Tourette Syndrome Plus - Conditions - Executive Dysfunction - Overview of Executive Dysfunction Pg. 4

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Information Section: Conditions
Condition: Executive Dysfunction
Article: Overview of Executive Dysfunction¹
Source: Leslie E. Packer, PhD, 1999
This File Last Updated: December, 2004

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NOW WHAT?

What happens when we recognize that someone has serious problems with organization and that the source of the problem isn't laziness or lack of motivation?

In the author's experiences with schools, she has often observed that the 504 Plan or IEP makes all kinds of provisions for the teachers and parents to somehow compensate for the student's problem: the teacher is to record the assignments or check off that the student has recorded and packed them; the parent is to initial a notebook showing what came home and what got done, etc. The parents and the teachers, who are already more organized than the child, just engage in more organizing behavior without ever really teaching the child how to organize himself or constructively engaging him in solving his problem. Seldom do I see an IEP where there are specific goals and objectives listed that address teaching the child the organizational skills that he will need to function independently.

Carrying that kid around when he's 30?

Unless you want to be following that child around when he's 30, you'd better start figuring out a way to teach him how to organize himself and meet his responsibilities.

There are two ways to view this problem. One is to say that the child needs our support, and that by supporting the child by providing the back-up copies, etc., we are reducing the child's vulnerability and doing A Good Thing. And maybe, along the way, the child will begin to do what he sees us doing and will develop the organizational skills. But if the child is feeling vulnerable and our taking care of all the organizational problems reduces that vulnerability, why will the child risk "blowing that" by attempting to organize himself? Even a child who is motivated to organize himself is likely to assess the situation and recognize that the adults are going to do a much better and more consistent job than he could ever do, so why even try?

Now consider another approach -- one in which we work with the child as their consultant or supporter to help them organize themselves. We let the child recognize and appreciate where their problems are and ask how we can be of help to them, assuming the best -- that they want to be responsible and organized. Often, the ideas or strategies that they come up with may be better than anything we could come up with and since they are now vested in the strategy, they are more likely to comply with it.

So we determine if they're motivated to organize themselves and offer our support. Within that context, there are a number of tricks or strategies that can be used. Hopefully, they will be used within in a context in which we are trying to support the child's efforts to organize themselves. We do so recognizing that there will be many 'failures' along the way, and that if we want the child to succeed, we have to make it emotionally safe for them to try and even to fail. We need to reduce their vulnerability and we do by reducing our own. As parents, teachers, or spouses, we are not responsible for doing our child's work. We are not responsible for 'nagging' them to do their work. If they tell us that they would find it helpful to have a reminder at a particular time so that they can start their work, we can provide that reminder. But we probably should stop at the point when our efforts are not experienced as support and become 'nagging' or confrontation -- particularly if they have mood lability or are otherwise prone to explosive outbursts.

One final note: students and adults both may benefit from computers or electronic organizers that incorporate calendars with repeating functions. How much better to teach someone that although he may not remember things easily, he can teach himself to rely on a computer as a memory prosthesis. We can teach most children and adults to program their own reminders on computers. Alarms can be set (by them) so that they stay in control of taking responsibility. Such devices become lifelong tools that enable independent functioning and can rightfully be considered assistive technology and/or a reasonable accommodation.

EXECUTIVE FUNCTION IN ADULTS

Although this site focuses on children and adolescents, adults with EDF have the same needs for strategies, training, and support. In the last decade, there has been a growing field of "coaches" to help adults organize themselves. There are also self-help books to provide tips and strategies, and there's even a show on cable TV oriented to how to organize one's space and belongings.

Executive dysfunction is not the kind of problem that you 'outgrow,' although many children and adolescents do learn strategies to manage themselves. But how many "terminally disorganized" adults never realized that they had a neurocognitive problem -- or knew what to do about it?

The same kinds of strategies that work for students may also be of benefit to adults who suffer from executive dysfunction. Learning to use a day planner or PalmPilot, learning to allow more time for activities or to get to a business appointment, learning how to successfully cope with the multi-tasking demands of the employment setting are all essential skills, and adults with EDF (or their spouses) may find it helpful to look at the tips or strategies articles on this site and adapt the strategies to their needs.

Adults who are really struggling may wish to hire a "coach" who can help with learning employment-related skills or routines; other coaches serve to help individuals organize their personal lives.

And if you're really disheartened -- or if you're a spouse who is frustrated beyond belief by all the time spent looking for misplaced car keys, the wallet, important documents, etc., here's a true story that may inspire you:

A few years ago, my husband decided that he was going to learn to organize himself (yes, I am married to one of those "terminally disorganized" ADDults). Off he went to the library to get a book to teach him how to organize himself. It was one of those books with an overly optimistic title like "How to Organize Your Life in 7 Days and Prevent Your Spouse From Killing You Out of Frustration" (if there's no book by that title, there probably should be). He came home with the book, read the preface, and then happily explained to me how he was to read one chapter a day, and at the end of the week, he'd be organized.

Six weeks later, the first overdue notice arrived from the library. My husband had put the book done after reading the preface, and had forgotten about it. Because the book was not where he'd see it as he went about his daily routine, he'd forgotten all about it and never gotten past the preface.

Did I mention that you should expect a bumpy road?

COMMENT

Boing!

If you're feeling a bit "stunned" by what you're reading, that's fine. I get a slew of emails from parents and teachers who just went "wow" when they read this section of the site and realized that I was describing their child or student.

If you're a parent and you're feeling guilty that you didn't know, then think about this:

If the professionals you talked to or took your child to didn't think to consider assessment, then why should you have known?

FOOTNOTES

1 The author is deeply indebted to Sheryl K. Pruitt, M.Ed., for her input and contributions to this section, but the author retains full responsibility for any errors.

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