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Asperger's and Problems with Executive Function


People with Asperger’s and High Functioning Autism (HFA) often face challenges related to their ability to interpret certain social cues and skills. They may have difficulty processing large amounts of information and relating to others. One core term relating to these challenges is “executive functioning.” Executive function refers to a set of mental skills that are coordinated in the brain's frontal lobe. It includes the ability to curb inappropriate speech or behavior, integrate past experience with present action, manage time and attention, plan and organize, remember details, and switch focus. 

When executive function breaks down, behavior becomes poorly controlled. This can affect the individual's ability to function independently, maintain appropriate social relationships, work, and academic pursuits.

Executive function can be divided into two categories: (1) regulation, which involves taking stock of the environment and changing behavior in response to it, and (2) organization, which involves gathering information and structuring it for evaluation.

Research has identified a number of specific executive functions, which include the following:
  • ABSTRACT THINKING: Being able to understand non-literal language (e.g., sarcasm, jokes, and metaphors) and non-verbal communication (e.g., the way we get our message across apart from the words we use, tone of voice, body language, facial gestures, etc.).
  • EMOTIONAL CONTROL: The ability to control escalating emotions in order to complete a task and keep emotions to a level that is appropriate.
  • INHIBITION: The ability to “contain” the desire to do something in order to stay on task until it is finished (e.g., staying focused long enough to complete a task, thinking through problem solving, staying on a topic and avoiding going off on tangents when telling a story, etc.).
  • INITIATING: Getting started on a task (e.g., knowing where to start and what to do next, writing tasks, etc.).
  • MULTITASKING: The ability to carry out more than one cognitive process at a time (e.g., being able to perform a task while talking).
  • PLANNING AND ORGANIZING: The ability to plan and organize time, information and procedures efficiently (e.g., carrying out instructions accurately, completing tasks on time and correctly, etc.).
  • SELF-MONITORING: Being mindful, recognizing when a change is needed, and noticing when an error occurs (e.g., staying on a topic when talking, noticing changes of topics in groups, answering questions accurately, noticing when you have made a mistake, being relatively accurate in your judgment of your own and others’ behavior).
  • SHIFTING FOCUS: The ability to shift attention if something changes (e.g., being able to change how something is being done when asked, being able to see multiple possible solutions to a problem, etc.).
  • WORKING MEMORY: The ability to hold onto information in order to process it (e.g., being able to identify the main point, take all information into account, tell a cohesive story in a logical sequence, reading comprehension, and following instructions).

Warning signs that you may be having difficulty with executive function include: (a) trouble in estimating how much time a project will take to complete, (b) initiating activities or tasks, (c) memorizing information, (d) planning projects, (e) retaining information while doing something with it (e.g., remembering a phone number while dialing), and (f) telling stories (verbally or in writing).

Executive function involves a set of interrelated skills. Thus, there's no single test to identify a problem. Instead, therapists rely on different tests to measure specific skills. Problems identified by individual tests can't predict how well people will function in complex, real-world situations. Sometimes, careful observation and trial teaching are more valuable ways of identifying and improving weak executive function.

Adults with Asperger’s and HFA often show impairment in three main areas of executive functioning:
  1. Flexibility: Poor mental flexibility is characterized by perseverative, stereotyped behavior, and deficits in both the regulation and modulation of motor acts. Some research has suggested that people with Asperger’s experience a sort of “stuck-in-set” perseveration that is specific to the disorder, rather than a more global perseveration tendency. These deficits have been exhibited in cross-cultural samples and have been shown to persist over time.
  2. Fluency: Fluency refers to the ability to generate novel ideas and responses. Although grown-ups on the autism spectrum are largely under-represented in this area of research, findings have suggested that kids on the spectrum generate fewer novel words and ideas and produce less complex responses than matched controls.
  3. Planning: Planning refers to a complex, dynamic process in which a sequence of planned actions must be developed, monitored, re-evaluated and updated. Adults on the spectrum demonstrate impairment on tasks requiring planning abilities relative to typically functioning controls, with this impairment maintained over time.

Generally speaking, adults with Asperger’s and HFA show relatively enhanced performance on tasks that do not require “mentalizing” (e.g., use of desire and emotion words, sequencing behavioral pictures, the recognition of basic facial emotional expressions, etc.). In contrast, these adults typically demonstrate impaired performance on tasks that do require mentalizing (e.g., false beliefs, use of belief and idea words, sequencing mentalistic pictures, recognizing complex emotions, etc.).

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5 comments:

  1. My 14 yr old needs help with this. How can I get him help? We are in NYC.

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  2. part of the reason that i think i 'talk too long' as an Aspie, is *partly* that i don't want to 'derail' the topic i'm discussing into my executive function oblivion, since once the other person is in the discussion i forget what i meant to say...

    ReplyDelete
  3. If a teenage Aspie needs help with this, what kind of specialist do you suggest? (Psychologist? LSW? ABA therapist? Other ideas?) Does it necessarily need to be someone who understands ASD, or simply someone who works with teens on executive function?

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  4. I'm struggling to understand the last paragraph. Maybe it's too early in my day and I need more coffee? But I'm an Aspie and overall this article does describe some of my struggles. As a supervisor I'm "successful" in life, but we're driven by policy and protocols and rarely do I have to drip more than adapt. I'm bad at planning and initiating even tasks I want to do, beyond the daily routine. Work can be very stressful yet it usually gives me structure and routine which I also need.

    ReplyDelete
    Replies
    1. I re-read that last paragraph a few times and gave up. Anyone want to give us a re-write? The rest of the article helps me not feel so bad about myself.

      Delete

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