track when interrupted
  • analyze ideas and think through concepts, especially as they apply to life-management
  • keep track to evaluate performance on everyday tasks

Which are foundational abilities to be able to do things like:

  • participate appropriately in conversations
    (without blurting, interrupting or changing the subject, or “drifting off”)
  • apply previously learned information and strategies toward new problems
    (lifelong learning, as well as getting through educational or workplace training)
  • organize – an environment or a schedule – and maintain it
  • follow directions & jump through multi-step tasks
  • understand when more information or assistance is needed
    (relatively clear when, why or how to ask for help, with few difficulties accepting help when offered)
  • keep track of and follow through on promises
    (including work and school assignments as well as personal promises made to loved ones)
  • many of the Challenges listed in a prior article on ADDandSoMuchMore.com, Variations on ADD-ADHD

In other words, the brain’s Executive Functions consist of a collection of mental abilities that help our brains organize information in a manner that we can act on it.

Once sufficient motivation is identified, STRONG executive functioning skills enable us to plan, organize, remember things, prioritize, pay attention and get started on tasks relatively quickly and easily.

With WEAK executive functioning skills, and without help developing strategies and work-arounds, handling even the simplest of tasks can be stoppers. Recalling a specific term, name or date, for example, could be as big a challenge as recalling an assignment or adhering to a schedule!

Everything is fuzzy when the PFC is doing a sub-par job!

Source: ldawe.org

Manifestations of executive functioning struggles

Executive functioning challenges can produce a wide range of symptoms in wide variety of individuals – as well as in the same individual in various environments, at various times, or as they age.

REMEMBER as you read, very few individuals exhibit everything on the lists above and below, and almost all of them struggle with a variety of things that aren’t listed at all.

Depending on which skills are the weakest (as well as how important they are to the initiation or completion of any particular task), you might see any number of the problems below, to varying degrees of struggle. (CLICK HERE for a prior list by type of task)

  • Difficulty making decisions (ex., stuck in the “research” phase or avoiding/delaying decision-intensive tasks, etc.)
  • Struggles getting started, or figuring out WHERE to begin
    (trouble seeing the main idea or the task objective; easily overwhelmed attempting to chunk tasks into smaller, more manageable sub-tasks and/or figure out which to do first, needlessly over-complicating,etc.) 
  • Trouble with transitions of all types
    (sleep/wake, work/home, chores/leisure time, etc. — switching gears from one activity to another)
  • Inability to stick to a plan or activity – OR – inability to abandon it,
    (even with the awareness of potential penalties for getting off schedule)
  • Micro/Macro issues: moderate ability to focus on small details OR on the overall picture, with low ability to track both in tandem
    (or to switch between them in response to task demands)
  • Task pacing fluctuations – troubles maintaining timing-appropriate attention to detail
    (rushing through tasks that require more detailed attention, or obsessing over details so that deadlines are missed and other projects ignored)
  • Limited self-awareness and low ability to self-evaluate. (Impaired self-monitoring abilities: may believe they are doing poorly when they are on-track, or doing well when they are not; consciously unaware that they’ve wandered off-task, lack of understanding about the need to check their level of engagement or their work)
  • Difficulties incorporating feedback
    (lack of understanding about what they are supposed to DO with the feedback, frequently defensive, sometimes oppositional, often troubles with accepting what they believe is negative feedback, overreacting to perceived injustices or problems getting started on a task – or finishing it when something upsets them.)
  • Inflexibility and black and white thinking (Seeming inability to change course when a specific strategy or plan doesn’t work – lack of awareness of alternate possibilities)
  • Trouble sustaining attention on tasks, instructions, feedback,
    or even everyday conversations
    (ex., easily distracted, loses train of thought or thread of conversation with interruptions, or registers only the first or last thing said – missing modifiers like “don’t” or “never;” needs to be told task or locational directions many times before they “stick”)
  • Isn’t always able to find the words to explain something
    (needs help processing what something feels/sounds/looks like – or describing what it is they need help understanding)
  • Isn’t able to think about or do more than one thing at a time effectively
    (yet frequently resistant to doing only one thing at a time, chronically multi-tasking with little to no awareness of the impact on the ability to focus)
  • Problems organizing or keeping track of things (including information)
  • Remembers or recalls information better in a specific manner (with cues like acronyms or mnemonics, or when they have repeated it aloud or written it down),
    Or when delivered in a certain way (spoken, written, etc.)
  • Insistent on or picky about seemingly “extraneous” things as necessary to task initiation or completion (typed instructions vs. neatly hand-written, fountain pen vs. ballpoint, college-ruled paper only – or never, etc.)

