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Autism

7 Executive Functioning Challenges for People With Autism

Executive functioning issues are common and problematic for autistic people.

Key points

  • Executive functioning is necessary for planning, decision-making, impulse control, and emotional regulation.
  • People with autism often have problems with executive functioning.
  • This can cause problems with communication, follow through, planning, self-care, and rigid thinking.

As humans, much of what we do happens without any conscious thought. We don’t need to think about breathing, for instance, and we’ll automatically take our hand away from burning heat.

For the rest of our daily responsibilities, we rely heavily on what is called “executive function” (EF). We need to have the ability to plan, set and meet goals, refer back to previous experiences, complete tasks, and manage our emotions. For this, we rely primarily on the front part of our brain (the prefrontal cortex). Life is increasingly complex, and EF allows us to meet these complexities by drawing on what we already know about the world, making links, and controlling our impulses. EF keeps us at our desk working when we’ve got a tight deadline to meet instead of taking the day off to lie in bed with a supply of coffee and biscuits. It’s a bit like having an effective boss keeping things in control.

But many children, adolescents, and adults with autism have issues with EF.1 No matter how good their memories may be for things like facts and details, and no matter how clever they may be, they may have difficulties with day-to-day living and emotional regulation. Having high-functioning (or level 1) autism doesn’t mitigate these difficulties—and while many people can handle complex and difficult information and careers, they may face considerable difficulties managing the more basic, but essential, aspects of life.

Renata Adrienn, Unsplash
Source: Renata Adrienn, Unsplash

Understanding Executive Function

EF is usually broken down into the following categories:

1. Working memory

Working memory refers to a person’s capacity to hold onto a limited amount of information in their mind so that it is ready for immediate use. Working memory can be thought of like a sticky note: the information is available and accessible when you need it—for instance, while you’re in the middle of a task. During conversations, working memory is what allows you to store information until you're ready to talk. Working memory also helps the brain store information for long-term memory.

2. Cognitive flexibility

This refers to a person’s ability to switch between separate concepts and think about something in more than one way. If you were in a group of people, for example, and suddenly the conversation shifted from talking about holidays to talking about dogs, your level of cognitive flexibility would determine how rapidly, and how well, you would respond to this shift.

Cognitive flexibility also refers to the capacity to update beliefs and respond to new situations, to be aware of a variety of choices, and to deconstruct bigger thoughts into smaller chunks. Difficulties with cognitive flexibility can cause rigid thinking, make it hard for people to switch tasks, and cause problems when it comes to making bigger life changes.

3. Inhibitory control

Inhibitory control refers to the ability to ignore distractions and to control our attention. It refers to the ability to suppress impulses and, for instance, could refer to the ability to delay a behaviour in order to benefit from doing so. A lack of inhibitory control can cause us to act in automatic but inappropriate ways and to lack the ability to come up with well-considered responses.

Executive Function and Autism

Some of the ways in which EF issues affect people with autism include:

1. Communication

EF can contribute to communication issues, particularly if someone finds it challenging to hold information during a conversation. Communication can also be affected by a lack of inhibitory control and a tendency to say inappropriate things.

2. Planning

Devising a plan can be difficult for people with autism; they can become easily overwhelmed and struggle to see how they can carry out what needs to be done in a manageable way. They may face difficulties with organising the tasks required to meet a bigger goal.

3. Daily tasks

Working memory is required for daily tasks, such as getting up, getting dressed, making breakfast, and doing housework. While many people with autism have incredible memories for facts, carrying out the types of activities that rely on working memory can pose a significant challenge.

4. Impulse control

Poor impulse control can lead to unhealthy or self-destructive behaviours. For instance, a lack of impulse control may contribute to someone with autism staying up all night researching their new hobby.

5. Attention

People with autism often have a great ability to focus, but they may experience difficulties in directing their focus in an appropriate way. If they have sensory issues, for example, their focus might be directed towards the ticking of a clock or the intensity of overhead lighting, while they cannot direct their attention to someone speaking to them or other more important information.

6. Verbal reasoning

People with autism may struggle to understand and process verbal concepts.

7. Rigid thinking

It can be difficult for people with autism to change their way of thinking. This may make it hard for them to adapt to new situations and can cause them to have rigid, unchangeable opinions.

How People with Autism Can Cope

All of the above EF issues can make it extremely difficult for people with autism, no matter where they are on the spectrum, to cope with life. But both children and adults can develop strategies to help with executive function—including, for example, creating “to-do” lists and breaking down larger tasks into manageable steps, sometimes in a visual or flowchart manner. Putting systems into place and having routines can be useful so that tasks aren’t left until the last minute to be dealt with at a stage when the situation feels overwhelming.

One of my clients reported that she consistently couldn’t face making breakfast, which left her feeling drained and anxious. By preparing breakfast in advance, she noticed a huge improvement in her day. Seemingly simple, proactive, and routine steps can create huge changes when it comes to EF. Seeking out the right support, therapy, and acknowledging that some regular tasks, no matter how “simple” they might seem, are simply more difficult for you can help improve your quality of life.

References

1. C. Hughes, J. Russell, and T. W. Robbins, “Evidence for executive dysfunction in autism,” Neuropsychologia, vol. 32, no. 4, pp. 477–492, 1994

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