What is Executive Dysfunction?: A Guide for Parents and Teachers

Everyone can struggle with motivation at times. This can make approaching tasks feel like an insurmountable challenge, leading to feelings of guilt and shame the longer we struggle to get started. Whilst for some this can be a temporary reaction to life’s distractions, for others it can be an unavoidable lifelong struggle. For neurodiverse children and young people with conditions such as ADHD and autism, this can make everyday tasks that many neurotypical people do not struggle with seem impossible. This in turn can impact their academic attainment and see them labelled as ‘lazy’ for something they cannot control. Whilst neurodiversity is not a monolith and people with the same condition can present in many different ways, understanding the correlation between neurodiversity and executive dysfunction enables teachers and parents to better support the children in their care who may be struggling. In this article we will explain what executive dysfunction is, provide examples of how it may present itself and offer guidance on how you can support someone who is struggling with executive dysfunction.

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What is Executive Dysfunction?

Executive functions refer to the mental skills that people use every day to get things done. Many of these functions are automatic and most people don’t need to give them much thought. Executive functions help people to plan things, prioritise activities, multi-task and have motivation. These are inherently complex abilities however the fact that they are automatic for many people means that they can easily be taken for granted. 

When someone struggles with executive functions they can find it hard to do tasks that appear simple to everyone else. This is commonly referred to as ‘executive dysfunction’ though it’s important to note that executive dysfunction is not a medical diagnosis, instead it is typically seen as a comorbidity of other diagnoses such as attention deficit hyperactivity disorder (ADHD) or autism.  

They ways in which executive dysfunction can manifest will be explored in-depth later in the article, however some examples include:

• Daydreaming
• Trouble planning or finishing a task
• Struggling to transition from one task to another
• Reduced impulse control
• Difficulties with self-motivation

What Causes Executive Dysfunction?

Executive functions are controlled by the frontal lobes of the brain. Neural networks, such as the prefrontal cortex, parietal cortex, basal ganglia, thalamus and cerebellum, impact a wide range of cognitive abilities such as drive and goal-oriented behaviour. Injury to or dysfunction of these networks can lead to the impairment of executive functions rendering it hard for someone to undertake certain roles, activities and interactions. Damage to these neural networks can be: 

• A symptom of a mental health problem such as depression or anxiety
• A symptom of a neurodevelopmental condition such as ADHD or autism
• A symptom of a specific learning difficulty such as dyspraxia, dyscalculia or dyslexia
• Temporary due to illness, stress, fatigue or substance misuse
• Caused by a neurological condition such as a head injury, stroke or meningitis
• Caused by natural age-related changes in the brain or a condition related to aging such as dementia

As mentioned above, executive dysfunction is not a standalone diagnosis and is typically seen as a comorbidity of a different diagnosis. As such, executive dysfunction is common among children and young people with ADHD and/or autism. 

For those with ADHD there are two common theories as to the impact of the condition on executive functions. The executive dysfunction theory posits that the symptoms of ADHD arise as a result of a reduction in executive control which is caused by abnormalities in the frontoparietal and frontostriatal neural networks. Difficulty with cognitive tasks is a common diagnostic criteria for ADHD though it should be recognised that studies have shown that those with ADHD do not necessarily show weakness in all key executive function domains. The state-regulation theory suggests that an inability to properly regulate brain arousal may contribute to the higher-level cognitive deficits found in ADHD. The theory argues that a lack of alerting signals leads to both executive dysfunction and hyperactivity symptoms. 

For autistic individuals, executive dysfunction can be caused by differences in how their brains process information. Autistic brains often utilise different areas of the brain to solve problems. Whilst this can lead to creative new ways of thinking, it can also cause difficulties in completing seemingly automatic executive functions. The difference in autistic brains may be linked to nerve fibres which carry signals that help process information. As these can be different for autistic individuals compared to non-autistic individuals, it can make socially expected executive functions harder to complete. Whilst it should not be assumed that all autistic individuals struggle with executive dysfunction, research suggests that up to 80% of autistic people suffer from it. 

It should be noted that external factors such as stress, trauma and an unfriendly environment can exacerbate executive dysfunction. These may not always be linked to neurodivergence regardless of whether a child or young person has a diagnosis. The NHS notes that it can be helpful to consider whether someone’s executive dysfunction is because of their neurodivergence or because they are trying to cope in a world that isn’t designed for them. It should also be considered that one to two thirds of children with autism also meet the criteria for ADHD. For children and young people who are autistic and have ADHD, often referred to as AuDHD, this can exacerbate their executive dysfunction as their brains are overloaded by a constant internal ‘tug of war’ between the two conditions.  

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Executive Dysfunction Examples

Neurodiversity is not a monolith and it can manifest vastly differently in each individual. This is also true in how it manifests in children and young people compared to adults. An autistic adult with lower support needs may not appear to struggle with executive dysfunction at all. However, this could be due to them masking and suppressing their autistic traits. Autistic children may find it harder to mask and so their executive dysfunction may appear more obvious. 

