Executive Function Disorder

Sgt Romeo said:

Does anybody else have this?

Executive Function

If you have EFD, or agree with a lot of the points above, please can you let me know what you use to cope with different day to day issues.

After being diagnosed with  both ADHD and autism spectrum disorder, I started reading up about executive function. I've always had problems with multiple tasks or anything to with project management. I can easily recall train times and telephone codes. But I can feel anxiety coming on, when I need to juggle multple tasks.

So what do I use to cope ?

Everything goes into a diary which is syncromised across mobile and all devices. So I reduces the chance of forgetting things.

Reduce big tasks into smaller jobs. I'm much better at step-by-step jobs with clear objectives.

In employment, try to arrange a structure to work. Even if that means going to my boss and asking clarity on what needs to be done.

Right everything down 'to-do' lists. The 'notes' feature on the iPhone is excellent.

I have OCD - at least that was what I have been treated for for the last 7 years, but I got my autism diagnosis last week, so now I'm indeed beginning to think that at least some of the OCD symptoms may due to autism.

I have OCD in the form of intrusive thoughts mainly. Well, that is the only really troubling bit of it. But life has been extremely difficult at times because of this. Any compulsions I have are not linked to the thoughts these days (which would be a common OCD pattern)  and are not too troubling any more - things like sorting stuff and things being in the right place. Now I kind of veer from one extreme to another with tidyness - mainly chaos -  as I mentioned above.

Just sharing this in case anyone else is suffering from OCD too. It's trivialised in the media but it can be very dark. There is hope though and CBT did help me.

I'm surprised that nobody has mentioned OCD as a label for some of the behaviour mentioned. I also think that this is a different set of behaviours to Sgt Romeo's planning/prioritisation/executive function issues that she mentions in her original post. I identify strongly with those behaviours but am not OCD. Equally, though, when I watch Channel 4's Obsessive Ompulsive Cleaners it strikes me that some (but not all) of the subjects are probably autistic. 

There are a few things that I do have to have "just so" - but they are very specific.  For example, aside from a couple of clocks/timers, I have to know that every electric socket is turned off at night.  And will check several times over that I haven't left a gas ring on, and that all the doors are locked.  Anything not on my list of specific anxieties, I can very easily start neglecting if I'm not careful.

I've always been astounded between the two facets of my personality.

On the one hand, when I'm writing, either correspondence or computer code, I am obsessively fastidious.  It often takes me an hour or more to write a single forum post - I can't press the 'submit' button until it has been through endless iterations of editing. (and then, as soon as I've posted it, I notice the stupid schoolboy error that was staring me in the face the whole time!).  My computer code has to do a lot more than just work without bugs - it has to look exactly right too, and be commented in a very specific way.

On the other hand (he writes at 6pm with his dressing gown still on.)  I've been know to just throw my crockery out and buy some new rather than face the vileness of my kitchen at times.  And in two jobs now, I've been called aside for words about my personal hygiene.  I'm so oblivious sometimes that I think the person telling me has been much more embarrassed than I have - it takes a long time to sink in that I'm showing obvious signs of neglecting myself.  When I used to share my home, I was always the "slacker" that had to be nagged to pull my weight.

I really sympathise with the point about how making lists can become more of a hindrance than a help.  How small should I divide the tasks up?  What if I do this one first?  No, that one?  I could do those two at the same time, if only...

I understand in principle how it should help, but if you're a born procrastinator like I am, it can become a way of avoiding tasks rather than initiating them.  (I like the pick ten at random idea too - I will certainly try that!)

As for tips of my own.  Only one comes to mind.  To remind people whenever possible that you are not uncomfortable with hearing their constructive criticism, even though you understand that the subject would usually be taboo.  I have one friend in particular who knows to discreetly let me know if I'm starting to let my personal hygiene lapse - and he knows that I appreciate his feedback and his discretion.

