Executive Function and Executive Function Disorder

What Is Executive Function?

Executive functioning skills help you get things done. These skills are controlled by an area of the brain called the frontal lobe.

Executive function helps you:

  • Manage time
  • Pay attention
  • Switch focus
  • Plan and organize
  • Remember details
  • Avoid saying or doing the wrong thing
  • Do things based on your experience
  • Multitask

When executive function isn’t working as it should, your behavior is less controlled. This can affect your ability to:

  • Work or go to school
  • Do things independently
  • Maintain relationships

Types of Executive Function

Executive function can be divided into two groups:

  • Organization: Gathering information and structuring it for evaluation
  • Regulation: Taking stock of your surroundings and changing behavior in response to it

For example, seeing a piece of chocolate cake on a dessert cart at a restaurant may be tempting. That's where executive function can step in. The organizational part reminds you that the slice is likely to have hundreds of calories. Regulation tells you that eating the cake conflicts with goals you may have, like eating less sugar or losing weight.

What Is Executive Function Disorder (Executive Dysfunction)?

Many ADHD symptoms are problems with executive function. ADHD is a condition that your doctor can diagnose, and while you may hear him use the term executive function disorder, it isn’t a true medical condition. It’s a weakness in your brain’s self-management system, particularly skills that help you:

  • Pay attention
  • Remember things
  • Organize tasks
  • Manage time
  • Think creatively

What Causes Executive Function Problems?

Some people are born with weak executive function. People with ADHD, depression, or learning disabilities often have problems with these skills. An injury to the front of the brain can harm your ability to stay on task. Damage from Alzheimer's disease or strokes may also cause problems.

Experts rely on different tests to measure specific skills related to executive function. Problems seen on these tests can't predict how well adults or children will do in real life. Sometimes, watching them and trying different things are better ways to improve weak executive function.

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How Do I Know if My Child Has Problems With Executive Function?

Warning signs that a child may have problems with executive function include problems with:

  • Planning projects
  • Estimating how much time a project will take to complete
  • Telling stories (verbally or in writing)
  • Memorizing
  • Starting activities or tasks
  • Shifting plans when situations change
  • Focusing only on one task
  • Shutting down when parents or peers don’t act as expected

How Are Executive Function Problems Diagnosed?

Because executive function problems aren’t recognized as an official illness, there isn’t a set of criteria you can use to diagnose someone. But there are tests to gauge how well your executive function works. These include:

  • Barkley Deficits in Executive Functioning Scale (BDEFS): This tool helps screen for problems with executive function tasks like organization, self-restraint, motivation, emotional control, and time management. It can provide information on how the person acts over a period of time, too, as opposed to other tests, which only provide in-the-moment information.
  • Comprehensive Executive Function Inventory (CEFI): This scale measures executive function strengths and weaknesses in kids from 5 to 18. Parents, teachers, and kids ages 12-18 can take part in the evaluation
  • Conners 3-Parent Rating Scale: This measures behavior in kids ages 6-18. It helps identify learning problems in specific subjects, like reading, spelling, math and also in terms of broader concepts like memory. Parents, teachers, and kids themselves can contribute.

How to Manage Executive Function Problems

Here are some tips from the National Center for Learning Disabilities:

  • Take a step-by-step approach to work.
  • Rely on visual aids to get organized.
  • Use tools like time organizers, computers, or watches with alarms.
  • Make schedules, and look at them several times a day.
  • Ask for written and oral instructions whenever possible.
  • Plan for transition times and shifts in activities.

To improve time management:

  • Create checklists, and estimate how long each task will take.
  • Break long assignments into chunks, and assign time frames for completing each one.
  • Use calendars to keep track of long-term assignments, due dates, chores, and activities.
  • Write the due date on the top of each assignment.

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To better manage space and keep things from getting lost:

  • Have separate work areas with complete sets of supplies for different activities.
  • Organize the workspace.
  • Cut clutter.
  • Schedule a weekly time to clean and organize the workspace.

To improve work habits:

  • Make a checklist for getting through assignments. For example, a student's checklist could include such items as: get out pencil and paper; put name on paper; put due date on paper; read directions; etc.
  • Meet with a teacher or supervisor on a regular basis to review work and troubleshoot problems.
  • There are also executive function coaches or tutors who can help you sharpen the way you plan and carry out tasks.

WebMD Medical Reference Reviewed by Smitha Bhandari, MD on March 25, 2019

Sources

SOURCES:

National Center for Learning Disabilities: "What is Executive Function?"

Chan, R. Archives of Clinical Neuropsychology, 2008.

Elliot, R. British Medical Bulletin, 2003.

University of California, San Francisco: "Brain 101: Topics in Neuroscience: Executive Functions."

Understood: “The Difference Between ADHD and Executive Functioning Issues.”

Journal of the Canadian Academy of Child and Adolescent Psychiatry: “A Review of Executive Function Deficits and Pharmacological Management in Children and Adolescents.”

Journal of the International Neuropsychological Society: “Executive Function in Children with Attention Deficit/Hyperactivity Disorder: the NIH EXAMINER battery.

Journal of Psychoeducational Assessment: “Test Review: Barkley Deficits in Executive Functioning Scale (BDEFS).”

Canadian Journal of School Psychology: “Test Review: Comprehensive Executive Function Inventory by J. A. Naglieri and S. Goldstein.”

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