Things get WORSE as time goes by . . .

Image Source: http://misscellania.blogspot.com/2010/01/fun-and-funny-links.html

Image Source: misscellania

because each new skill must build on the ones before it.

If you never learned to add or subtract, multiplication and division would remain a mystery.

If you hadn’t mastered basic arithmetic, how could anyone expect you to do well in math as you moved through school? Exactly!

Similar to moving from basic arithmetic to higher math, learning how to manage one’s life is also an incremental, multi-stepped process.

Early skills development is possible only if a child’s parents and teachers are aware of what’s really going on.  Otherwise, getting through the day remains a frustration for everyone.

For example, children with task management problems can come across as chronic procrastinators, or as if they are deliberately disobeying, when that’s not what’s really going on.

Perhaps, for example, they’re so overwhelmed that they shut down, doing nothing in an attempt to back away from their increased anxiety over not being able to do what seems easy for others. 

No promise of reward or threat of punishment will change things — any more than a child who needs glasses could squint her way into visual focus to improve her reading ability.  Failures multiply, self-esteem is decimated, and behavior problems tend to result.

What’s needed, like getting glasses for a child who can’t see clearly enough to read, is an awareness of the source of the struggle and the development of interventions that will help work around EF weaknesses – the sooner the better.

  • Early intervention helps develop ways to use strengths to support weaknesses before failure expectations take hold.
  • Early awareness of the need for intervention will allow most EF-challenged children learn to compensate for those challenges well enough to learn effectively and complete age-appropriate tasks successfully.
  • Success builds on success.

Thanks to the miracle of neuroplasticity, appropriate intervention can be helpful at any age.  Things can change, even into adulthood – but only once you’re aware of the reason behind the need for change.

Most of us who were undiagnosed as children put together coping skills of some type, but perhaps not the ones that that we really need.  At best we are underfunctioning, swimming upstream.

Turning yourself around to swim WITH the current

It’s a very simple process – not to be confused with easy:

  1. Learn about Executive Functions & how they work: expose yourself to the information in the articles linked above – in whatever manner will work for you now.
  2. Identify the areas where your brain is not neurotypical. (Hint: where are you struggling? Check out Optimal Functioning (Challenges) Series of articles to help you get specific – start with those that match the areas that are most challenging for you.)
  3. Accept the reality that things have seemed harder for you because they ARE harder for you – and stop beating yourself up!  (Don’t let anyone else do it either.  “Tough” and “love” make lousy companions.)
  4. Embrace the idea that you haven’t been handed a life sentence – just because you always have doesn’t mean you always will!  You can develop work-arounds that will allow you to manage what you’re currently avoiding or struggling to do.
  5. Systematize. Set new habits in place. Decide how you are going to attempt one task on your “difficult” list and do it that way every single time – until it becomes a habit. Habits are patterns – the human brain has evolved to be a pattern-recognition machine. For inspiration and understanding, read through the entire Habits, Decisions, Attention Series as you begin to systematize your life.
  6. Enroll support. Find someone to serve as a sounding board and accountability partner.  You can work with an understanding friend or loved one as long as they are willing to do some reading to understand Executive Functioning struggles so that they don’t inadvertently make things more difficult.  If you can afford it, hire a comprehensively trained brain-based coach – or locate a therapist who is EFD-knowledgeable, willing and able to work in a coach-like fashion.

——————————————————-
Stay tuned — future articles in the Executive Functioning series will continue to take a look at the implications of Executive Functioning struggles on the way to helping you figure out how to drive the very brain you you were born with.