I have had to accept that actually, yes, I do need nagging sometimes, and it is very often for my own good (Oh, if only my Mum could hear me now!).  I'm actually looking for some help at the moment from local autism services for exactly that - just someone to pop in for a visit now and then, to give me a prod if there are alien life-forms growing in my sink!

Wow, yes all of these Sgt Romeo! So much. I was diagnosed with autism just this week, but for a while now i had started to realise that things I thought I was just rubbish/lazy/useless at, might actually be a part of something bigger. I'm still wary of using ASD as an excuse of course, but it's helping my self esteem a lot to realise that I/we just genuienly find some/all of these things harder than others do.

Songwriter, the single dish dirty example resonates *so* much with me - during my assessments, when asked if I like to have things tidy and in order, I answered that it's either all or nothing - ideally, I'd like everything to be all in its place and in a good order... and indeed, when I was a child I managed this and would spend hours sorting things in my bedroom. But now that I'm an adult and a parent it's just tooooo much to keep it all like that... and when it starts to get a bit messy I just can't cope with keeping on top of it and it turns to chaos. It's just easier to live in the chaos sometimes than constantly maintain the energy required to keep it straight.

But yeah, my husband will be happy to do *just* the dishes and not clean the worktops, or *just* tidy things from the floor and not tidy the piles of things accumulating on the side... for me I just can't motivate myself to do only some of it, only all.

But the choosing ten things at random does sound like a good idea and I will definitely give it a go. I'll let you know the results!

*edit* sorry, just realised I didn't add any tips of my own - I'm afraid I don't have any yet but hope to learn some over time now that I know what the problem is

I am only just beginning to label myself as being on the spectrum (no formal diagnosis) but, whilst there are some things that I've always thought could link me to Asperger's, Executive Function Disorder is something that I have only discovered this week and is one of those things that seemed to slot into place with me.

Task initiation, definitely, assuming that there is any other mess around. If the house is completely clean and tidy and I use a plate then I can wash it. If there are other things lying around then I leave my plate, too. I cannot cope with cleaning it and feel overwhelmed because there is other mess around. I never linked this to any wonder about having Asperger's, but it's something that's always caused difficulty for my poor husband who is often left doing all of the housework because I can't cope and feel overwhelmed. And of course, for him, cleaning up is a gradual job - a bit at a time - so he rarely leaves the house entirely clean so that I can cope, which means that I don't cope, which means that he returns home to more mess. On the rare occasions that he manages a full clean and tidy of the house, I can maintain it until such time that he leaves something out again, then the system crumbles!

I don't have issues with planning/not making reservations though, as long as I don't have to phone! In fact, I need to plan everything down to the smallest detail, so I'm possibly the opposite of this.

Organisation I again don't have an issue with as I'm obsessed with keeping my things in their own place.

Flexibility is a real sticking point for me. I can't cope with routine or schedule changes very well, and also cannot handle if people ask me to do something 'on the day' (though I am improving out of necessity). I prefer to know at least 24 hours ahead of time if a friend wants to see me the next day. I can't do "Do you want to come over today?"

Working memory, perhaps. I write lists for everything, though. I couldn't go food shopping without a list, and I have to read through it constantly as I'm going around and recheck things in my trolley.

So far, other than writing lists which I have always done, the only coping mechanism I've found is the '10 things' mechanism which someone on here suggested. When trying to tackle the cleaning/tidying, pick up 10 random things and deal with them. I've always read about just getting on with it, or even 'breaking jobs down into individual tasks', but even that hasn't clicked with me enough to get anything done - what smaller tasks? which ones first? - whilst I've discovered that I am able to just grab any 10 things and deal with them. It's not going to get the job done, but it helps!

For flexibility, which is now essential in my life, I've learned to cope by waking each day assuming that I'm going to meet a friend already. I find that it's easier for me to adapt to having plans cancelled than having them made, so if I end up not meeting a friend then I can handle that. Far better than waking intending not to have plans, and then someone inviting me out!

