Anyone overcome executive functioning problems?

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There is an old thread about reticulating splines, autistic inertia, and token theory, which does an excellent job describing a common autistic problem. Thread can be found here. Since this is a big problem for me as well, I am hoping we can discuss possible solutions.

If you recognize these as real problems in your past or present, what is your solution? Many professionals, who probably never struggled with this, recommend just practicing over and over to build executive functioning skills up to normal levels. Since I am still so impaired in executive functioning and have seen very little improvement over 32 years, I find this solution too inefficient and unpromising. I am hoping to hear about tools or work-arounds you have tried, and/or what goals or responsibilities you have given up, in order to function better overall. But, I am also interested in hearing if the "practicing over and over" method worked for you.

Not yet. I'm curious about whether stimulant medication would help me - but the person who diagnosed me doesn't know anything about medication and I don't trust my psychiatrist as its not his area of expertise (though I might try asking him anyway).

Anyhow, I'm waiting for an adult social care assessment because I need OT and there's been changes to the local pathway so I need to hoop jump.

So fast, I've been told that the changes are largely pragmatic - for example accepting that things may take me longer, looking into a sensory diet because my EF is better when I'm not overwhelmed.

At the moment I have lots of prompts from my wife to get things done. I'm at university so I'm going to have someone help me keep on top of things, though that still doesn't really get around it.

It sucks.

So if I understand this right the concept is that you have a limited amount of mental resources to go around and complete all the tasks necessary at any given moment in any given day?

If I understood you correctly, I often think in the same terms. What do I do about it? I prioritize. I ask myself what needs to be done immediately, and what can wait. If there are excess resources left over after all of my immediate/short term goals are accounted for, I spend the remaining on any mid and long term goals or doing activities that I enjoy.

When I prioritize, I try my best to consider and weigh the possible consequences, benefits, financial costs, social costs, health effects, both short, mid, and long term of choosing to devote my energy to completing the task or ignoring it and setting it aside for later. I often find that completing tasks that I find are the easiest and quickest to get them out of the way helps by giving my mind one less item to focus on.

I find that if I set aside a moment in the day to sit down and work through just my mid term or long term goals. I will plan out my next move, a time frame in which I plan to follow through with those plans, set reminders in my phone, and then put them to the back of my mind and forget about them. That way I don't have to constantly devote resources and space in my mind to worrying about my mid or long term goals, resources which could be better used day to day addressing more immediate concerns. My phone will remind me on a predetermined date at which time I will once again sit down and plan out my next move, set a reminder, then put it at the back of my mind and forget about it.

With regards to day to day activities, I approach nearly every situation with a mindset asking myself "what can I do to streamline this task and how can I become more efficient at completing it, how can I improve?". Over time I am able to refine my skills specific to that one task so that I can complete it better and quicker each time while needing to devote fewer and fewer mental resources, which frees up resources (or spoons in the spoon theory analogy) to be used to complete other tasks. I have this mindset even when it comes to making my bowl of oatmeal for breakfast each morning or even tying my shoes.

I also try and complete tasks that are similar in nature to be completed all in immediate succession, one after another. If there is a task I must complete on a regular basis, ie, daily, then I like to set a aside a strict routine and time in my day to do that. I find that the more repetitive and simple I can make a task, the less resources it eats up, and the more chance that it will have to be sustainable long term.

No luck here. This sucks.

I've been reading a book called Living Well on the Autism Spectrum, which is nice enough to actually acknowledge that this problem exists, but the advice was mostly a bunch of organization tips. Useful, if you aren't already using them.

Just for the sake of discussion, I'm going to list some of the different problems that fall under or are related to executive function/dysfunction. I think the reason we struggle so much is because we have all or most of these problems. The solutions for one problem tend to conflict with the other problems. (Like, organization techniques would be great for the organization problems, but the task paralysis, spoons, and possibly inertia make it hard to implement. Noca's advice could help for limiting energy/spoon consumption, but it seems like it'd require decent planning skills. And so on.)

Attention problems: Getting distracted, failing to get distracted by things that should get your attention, zoning out. I think bad "working memory" falls into this area. Not enough RAM in your computer, metaphorically. Stimulant meds can help with this. Insufficiant sleep and stimulant withdrawal (including caffeine) will make it worse.

Horribly disorganized: Bad at planning, scheduling, and organizing. Easily misplace things, forget about tasks that need to be done, mis-estimate time, running late, etc. It seems like the folks who manage this problem do so by being super over-organized. Like, they've worked out a system/schedule that works, but they have to adhere to it very strictly to keep it working.

Inertia or trouble with transitions (difficulty "shifting gears" or "reticulating splines"): Difficulty changing from one activity to another. It seems like forcing a transition will cause all the other problems on this list to get worse in regards to the new activity, and that's why it's so hard. At least, that's the only way I can think to explain it.

Task paralysis? Pathological demand avoidance?: Extreme reluctance toward tasks, for no apparent reason. Disproportionate amounts of stress, sadness, or anxiety when faced with a task. I often have to really force myself to do even small tasks that should be easy. I think this is related to the "emotional regulation" aspect of executive functioning. (I heard the term "pathological demand avoidance" just recently. Apparently that's an actual diagnosis in the UK, and it's considered a related condition or subtype of ASD. But it's not well-studied, and the diagnostic criteria is all child-based.) This usually gets lumped in with the inertia thing, but I feel like it's worth distinguishing. They're pretty closely related though.

Low mental/emotional resources (not enough "spoons"): It feels like you don't have enough energy for all the things you need or want to do. This could be because you have less energy than most people and/or because tasks take more of your energy for some reason.

