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ASD and Problems with Executive Function


People with ASD [High Functioning Autism] 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).

==> Living With Aspergers: Help for Couples

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 ASD 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 ASD 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.).

Resources for Neurodiverse Couples:

 ==> Cassandra Syndrome Recovery for NT Wives

==> Online Group Therapy for Men with ASD

==> Online Group Therapy for NT Wives

==> Living With Aspergers: Help for Couples 

==> One-on-One Counseling for Struggling Individuals & Couples Affected by Asperger's and High-Functioning Autism  

==> Online Group Therapy for Couples and Individuals Affected by Autism Spectrum Disorder


Comment:

Yes. I was scrolling down for a reply to state that one cannot talk about EF issues in this population without also discussing the same symptoms on ADHD. Based on EF symptoms alone, is there any particular symptom that can distinguish between ASD and ADHD? It’s okay if there isn’t; they obviously share genes, and so some expressions could manifest similarly, but I found it helpful to see a distinction between social issues experienced by autists (developmental issue with no self awareness of social errors) and ADHDers (better understanding of rules but difficulty controlling impulses, feeling bad about screwing a social interaction and trying to make a repair). Something like that would be useful here.

Of course, where it gets really confusing is when someone can identify with both (doing okay socially in some respects, like finding a way to be interested enough to get to know a person that you can conjure up questions to ask them as a way of continuing the conversation instead of monologue get, albeit with effort, but still hate small talk and fakeness, be blunt, only come to life when a pet topic comes up, and so on. Like, some sort of strange hybrid where you can be aware that you might have run afoul of a social rule, even if only because you have learned to recognize a particular response as negative, and know that a repair is required, but then dig yourself a deeper hole with a clueless repair. If your energy is good, you may even feel proficient in conversation and feel like it went well, only to wonder why those people have ghosted you later.

It’s maddening not to be able to tease this out and, even if it is comorbid, all the more maddening because it would seem to complicate improving at this. I suppose if ADHD meds are successful, then this might improve those aspects of social issues, leaving more apparent that which is more directly a result of ASD.

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