As always, if you want notification of new articles in the Habit Series – or any new posts on this blog – give your email address to the nice form on the top of the skinny column to the right. (You only have to do this once, so if you’ve already asked for notification about a prior series, you’re covered for this one too). STRICT No Spam Policy.

Want to work directly with me? If you’d like some coaching help with anything that came up while you were reading this Series (one-on-one couples or group), click HERE for Brain-based Coaching with mgh, with a contact form at its end (or click the E-me link on the menubar at the top of every page). Fill out the form, submit, and an email SOS is on its way to me; we’ll schedule a call to talk about what you need. I’ll get back to you ASAP (accent on the “P”ossible!).
——————————————————————————————————————————————

You might also be interested in some of the following articles
available right now – on this site and elsewhere.

For additional links in context: run your cursor over the article above and the dark grey links will turn dark red;
(subtle, so they don’t pull focus while you read, but you can find them to click when you’re ready for them)
— and check out the links to other Related Content in each of the articles themselves —

Related Content on ADDandSoMuchMore.com

Exercise, Sports & Executive Functioning

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About Madelyn Griffith-Haynie, MCC, SCAC
Award-winning ADD Coach Training Field founder; ADD Coaching field co-founder; [life] Coaching pioneer -- Neurodiversity Advocate, Coach, Mentor & Poster Girl -- Multi-Certified -- 25 years working with EFD [Executive Functioning disorders] and struggles in hundreds of people from all walks of life. I developed and delivered the world's first ADD-specific coach training curriculum: multi-year, brain-based, and ICF Certification tracked. In addition to my expertise in ADD/EF Systems Development Coaching, I am known for training and mentoring globally well-informed ADD Coach LEADERS with the vision to innovate, many of the most visible, knowledgeable and successful ADD Coaches in the field today (several of whom now deliver highly visible ADD coach trainings themselves). For almost a decade, I personally sponsored and facilitated seven monthly, virtual and global, no-charge support and information groups The ADD Hours™ - including The ADD Expert Speakers Series, hosting well-known ADD Professionals who were generous with their information and expertise, joining me in my belief that "It takes a village to educate a world." I am committed to being a thorn in the side of ADD-ignorance in service of changing the way neurodiversity is thought about and treated - seeing "a world that works for everyone" in my lifetime. Get in touch when you're ready to have a life that works BECAUSE of who you are, building on strengths to step off that frustrating treadmill "when 'wanting to' just doesn't get it DONE!"

74 Responses to Executive Functioning Disorders – not just kid stuff

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  30. Wow….how very generous you are….this is such great information and as a child and youth mental health clinician/social worker (for only 2 years, now), I am familiar with what you’ve shared, but I’ve found the way you’ve outlined/presented the information so helpful. Thanks for sharing 🙂

    Liked by 1 person

    • Thank YOU for the generosity of your comment – it is JUST the bit of “wind beneath my wings” I need right this very moment.

      It’s a cold, rainy, miserable day, my car won’t start so I can run a few errands that are truly urgent, and I am experiencing some WordPress slow-downs and glitches as I am working on an article on emotional resiliency — which is TOO ironic, given my own emotions as the result of the events of my day so far.

      Hearing that someone like YOU found something I posted helpful is just the shot of feel-better I need!

      God Bless You!
      xx,
      mgh

      Liked by 1 person

      • God bless you, too…and I am so pleased to know that I could do a little something to give back to someone who so obviously has a passion for helping others….I know it can sometimes feel like you are whispering in the wind….but, I want you to know that I hear you roar….as for cold and rainy, that is enough to test my mental metal under the best of circumstances (wet and dreary are not my colours)….and, my car not starting would be enough to make want to escape to a warm bed and a make-it-all-go-away nap. So, kudos for you for hanging in there 🙂

        Liked by 1 person

        • You’re a DOLL!

          Since it takes one to know one, I’m betting that you are *wonderfully* passionate about what you do as a truly helping professional (vs. the too many who hang out a shingle that are not particularly helpful, as you must surely be aware)
          xx,
          mgh

          Like

          • Yes, I very committed and passionate…I actually don’t have a private practice…my employer is a health network and the wonderful thing is, as part of a multidisciplinary team, my colleagues and I see the children and youth at school…that is where we conduct sessions…the exception is if we are doing trauma-based interventions–those we do out of the office. Many, many of our clients have anxiety and/or depressive disorders….and ADD is also common. I love my job, as draining, intense, and sad as it can be sometimes….