In my experience, and in the stories I've heard from others, stimulant meds help with attention-related problems, but not everything else. I also feel like it take my hypersensitivity down a notch, but it's hard to tell.

There was some other non-stimulant medication (I can't remember the name, but I could probably find it) that some people have started to use as an ADHD treatment even though it was originally an antiviral, because it raises dopamine levels. It hasn't been well-studied, but apparently it actually does help with executive function moreso than most ADHD meds. The hard part is getting a doctor to prescribe it though. Even if you have an ADHD diagnosis, it's not an official or approved treatment for ADHD.

Thank you for sharing...

Thanks for posting this. These are problems I have been struggling with too. I am really glad to read some thoughts & solutions others may have. The thread (and blog post linked therein) were really enlightening.

The things that I have tried (with my thoughts on how they work for me) follow:

- Clear plan for my day organized as a prioritized list (I try to keep it as short as possible & avoid attaching times unless items are appointments). I find this works best writen on paper so that I can physically highlite completed items.

- Mind map software. I use an app called SimpleMind+, but there are many free ones available. I use mind maps to organize projects/procedures/decisions that have multiple steps. I like that the steps are visually hierarchical & can be dragged to reorder them easily. I also like that sub-items can expand/collapse. This helps me to plan the whole project, then focus only on the current step of the project. I also use mind maps to info-dump when I research. By keeping information in a form that is easy to rearrange and can reference or link to resources/documents I am able to clear mental real estate and 'reticulate my splines' more efficiently by keeping most data organized outside of my brain!

- Timers. If I get hyper focused or have multiple time sensitive tasks to complete I set timers on my phone to alert 15 minutes befor I need to switch my focus to another task. This allows me to wrap up any important details before moving on.

I agree that the suggestion to 'practice over and over' is not the most useful tactic because it does not take into account the real nature of the problem. My experience and intellectual understanding of executive function leads me to believe that it is more of a set of processes than a set of skills, thus, trying to force ones self to acquire skills that may appear to mimic normal executive function is only going to slow down and frustrate an individual who is naturally impaired on this front. My experience leads me to believe that it is always better to take the time to analyze the specific ways that impaired executive function causes problems for an individual, and then to problem solve an adaptive procedure for each problem area (for me this works best if I go slowly & solve one problem at a time, taking some time I between implementing new strategies also seems to be key to success.)

Always better to respect the ways that our brains work differently & work with the differences instead of against them.

Thanks again for starting this discussion.

I'd like to add to the discussion but I'm off to work now. Hope to return.

Tried for decades, complete failure in "being an adult", supported by family at 45.
A lot of shame comes with saying that. American culture looks down on someone like me as the scum of the earth.
Because I can't be a "real" adult and support myself.
I'm just a single 45 year old loser, supported by parents.

"executive functioning"? whats that?
I can't get anything taken care of.
I can't make business type phone calls, setting appointments, inquiring about products or services.
Whenever I try I get all tongue tied and nobody ever knows what I'm requesting.
Bureaucracy and forms I just plain find offensive, and I have a personal quest to help purge the world of the evils of bureaucracy. I refuse to participate whenever I can.
Bureaucracy is the root of the worlds problems.

Really that's what "executive functioning" is partly, the acceptance of bureaucracy as a way of life.

But I am really grateful that I'm not some mindless worker drone like most of the population.
So many salves to "the empire".
Well, "the empire" is not compatible with me, I reject it.
It's thousands of years old and needs to go anyway.
Sure changed names, capitols & borders many times, but still the same authoritarian tyranny as always.
And the mind virus it spreads is called "executive functioning".

To Pete: I have worked at length with my aspie daughter on things like phone calls, prioritizing, etc. Fact is, with practice, you learn. I often have to reinforce the reality that she can do many of these things on her own. You start small, have a support person call for you with you in the room available if needed to talk to the bureaucracy-person. Then maybe you dial yourself, work through the phone menu, then have your support person do the actual talking. Then maybe you try one yourself, with support person in room if needed.

If a parent or social worker has never done this sort of behavioral shaping with you, perhaps it is because no one knew to ask for it or offer it. Don't blame them for that and don't blame yourself. If you still want to learn "how," you probably can.

You aren't off to combat in Syria are you?
Seriously, a very bad situation...

These concepts are new to me...spooning/splining...
I didn't have enough "spoons" or have enough energy to upload splines yesterday to properly process what I read...

Not related to spooning, etc, but I do know, as a personal fact, that simple caffeine helps enormously with combating psychological inertia...
I am super-sensitive to it...
It is like amphetamines to someone else...

Caffeine, however, does inordinately heighten all aspects of the emotional spectrum for me...
And it removes the "think before you speak" mechanism that is usually there...
As a consequence, I avoid it if I have to relate to others that day...

My executive functioning and focus is so poor I cannot read any more than the first post here even though the subject is fascinating for me.

I am going to be admitted to hospital soon because my problems are so bad.

Sorry to hear you are having so much trouble, Herman.

Im actually very lucky to be getting this highly specialised help. It seems pretty rare even worldwide to go into an hospital/treatment for Autism related issues.

I might write an article or keep a diary/blog or something about the experience.

Please do! I am very interested in what they do for you.

I have the same problem regarding my ability to read. I have settled on the decision to learn mindfulness in order to improve my focus. The wait list to see anyone specializing in this field is long and may not begin until February for myself but it may be something you could look into as well.

hmmm..... I can't seem to do any reading nowadays (unless it pertains to a special interest, and barely even then) but I thought it was because my eyesight is getting lousier. It never dawned on me that it might be that my brain is causing problems. I used to read quite a lot but don't now.

I take yoga, it's not the same as mindfulness but it does have some things in common.