What is executive function?
Executive function is a set of skills that enable you to do things such as:
- pay attention
- remember information
The skills are used in:
- paying attention to little details
- time management
These skills start developing around 2 years old and are fully formed by the age of 30.
Executive dysfunction can describe difficulties in any of these abilities or behaviors. It can be a symptom of another condition or result from an event such as a traumatic brain injury.
Sometimes executive dysfunction is called executive function disorder (EFD). EFD is not clinically recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM) used by mental health clinicians.
Examples of executive function
Executive functions (EFs) are a group of mental processes. It is generally accepted that there are three core executive functions:
- inhibition, which includes self-control and selective attention
- working memory
- cognitive flexibility
These make up the roots from which the other functions stem. Other executive functions include:
These functions are necessary for healthy development. They’re especially important in your job or school performance.
In everyday life, EFs show up in things like:
- the ability to “go with the flow” if plans change
- doing homework when you really want to go outside and play
- remembering to take all of your books and homework home
- recalling what you need to pick up at the store
- following complex or detailed requests or instructions
- being able to plan and execute a project
What are the symptoms of executive dysfunction?
Symptoms of executive dysfunction can vary. Not everyone with this condition will have the same exact signs. Symptoms can include:
- misplacing papers, homework, or work or school materials
- difficulty with time management
- difficulty organizing schedules
- trouble keeping your office or bedroom organized
- constantly losing personal items
- difficulty dealing with frustration or setbacks
- trouble with memory recall or following multistep directions
- inability to self-monitor emotions or behavior
What causes executive dysfunction?
A variety of conditions can impact executive function. These conditions can include:
- conduct disorder
- obsessive-compulsive disorder
- fetal alcohol spectrum disorders
- learning disabilities
- Alzheimer's disease
- drug or alcohol addiction
- stress or sleep deprivation
A traumatic brain injury can cause executive dysfunction, especially if there has been injury to your frontal lobes. Your frontal lobes are associated with behavior and learning, as well as higher-order thinking processes like planning and organization.
There is also some evidence that executive function can be hereditary.
How is executive function diagnosed?
There are no specific diagnostic criteria for executive dysfunction, since it’s not a specific condition listed in the DSM. Rather, executive dysfunction is a common aspect in the disorders mentioned earlier.
If you suspect that you have executive dysfunction, talk with your doctor. They will examine you to see if any physical condition might be causing your symptoms. They might also refer you to a neurologist, psychologist, or audiologist for further testing.
There’s no single test that identifies executive dysfunction. But there are a variety of screening tools and methods like interviews to discern whether you have any executive dysfunction, and whether it is associated with an existing condition.
If you’re concerned about your child’s executive function, you and their teachers can fill out the Behavior Rating Inventory of Executive Function. This will provide more information about behaviors.
Other tests that might be used include:
- Conners 3, a rating scale often used with ADD and EFD
- Barkley Deficits in Executive Functioning Scale for Adults
- Comprehensive Executive Function Inventory
How is executive dysfunction treated?
Treating executive dysfunction is an ongoing process and is often lifelong. Treatment can depend on the conditions and the specific types of executive dysfunctions that are present. It can vary over time and depends on the specific EFs that are challenging.
For children, treatment typically includes working with various kinds of therapists, including:
- speech therapists
- occupational therapists
Cognitive-behavioral therapy and medication can be helpful for individuals with executive dysfunction. Treatments that focus on developing strategies to address the particular dysfunction are also helpful. This could include using:
- sticky notes
- organizational apps
Medications have been helpful in some individuals with EF disorders. According to one review, the parts of your brain that play roles in EFs use dopamine as the main neurotransmitter. So, dopamine agonists and antagonists have been effective.
What is the outlook for executive dysfunction?
Executive dysfunction can interfere with life, school, and work if not treated. Once it's identified, there are various treatments and strategies that can be used to help improve EFs. This will also improve work and school performance and improve your or your child’s quality of life.
Issues with executive function are treatable. If you think you or your child might have EF problems, don’t hesitate to talk with your doctor.