Do you have deficits in Executive Functions?
Finding it hard to start tasks?
Have trouble figuring out how much time a task requires?
Do things either quickly and messily or slowly and incompletely?
Have trouble paying attention and are easily distracted?
Lose a train of thought when interrupted?
Need to be told directions many times?
Have trouble making decisions?
Have a tough time switching focus from one activity to another?
Don't always have the words to explain something in detail?
Need help processing what something feels/sounds/looks like?
Are not able to think about or do more than one thing at a time?
A person with Attention Deficit Hyperactivity Disorder (ADHD) might be hyperactive, inattentive, and/or impulsive. Clinicians have always understood hyperactivity and impulsivity.
Executive function disorder (EFD) involves a pattern of chronic difficulties in executing daily tasks. These difficulties cause the most problems on a daily basis.
Executive functions allow us to:
1. Analyze a task
2. Plan how to address the task
3. Organize the steps needed to carry out the task
4. Develop timelines for completing the task
5. Adjust or shift the steps, if needed, to complete the task
6. Complete the task in a timely way
Executive skills include:
Impulse control: This is a person’s ability to stop and think before acting. They may blurt things out. They may do unsafe things without thinking it through. They also may quit a chore halfway through to go hang out with friends and have trouble following rules consistently.
Emotional control: This is the ability to focus on the end-result or goal. This creates trouble accepting negative feedback. This causes struggle in finishing a task when something is upsetting.
Flexibility: This is the ability to change behaviour based on circumstances.
Working memory: This is the ability to hold information in the mind and use it to complete a task. Reduction causes trouble with multi-step tasks, remembering directions, taking notes or understanding something that’s just been explained to you.
Planning and prioritising: This is the ability to come up with the steps needed to reach a goal and to decide their order of importance.
Task initiation: This is the ability to get started on something. Reduced ability causes issues with planning and prioritizing.
Organisation: This is the ability to keep track of information and things.
What causes executive functioning issues?
People differ in how they use executive skills. Studies show that the differences among people are almost completely influenced by genes.
For the most part, executive functioning is controlled by a region of the brain called the prefrontal cortex. Research has shown that people who have disorders, diseases, or injuries to the prefrontal cortex often develop executive functioning issues (ADHD, learning disabilities, dyslexia, dyspraxia).
How are executive functioning issues diagnosed?
Questionnaires or screening forms. One tool commonly used is the Behavior Rating Inventory of Executive Function (BRIEF).
Intelligence testing includes tests like the Wechsler Intelligence Scale.
Observation and interviews. Most professionals will also want to see the way you interact with people and the world around you.
Contact Dr Rajpal for more information and discussion of what help is available if you struggle with EFD