Executive Dysfunction

individual suffering executive dysfunction fell asleep on his laptop after exhausting day at office
Young Asian businessman suffering executive dysfunction who worked late and fell asleep on laptop computer in the office.

Executive Dysfunction

Do you know someone who has a challenging time making decisions? Maybe they can’t manage their time or their emotions well. They may be easily distracted. Do you work with someone who has trouble organizing the things they need to do?

You may have a member of your family or someone you work with who can’t seem to finish the task they started or even organize the task at all. It can be very frustrating to live with or work with someone who’s suffering from this type of executive dysfunction.

What causes this type of disability? Why do some people suffer from these types of cognitive and emotional difficulties? Many of these types of personal struggles fall under the umbrella of executive dysfunction. 

Read on to learn more about executive function and dysfunction and learn how to recognize the warning signs there’s an issue.

What Is Executive Function?

In order to better understand the concept of executive dysfunction, let’s first have a good grasp on the idea of executive function. 

The frontal brain lobes help to control your executive function. Executive functions are those things that help you to get things done. 

Your executive function includes the skills that allow you to remember information, pay attention to things, and multitask. These skills begin to form during the toddler years, often as early as age 2, and will continue to develop to around age 30. 

As a person develops these skills they help them to:

  • Organize
  • Plan
  • Pay attention to details that matter
  • Strategize
  • Practice time management

Those who study executive function believe there are three core areas of executive function. These areas are working memory, cognitive flexibility, and inhibition including self-control. Other executive functions include problem-solving, reasoning, and cognitive planning. 

In real life, executive function shows up when you choose not to eat the chocolate cake you love because you also know about its calories.

It is turning off the video game or movie because you brought work home from the office that needs to get done. It is following the directions you get in life from others and also making a plan and sticking to it. 

What Is Executive Dysfunction?

Once you understand the executive function and see the word dysfunction, you can start to imagine how executive dysfunction works, or doesn’t work for some people. 

Executive dysfunction is the range of cognitive, behavioral, and emotional difficulties a person faces as they go about their life. Once you understand the executive function, you can see how those with executive dysfunction will struggle with planning, problem-solving, organization, and time management.

Executive dysfunction can show up in both children and adults for a variety of reasons. 

When a person is struggling with executive dysfunction, they have trouble sticking to a plan, making plans, and organizing. Executive dysfunction means the person is likely going to struggle with regulating their emotions. These are people who regularly misplace items and have a hard time following a schedule or seeing a task through to completion.

Signs and Symptoms of Executive Dysfunction

For many adults, getting forgetful or having trouble paying attention to things seems like a natural course of aging and well, being an adult. 

You might go from one room to another and not remember what you wanted to get. You might forget what you needed at the grocery store or even what you hoped to make. 

Does that mean you have executive dysfunction issues? Maybe, or maybe not. 

The signs and symptoms of executive dysfunction would be a part of a bigger pattern. They’d likely be connected to another disability or an injury like a traumatic brain injury. 

They also wouldn’t be one time, here or there. You’d see the signs as a pattern over time. 

Here are some signs you should watch for that might indicate executive dysfunction:

  • Difficulty managing emotions 
  • Difficulty dealing with frustrations
  • Getting distracted during conversations or meetings
  • Forgetting to perform tasks that have been automatic 
  • Memory loss, greater than just being forgetful
  • Tasks make you feel overwhelmed
  • Inability to solve problems
  • Struggling with following directions

Many adults who struggle with executive dysfunction have a hard time organizing their day-to-day life and will struggle with time management. 

What Causes Executive Dysfunction?

So, are you born without the ability to grasp those executive functions? Or is there an event or medical diagnosis that triggers the executive dysfunction?

Many people will have other medical conditions that cause executive dysfunction for them. Some of the most common causes associated with executive dysfunction include:

  • Depression 
  • Obsessive-compulsive disorder or OCD
  • Conduct disorder
  • Disorders associated with fetal alcohol disorders
  • Learning disabilities
  • Autism
  • Alzheimer disease
  • Schizophrenia
  • Addiction to drugs or alcohol
  • Chronic sleep deprivation
  • ADHD (more later)

If a person suffers a traumatic brain injury, very often this causes executive dysfunction problems for them. This is especially true if their TBI was centered on those frontal lobes that control executive function. 

