Do you get frustrated with the young autistic person you care for because they seem unable to carry out a simple task without zoning out, getting frustrated, forgetting about it or seemingly giving up? Do you often find them sitting on their bed with one sock on, one sock off, staring into the distance two minutes before they are due to leave the house? Do they leave homework until the last minute? Do they focus on tiny details but never finish the whole thing?
Autism and other neurological conditions like ADHD have a huge impact on what is called executive functioning. Executive functioning essentially deals with the ability to plan and carry out tasks and how we organise our lives.
To help us to understand the impact poor executive function has on someone, it is useful to look at the many steps we need to go through to achieve a task. For most of us, we do these instinctively without even being aware of them. The brain’s cogs are well oiled and life’s tasks mainly seem a breeze to achieve. For others, the very thought of having to go through every stage to achieve a task is incredibly overwhelming. They may get stuck at one stage and can’t get past it, or the very thought of even starting is so crushing it becomes impossible to begin. The brain’s gears get jammed and things don’t get done.
The diagram above is an illustration of the stages we unconsciously go through with every task that needs doing, whether that is completing a large work project or deciding what to have for lunch.
To give you an example, let’s look at putting a card in the post. Sounds like a simple task right? However, when you think of all the steps involved in posting something like a birthday card you can see there are actually quite a few! And they need completing in time, in the right order and at the same time as juggling the many other life tasks that need to be done during any given day.
So this is what posting a birthday card may look like:
- Organising (What do I need to complete the task?) A birthday card, a pen, address book, stamp, post box.
- Prioritising (What order do I need to do things in?) Buy the card, think of what to write in the card, write in the card, find the address, write the address on the envelope, buy or find a stamp, travel to a post box, post the card.
- Remembering (How did I do this last time?) Where is my address book? What day does the card need to arrive by? Is there a post box between my workplace, the supermarket, and home, do I have to post it today for it to arrive on time?
- Execution (Let’s get this thing done!) Trying not to forget, trying not to get distracted by other tasks, finding the time after work to go shopping, and to the postbox, before the last collection at 5pm.
- Flexibility (Could this be done differently?) Could I buy all the birthday cards and stamps I need for the next month at once? Could I put reminders of when people’s birthday cards need to be sent in my phone? Could I set up an e-card account that automatically sends cards on time?
- Self Checking (Did I do this right?) Was the card posted in time and did it go to the right address? Was it stressful getting it done?
Think about tasks the child or young person you care for struggles with regularly and apply the above steps to them. For example, getting dressed in the morning, going to bed, managing their homework schedule, tidying their room.
How you can help your child
So, now we understand a little more about what effect poor executive functioning can have on our abilities to carry our everyday tasks, how can we help and support neurodiverse people with their executive functioning?
- Help them to break the task down into manageable chunks This could be a simple list of steps to take, a flowchart, a social story, picture diagram, or comic strip – whatever works best for your child.
- Direction and prompting Help them along by guiding them through each stage, and reminding them of what comes next to keep them on track. Or use the options mentioned above as visual prompts for regular tasks.
- Encourage list making If appropriate, help the person who you care for how to make to-do lists, or organise their tasks using a diary or online scheduling app.
- Get organised Find set places to keep items or papers they need, so things don’t get lost and they don’t have to look for things all of the time.
- Keep to a set routine Structure makes tasks easier, so consider assigning recurring tasks to set times of the day or week. For example, Monday and Wednesday night is homework night, 6pm is the time we pack our bags ready for the following day.
You can read more about executive functioning here:
Organising, sequencing and prioritising from the National Autistic Society
What is Executive Function Disorder? from ADDitude Magazine
These are good sources for social stories and visual schedules: