Lack of Executive Functioning

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Executive functioning is the ability to understand the steps needed to do a process and then to actually do those steps in order without any aids(lists, reminders).

This includes things like being able to listen to someone give a list of things to do and actually do them in order.

I forget things. A lot of things. Like I will walk into the kitchen to prepare food, prepare the ingredients, put them in the oven, go into my bedroom, forget that I'm cooking, decide that I'm hungry, walk into the kitchen to prepare food, and realize that I was already preparing food. Or I might start preparing food and then go to bed and wake up with the smoke alarms going off.

Or I will start preparing to cook a meal and not check that I have all of the needed ingredients until I've actually gotten to the point when I need to add those ingredients(sometimes not even having the main ingredient).

Or I will go to a store to get one specific item, go into the store, find some other things I need, buy those things, forget the thing I needed, and then come home and realize that I forgot to get the one thing I needed.

Or I might realize that I need to do something in one room and I walk toward that room and then realize that I needed to do something back in the room I started in. I might walk partway, realize I need to go back, walk partway, realize I need to go back, and repeat(until I notice that I've turned around several times).

Executive function... probably my major problem at the moment. First thing to go when stress levels go up.

I have gotten past needing a list of steps to take a shower or clean a room; but not yet to do more complex things. I make lists for everything, pretty much. If I'm too overwhelmed, I can just get stuck, unable to figure out what to do, so I'll just stand there, or walk back and forth uselessly. Generally I can kick myself out of it after a few minutes, back up, and think about what I need to do. Worst comes to worst, I'll just go lie down somewhere until I'm thinking straight again.

Concerta increases my executive functioning... but that can be a problem because now I can push myself harder than ever before... and everybody else has started expecting more and more of me, because they think it is easy for me to keep up that level of effort. It seems like there is no in-between from thinking I am useless and expecting absolutely nothing of me, and expecting me to be absolutely brilliant and capable of everything.

it depends on what is meant by the term executive function since if we were all like the "textbook cases" of executive dysfunction, like those with lobotomies, (not just like those with add or asd) than we would not have normal to high iq's. i guess the definition of intelligence varies due to plasticity in the brain, yet most neuroscientists seem to agree that intelligence comes from the frontal and temporal lobes. someone with 0 executive function also has non asd traits, such as not understanding anything logical or abstract. for someone with a lesioned frontal lobe, the main problem is fluid intelligence (reasoning that requires resourcefullness and comprehension rather than just rote knowledge), while the main issue for us is coordination and social intimacy. someone with frontal lobe damage may have semi-normal kinesthetic skills but might be intellectually impaired. most of us are not intellectually impaired, in fact, many of us thrive in academic settings. i know a lot about diagnoses and disorders since many people in my family work in medicine.

Your explanation is fairly true, except for the fact it is not really possible to say someone has zero executive dysfunction as it is a very broad abstract concept and they would have no sense of self which that would be very difficult to prove, but they would otherwise present themselves as inanimate. Basically beyond a minimum it becomes impossible to test, it is pure estimation.

I do have cognitive impairment (call it intellectual if you like), it is not that obvious because good verbal skill mask such problem, but it is the bane of my life. There is some overlap of traits between people who have executive dysfunction caused by brain injury and those where it is purely developmental. They are not mutually exclusive.

Executive dysfunction term is flung around a lot. It is used in a buzz word in Psychiatry, with relation to things like ASD. However these aren't the people doing the measuring, so they often know little more than the bare bones concepts. Technically you could say that ASD and savants could come under the umbrella of executive dysfunction, as theoretically the executive is not working as expected. However with clinical executive dysfunction they are talking about measurable deficits which cut across many areas of functioning rather then being specific learning difficulties. Someone mentioned use of stimulants. Whilst you might expect some executive dysfunction with ADHD, it isn't the bit that can be treated by stimulants. As you frontal lobe isn't working properly, stimulant cannot fix this problem. I learnt that the hard way. With ADHD the neurotransmitters are getting hoovered up before they can pass the messages on, that is why stimulant may help in the short term.

If you have clinical executive dysfunction, writing lists don't help you much to be honest. Not as a sustainable long term strategy. You need a minimal of executive to do any task in a reasonable time including the interventions.

you sound more inciteful than that. it is possible that some people with executive problems could have one core problem that affects everything else, yet the nature is different from someone who has no function in that area, such as someone with no conciousness.

Some people seem to use executive dysfunction as meaning any and every skill required to get things done.

I have trouble getting things done but it seems to come from mostly two sources.

1. The stuff that's been called movement differences by Martha Leary etc., although they use movement to mean far more than physical movement. This page (link) has information about it. The abbreviated description is, Marked difficulties in Starting, Stopping, Executing, Continuing, Combining, Switching... may affect Postures, Actions, Speech, Thoughts, Perceptions, Emotions, Memories.

For me it means that unless triggered in just the right way, none of those things happen. That gap has gotten broader with time and got me diagnosed with an autism-related parkinsonlike movement disorder. And it means I get stuck a lot.

2. There is no handy list for this one. My perceptions of the world around me are as if the world is a lot of raw sensations. It takes effort to get out of this. In addition, my perceptions can get fragmented in other ways. I deal with this by learning patterns of sensations, deal with words the same way. It is really difficult for me to simulate the kind of thinking that relies on categories and abstract towers in the air.

All of which affects my ability to plan and my ability to understand enough of what's around me to keep up with whatever I'm doing. I totally understand an autistic person who said they could lose a broom while in the process of using it.