There have also been some studies in the medical field that indicate a problem with executive dysfunction could be hereditary and passed from one generation to the next. 

Executive Dysfunction and ADHD

Attention deficit hyperactivity disorder or ADHD is a biological disorder. When a person has ADHD they have a developmental impairment of their executive function. 

People who have ADHD will struggle with different executive functions in a variety of ways. Yet, not everyone who has executive dysfunction will have ADHD.

There are certain functions that more predominantly show up for those with ADHD. The executive function is broken into six areas which include:

  • Focus or the sustaining and shifting attention to a task as needed
  • Effort or the ability to regulate, sustain motivation, and process information
  • Activation to organize tasks or materials, estimate time, and get started on a task
  • Manage frustrating feelings
  • Use memory and active recall
  • Regulating physical activity

It’s important for people to remember, especially those who are around people with ADHD, that the person knows what to do. They can recognize the need but can’t execute it to get done.

Developing Executive Functions and the Brain

 It’s important to remember that the development of executive functions starts at a very young age and will continue over many, many years to build in a person. Scientists don’t believe you are automatically born with executive functions, but instead, need to learn them.

It’s also worth noting that executive function skills are often sequential and will build on each other. Much like a toddler needs to learn to walk before they can run, the same is true for executive functions. Maybe first they develop memory, then work on using their stored knowledge to execute a plan.

Executive functions are interactive with each other and will impact how a person regulates their behavior based on these interactions. While the back of a person’s brain stores information they’ve learned already. The front of the brain takes what they’ve learned and uses it to execute executive functions.

In essence, there are circuits in the brain communicating with each other. When a person has executive dysfunction problems, often those circuits aren’t working properly.

Diagnosing Executive Dysfunction

Executive dysfunction isn’t diagnosed as a stand-alone illness or impairment. Instead, it’s often a side effect of something else happening in the brain. 

This means that diagnosing executive dysfunction isn’t always straightforward. There might be all the signs and symptoms demonstrating executive dysfunction problems. Yet, the question becomes what is triggering the executive dysfunction?

There are several tests that are used for diagnostic purposes that tell how well a person’s executive functioning is working. These tests include:

  • Barkley Deficits in Executive Functioning Scale (BDEFS)
  • Comprehensive Executive Function Inventory (CEFI)
  • Conners 3-Parent Rating Scale

These diagnostic tools help determine how well executive function is working on a scale. Remember, often this isn’t a singular incident, but instead a pattern over time of certain behaviors.

Managing Executive Dysfunction

There are ways to manage executive dysfunction like you might learn to manage other disabilities. It’s important to have awareness and then work towards finding ways to help with the areas of dysfunction.

This might include using time organizers and alarms and making schedules that you closely monitor each day throughout the day. It often helps to create visual reminders to help the memory. 

When a person has executive dysfunction, they will often struggle with transitions and shifts in activities. It will help to have a clear-cut plan for those times.

Understanding the Impact of Executive Dysfunction

Executive dysfunction can create real problems for people from a young age into adulthood. It’s important they learn about the issue and then find ways to address the struggle that can help them. Often this means addressing an illness like ADHD.

For more information on executive function and how the dysfunction can impact you, contact us today.

An example from my own life:

I have experienced problems with my focus and attention all my life. It has been so integral to the way I work and live that I have always accepted it as normal. During grade school and high school I was an average student academically. While I would put in effort to do better academically, I never could focus enough to excel in any subject. When I entered college it really became difficult. I was very driven to do well so I would spend outrageous amounts of time mastering the courses I took. I started comparing myself to others and realized I was probably putting in two to three times as much study as my friends. Part of the problem was an inferior public school education but there was something else. I remember how quickly I forgot what I studied and it took repeated readings of books before significant retention occurred.

When I began my work career I again found that I had problems with concentration and focus when completing tasks. It was not uncommon for me to be doing research on a topic when my mind would begin wandering and before I knew what I was doing, I was focusing on some other information that had caught my attention. I would become flustered when I attempted to get back on track because I had forgotten what my original topic was about. The same thing would occur when writing. I would be writing an idea when another thought would intrude and the whole continuity of writing was disrupted. To be continued……

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