Ok fuckeroonis, I’ve had an anger storm brewing for a few days because people have been awful on the internet and also some total garbage juice of a human being murdered some children last week and then our fucking president blamed it on mental illness so I HAVE FEELINGS.
Which means that this post is going to be less safe for work than usual. It’s gonna have some Words and some Thoughts. We’re going to talk about executive functioning and how a lot of asshats out there want to call neurodivergent people “lazy” instead of recognizing that executive dysfunction is a thing.
First of all what does the phrase “executive functioning” mean? It’s something that I talk about approximately once every 30 seconds because it’s hugely important for how humans work, whether we have functional executive functioning or dysfunctional executive functioning. It also is one of those things that when you explain it to someone with dysfunction, a little lightbulb goes off in their head and you can see the light in their eyes and they burst out with “THAT’S why I’m like this?” and it’s really beautiful and affirming to see. Hopefully I can give a few people that moment today.
At root, executive function is an umbrella term that refers to all the thinking skills that help you manage your life and get things done. It includes things like time management, impulse control, task prioritization, transitioning, working memory, attention, flexibility, and planning. From what we can tell, these are all controlled by the frontal lobe, and good executive function is highly correlated with success in school and later in life.
For people who have executive dysfunction it can be inexplicably difficult to start on a new project, break something into reasonable steps, switch focus, manage time (you might look up and notice hours have passed and you had no idea), or keep track of what you’re doing. It can even play a role in emotion regular. You’d be surprised at how many tasks in our daily lives require us to engage our executive function. Everything from cooking a meal (you have to plan ahead to have the ingredients on hand, plan to start cooking before you’re hungry, follow the steps in the recipe, initiate multiple tasks over time, pay attention to each step and potentially multitask, and keep all your ingredients and implements organized then put away) to planning a paper (there’s a reason we go to school to learn how to break this down into steps and understand how to start and plan it as a project).
There’s not really any debate about the fact that human beings have this set of skills and that we often use these skills to accomplish things in our daily lives. Many people don’t realize how often we’re using these types of skills each day because for those who can do it naturally it’s easy to ignore all the small tasks your brain does automatically.
What many people DO have an issue with is the idea that some people (and most often people with specific diagnoses like autism or ADHD) actually CANNOT use these skills in the way that neurotypical people can. That’s called executive dysfunction. In ADHD and autism circles it’s fairly well established that the diagnoses come with executive dysfunction. There are studies that show consistently that these diagnoses are correlated with executive dysfunction and that in imaging studies there are differences in the brains of neurodiverse individuals who are trying to use executive function in comparison with neurotypicals. In addition, patients who sustain damage to their frontal cortex lose executive function skills, indicating a clear correlation.
It’s extremely common for folks to say that people with bad executive functioning are lazy, unmotivated, or just not trying hard enough. Let’s talk about some studies and some science, and what it indicates about the actual cause of the struggles that people with executive dysfunction have.
First, it is possible to look specifically at the skills we label “executive function”. It’s not a general word for “intelligence” or “success”. There are discrete skills, and those skills can be studied. You can check out a 15 year meta analysis of the data on executive function in preschoolers here if you’re interested in the basics of executive function and how we quantify it.
In ADHD in particular, we have a fairly decent understanding of what chemicals are responsible for the impairments, and good evidence that medication helps to improve the situation. We also have fairly extensive studies of how well individuals with autism do on executive functioning tasks in comparison with control groups, that seem to demonstrate impairment in executive functioning in ASD.
It’s easy to think that diagnoses like ADHD and autism are just things that clinicians create based upon their experience with patients. However there is a great deal of money that goes towards studying these phenomenon and trying to understand the underlying impairments. We have years of studies that show in clinical trials people with diagnoses cannot complete executive functioning tasks with the same acuity as neurotypicals, and we also have data correlating those challenges with difficulty in school and work. The science backs up the fact that people aren’t faking how hard it is for them to focus, begin tasks, plan, and remain on task. In fact it doesn’t matter how much they want to, how much their parents yell or plead or bed, how much they punish or reward themselves…what works are executive functioning training/skills programs or medication.
Finally, I just want y’all to imagine that you have the ability to complete your tasks. Every time you don’t, you get flak from parents, teachers, friends. You lose jobs. You get kicked out of school. You’re barely scraping by. You forget to eat or shower. Now I want you to think about whether you would ever intentionally do that to yourself. NO because it sucks, and not being able to take care of basic tasks is awful. It sucks to make mistakes at work, to screw up at school, to know you should be able to get something done but not know how to make yourself do it.
So if you’re one of the folks that thinks everyone should just buckle down and work harder, know that fighting your own brain to complete every task is exhausting and painful. We’re already working harder than you can imagine. It doesn’t actually help anyone, it’s not “tough love”, and it’s not “just the truth” to say we’re lazy and could just do it. It causes shame, self hatred, low self-esteem, and depression because being told you should just go ahead and do something you cannot do is gaslighting on the next level.
Now please never ever say that people with ADHD and Autism and other neurological disorders are just lazy ever again or I’ll have to find you more research.