Autism in the Adult

Join Dr. Regan in an episode about the power of small talk as a social welcome mat and a way of testing the waters before creating longer social connections.  Neurodiverse Love Conference 2025 Use checkout code Theresa50 for $50 off _______ Autism in the Adult website Resources for professionals Video Visits Video Courses      

Join Dr. Regan for this episode of the Lifespan of a Household Series. The episode focuses on the experience of the autistic adult during the seasons of retirement and the empty nest.  Calendar example:      Autism in the Adult website Resources for professionals Video Visits Video Courses  

Join Dr. Regan for this episode of the Lifespan of a Household Series. The episode focuses on the experience of the autistic parent in a household with teens and young adults. Dr. Regan discusses the child's quest for identity and separation and the parent's changing role. She reviews coping strategies for the parent during this time of transition and uncertainty. Autism in the Adult website Resources for professionals Video Visits Video Courses  

Join Dr. Regan for the sixth episode of the Lifespan of a Household Series. The episode focuses on the experience of the autistic parent in a household with preteen children. Dr. Regan discusses the parent's shifting role across the child's developmental seasons, develops images to help parents relate to the shift, and provides practical input about succeeding in these changes in the parenting role.  The Holidays and Autism: Holding Fast and Letting Go Planning a Merry Holiday on the Autism Spectrum How to Talk So Kids Will Listen and Listen So Kids Will Talk   Autism in the Adult website Resources for professionals Video Visits Video Courses      

Join Dr. Regan for the fifth episode of the Lifespan of a Household series. Today's episode focuses on topics important to autistic individuals who are parenting young children.   Autism in the Adult website Resources for professionals Video Visits Video Courses    

Join Dr. Regan for the 4th episode in the Lifespan of a Household series. Today's episode focuses on topics important to the autistic individual who is preparing for parenting.    Autism in the Adult website Resources for professionals Video Visits Video Courses  

Join Dr. Regan for this third episode in the "Lifespan of a Household" series. This episode highlights topics important to living in shared space, including the sensory environment, alone time, and control over objects. Also, check out links to resources on her website and a transcript of the episode below.  Autism in the Adult website Resources for professionals Video Visits Video Courses   Hi, everyone. Thanks for joining me for this third episode in our series on autism and the lifespan of a household. My name is Dr. Theresa Regan, and I'm your host. I'm a neuropsychologist, a certified autism specialist, and mom to a young adult on the spectrum. This series is the result of listener requests about living as a couple or as a family within a shared household. And as we've touched on, one of the challenges of tackling the topic is that households can take so many different forms. And I know that I can't do them all justice in just one series, but I wanted to touch on some important life seasons within a household. So our first episode was about dating, and the second covered the topic of physical intimacy and relationships. And today we're going to talk about sharing physical space with other people. So joining households, living in the same space. I'll also let you know that a lot of my website renovations have been completed. There are still some things I'm tweaking and trying to make work better, but lots of the pages are active and working. And I also now have the new service of video visits for people to consult me about the topic of autism or how that impacts you in your household. There are some geographic limitations and there are some specifics about payment and if you are interested in that type of service head on over to my website at adultandgeriatricautism.com and look under video visits. So there are many different instances where physical space might be shared in a type of household. So we may be talking about a traditional couple or a family household or even other situations like having roommates or renting a portion of someone else's home. And sharing living space can be complex for lots of reasons, but for the autistic, there may be a few specific challenges that we could cover in the episode today that would help people navigate those things. So in particular, we're going to cover the sensory environment, alone time, and having control over objects. So let's tackle the sensory environment first. First, because the autistic individual may have sensory sensitivities, living in the household with other people may be overwhelming because people bump into each other or reach over each other or they brush against each other to navigate the physical space. Noise can be another sensory input that's elevated in a household, and the noise could include voices, babies crying, arguments, even just surround noise like television or music. How things smell can be important to someone on the spectrum. The scent of food cooking or aftershave, candles, cigarettes, cleaning products, taste and texture can come into play if we're talking about shared groceries or family meals, does everyone have to eat the same thing? Let's not forget about visual inputs. So not only does this include lighting, but a very common issue that I hear about is concern for the visual space or having visual chaos. So for some on the spectrum, the sight of a visual messiness or overcrowdedness or chaos can be overwhelming. And this could include things like decorations, messy work areas, things on the floor, clothes, garbage, food, strewn about various surfaces. And this visual chaos can feel overwhelming. Now, before you start laughing because you've seen someone's space and you know that they're not concerned about visual chaos, that's true. Not everyone on the spectrum will have the same sensory processing feature. And neither will everyone who is neurotypical. So people in the household will have different preferences. Many people on the spectrum may have very little care for the visual cleanliness or organization of their space except for a few specific things. So maybe they have very significant care about where their favorite objects are placed or how things are lined up, but other things are strewn over the floor and there's not much care at all. The more people there are in the household, the more mix there will be of habits and preferences and clash with the habits and preferences of others. Another complicating factor is that as people age across life seasons, their sensory processing and preferences can also change. So you have not only complexity, but you have this multifaceted, always changing sensory sensory environment, and sensory preferences across multiple people within the same shared living space. So that is a moving, dynamic, complex kind of issue. Now, one of the best ways to start addressing this is what we've talked about in multiple other episodes, And that is self-awareness. So that's that ability to say, hey, I know what makes me tick. I know what my nervous system likes and doesn't like. I know what I need today. And I also observe and have talked to and am aware of other household members. I have awareness that what they need may not be the same thing I need. And this place is shared by people with different needs. So having awareness of what the needs are is a huge place to start. The next step is to add the right now element. So the self-awareness that we talked about, that's the always element. Like, I know what's generally, typically always true about our household from day to day. Now, look at the right now element. So in this specific moment, what do people need? What do people need this morning, today, this week, this holiday season? One way to accomplish this in a household is to have huddles. So a huddle is a very quick rundown. It's a triaging process. For those of you who maybe use that in a workplace or know what that means, triaging is the ability to quickly scan what's happening, what's most important, what needs to be done the quickest, and to prioritize how these things will be handled. So in a triaging process where people are able, they're already self-aware, they're are able to highlight how their system is doing and what the day will be or has been like given their schedule. A huddle could take place between two parents of three young kids, maybe in the morning and after work. This type of brief communication helps everyone get on the same page. So instead of this confrontation and argument where one person says, I told you to do this or why are you doing that? We start with, hey, this is really chaotic. what do you need right now? This is what I need. This is the schedule for the day. This type of communication also represents and reestablishes that the household is committed to partnership. I want you to do well. I want to know what's important to you and what you need. And here is what is a priority for me today. So rather than being impulsive and reactive to what's happening throughout the day, oh my gosh, something just happened to me. I react to it because I want it to stop. We can start off with awareness and a general game plan rather than kind of flipping around crisis mode, and often that means pushing against other people. The household itself will also need some adaptations to the sensory needs of the individual. So not only do we start with self-awareness and then have up-to-date huddles, like this is what's going on this morning, this is what's going on after work, we also have to look at the sensory needs in the whole household and how that can be adapted. So there will likely be some foods that are completely off the table, like there's just such a high smell, taste, or texture aversion that cannot be avoided or coped with that it's not worth the amount of drain on people in the household. So one person may love fish or collard greens or something with a strong smell or scent that's really overwhelming to someone else and there's just no way around it. It just gets into the house. So those foods are off the table. If you're going to have that food, go out to someone's house as a guest and eat it there or eat it at a restaurant. Some adaptations may not be all or nothing. They may have to do with getting equipment like sound-canceling headphones or earbuds for people, sometimes having a designated quiet time if the kids are old enough to understand stand and regulate this. Like 12 to 1 is quiet time. A weighted blanket may be a good sensory tool for calming, as might something like a rocking chair or a swing set. Another thing I want to point out that may be confusing to people about the sensory environment in household with neurodiversity is that the person who is sound sensitive may also make a lot of noise. And that seems to be because the noise they make is predictable and controlled by them, whereas the noise that comes at them can feel repeatedly startling and overwhelming and they don't have the control that they need. And another thing is that sometimes, you know, it's this hard to understand presentation because the person may be loud because they're overwhelmed and need quiet. So it can be, you can't always kind of look and say, well, you're being loud, you must not need quiet. Or you're running around and crashing and rolling, you must not need quiet time. So a lot of times those kinds of behaviors are a signal that the person does need some regulation help, and that can be achieved by a quieter space, time alone, a weighted blanket, and those kinds of things. In addition to having things about the environment that support sensory needs within the household, consider having separate time or alone time so that people don't have to do things together. I know sometimes as a family, we try to create this together time or a family evening or a forced family time. And sometimes that's great and there are great memories. And other times, you may become aware that

