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Executive Functioning in Autism

Have you ever wondered why your son or daughter always has a hard time holding on to directions you give? Or, ever wonder why when you give the direction “Clean your room,” it never looks exactly how you pictured it in your head?

Executive Functioning in Autism https://www.autismparentingmagazine.com/executive-functioning/

Sure, children, adolescents, and young adults, at times, choose to listen to certain things. They look like they heard you; they may even be able to repeat back to you what you asked them.

Yet so many parents tell me, “But they still don’t do it!” With the start of a new school year upon us and for many who have not been in school for months, this transition may make things even more difficult.

Although things can get extremely frustrating and look behavioral in most instances, we also have to be aware of and consider how one’s invisible deficits may be impacting that individual. One of these “invisible deficits” most individuals on the autism spectrum deal with is executive functioning (EF).

So, what are these invisible executive functioning deficits? From a traditional sense, EF involves the basic skills of self-management that allow us to set goals and achieve them. They include such areas as managing our emotions, taking initiative, staying focused, being organized, planning, prioritizing, and recognizing when we’re off track and figuring out how to recover.

Deficits in such EF skills may impact how someone organizes his/her backpack or his/her desk, prepares to do homework, remembers the steps to cleaning one’s room, etc. Based on our work in social cognition and development, we also understand various EF skills (including cognitive flexibility, goal orientation, attentional control, information processing, and emotional recognition) impact one’s social development and adaptive skills.

These are cognitive skills we use on a daily basis. We will have days where our EF looks stronger than other days. This is impacted by one’s level of anxiety, mood, other life stressors, etc. If we look within each of us, we all have times when our EF is not where we would like for it to be.

We rely on others to help support those areas of EF that are weaker. Kids and adolescents can’t “hire” an assistant or delegate items to be done. We expect their brain to just do it, and at times, especially for individuals on the autism spectrum, that’s taxing and overwhelming. Here are four EF areas and ways to address these barriers at home so you (and your son/daughter) can start feeling more successful in day to day life.

0-100: Coping with emotions

Does anyone have a son or daughter who has elephant-sized reactions to ant-sized problems? When you ask him/her to get off the video game, he/she yells, “I can’t right now,” or maybe says things when he/she is upset because he/she knows it will hurt you and get you off his/her back. Having the ability to regulate and recognize your emotions is part of one’s executive functioning.

Think of it as your on/off switch to emotions and how you show them. The problem comes when we have emotional reactions that don’t fit the situation or the context. It’s okay to have emotions, and it’s even okay for kids to be pissed at their parents (we all were at some point in our lives). However, we need to be able to recognize what we are feeling when we are feeling it, and how to manage or cope with that feeling in an appropriate way, hence the term emotional regulation.

You may have found asking your son or daughter to “calm down” in the moment doesn’t always work. In fact, in some cases it only increases his/her emotional reactions. The trick is to catch him/her before he/she reaches that level where his/her emotions, body, and language all start to lose control at the same time.

A positive family routine to establish is a way to “check in” with family members as to how they are feeling. Start when you notice people feeling calm and in a good place. Having them rate where they are (on a 1-10 scale with 10 being the highest level of stress or negative emotion) is a great way for parents to gauge their kids’ emotional state.

This scale can be modified for younger children as needed (maybe use a 1-5 scale or colors, like what is talked about in the “Zone of Regulation” curriculum). This idea of checking in also opens up some communication about emotions. The trick here is that everyone in the house should be “checking in,” not just the person on the spectrum!

The most important part of this process is how we handle when someone says, “I am angry” vs. when someone just “shows” he/she is angry. Many of my clients tell me they don’t know what mom or dad will say or do if they learn they are angry or mad at them.

Allowing them to identify their emotions and then responding to their perceived emotions in a calm and matter of fact way can be a huge turning point in one’s ability to regulate his/her emotions. We have to take the “guessing” out of what our response will be. It’s okay to say, “I am sorry you are mad,” or for older kids, “Yeah, I would be pissed too.” Modeling how we identify and what we do with those emotions is critical to developing one’s emotional regulation skills.

Visuals are key to executive functioning improvements

Planning and organization are two executive functioning components that go hand-in-hand. These skills help our children make sure they are completing all of the tasks they need to when they need to be. To ensure we complete the tasks we are responsible for, we first have to figure out when to do them.

One easy strategy to use is to make a schedule. In this case, the schedule serves as more than just an indicator of when an assignment is due or when someone’s birthday is. This type of schedule is for laying out exactly when a task is going to be worked on and for how long.

For example, if your child has a test coming up at the end of the week, his/her schedule might look something like this: Monday—study from 4 pm to 5 pm; Tuesday—study from 4:30 pm to 6 pm; Wednesday—study from 4 pm to 5 pm; Thursday—review all test material from 6:30 pm to 7:30 pm.

There are two key aspects to these types of schedules. First, they should be visual. Have fun with this—make it unique to your child and/or your family! Visual schedules help us to physically see what we need to be doing, so they can help to eliminate the anxiety of the unknown as well as allow the individual(s) using them to be in control of their responsibilities. Secondly, they should be visible.

Making a schedule is a great strategy, but if it is put in a spot where it cannot be easily seen, it cannot serve its purpose. These visual schedules should be located somewhere that is accessed regularly. This could mean it hangs on the refrigerator door, is pasted on the table or desk where your child does homework, or even is taped to your child’s bedroom door. No matter where it is located, it should be seen regularly to get the most out of it.