Similarly, an adult with ADHD may have a better understanding of how executive dysfunction impacts their life due to getting targeted support. Many people with ADHD struggle with feelings of guilt and shame due to social challenges, self-criticism and perceived failure. For young people who have not had targeted support for their ADHD, this cycle of guilt and shame can exacerbate executive dysfunction to the point where they are unable to actively seek help. 

A child or young person who struggles with executive dysfunction may struggle to:

• Pay attention for extended periods of time
• Exercise self-control
• Switch from one activity to another
• Retain information in their working memory
• Manage their time effectively
• Start a task or project
• Finish a task or project
• Keep track of what they are doing
• Wait their turn
• Manage their emotions
• Think before they act

These difficulties can greatly impact a child’s education as they may struggle to:

• Prepare for important exams
• Start and/or finish work without support
• Focus on important details 
• Retain important information 
• Bring the correct supplies to school
• Keep track of items that they need for school
• Control their impulses leading to class disruptions or exclusions

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How to Support Children with Executive Dysfunction

As mentioned above, executive dysfunction is not a standalone diagnosis but a common comorbidity of conditions such as ADHD and autism. Only a medical professional can diagnose a child with ADHD or autism, however as a parent or teacher you may notice signs that suggest a child has one of these conditions. In this instance you should seek out professional help as treating these conditions, either with therapy or medication, can help to alleviate symptoms of executive dysfunction. It should also be remembered that a child or young person who shows signs of executive dysfunction is not automatically neurodiverse. It may be a temporary response to certain factors such as stress or it may be because of something else that has caused damage to their frontal lobes. 

If a child already has a diagnosis of ADHD or autism, or another neurodevelopmental condition that impacts their frontal lobes, it should not be assumed that they will automatically suffer from executive dysfunction. As research has shown, many autistic individuals and people with ADHD are able to fulfil certain executive functions with no issues whatsoever. Nevertheless, having a pre-existing diagnosis allows teachers and parents to better prepare for the struggles that a child may have and pre-empt these with reasonable adjustments. 

Finally, it must be remembered that ADHD and autism are lifelong conditions. The belief that you can ‘outgrow’ ADHD is an archaic and damaging myth that can cause many adults with ADHD to feel continued shame and guilt. Therefore, children and young people should not be encouraged to ‘grow out’ of their executive dysfunction. Their struggles are not a reflection of their youth or perceived immaturity, but a neurological challenge which they are likely to struggle with their for entire lives. Instead, they should be encouraged to find ways to cater to their needs and find resources and tools that can alleviate the difficulties caused by executive dysfunction. 

There are many different ways to support a child or young person with executive dysfunction depending on what they are struggling with. It may be beneficial to ask them what they struggle with and to observe what functions they seem to find challenging so you can offer targeted support. You may find that they require different support for school compared to at home. As such, teachers and parents working together can ensure that the right support is always available regardless of the environment. 

To support a child or young person with executive dysfunction at school you can:

• Remove things from the classroom that are likely to cause distractions
• Encourage them to spend a few minutes thinking before starting a task
• Break activities down into smaller steps
• Make a timeline for longer tasks/projects to help manage expectations
• Use written checklists to support them through different tasks
• Use visual stimuli such as calendars to help with long term memory  
• Model or demonstrate a task in advance to highlight what skills will need to be used
• Set time limits for tasks or the steps within a task
• Introduce a planner to help with poor working memory
• Explore different teaching methods to help them retain important information

To support a child or young person with executive dysfunction at home you can:

• Establish a post-school routine to help with transitional periods
• Introduce mindfulness practices such as deep breathing or meditation to help with emotional regulation
• Use a rewards system to boost motivation
• Externalise planning with visual reminders of things they need to remember 
• Create a daily/weekly to-do list that can be checked off as each step is completed
• Give time warnings well in advance 
• Clearly explain social expectations in certain situations
• Play games that can help them to practice executive functions such as maintained focus and planning ahead
• Encourage them to consider different potential outcomes to develop their ability to adapt to change
• Give clear and concise direction when asking them to do tasks around the house

Whether supporting a child in the home or at school, positive reinforcement is a powerful tool when helping to combat executive dysfunction. As many of these functions are automatic for neurotypical individuals, those who struggle can feel immense feelings of shame at the fact they find seemingly simple tasks so difficult. Positive reinforcement helps to reduce shame and can encourage a child to think more positively about the adaptations that they need to support their executive functions. 

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Anyone can struggle with executive functioning but when those struggles are daily and debilitating they can cause frustration, anxiety and shame. Executive dysfunction is not laziness, it’s a neurological challenge that many children and young people struggle to overcome without the right support or guidance. Teachers and parents are well positioned to support children and young people with executive dysfunction by providing them with tools and resources that can help them throughout their lives. 

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Further Resources:

• How to Support a Child with Autism in the Classroom
• Managing ADHD in the Classroom: Teaching Strategies and Tips
• Sensory Needs in the Classroom
• Parenting Changes to Make for Teens with Autism
• Recognising Signs of ADHD in Children
• ADHD Myths and Facts
• Non-Verbal Communication in Autism
• Autism Awareness Training Course
• ADHD Training