By Kristina Marie Smelley
Imagine how frustrating your day would be if you were unable to plan ahead, predict what would happen next, organize your thoughts, or keep track of time? What if it was a daily struggle to remember homework, solve problems, get to class on time, or simply find your pencil? Is it just laziness or rebellion, as many would assume?
For many students with autism, the real problem is a deficit in executive functioning skills.
Executive function processes, located in prefrontal cortex of the brain, play a large part in directing our behavior choices. They help us plan, organize, keep track of time, remember details, make decisions, organize our thoughts and control our emotions and impulsivity. From getting dressed to choosing what to play on the playground, kids rely on executive function to get them through the day.
“At around 9 to 11 years old, children are expected to be more independent,” says Mikki Kistler, occupational therapist at Groundplay Therapy Works in Portland. “It’s important for parents and teachers to realize that because of the executive function deficit, many children with autism need supports because they just don’t have these abilities yet. We need to work together to come up with strategies and modifications that can help keep them organized and emotionally regulated.”
Executive function skills come from a region of the brain that is more sensitive to stress than any other. Even mild stress can flood the prefrontal cortex with the neurotransmitter dopamine, causing executive functioning to shut down. Sensory processing problems, commonly seen in those with autism spectrum disorder, can often result in so much stress that children will act out impulsively or become overridden with anxiety. This is where teaching self-awareness can help.
“Children with autism don’t understand they have a deficit in this area,” Kistler adds. “We need to teach them to become aware of their own body and to recognize when they are having a problem. Only then can they learn how to deal with it appropriately before panicking or feeling discouraged because they aren’t coping well.”
There are many tools Kistler uses to help children become more self-aware. Programs like Zones of Regulation or How Does Your Engine Run help children recognize when their body is getting out of control and gives them tools to cope. For example, if a child is in the “blue zone,” it signifies that he or she is feeling sick, tired, sad, bored, hurt or exhausted.
On the other extreme, the red zone represents that the child is feeling angry, mean, terrified or aggressive. Coping mechanisms may be anything from deep breathing and stretching to taking a break to rest in a quiet place.
Executive function processes are located in the part of the brain that also is the last to mature, not fully developing in most individuals until age 25-30.
Amanda Swinford, mother to a 19-year-old boy with autism, still deals with her son’s executive function challenges.
“My son still needs lots of reminders, notes and scheduled check-ins,” she says. “Acknowledging successes and talking through how helpful strategies can be applied to other situations is important. Simplifying multi-step tasks, having daily ‘debriefings’ and reviewing upcoming events and tasks is crucial.”
Implementing daily visual daily schedules and planners for older students, timers, maps of the school, scheduled check-ins and social stories are all supports that can be implemented. Music and songs have also been proven as a great way to help kids remember important details.
“All of these strategies work sometimes for some things,” Swinford says. “Supports—along with time, maturity, communication and lots of patience—have been the biggest helps for us in overcoming executive function deficits.”
Kristina Marie Smelley is a Portland freelance writer with many years of experience in public relations and corporate communications. She co-leads a Portland area support group called “REST” for moms with children who experience special needs. She is married with two children, one with autism. She is also a local singer-songwriter currently working on a collection of life-skills songs for children with special needs.