A Guide to Executive Function Disorder in Adults

Transitioning from one activity to another can be tricky, even for adults. It can be incredibly challenging to shift from something enjoyable to less desirable. Moving from one activity to another is one of many executive functioning skills we use to carry out daily activities.

Individuals with weak executive functioning skills may have problems completing common tasks, such as getting dressed, doing the laundry, packing a suitcase, or grocery shopping.

This article answers your questions about executive functioning, provides tips to improve your skills, and offers online one-on-one professional coaching. It’s never too late for an adult to develop stronger executive functioning skills!

What Does the Term Executive Function Mean?

12 Components of Executive Function

Why are Executive Functioning Skills Important?

The Role of Executive Function in the Modern World

Causes of Executive Function Disorder

7 Signs of Weak Executive Function Skills

How to Diagnose Executive Function

8 Useful Tools That You Can Start Using Today

Professional Help for Executive Functioning

What Does the Term Executive Function Mean?

Executive function disorder is an umbrella term for a cluster of behavioral symptoms characterized by difficulties in self-regulation, planning, shifting focus, or managing time appropriately.

Executive function can help us plan, organize, make decisions, dynamically move between situations or thoughts, control our emotions and impulsivity, and learn from our past mistakes.

Executive function skills play a role in learning, working habits, and managing day-to-day activities. Conversely, individuals with weak executive functioning skills may have difficulty following directions, controlling emotions, or juggling multiple tasks.

Executive functioning develops shortly after birth. Development of skills continues during youth and adolescence. A window of drastic growth of executive functioning skills occurs between the ages of 3 and 5, and improvement of skills generally continues through adulthood. As we age, a decline in executive function skills occurs.

12 Components of Executive Function

Executive functioning skills play an important role in many areas of life. Some things that you do every day that require these skills include:

  1. Planning and Prioritizing

    The process of making decisions or taking steps needed to reach a goal.

  2. Time Management

    The skill that allows a person to exercise conscious control over the amount of time spent on specific activities, especially to increase effectiveness, efficiency, or productivity.

  3. Organization

    The deliberate, systematic arrangement of ideas. It is the ability to create order in work and play.

  4. Working Memory

    A cognitive ability that allows an individual to hold information in the mind while using it to complete a task.

  5. Self-Monitoring and Metacognition

    The ability to monitor one’s own learning and performance or keep track of one’s abilities and compare them to peers.

  6. Response Inhibition and Impulse Control

    The ability to control behavior that may be undesirable.

  7. Emotional Control

    The ability to identify, understand, and manage one’s own emotions and change and adapt emotional states as needed to complete tasks.

  8. Task Initiation

    The ability to start a task because a person is organized and able to focus on others during interactions.

  9. Flexibility

    The ability to adapt to new situations when necessary. Flexibility allows an individual to create a new approach when a particular plan fails.

  10. Goal-Directed Persistence

    When a person focuses on their goals and follows through to achieve the desired results.

  11. Sustained and Disengaging Attention

    Sustained attention is attending to and focusing on a specific task. The ability to sustain attention helps to reduce distractions. Disengaging attention is the ability to withdraw attention from one stimulus to focus on another.

  12. Regulation of Processing Speed

    Processing speed refers to the time required to respond to or process information in an individual’s environment. Regulation of processing speed is when a person can consciously decide how slowly or quickly to perform a task. A person can consciously make this decision based on its value and importance.

Why are Executive Functioning Skills Important?

Executive functioning skills allow individuals to prioritize tasks and correctly sequence needed behaviors to complete them efficiently. Planning and organizing are crucial to success at work, school, and daily life. At every stage of development, these skills are necessary to manage our homes and thrive in our careers.

An Example of Executive Function Skills in a Preschool-Age Child

The child must use executive function skills to complete the seemingly simple building block tower task. First, the child must take out the blocks they want to use. Then, they might sort through the blocks to find the best ones to use as a base. Next, they must continue to find empty spots to place new blocks, and they may even need to negotiate and collaborate with their peers for space or to use the blocks they need. To complete the tower, they must have a plan and execute it from start to finish.

An Example of Executive Function Skills in a College Student

A college student has a professor who communicates with his class about upcoming assignments and exams using an app. The professor asks his students to submit assignments using a different web-based platform. The student has a different professor who wants to use a completely different online platform for submitting assignments and sends a weekly Zoom invitation to connect for weekly web-based classes. In this situation, the student must rely on the professor’s organizational skills and familiarity with technology. The student must also have solid organizational and planning skills to be successful in their classes.

