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Autism

How Is Executive Functioning Affected by Autism?

Elemy
Updated: January 6, 2021

Executive functioning describes the high-level thought processes that help people plan, strategize, organize, and problem-solve. Because of the developmental delays caused by autism, executive functioning is not fully developed in people on the spectrum.

People with autism can be taught to manually develop some of these skills. They can learn workarounds for others, allowing them to function well.

What Is Executive Functioning?

Psychology Today explains that executive functioning is a broad neuroscientific term that describes the brain’s processes to regulate impulse control, attention span, memory, time management, organizational skills, and effective responses to social and stressful situations.

Effectively, executive functioning is all about mental control and self-regulation. Processes for managing executive functioning are regulated in the prefrontal cortex. The cortex is in continual development from the time a baby is born until the person is in their early to mid 20s. Therefore, the executive functioning of a child is not as well-developed as that of a person in their 40s.

This means that executive functioning is one of the slowest mental processes to develop. Many children and teens struggle with implementing their executive functioning during school, but they can go on to have productive and fulfilling lives as adults once these abilities fully develop.

How It Functions

Proper executive functioning is what helps people identify goals, set a plan to achieve these goals, and then carry out that plan. It comes into play in small and big ways, such as in performing a simple task at home or coming up with a lifechanging strategy over the course of many years. It functions on many levels.

Executive functioning is needed for any process that requires management of time and resources, decision-making, and storing important data to be used later. This does not cover subconscious actions like breathing or avoiding danger, such as getting out of the way of an oncoming car.

Executive functioning can be disrupted by environmental threats, substance abuse, mental illness, or cognitive impairments. This makes it difficult for a person experiencing these factors to perform well at school or work since a good degree of executive functioning is needed to perform and thrive in these environments.

The Brain’s Conductor

Some have compared executive functioning in the brain to the role of a conductor of an orchestra. The conductor’s responsibility is to control, direct, organize, and facilitate interaction between each member and each section of the orchestra. The conductor cues and prompts each musician so they know when to start playing. They communicate what the tempo and volume should be, and when one musician or section should stop playing so another musician or section can take over.

Even though the individual members of the orchestra are talented in their own right, they need a leader to coordinate their performance with the rest of the ensemble. That is what executive functioning does in the brain. Various abilities and skills are present, but they need to be organized and directed by executive functioning.

Schools teach the principles of executive functioning very early on, requiring children to work collaboratively on a timeline or to accomplish a task with the understanding of achieving a goal. But executive functioning development can also start in the home, when parents tell their kids to clean up before having dinner or to finish their homework before they can play.

Ultimately, executive functioning helps children (and people in general) conceptualize what the big picture is. Then, with help, they can plot out a step-by-step process to get to that point.

Autism’s Effect on Executive Functioning

But what does executive functioning look like for a person with autism spectrum disorder? To understand this, it’s necessary to further understand how autism changes the way a person thinks.

Most people with autism are adept (or even very good) at seeing the step-by-step parts of the process, but they cannot conceptualize the big picture. Without that frame of reference, they struggle to see what details are relevant to the overall plan.

Similarly, most people on the autism spectrum are quite good at adhering to routines or schedules, but they may lack the executive functioning to change those schedules in response to a setback or change of plans. They may be unable to cope if the schedule is changed for them. Difficulty with change and transitions is one of the hallmarks of autism.

A person with some level of ASD may understand rules and how to follow them, but may become quite distressed when rules are broken, when steps are skipped, or shortcuts are taken. For a person without autism, these measures may be acceptable in the pursuit of the end goal. The person with autism may be unable to see the bigger picture so these “incorrect” steps are very upsetting to them.

Because of how autism affects a person’s interactions with the world around them, people with the condition typically do not maintain their focus or motivation if the steps they have to take are not instinctively interesting to them. While a person without autism can understand that some parts of the process are more interesting than others, an autistic person might become completely detached from the process. As a result, it can be difficult for them to stay engaged.

Like a conductor ensuring harmony between all parts of an orchestra, executive functioning helps people switch from one activity to the next, from one part of the process to the other. A person with autism will likely struggle with these transitions.

Communication & Multitasking

The very nature of autism makes it difficult for a person on the spectrum to communicate their needs and ideas to other people on a team. Similarly, they may not pick up on communication and cues from other people.

It may never occur to an autistic person to look around and see what their teammates are doing, to ask for help, or to follow someone else’s lead. This can make relationships and teamwork tough.

A key part of executive functioning is working memory, which is the ability to hold and work with many different pieces of information at the same time. It is, in effect, multitasking. While a person without autism can develop the mental skills to do this, a person on the autism spectrum will not, likely insisting that they work on one piece of information at a time and then becoming distressed if pushed to multitask.

A summary of a study done at the University of Strathclyde in 2011 found that young autistic individuals find it tough to multitask because they tend to be inflexible. They were given a set of tasks to complete in order; deviating from that order or task list was upsetting to them. Again, this is often because they lack the big-picture visual and the flexibility that enable them to make allowances in order to complete the overall goal.

