What is Executive Dysfunction?

Have you ever heard the term Executive Dysfunction?

Executive Function is the set of mental skills or processes that allow us to use our intelligence and problem-solving abilities to help us work toward achieving our goals.  They affect a person’s ability to plan, organize, initiate, and complete tasks. It is a common problem for people with neurological conditions such as ADHD, traumatic brain injury, and various types of neurological and psychiatric disorders to struggle with these skills.

While, as professionals, we mostly agree on what Executive Function means, we still differ on ways to categorize or describe these skills.  In fact, I still remember the professional conference I attended about 15 years ago when the top experts in the field of ADHD and learning disabilities first began talking about Executive Function.  At the time, we were still debating if it should be called Executive Function, Executive Functioning, or Executive Functions😜.

Executive Functions are located in the Prefrontal Cortex, the part of the brain that lies directly behind the eyes and the forehead.  This is the last part of the brain to develop and is typically fully developed between 25 and 30 years of age. This part of the brain controls our ability to focus, pay attention, plan, problem–solve, and switch tasks when necessary.

When someone struggles to demonstrate developmentally appropriate Executive Function skills, we sometimes refer to this as Executive Dysfunction or Executive Function Disorder.  While these are not formal diagnostic terms, we can assess someone’s ability to use these skills at a developmentally appropriate level.  In fact, the term “Executive Function” does not appear in the Diagnostic Statistical Manual (DSM) that is used to diagnose disorders.

Executive Dysfunction can have a profound impact on a person’s daily life. It can affect a person’s ability to perform at work or school and can lead to problems with social interactions and relationships. People with Executive Dysfunction may also experience low self-esteem and feelings of frustration, anger, depression, and hopelessness.

But here is the good news.  We can each improve our Executive Function skills.  Below is the Executive Function chart I use to teach parents and educators.  It is important to begin by learning what each Executive Function skill involves and how it impacts learning and behavior.  I believe children should learn what Executive Functions are at a very young age to participate in their education fully.

What we often assume is willful resistance, or poor behavior may look different when we know what is causing the challenge.

Executive Function skills have nothing to do with Intelligence!

Someone can have a very high IQ yet struggle with Executive Dysfunction.

For example, suppose you ask your child to go upstairs and get their backpack, shoes, and tennis racket, and on the way downstairs, check your bedroom to grab your book and see if you turned your light off.  Now I know many of you are cringing right now at the thought of your child actually complying appropriately. When I ask parents how they are feeling at this moment, I often hear words like frustrated, exhausted, and even angry.  After all, sometimes they can comply. Especially when it is for gathering things for something they are interested in doing.

But what if you understood that complying with such a request involves accessing your Working Memory?  There are actually three types of memory. Short-term memory is when we need to remember that we need juice, eggs, and milk, but we go to the store. Long-term memory is knowing your phone number from your childhood. Of course, many kids today don’t know their phone number since it is stored in their cell phones, and they never have to tell anyone since they can share their contact.

Working Memory is the ability to keep multiple bits of information in mind and apply them to a task. Think of it as the brain’s search engine. You must consider what you already know and integrate it with the new information.  For example, when you do long division, you need to remember the multiple steps involved – unless you use a calculator😜.  If you know that your child’s (or partner’s) working memory is weak, you are more likely to consider problem-solving instead of getting angry or frustrated. There are many ways to support someone with a weaker Working Memory:

• Provide a visual aid such as a list or pictures.
• Break tasks into smaller chunks.
• Reduce the number of tasks required at one time.
• Keep new information or instructions brief and to the point
• Be willing to repeat the steps if needed.
• Develop routines, so the same task is required in the same way each time.
• Develop a Mnemonic device.
• Ask the person for input on what might make it easier for them to remember and comply.

Keep in mind, Executive Function skills are just that, skills.  They develop over time.  People with ADHD can be up to 30% delayed in developing their Executive Function skills.  And just as with learning disabilities, sometimes people will continue to need modifications and accommodations to achieve what they are capable of doing.

In conclusion, Executive Dysfunction can significantly impact a person’s life, but with the proper tools, strategies, and support. they can learn to manage their symptoms and lead fulfilling, productive lives.