An Example of Executive Function Skills in an Adult Professional

The adult will be asked to use executive functioning skills to lead a team involved in planning and developing a new section of a city. The person will be required to determine the sites for the new buildings and roads, consider emergency and evacuation plans, and collaborate with professionals from various disciplines who will each do their part. The leader will plan, organize, and make decisions to take the project from an idea to a plan to action and ultimately to the point of completion. Without strong executive functioning skills, the plan will not likely come to fruition.

Executive Function Skills In 2024

We used to live a simpler life. Today, our brains are taxed to the limit, and we are met with a constant barrage of decision-making. We make decisions at work, about our homes, and how we will conduct our lives.

As parents, we constantly plan and organize to ensure our children’s needs are met. We continuously communicate via email and text and stay in touch through social media.

The rates of depression and anxiety are soaring. All the demands we put on ourselves may contribute to the skyrocketing numbers. To overcome executive function issues, it is essential to recognize its symptoms and learn how to prevent them.

Causes of Executive Function Disorder in Adults

Some conditions that may contribute to a person having symptoms of EFD include:

Executive function disorder may also be associated with Bipolar Disorder and Obsessive Compulsive Disorder (OCD). Some factors can temporarily lead to executive function issues, including alcohol and drug abuse, sleep deprivation, severe pain, exhaustion, and stress. Executive function skills tend to be weakest in older adults, but they are also becoming a more common problem in younger adults.

7 Signs of Weak Executive Function Skills

Some people are born with weak executive function skills, but those with ADHD, depression, anxiety and autism spectrum disorder (ASD) are at higher risk. Identifying executive function disorder symptoms as early as possible is essential to obtaining the treatment available. Some of the signs of EFD are as follows:

  1. Weakness in Planning and Prioritizing

    People with weak planning and prioritizing skills may not know how to start planning a project. They may be easily overwhelmed trying to break tasks into smaller, more manageable parts, and they may have trouble seeing the big picture. 

    This can be frustrating for the person with poor planning skills and the colleagues and family members who rely on them to meet deadlines and maintain productivity.

  2. Time Management Difficulties

    Allocating time for completing tasks, such as planning out a week of meals or determining how long it will take to complete a project at work, can be a problem for individuals with weak executive function skills. 

  3. Poor Organizational Skills

    People who have weak organizational skills may be considered scattered. They may have poor ability to follow directions and listen. Workspaces may become too cluttered, making it difficult to accomplish tasks. Misplacing and losing possessions, paperwork, etc., occurs often.

  4. Trouble With Flexible Thinking

    Some individuals do not learn how to use flexible thinking intuitively. Others must be taught these core concepts more explicitly.

    Those with trouble being flexible may be rule-bound and rigid in their thinking. They may not be willing to negotiate with other people. They tend to be poor problem solvers and will repeatedly try the same solution that isn’t working. A person with reduced flexibility may have a hard time switching plans once they have been set. 

  5. Working Memory Problems

    This is one of the main areas of executive function. Working memory involves storing information, remembering lists of items and instructions, and solving problems quickly.

    Individuals with working memory problems may find it hard to manage finances, recall and follow both simple and complex directions (i.e., following a recipe), or remember a list of items they are supposed to purchase at the store.

  6. Poor Emotional Control and Impulsivity

    Individuals with poor emotional control may have trouble adapting efficiently to different situations. They may have difficulty self-monitoring their behavior and emotions.

  7. Trouble with Multi-Tasking

    Multi-tasking is a skill that requires an individual to quickly shift their attention and focus from one thing to the next, perform two or more tasks simultaneously, or perform several tasks in rapid succession.

    While some people can manage multiple tasks effectively, others have a hard time focusing on one task for more than a few minutes at a time. A deficit in this area can make life challenging.

How to Diagnose Executive Function

Executive function may be diagnosed informally or through a more formal process, including standardized testing. The gold standard for evaluating executive function is through a neuropsychologist.

Children can often get tested through the school system if they are not meeting the academic standards set up by the school system. In addition to diagnosing executive function, a neuropsychologist can rule out other conditions such as ADHD and learning disabilities as contributing factors.

Speech-language pathologists can also provide an evaluation of executive function. An evaluation will consist of clinical observation, clinical intake, an executive function inventory and can also include executive function formal testing. Speech pathologists typically factor in input from the individual’s neuropsychologist, psychologist, social worker, or school counselor.