Theory of Mind

Executive functioning helps neurotypical people work with (or around) abstract concepts. As the Journal of Autism and Developmental Disorders explains, this will not come easily (or at all) for a person with autism.

For example, an autistic person might not be able to grasp the idea of a brainstorm session, and they almost certainly will not be able to participate in one. Instead, they will feel much more comfortable working with concrete objects and goals, and they will be significantly uncomfortable with any ambiguity or unknowns.

Autistic people in general struggle with the “theory of mind” — the concept that other people will not know, share, feel, or understand their own thoughts, and that everybody has perspectives and emotions that are unique to themselves. The theory of mind is a core part of executive functioning.

Pediatric Research notes that an autistic person has struggles with the “dense interaction that occurs between brain development and (social) environment.” They will likewise struggle with conceiving that other people on their team cannot understand them. Again, this presents difficulties in relationships for autistic individuals.

Working Around Executive Functioning Delays

Autism is a lifelong condition, so some people on the spectrum will never develop the full complement of skills that make up executive functioning. However, it is very possible to manage the complex situations that assume executive functioning, helping autistic people build the skills they need and work around the ones they don’t necessarily need.

In therapy, autistic individuals can build certain executive functioning skills. This often involves building communication skills as well.

It can start with direct instruction. Plain and repeated instruction, done face-to-face, can teach the skill of plotting through the steps that are required for a specific outcome, like teaching the importance of completing one task before moving to the next or how to use a calendar to stay on schedule.

A therapy team can help a client understand this model and then teach it every day, repeatedly, until the principles sink in. This often means very distinct, clear instructions.

Rather than telling a person with autism to brush their teeth (the big picture), the therapist will break down the task into small, individual steps. This may start with taking out the toothbrush, unscrewing the cap from the toothpaste, and squeezing a small bit of toothpaste onto the toothbrush. The therapist will then take the client through the remainder of the steps until the process is complete. Later, the therapist will work on stringing these tasks together until the client can complete the full process on their own.

As therapists work with autistic individuals on this, they will take care to use straightforward language. Clear, concise direction works best. Metaphors or flowery language makes it difficult to follow the message.

Neurotypical people will internalize many of the skills of executive functioning without even thinking about it, but autistic people (and even non-autistic people who have delayed executive functioning development) will benefit from direct instruction on time management.

Talking Through Processes

Another way to help an autistic person through their executive functioning limitations is by role-playing. This simply means talking through the situation beforehand or practicing the situation.

Practice challenges offer a low-stress situation where the person will be asked to try some executive functioning skills. Role-playing ultimately helps autistic individuals to get comfortable with novel situations.

At home, where they will feel most safe, they can be tasked with doing laundry. This process would likely be overwhelming for most people with autism, but a therapist can help them prepare by role-playing the process. Similar to direct instruction, it involves breaking down the large task into smaller tasks and then even smaller individual steps.

Doing laundry is a three-part large process: washing the clothes, drying the clothes, and folding the clothes. First, it involves putting clothes in the washing machine, adding detergent, selecting the appropriate water temperature, and choosing the right cycle. Next, it involves waiting for the washing machine to finish, transferring the clothes to the dryer, and waiting for the dryer to finish. The final part of the process involves removing the clothes from the dryer, sorting them, folding them, and putting them away.

All this tests multi-step planning, time management, and memory, among other skills. Practicing this situation isn’t just about being able to eventually do laundry. It’s also about developing these skills, and executive functioning manages the process.

Social Stories

Executive functioning helps people respond to unexpected events in the process (like running out of detergent or someone else wanting to use the machines). Since autistic individuals often lack executive functioning abilities, they may be taught to develop “social stories.” These are essentially short stories, complete with pictures, that help autistic individuals to navigate the world.

In the laundry situation, a social story may dictate and illustrate what happens in the process as well as potential things that can happen (like the above unexpected events) and how to deal with them. The story will give answers to questions and eventualities that naturally arise, so that the person can keep their anxiety and distress in check when there’s an error in the system.

Autism Speaks provides some templates for personalized teaching stories that parents and therapists can use to create their own.

From Visual Reminds to Rewards

Therapy can help autistic people develop some executive functioning skills, but in all likelihood, many people on the spectrum will have to learn to live without the full range of skills.

Still, solutions are available to help autistic people overcome these limitations. For example, many smartphone apps can help them to manage time and stay on track. Visual reminders, like charts or infographics, can remind people of the step-by-step tasks needed to finish a project or accomplish a goal.

Some of these tools help to break a process down as much as possible. The key is to simplify the steps and make the connections between each step explicitly clear. The big picture then becomes clearer as the person is able to see the individual steps to get there.

While neurotypical children may respond to discipline when they fail in a task, autistic children will often not be able to understand why they are being punished. Instead, small, tangible rewards are often recommended when they get a step in the process correct. This can help them internalize the process as much as they can, so they repeat the steps in the future.

People with autism can compensate for a lack of executive functioning. With therapy, they can learn vital skills to help them work with others, and set and accomplish goals. While they may always struggle somewhat in this area, it doesn’t have to hold them back from a robust, successful life.