2.1 Symptoms of EFD

Executive functions do not develop in the exact same way for everyone, so the signs of EFD may differ from person to person.

2.1.1 General:

People with EF difficulties may experience the following symptoms:

• time blindness, or an inability to plan for and keep in mind future events
• difficulty stringing together actions to meet long-term goals
• trouble organizing materials and setting schedules
• trouble controlling emotions or impulses
• difficulty analysing or processing information

Executive functions allow people to do the following:

• Analyse a task
• Plan how to address the task
• Organize the steps needed to carry out the task
• Develop timelines for completing the task
• Adjust or shift the steps, if needed, to complete the task
• Complete the task in a timely way

When a person has weak executive functions in certain areas, he or she may have trouble analysing, planning, organizing, scheduling, and completing tasks. People with executive dysfunction and/or ADHD commonly lack the ability to handle frustration, start and finish tasks, recall and follow multi-step directions, stay on track, self-monitor, and balance tasks (like sports and academic demands). Remediating the area of deficit reduces academic or work difficulties.

2.1.2 In children

What are symptoms? Children and adolescents with executive functioning difficulty struggle with working memory, impulse control, and cognitive flexibility, which interfere with their daily lives. Issues with executive functioning can look different at different ages, below are some examples. Working Memory:

• Trouble remembering rules of a game or steps in a process
• Has trouble estimating the time needed to complete a task, struggles with time management
• Has difficulty with organization and loosing personal possessions
• Difficulty memorizing and retaining facts and information
• Has trouble evaluating or monitoring their progress or performance

Impulse Control:

• Has difficulty sustaining attention
• Speaks or acts without regard for consequences
• Has difficulty waiting for things, or taking turns
• Has trouble regulating emotion and frustration

Cognitive Flexibility:

• Has difficulty changing tasks
• Has trouble shifting problem-solving strategies even if the current strategy is not working well
• Difficulty applying different rules in different settings, or changes in routine

Part of executive function is how fast you process information. Some children have slower processing speed, which means they need more time to take in and respond to information. Since executive skills develop over time, children can struggle in different ways at different ages. Here are some signs you might see at various ages. Age 3-5

• Gets frustrated easily, might throw things instead of asking for help
• Has trouble following directions and often forgets what to do

• Has lots of tantrums over things that seem minor (Please see our courses Understanding Sensory Processing or Understanding Discipline to learn the differences between tantrums and a sensory meltdowns)

• Acts out instead of expressing feelings
• Struggles with basic classroom tasks like finding things in a cubby or packing up at the end of the day
• Raises hand but does not remember the answer when called on
• Is very stubborn about doing things a certain way
• Answers questions in a way that is off-topic

Age 5-10

• Starts a task and gets distracted, then does not finish
• Can solve a math problem one way but gets stuck when asked to solve it a different way
• Focuses on the least important thing you said
• Mixes up assignments and does not bring home the right books and handouts needed for homework
• Has a messy desk and backpack
• Panics when rules or routines change, like going out to dinner instead of ordering in because it is Friday and that’s pizza night
• Sticks with a plan even when it is clear that the plan is not working

Age 11-13

• Wants to invite children over but never gets around to scheduling it
• Hesitates to make afterschool plans and instead just follows what the other children are doing
• Is still arranging materials in science lab while the other children are halfway through the experiment
• Has a hard time starting a big assignment and focuses on the less important details first
• Gets very upset about seemingly small things, like running out of a favourite snack at home
• Often thinks the teacher is being “unfair,” like when told to do work at home that other children finished in class

Age 14-18

• Has trouble finishing short-answer tests on time
• Loses track of time and is often still “in the middle of something”
• Has not filled out any of the job applications that have been sitting around for a month
• Tries to convince you to extend curfew but cannot give any good reasons why
• Has trouble working in groups and complains about the other children
• Has a hard time taking and acting on feedback
• Is impulsive and takes lots of risks
• Is overly optimistic or unrealistic

If some of these signs sound like ADHD, there is a reason. ADHD is a problem with executive function. But children do not have to have ADHD to have trouble with executive skills. However, if you are noticing a lot of these behaviours, you might want to learn more about ADHD. An ADHD evaluation can help you understand what is going on. (Please also refer to our course Understanding ADHD for comprehensive information on this topic)

2.2 Executive Function Disorder in Adults

These seven executive function skills are critical in managing everyday life and long-term goals:

1. Self-awareness: Simply put, this is self-directed attention
2. Inhibition: Also known as self-restraint
3. Non-Verbal Working Memory: The ability to hold things in your mind. Essentially, visual imagery — how well you can picture things mentally
4. Verbal Working Memory: Self-speech, or internal speech that people think of this as their “inner monologue”
5. Emotional Self-Regulation: The ability to take the previous four executive functions and use them to manipulate your own emotional state. This means learning to use words, images, and your own self-awareness to process and alter how we feel about things
6. Self-Motivation: How well you can motivate yourself to complete a task when there is no immediate external consequence
7. Planning and Problem Solving: Experts sometimes like to think of this as “self-play” — how we play with information in our minds to come up with new ways of doing something. By taking things apart and recombining them in different ways, we are planning solutions to our problems

When a person has EFD, he has trouble analysing, planning, organizing, scheduling, and completing tasks. People with EFD commonly lack the ability to handle frustration, start and finish tasks, recall and follow multi-step directions, stay on track, self-monitor, and balance priorities. Fixing the area of deficit is key to fixing academic or occupational difficulties. Common signs and symptoms of EFD in adults include:

• Forgetting to complete tasks
• Inability to keep track of personal items like keys and cell phones
• Trouble following conversations
• Losing train of thought
• Difficulty remembering steps in a multi-step processes
• Inability to remember names
• Often late
• Problems breaking big projects into steps
• Trouble meeting deadlines
• Unable to multitask
• Difficulty remembering abbreviations and acronyms

Identifying symptoms can help adults set up external supports to supplement areas where they struggle. An adult diagnosis of ADHD or ASD may prove helpful in understanding symptoms as well for future therapy options.

2.2.1 Symptoms of Executive Dysfunction at Home

These, and other common manifestations of EFD may be apparent at home:

• You have something you want to ask your friend, but she is on the phone and you must wait a few minutes before asking. By the time she is finished, you completely forget what you wanted to ask.
• When you are talking with a friend, you find it difficult to follow the conversation, forgetting what your friend said just moments before.
• When you are completing a task with several steps, such as getting the trash, taking it outside, and then putting a new bag in the trash can, you usually forget the last step.
• When you read something, you usually end up going back to re-read the prior section because you cannot remember it.
• You constantly misplace your cell phone. You feel like you waste time every day looking for your phone and other misplaced items like keys or glasses.
• You have difficulty finding a work-life balance. When you try to take on personal activities, it is hard to figure out how much time to spend on what.

2.2.2 Symptoms of Executive Dysfunction at Work

These or similar manifestations of EFD may be apparent at work:

• In the morning, you rush around to get ready for work but still often end up being late.
• You plan to complete some work at home and pack up the items you need at the end of your work day. When you sit down to do the work, you realize that you forgot to bring home several critical items.
• You are often accused of not listening because you do not follow through on tasks you are asked to do.
• You have a hard time remembering your co-worker’s names, even if you have met them multiple times.
• You have a hard time managing large projects. Even when you break them down into steps, you find you miss pieces or end up spending too much time on tasks that do not have much importance.
• Even when you have a deadline, it is hard to just sit down and get started on your assignments.
• Co-workers would describe you as ‘easily frustrated.’

If you experience these or similar symptoms of EFD, consult a doctor or mental-health professional for a formal assessment.