8 Useful Tools That You Can Start Using Today

  1. Make a Daily To-Do List 

    Creating a daily list of tasks and projects can help to improve the challenges of executive function disorder. To-do lists can help you stay motivated, organized, and make progress towards your goals. A daily to-do list is a powerful way to manage impulses that can lead to poor decision-making.

  2. Use a Calendar

    Create a daily, weekly, or monthly schedule to track important dates and appointments. Update your calendar daily. Try to make recurring appointments at the same time of day. 

  3. Learn How to Manage Your Time

    Break down to-do lists as "urgent," "important," and "non-urgent." This will allow you to budget plenty of time for those long-term projects that are important to you.

  4. Take Notes

    Take time to write down important dates, reminders, or rules that come up in a designated notebook. Keep it organized. Keep sticky notes in a place that is easily accessible. Take notes related to important calls so that you can keep track of details discussed in meetings and conversations. 

  5. Use Reminders

    Use reminders and alarms to keep you organized and on time for appointments and meetings. 

  6. Keep It Simple

    Reduce the number of activities that you attempt to complete at one time to help you focus and complete the task before moving on to another.

  7. Relax and Breathe

    Practicing stress management techniques like meditation, yoga, deep breathing can improve symptoms associated with weak executive function skills and can help to reduce executive function anxiety.

  8. Stay Organized

    If you find yourself losing items frequently or feeling overwhelmed, try decluttering your home or office. Stay organized and keep your area tidy to help you locate items and feel less overwhelmed.

Professional Help for Executive Functioning

If you want to go beyond implementing simple strategies independently, you may want to consider working with a professional.

A speech-language pathologist is the ideal professional to deliver executive function coaching for adults. Speech pathologists are trained to help individuals develop language skills and assist with the social language aspects of executive function, such as initiating interactions, topic maintenance, and ending/wrapping up a conversation. 

At Connected Speech Pathology, our speech-language pathologists provide direct, one-on-one coaching to address the concerns you may have. We can teach adults and children how to manage multiple activities, including business projects, preparing for presentations, or even homework, all while still finding some downtime.

There are two primary approaches that we can use for building and restoring executive function skills: Environmental and Individual.

Environmental Approach

An environmental approach considers manipulating your surroundings to build executive function skills.

These foundational skills may involve things like:

  • creating a healthy, stable environment at home and in the workplace

  • getting adequate sleep

  • reducing anxiety

  • increasing relaxation time

  • maintaining a healthy diet

  • exercising

Individual Approach

By focusing on real-life daily situations, the individual intervention approach strengthens executive function skills by teaching individuals how to adapt to changes and demanding situations.

A speech-language pathologist can help determine the appropriate ways to target executive functions for each person's unique situation.

Speech therapy for executive function may target how to:

  • identify a core problem

  • plan a solution

  • implement solutions

  • monitor progress

  • adapt to new situations

Executive functioning coaching may also include using positive self-talk and reframing a state of mind or situation; and behavioral techniques such as relaxation breathing.

Not all speech-language pathologists are trained to help individuals with executive function challenges. At Connected Speech Pathology, our speech pathologists have training in this area, and our services are provided remotely in the comfort of your home.

Start by scheduling a free phone consultation!


allison-geller

About the Author

Allison Geller is a speech-language pathologist (SLP) and the owner of Connected Speech Pathology. She obtained her Bachelor’s and Master’s degrees from the University of Florida in Speech-Language Pathology. Allison has practiced speech therapy in a number of settings including telepractice, acute care, outpatient rehabilitation, and private practice. She has worked extensively with individuals across the lifespan including toddlers, preschoolers, school-aged children, and adults. She specializes in the evaluation, diagnosis, and treatment of a variety of communication disorders including receptive/expressive language disorders, articulation disorders, voice disorders, fluency disorders, brain injury, and swallowing disorders.

Allison served as the clinical coordinator of research in aphasia in the Neurological Institute at Columbia University Medical Center in New York. She is on the Board of Directors for the Corporate Speech Pathology Network (CORSPAN), a Lee Silverman Voice Treatment (LSVT) certified clinician, and a proud Family Empowerment Scholarship/Step-Up For Students provider. Allison is passionate about delivering high quality-effective treatment remotely because it’s convenient and easy to access. What sets us apart from other online speech therapy options is—Allison takes great care to hire the very best SLPs from all over the country.



If you have any questions or would like to work with one of our speech therapists to see how we can help strengthen your executive functioning skills, get started with a Free Consultation.

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