One Commonality for ADHD, ASD, and Related Neurological Disorders

By February 23, 2018Articles

Introduction

One issue often faced by children with neurological disorders is impaired executive function.  Executive functions are mental abilities that contribute to our understanding of the world, helping us study problems, making and carrying out our plans, assessing how well our plans are working, and taking corrective action when necessary.

Executive Function

In the next discussion, I will explain the important executive functions that a person must have to function independently and successfully in society.

  • Memory: Remembering similar situations, and how you reacted to them in the past.
  • Working memory is a short-term memory you use to keep track of information until you need to use it (your mental sticky note).
  • Inhibitory control: Suppression of thoughts or fears that might keep you from reaching a goal. In short, the ability to resist interferences.
  • Planning: The ability to create a mental picture of how to reach your goal.
  • Organization: Arranging your thoughts to better understand and complete a task.
  • Time management: Evaluating the time restraints in any given situation.
  • Metacognition: awareness and understanding of one’s own thought processes.
  • Self-regulation of Affect: Managing your emotions to control your behavior.
  • Task initiation: The ability to start a task with enough time to finish it.
  • Goal-directed persistence: Tightly visualizing a goal so that you can ignore distractions and keep working until the goal is met.

For most of us, executive functions (EFs) are automatic and require little thought. For example, we rarely think twice about crossing the road. We make our decision, remember to check both ways, and conquer our fears so we can get it done. For a child with executive dysfunction—a failure of one or more executive function skills—this can be very difficult.

The ability to think is often taken for granted; however, the capability to do so plays an integral role in our development and enables us to recognize that we are social beings. To paraphrase a popular saying, we think, therefore we are.

In a way, life is a series of little challenges, one after another, and most of us depend on a mental framework of executive functions (EFs) to carry us through. Usually, all this goes off without a hitch … but sometimes we experience minor executive dysfunctions. Suppose you decide to go shopping, but can’t find your keys. You saw you needed something, decided to buy it, and headed for the door—all the result of applying various EFs. But one, working memory, didn’t function as well as the rest. Now, you’ve got to find your keys before you can go.

Little executive dysfunctions like this are mildly embarrassing at worst. But long-term EF problems, like those resulting from brain trauma or neurological disorders like autism, can impact a person’s quality of life. Communication, social skills, school and career, and behavior can all be compromised.

Now, imagine what life might be like if you couldn’t use one or more of these EFs at all, which is what children with autism and related disorders regularly encounter.

Executive functions (EFs) guide much of our social functioning. Two of the most important EFs are working memory and inhibitory control.

Working memory lets you hold a picture in your mind of the final goals while completing the intermediate steps. For example, you can remember where you put your keys (most of the time), and you can remember to buy bread on the way home from work if you ran out at breakfast.

The inhibitory control allows you to fight thoughts or impulses that can make you seem socially unacceptable or even get you into trouble—like losing your temper when you can’t find your keys or not paying for bread at the store. You can evaluate the consequences of your actions, making sure you avoid negative consequences.

Assessing Executive Dysfunction

We can use a number of tests to check for executive dysfunction in children. Generally, it begins when people closest to the child (like parents or teachers) identify key traits that may be linked to executive function deficits, such as a short attention span or the inability to complete simple tasks despite a normal level of intelligence. Parents often voice concern when a child is unable to regulate his or her behavior in common situations. If the child is showing severe lack of self-control and attention deficits, it’s time to schedule a visit to a neuropsychologist, who will assess the extent and types of EF deficit(s) involved.

Remedies for Executive Dysfunction

There is evidence that early self-regulation has a stronger association with school readiness than does IQ or entry-level reading or math skills, and they are closely associated with later academic achievement. Self-regulation affects a children’s abilities to successfully function in school settings in two ways: first, social-emotional self-regulation makes it possible for children to conform to classroom rules and to benefit from learning in various social contexts, from one-on-one interactions to large groups; and second, cognitive self-regulation allows children to use and further develop the cognitive processes necessary for academic learning and problem solving.

Researcher Lev Vygotsky found that children do better at tasks with adult help (mediation) than they do on their own. This led to the idea of the adult as a mediator for cognitive skills, not just someone who tells the child what to do. The adult acts as the child’s consciousness rather than as a human instruction manual.

The best place for executive function training is at home, using everyday activities. When the child has to perform a task, start by having him tell you how hard he thinks it will be and why in his own words. This encourages him to think about the possible outcomes and help identify any potential obstacles. As the child performs the task, ask him how he’s doing; this encourages more thought about how to complete it. When he’s finished, ask how he thinks he did. This helps him evaluate performance.

Let’s say you ask him to put away toys. You’ve presented a goal, and now you can guide him along the logical steps toward that goal. You have to make sure he takes the right steps in the right order, and understand why he’s made the decision to follow those steps.

  • Goal: What am I trying to do?
  • Plan: How will I do it? What other things do I need to complete it?
  • Prediction: Is this task easy or hard? How will it turn out?
  • Do: What problems do I run into, and how do I solve them?
  • Review: How did I do? How can I do better next time? Is there a best way to do it?

Learn more about what critical skills are important to achieving social potential.

 Social Potential Is Within Reach