Kimberly Louvin, LCSW, LICSW, LSSW

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What is Executive Function and Dysfunction? A Lighthearted Look at the Experience of Autistic and ADHD Adults

Ah, executive function: the mysterious brain process that helps us organize our thoughts, stay focused, and generally not be walking chaos. For most people, executive function is like having a personal assistant who keeps everything in check. But for autistic adults and those with ADHD, that personal assistant may take frequent, unannounced vacations, leaving them in charge of planning and organizing life’s to-dos on their own. Spoiler alert: things can get messy.

So, what exactly is executive function, and how does it go rogue in autistic and ADHD brains? Let’s dive into the fun and dysfunction of it all.

Executive Function 101

In a perfect world, executive function is the brain's “manager” that handles all your daily operations. It includes:

  • Working Memory: This is the ability to hold and manipulate information in mind over short periods. It allows you to remember a phone number long enough to dial it or to follow multi-step instructions without losing track.

    • Remembering where you left your keys while also deciding what to make for dinner. (Spoiler: those keys are long gone.)

  • Cognitive Flexibility (Flexible Thinking): This skill enables you to adjust to new situations, shift your thinking, and see things from different perspectives. It's what allows you to switch between tasks or adapt when plans change unexpectedly.

    • Being able to roll with the punches when your perfect plan doesn’t go as expected. (Like when your favorite show releases another season right when you’re about to start being productive.)

  • Inhibitory Control (Self-Control): This involves controlling impulses and resisting distractions. It's the mental brake that prevents you from acting on every thought or urge, helping you stay focused and behave appropriately in various contexts.

    • Suppressing the impulse to check your phone every 10 seconds or buy that life-sized replica of Baby Yoda.

But when executive dysfunction comes into play—especially for autistic adults and those with ADHD—these processes can feel like a comedy of errors.

Executive Dysfunction: When the Command Center Misfires

Executive dysfunction occurs when these cognitive processes are impaired, leading to difficulties in managing thoughts, emotions, and actions. For autistic adults and those with ADHD, executive dysfunction can manifest in several ways:

  • Organization and Planning Issues: Struggling to keep track of belongings, manage time effectively, or plan ahead for tasks and responsibilities.

  • Difficulty with Starting and Completing Tasks: Procrastination or trouble initiating tasks, even ones that are important or of interest, and difficulty following through to completion.

  • Problems with Focus and Attention: Being easily distracted by external stimuli or internal thoughts, leading to challenges in maintaining attention during tasks or conversations.

  • Impulsive Behavior: Acting without considering the consequences, interrupting others, or making hasty decisions.

  • Emotional Regulation Challenges: Difficulty managing emotions, leading to heightened responses like frustration, anger, or anxiety over seemingly minor issues.

Executive Dysfunction in ADHD: The “What Was I Doing Again?” Loop

Adults with ADHD often live in a world of constant distractions, impulsivity, and forgotten tasks. As Barkley (2015) humorously describes, the ADHD brain often struggles to prioritize—which is why laundry day can turn into a spontaneous quest to deep-clean the fridge. Focus can be elusive, and time management? Well, that’s more of a vague concept than an actual skill. If you’ve ever had an hour-long work meeting turn into 45 minutes of mentally planning a vacation, you know what we’re talking about.

In addition to squirrel brain moments, impulsivity in ADHD means blurting out a random idea in the middle of a serious conversation or suddenly deciding that reorganizing the bookshelf is way more important than answering emails.

In adults with ADHD, executive dysfunction often appears as:

  • Inattention and Distractibility: Challenges with working memory and inhibitory control can make it hard to focus on tasks, especially those that are less engaging.

  • Hyperactivity and Impulsivity: Excess energy and difficulty controlling impulses can result in restlessness, interrupting others, or engaging in risky behaviors.

  • Time Management Difficulties: Problems estimating how long tasks will take or prioritizing tasks can lead to procrastination and missed deadlines.

Executive Dysfunction in Autism: The “Wait, I Didn’t Plan for This” Struggle

Autistic adults experience executive dysfunction differently, often manifesting in cognitive rigidity (Ozonoff et al., 2016). If you’ve ever seen someone stick to a routine like it’s their life’s mission, that’s because change can be pretty distressing. Planning and flexibility aren’t just tricky—they can be downright overwhelming.

And let’s not forget that many autistic people hyperfocus on certain interests. Hyperfocus can be amazing for diving deep into a hobby but less so when you realize you’ve spent five hours learning everything about 17th-century shipbuilding and forgot to eat lunch.

For autistic individuals, executive dysfunction may contribute to:

  • Routine Dependence: A strong preference for routines and difficulty adapting to changes can be linked to challenges with cognitive flexibility.

  • Detail-Focused Processing: While often excellent at noticing details, autistic people might struggle with seeing the bigger picture, affecting planning and organization.

  • Emotional Overload: Difficulties with inhibitory control can make it harder to regulate emotions, leading to sensory overload or meltdowns in overwhelming situations.

When ADHD and Autism Team Up: Double Trouble

Now, imagine both conditions together. You might find yourself caught in a never-ending loop of hyperfocus, while also struggling to keep up with the chaos that surrounds you. Planning can become extra tough because both the impulsivity of ADHD and the rigidity of autism are in full force. (Think of it as a never-ending fight between spontaneity and the need for order.)

How to Tame Executive Dysfunction (Sort Of)

Managing executive dysfunction doesn’t require a brain overhaul—just a few strategies to get that personal assistant back on track:

  • Cognitive Behavioral Therapy (CBT): This is like giving your brain a toolkit to manage impulsivity and break tasks into bite-sized pieces. Suddenly, checking things off your to-do list feels achievable.

  • Assistive technology: Using phone reminders, timers, and calendars can help keep things on track. Who knew that a digital reminder to drink water could be life-changing?

  • Environmental modifications: Create a predictable routine that helps you feel grounded. Even a sticky-note army can be a step toward keeping the chaos under control.

Conclusion

Executive function can be like trying to herd cats for autistic adults and those with ADHD. The brain’s “manager” often goes off duty, leaving behind a trail of disorganized thoughts and impulsive decisions. But with the right strategies—and maybe a few sticky notes—executive dysfunction can become a little more manageable. After all, life is more about finding a balance between spontaneity and structure, even if that means occasionally losing your keys.

References:

  • Barkley, R. A. (2015). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment. Guilford Press.

  • Ozonoff, S., Goodlin-Jones, B. L., & Solomon, M. (2016). Evidence-based assessment of autism spectrum disorder in children and adolescents. The Guilford Press.

  • Craig, F., Margari, F., Legrottaglie, A. R., Palumbi, R., de Giambattista, C., & Margari, L. (2016). A review of executive function deficits in autism spectrum disorder and attention-deficit/hyperactivity disorder. Neuropsychiatric Disease and Treatment, 12, 1191–1202.