Once the plan is set, the focus shifts to making sure we are able to complete the tasks with the appropriate tools, materials, and information. A great way to increase organization skills is to create a list of all of the things you need for the task before you begin working on it.

For example, if your child has a baseball game in the afternoon, but you are worried he/she might forget his/her glove or cleats, have him/her make a Baseball Preparation List. Here, your child can write down everything he/she needs for his/her game, then check it off once it is packed and/or ready to go.

These types of lists are great because not only do they help make sure your child has everything he/she needs, but they can also be made for any type of activity and reused in the future. So, even when this year’s baseball season ends, your child will still have access to his/her Baseball Preparation List next year.

With the implementation of strategies like schedules and organizational lists, your child will be developing his/her executive functioning skills without even realizing it.

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Understanding the passage of time

What do five minutes feel like? When working towards strengthening time management skills, it could be very helpful to incorporate a visual timer. Visual timers help children develop a more concrete understanding of time. An easy way to introduce a visual timer to your child is to use it when he/she is engaging in a preferred activity.

For example, you can set a timer for 10 minutes when he/she is crafting, or playing pretend. Many different kinds of timers can be used; you may choose to use the timer on your phone or even the one on the microwave! Either way, be sure the timer is close to your child’s play so it can be easily referenced.

During the interval, it is critical to consistently remark on the passing time. Comments like, “It has already been two minutes, we have eight more minutes left,” or “Look at our timer, we have played for five minutes, which is half of our playing time,” could be very effective. Pairing the visual timer with a preferred activity will make it easier to incorporate the timer into a less preferred task at a future time.

When using a visual timer to help increase your child’s ability to work independently, it is essential to start small. For example, encourage your child to work independently for 10 minutes. For younger children, this time can be reduced.

It is important to use your discretion and consider the unique characteristics of your child when setting an appropriate time. Set the visual timer close to his/her workspace, and when the timer goes off, allow your child to take a break and celebrate the independent working time with a small reward.

Doing this will foster feelings of accomplishment and competency within your child. If your child is experiencing continued success with the set time, increase it by three minutes, and follow the same routine. This gradual increase in time will help build your child’s stamina with independent work.

The thinking behind behavior

We have all been guilty of getting caught up in the moment, losing track of where we are, what we are doing, and how we are doing at our activities or goals at hand. For kids on the autism spectrum, this too is the case—whether it’s playing video games with the volume through the roof, speaking too loudly inside a library, or standing too close to other people in line at the grocery store.

But they also have unique deficits that make this much tougher to deal with. Some of our kids struggle with overstimulation, and once that stimulation reaches a threshold, it can seem impossible for them to think and talk about how, why, or when the situation became too much for them.

All of these responses involve the executive function skill of having the ability to measure, record, and evaluate one’s own behavior: our ability to self-monitor. A great way to help our kids with self-monitoring is to develop a concrete, visual system for measuring, recording, and evaluating how they are doing on a specific activity or goal.

Helping an individual to self-monitor starts with him/her being aware of the expectation. It is important to identify a specific behavior or skill you and your child would like to monitor. Be as specific as you can so there is no guessing what you or your child need to do.

For this example, let’s say you want your child to be quieter when playing video games. What does quieter mean? It could be reducing an earth-shattering scream to a strong yell. For the sake of everyone’s ears, it helps to be specific about what loud vs. quiet means and how to measure that. A great way to do this is to create a visual scale with measurable levels (four to five levels is recommended, depending on the scale). This can be done using numbers, colors, and/or pictures.

It will be helpful to incorporate your child’s interests into this scale so he/she develops a greater understanding of the measurement of that behavior. If your child loves planes, at the bottom of the scale, there can be a picture of a paper airplane (signifying silence or very quiet volume), and at the top, there can be a picture of a commercial jet engine (signifying extremely loud volume).

mother and daughter talking

In between those two extremes can be two to three more pictures of increasingly louder planes. To finish off the scale, you can put a star or another symbol (and make that slightly larger than other visuals) next to the level your child should aim to keep his/her volume at or below.

Create a “check-in phrase” with your son/daughter which signifies that you need him/her to “rate” where he/she is on the scale at a certain time. Having him/her say “I am a two, mom,” is a great start to the process of having him/her stop and reflect on where he/she is (behaviorally and emotionally) at a certain time.

You may not always agree, at which point I may suggest saying, “You sound like a four to my ears,” and then walk away. If he/she stays within the expected noise range while gaming, reward him/her! Celebrate that success by allowing more time to do a preferred activity. The process of self-monitoring can be a skill a person is working on well through his/her 20s and beyond. Starting to address it at a younger age will only help to make it a part of his/her behavioral habits.

Executive function skills are cognitive processes an individual will be working on possibly through life. As a child gets older, he/she will develop competencies for those areas he/she is not as strong in. It is important to remember many behaviors observed both at home and at school are a result of these invisible deficits and not just because the child is being oppositional.

Understanding these deficits are real and do have an impact on individuals from a behavioral, social, and emotional perspective is key to helping a person who wants to improve in this area! Please remember this new school year will bring its own set of unique challenges and difficulties while getting back into a routine.

Take one thing at a time and address those executive function skills most impacting your child’s daily functioning. All the best as we head back to school and new routines!

This article was featured in Issue 104 –Transition Strategies For Kids With Autism

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