<p>Can someone explain in very basic terms what exactly "executive functioning" means? I keep coming across this term and don't quite understand it.</p>
<p>Certainly. If you think of an executive in a company, it’s the skills they need in order to be successful. The skills include planning (e.g. what needs to be done tomorrow to meet a deadline on Friday), organizing (e.g. in order to have a meeting in two weeks with 25 people, what needs to be done), and sequencing (e.g. first you do this, then you do that). In high school and college, it impacts long-term assignments and multi-step and multi-component projects and work.</p>
<p>It also involves what is called “working memory” which is holding current information in your mind and being able to manipulate it as other information comes in to the mix. Also, it involves speech – when telling a story or relating a complex situation, being able to organize and convey the information in a logical way.</p>
<p>Executive function deficits are very common with children, adolescents, and adults with autism spectrum disorders (including Asperger’s Syndrome) and ADD. There are strategies that can be taught/learned to help strengthen these areas of need. Recognizing that these are areas of need is the first step. If you need more information, feel free to contact me privately. Hope this helps.</p>
<p>Ok, so how does one go about learning these better?</p>
<p>I brought this up with my psychiatrist today. (I go in for ADHD.) I explained in more detail things I couldn’t figure out how to explain in the past. Apparently not only do I have ADHD, but I have a minor anxiety condition (I’ve kind of always known this. But we just thought it was tied into the ADHD.). I’m starting a very low dose of a medication that should help by bumping up my serotonin. But what can I do to learn habits to increase my ability in executive functioning?</p>
<p>My whole issue is that I have an extremely difficult task doing little things. My best example of this is sometimes I’ll eat in my room and leave the dishes there. Sure, in the beginning not bringing them to the kitchen could just be procrastination. Mostly I eat at night when everyone is asleep and we often have someone sleeping on the couch so putting it away after their asleep isn’t an option. Well, every day it’ll sit in my room in plain site. It will start to mold. And even though I know there’s mold there. Even though all I’d have to do is walk down the hall and around the corner to the kitchen with it to take care of it, doing something like that is <em>extremely</em> difficult for me. This same concept carries over to taking out the trash, cleaning the bathroom, doing homework, mowing the lawn I’m being paid to mow, and so on. To most people it sounds crazy and like I just need to discipline myself better, but I promise I’m working really hard. I just can’t get past those simple things at all. Along with this, I often forget things. I have to leave my shoes outside beside the front door or I’ll lose them in the house. I have to set my keys behind the bathroom sink every day or else I’ll lose them. I have little tricks for those forgetful things but some things aren’t that easy. (Taking medicine on breaks… ya… That’s an interesting experience. During a school day I know to take it as part of getting ready but without that structure I’m screwed.) </p>
<p>I explained all of this and more to my doctor today and he has a very low dose of a medication he wants me to try–which I feel fine with. (Normally I’m apprehensive, but my doctor is great about not pushing meds and working with me and answering my hundreds of questions, versus other psychiatrists I’ve tried.). </p>
<p>But what can I do to work on this and other “executive functions”? Should I see an ADHD counselor or are there skills at home or any reading I can do on my own?</p>
<p>A psychologist I talked with said it takes time to “retrain” and “relearn” habits. For instance - people who are considered masters at something likely spent 10,000 hours doing it.</p>
<p>We took care of a relative about your age who was suffering from this problem so I can try to suggest strategies the doctors provided:</p>
<p>Treat it like a chronic disability. One of the problems with executive functioning is “processor” speed. The brain may not be “storing” all the information coming at you. And what is stored takes longer to retrieve. So to help the process you have to slow down a bit and concentrate to absorb information. So in class, for instance, if it’s hard to write note and listen to a lecture, tape the lecture so you can listen to them later and “store” the information at a more relaxed pace.</p>
<p>Checklists help. That way each day you have written notes as a reminder of what tasks you wanted to perform and what appointments you have. Create color coded calendars on your computer and make sure all major functions are programmed with alarms on both that and your phone. Then you can concentrate on tasks without having to try to “remember” and “retrieve” data that might not have been stored in your brain.</p>
<p>Limit the number of tasks that are deadline oriented and then slowly rebuild the volume as you adapt and improve.</p>
<p>Did your doctor run tests? There are tests for ADHD and ADD but also for executive functioning so you can pinpoint where you’re doing well and where the trouble spots are. Testing takes about 4 hours if its comprehensive. And it will make you feel better that the problem is not insurmountable. If all fails, try a specialist in brain injury to see if they can run the test or recommend someone who can (not because your brain is injured but because they know how to do the testing). Some can be found in hospital rehabilitation clinics.</p>
<p>Then remember - repetition and putting in enough hours over time is the key to improvement. So don’t take it all on at once. Just start with a routine or behavior you know needs to change (taking the dishes out of your room each day) then each week add one more thing to your list of “routines” you want to master. It will get better. Trust me, we’ve lived through it. And what doesn’t return to full “normal” at least gets to the point where you will feel less frustrated about life.</p>
<p>In my relatives situation, “rehab” also included development of social awareness to increase their ability to relate to classmates in college (conversation, listening, processing information, impulsiveness, etc.) By the way - you’d be surprised how many people diagnosed with executive functioning problems actually have really high IQ’s. I suspect a lot of the world’s geniuses are undiagnosed. We just call them “eccentric” or "reclusive’.</p>
<p>So time - grasshopper. </p>
<p>Good luck.</p>