[sorry if this post seems out of sync - the post immediately above arrived while I was procrastinating!]

Yes exactly right, recombinantsocks.  Being able to choose which battles to fight more wisely has been the most positive part of finding out my diagnosis.

I agree about the nature of employment too.  I was a bit of a victim of my own success at my last job.  I loved it when I started.  I was pretty much left alone to get on with working in the workshop building whatever orders came down for the day - mostly light engineering and stores work.  My 'promotion' up to the design shop was when it all starting going downhill.  I loved the actual work of dreaming up new products, but couldn't cope with the constant interaction and having to juggle multiple projects at the same time.  Now that I'm looking for work again, I know to try and find another "working with my hands" type of job, and not one where a lot of situational decision making skills are needed.

There is a an interesting article about EFD here http://www.additudemag.com/adhd/article/7051.html

Curiously, this talks about differentiating EFD from ADHD and Learning Difficulties but doesn't mention autism! Personally I find that a bit strange. I think it also suggests to me that a LD label might be given to someone who is actually suffering from a mental health issue which might be temporarily suppressing, or hiding, a persons ability to think straight when the person is examined.

Trogluddite said:

For autistic people, the 'sustained attention' and 'goal directed' areas can be a little different than described above (though not always).  Rather than our attention wandering too easily, we often display long periods of perseveration - an extreme kind of 'one track mind'.  For example, once I have engaged in a task, I cannot stand to be interrupted until I have finished - my focus is so on that single task that other thoughts are excluded and I can even lose awareness of my surroundings and physical discomfort.

In my case, I have certainly been able to sustain my concentration and focus at some points in my life but am aware that if I am stressed or anxious or under great pressure then it can all go to pieces. I think that someone who is aware of, and in control of, their autism and their environment can achieve great things. In modern life in modern organisations with open plan offices and relentless target setting then we don't perform so well.

It is very hard to work out what behaviour has which root cause but it is certainly a good thing to try and split out the different issues that we have to try and deal with them individually. If you can deal with one issue then move on to another area then you can potentially climb out of a hole that you have fallen into.

Most of those are certainly familiar to me too.  I was only diagnosed recently; but with hindsight, I can see how they've directly or indirecectly led to all sorts of problems with everything from jobs to simply making sure I feed myself.

I think recombinantsocks is correct that, formally, executive functioning impairments are classified as a category of traits rather than a disorder in their own right.  My understanding is that this is because those traits overlap a great deal with other diagnoses, such as autism and attention deficit impairments.

For autistic people, the 'sustained attention' and 'goal directed' areas can be a little different than described above (though not always).  Rather than our attention wandering too easily, we often display long periods of perseveration - an extreme kind of 'one track mind'.  For example, once I have engaged in a task, I cannot stand to be interrupted until I have finished - my focus is so on that single task that other thoughts are excluded and I can even lose awareness of my surroundings and physical discomfort.

I don't intend the previous comments to confirm or exclude any particular diagnosis, they're just examples of how diverse the traits can be within any of the 'spectrum' disorders like autism.

I'm only just beginning to learn to deal with these problems myself, but I am having a little success since I learned I am autistic.  The best tip I can give you is simply to always make a permanent record of what you need to do - lists, post-it pads, dictaphone recording; whatever works for you.  I find that this helps with the procrastination and poor working memory/  Even without looking back at my notes, the act of writing it down separates the "deciding" stage from the "doing" stage of the task - which I think is sometimes the very hardest kind of 'multi-tasking'.

Hi ROmeo,

I have suffered from all of those things. I bet most others on the forum will see these behaviours in themselves.

In my opinion they link to 

a) Stress - which follows from an autistic person living amongst non-autistic people. Stressed people do not perform efficiently or effectively.

b) Autism - leads to inexplicable behaviour like metacognition. We can't describe how we get to a conclusion because we have communication issues.

c) AD(H)D - 

All of these things impact executive function. I don't think this is a recognised diagnosable disorder is it?