            Liked by 1 person

            • So sad (and frightening) to see the rise of anxiety and depression in children – true of many other mental health challenges as well, unfortunately. I am so glad to read that at least some of the health networks (like yours) are actively supporting these kids. I completely undersand your last sentence, by the way. Those of us with what I call “helpers disease” struggle with boundary management and Self-care (at least *I* do, anyway).

              I hope you will return to use ADDandSoMuchMore as a resource. If you use the search box at the top of the site for any of the challenges you’ve mentioned, you’ll find quite a bit of comprehensive content (my C-PTSD article will lead you to others in the PTSD/TBI Series, as one example)
              xx,
              mgh

              PS. I jumped over for a quick read of your blog, and couldn’t find a follow button. I’ll keep trying – WordPress features tend to blink in and out.

              Liked by 1 person

            • I will definitely avail myself of the resources you share…thank you so very much!!!! As for my follow button, I am clueless…I’m sure it will appear at some point…but, I will be sure to stay connected to your blog…it is awesome and so are you 🙂

              Liked by 1 person

            • AS I SAID, I’ll keep trying – my ADD Poster Girl brain *needs* reminders to visit and support the blogs of people with whom I want to stay connected.
              xx,
              mgh

              Liked by 1 person

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  65. Pam Augspurger says:

    I feel like I have lost all EF. I use to be super organized (with most things), I could plan anything to the last detail and on and on. I have a shop and I have a home. Lots of stuff gets lost in my brain between the two. I can’t complete tasks at either location.

    I’ve always been very visual and if I wrote something down, it was imprinted in my mind. I’ve always operated on the “pile” system and it’s always worked for me. If I organized my desk, it was back to the way it was in a day or less. That’s just me, but I seem to be taking everything to a whole new level. Among others, these particular points are “so me”:

    Trouble sustaining attention on tasks, instructions, feedback,
    or even everyday conversations
    (ex., easily distracted, loses train of thought or thread of conversation with interruptions, or registers only the first or last thing said – missing modifiers like “don’t” or “never;” needs to be told task or locational directions many times before they “stick”)

    Isn’t always able to find the words to explain something
    (needs help processing what something feels/sounds/looks like – or describing what it is they need help understanding)

    Isn’t able to think about or do more than one thing at a time effectively
    (yet frequently resistant to doing only one thing at a time, chronically multi-tasking with little to no awareness of the impact on the ability to focus)
    Problems organizing or keeping track of things (including information)

    I even find myself trailing off on sentences and it drives my family nuts! I keep wondering “what is wrong with me?” I’ve always been a paradox (kind of like the no focus/hyper focus concept) but now I’m just a complete mess. I honestly feel like I need a handler!!!!

    And I couldn’t read your post thoroughly…sad, sad, sad.

    Thank you!
    Pam

    Liked by 1 person

    • Not to make light of your comment Pam, but some days my functional temperature is so low that *I* can’t even read my posts thoroughly – and I researched and wrote the darned things! (printing and hi-lighting helps immensely, btw).

      Understanding what’s going on helps – but it is still beyond frustrating not to be able to DO what you know! Believe me I GET IT! EF struggles are a BEAR!

      No kidding, sometimes when I’m struggling myself I search for an article on my own site for a bit of inspiration and coaching. Sometimes I can then get back on the same horse, and other times I must move on to something else that seems “easier” at the time. Those of us with EFDs simply cannot approach things the same way as “vanilla-brains.”

      Get the neurotypicals in your life to read the darned things, Pam. Their understanding will make a HUGE difference in *your* life.

      Always love it when you ring in. THANKS.

      xx,
      mgh

      PS. Check out Goals Drive Habit Formation for a bit of practical help. Written when I was only 3-months behind, work-wise, it has become my go-to now that I am a year behind after a sudden forced move and recurring cell-phone drama continually tossed my salad for the entire year of 2014.

      Like

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