About the Author
Dr. Willoughby is co-founder and co-director of Achieve New England. He is a licensed child clinical psychologist specializing in neuropsychological, educational, and developmental evaluations. His areas of expertise include learning disabilities, attention and executive functioning concerns, autism spectrum disorders and other neurodevelopmental conditions, as well as anxiety and mood disorders.
Recent years have witnessed an intensified interest in the neuropsychological construct of “executive function.” In short, executive functioning is a multidimensional concept referring to higher-order brain functions necessary for individuals to execute, or perform, tasks. Examples of these brain-based functions include the ability to effectively manage one’s time, plan ahead and organize, and carry out activities with multiple steps. From a developmental standpoint, the daily demand on one’s executive functions increase over time. For instance, the executive functioning demands placed on a preschooler would be much different from those placed on a college student. A preschooler may be expected to perform simple tasks, such as tidying a playroom with parent oversight, while a college student would be expected to manage more complex daily tasks, such as juggling multiple courses, keeping track of appointments, and independently planning social outings. As the human brain develops, the capacity to manage executive functioning demands increases and individuals are better able to handle the more complex tasks of daily living.
As noted above, executive functioning is commonly thought of as multidimensional and prominent scholars in the field have posited eight different domains of executive functioning (e.g., Gioia, Isquith, Guy, & Kenworthy, 2000). Behavioral descriptions of these eight domains are provided below:
- Inhibit: controlling impulses, appropriately stopping one’s own behavior at the proper time
- Shifting: moving freely from one situation or activity to another, solving problems flexibly
- Emotional Control: appropriately modulating emotional responses
- Initiate: beginning a task or activity and independently generating ideas
- Working Memory: holding information in mind for the purposes of completing a task
- Planning and Organization: anticipating future events, setting goals, and developing appropriate steps ahead of time to carry out a plan
- Organization of Materials: keeping work space, play areas, and materials in an orderly manner
- Monitoring: checking work for errors and tracking how one’s own behavior impacts others
A large body of research indicates that executive functioning impairments are very common in individuals with Autism Spectrum Disorders (ASD; e.g. Lai et al., 2017). In fact, as many as 80% of autistic individuals also have associated executive functioning challenges. It is important to note that executive functioning issues are not part of the diagnostic criteria for autism. That is, autism is a neurodevelopmental condition defined by social-communication differences and restricted/repetitive patterns of behavior. However, while not part of the diagnostic criteria, executive functioning challenges are associated features of autism. Of note, executive functioning problems are seen in other developmental and psychiatric diagnoses, such as Attention-Deficit/Hyperactivity Disorder (ADHD), Depressive Disorders, Learning Disabilities, and Anxiety Disorders.
Individuals with autism may show mild executive functioning impairment, such as having challenges in a single domain of executive functioning, while others may show more significant issues and exhibit problems across multiple domains. There are several common executive functioning issues often observed in autistic individuals. For instance, many have trouble shifting sets, namely becoming stuck on a particular line of thinking or showing difficulties tolerating changes in routine. Also commonly associated with autism are difficulties with organization and planning, such as trouble remembering appointments or obligations and trouble organizing social outings. Impulsivity and difficulty with emotional control may also be commonly seen in individuals with autism, such as interrupting others or becoming overly reactive to seemingly small triggers. Further, difficulties with task initiation are frequently seen in autistic individuals, including difficulties getting independently started on complex tasks or trouble knowing how to initiate social interactions.
As the body of research on executive functioning has grown in recent years, so has an interest in interventions for executive functioning challenges. One of the most common interventions for executive functioning issues is enlisting the support of an executive function tutor or “life coach.” These professionals work individually with children, adolescents, and adults to directly teach executive functioning strategies and help enact organizational systems to bolster executive skills. While direct teaching of executive functioning skills may prove helpful, individuals with executive functioning challenges also benefit from accommodations, such as being granted extended time to complete tasks or use of organizational templates for writing assignments. Further, assistive technology, such as the use of a cell phone’s reminder function, may also be especially helpful for individuals struggling to manage the demands of daily life. As researchers and clinicians discover more about the nature of executive functioning, it is expected that evidence-based treatments for executive functioning challenges will be better understood and more widely available to those in need of support.
Gioia, G. A., Isquith, P. K., Guy, S. C., & Kenworthy, L. (2000). Behavior rating inventory of executive function: BRIEF. Odessa, FL: Psychological Assessment Resources.
Lai, C. L. E., Lau, Z., Lui, S. S., Lok, E., Tam, V., Chan, Q., … & Cheung, E. F. (2017). Meta‐analysis of neuropsychological measures of executive functioning in children and adolescents with high‐functioning autism spectrum disorder. Autism Research, 10(5), 911-939.
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