Because of these things, my attempts at cleaning the house involved a lot of stillness or barely inching forward and finding and losing my body parts over and over. And also a lot of walking or running in various patterns around the house without being able to stop or control direction or speed. Meanwhile perceiving mostly a lot of fragments visually, not fully feeling my body, etc. And every time I stopped to concentrate on one thing I would forget anything else. If I did get something in my hand I would automatically use it, like opening and shutting doors. And nothing much would get done even with hours of effort.

Some people would call that executive dysfunction but I am not sure I would. Just because it keeps you from getting things done doesn't mean it's all the same thing. I did have people wondering if I had a frontal lobe syndrome for awhile (and contrary to what some have said here there are many such syndromes where even when they are severe the person can act normal). But I wasn't told much, I just overheard people talking. So I don't know which one or why.

OMG, that sounds so like me! I would otherwise enjoy cooking (baking is okay because generally there's a ready-made list with measurements etc but cooking is difficult for me), if it weren't for these things. And going into a room and not being able to remember why I went in there, or remembering last-minute that there is something I forgot in the other room. I make lists for the store, but they don't do much good when I lose them!! ! Vyvanse (treating my ADHD) helps some but it's still there. And yet, my IQ is totally unaffected...

~Kate

Matt, me too.

In a class I took recently on the effects of brain damage, I learned that patients wiu damaged frontal lobes actually have normal abstract reasoning ability and perform normally on an IQ test. They also talk normally unless the damage specifically affects Broca's area. What is affected is planning, thinking about the future, socially appropriate emotions, and social skills. (hmm...sound familiar to anyone?). I believe Antonio Damasio has written a lot about this...

planning and thinking about the future are also slightly vague since, in order to plan ahead, one needs to have a minimum of awareness of what is going on, or actions are taken out of context. i do not know about the rest of you, but as hypervigilant as i am to compensate for deficient processing, which results a lot from difficulty processing simultaneous information, i still cannot seem to be able to collect enough information and then generalize from it in order to understand what the future brings, so that i could act upon that information.

because each moment for me brings with it tremendous difficulty collecting information and pulling it all together, i tend to be extremely tentative in my actions for fear of screwing up. i think the fact that i tend to be unresponsive is one reason why people have sometimes thought that i was intoxicated or on drugs, even though i have never touched those things in my life.

i do not know whether active attention is classified as an executive function, but staying "in tune" is such an issue for me that i often do not see people waving to me. my cluelessness also affects my organization since, for example, if one of my professors makes an important announcement in class without writing it down, i will never pick up on it, and then i'm screwed. i am often also screamed at by other people since it is typical of me to be focusing on something that is not socially relevant, while missing out on things, like someone i am working with on a team project needing help (this is why i do not like team projects).

this drains energy, since unlike organizing and planning, these difficulties are not task specific. they mostly result from the way i think, which means it is impossible to make improvement.

yet, i do not find it hard to plan and organize things. i think this is one of the differences between executive dysfunction in asd and executive dysfunction in adhd. people with adhd are often more "with it" than spectrumites, yet they are disorganized. autistic people are often described as being very "out of sync". what i mean by "out of sync" is not "out of touch with reality" since we are able to test reality, even though we often appear "out of touch with reality" to others. it is possible that i am only speaking for myself, since i have atypical autism rather than a.s.

Sound? I already told you about verbal intelligence can mask deficits

There are countless hypotheses.

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Is there a memory aspect to executive functioning? Yes.

Are analogies which compare human memory to memory chips on a desk computer valid in many ways? Yes.

Working memory/short-term memory, medium-term memory, long-term memory.

Is the memory more of a picture (motion picture) or a sound (a conversation, a sound) or both, etc.?

What you describe it seems to me is more complex than only just the frontal lobe.

When you say you have a very, very hard time processing info through your ears, that hints at possible temporal lobe involvement.

http://www.nidcd.nih.gov/health/voice/auditory.html

http://en.wikipedia.org/wiki/Neuroanatomy_of_memory
http://en.wikipedia.org/wiki/Music_and_the_brain

As soon as you start to talk, often times you have no idea what you're even saying...

http://www.ninds.nih.gov/disorders/aphasia/aphasia.htm

http://www.sportsconcussions.org/

http://www.waiting.com/glossarya.html (Paying Attention)
http://www.waiting.com/glossarym.html (Memory)

http://en.wikipedia.org/wiki/Human_brain

http://www.redreef.com/ (Brain sciences)
http://www.sfn.org/

http://en.wikipedia.org/wiki/Executive_functions

http://www.daytimer.com/birk/
http://www.daytimer.com/

Other

Yes. This describes me. What is worse is, where I am living has no garbage collection. So it is pointless to put it in a bin. they burn rubbish, but I dont think it is a good idea to burn plastic wrappers.

I am planning on getting it all in a bag and taking it in my car to a refuse centre in town.

But anyway, that hasn happened yet as I have poured all my energy into the work I have been doing, there is pretty much none left over for coolking and cleaning. I feel so mentally exhausted by the end of the day that all I want is to lie in front of my DVDs.

This is probably the difficult thing I have to deal with also.

I've worked on advanced degrees and being responsible for small businesses but can never quite put things together the way they need to be. Heck, I have a difficult enough keeping up a simple checkbook. It makes me feel so inadequate. I can come up with the big ideas, but can't sift through the details needed to implement them. So frustrating.

ADHD drugs are a no go for me. Strattera did nothing for me. And stimulants have nasty side effects of disorientation, confusion, and detachment for me. Has anyone had any of those problems?