Dr. Regan continues the series about the lifespan of a relationship and/or household. The first episode focused on dating relationships, and this second episode focuses on sexual intimacy in relationships with an autistic partner.    Dr. Regan's Resources: Empowered Parenting Zur Institute courses for clinicians Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians      

Dr. Regan begins a new series about the lifespan of a relationship and/or household. This first episode focuses on dating relationships. The episode provides practical insights and strategies to help you make informed and intentional choices in your relationships, ensuring they are fulfilling and sustainable for both partners. Dr. Regan's Resources: Empowered Parenting Zur Institute courses for clinicians Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians      

Join Dr. Regan for the final episode of the Powerful Self-Care Series. Rather than becoming the victim of an intense world, constantly in survival mode, learn strategies for self-care. This episode focuses on how to increase resilience in active and effective ways. Empowered Parenting   Dr. Regan's Resources: Zur Institute courses for clinicians Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians    

Join Dr. Regan for this second episode of the Powerful Self-Care Series. Rather than becoming the victim of an intense world, constantly in survival mode, learn strategies to become effective with self-care. This episode focuses on how to reduce draining inputs in order to budget your resilience.  Explore Dr. Regan's new Learning and Equipping page and the specific course page for "Empowered Parenting."  Dr. Regan's Resources: Zur Institute courses for clinicians Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians    

Join Dr. Regan for this first episode of a new self-care series. Rather than becoming the victim of an intense world, constantly in survival mode, learn strategies to become powerful at self-care. The first step is self-awareness which can begin by noticing your fight, flight, freeze, and physical reactions to events and experiences.  Explore Dr. Regan's new Learning and Equipping page and the specific course page for "Empowered Parenting."  Dr. Regan's Resources: Zur Institute courses for clinicians Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians    

Join Dr. Regan for the third and final episode of the Communication Series. This episode highlights ways to communicate while talking about challenging topics.    Explore Dr. Regan's new Learning and Equipping page and the specific course page for "Empowered Parenting."    Dr. Regan's Resources: Zur Institute courses for clinicians Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians    

Join Dr. Regan for the second episode in the Communication Series. This episode highlights ways to use communication to protect and grow relationships.    Dr. Regan's Resources: Zur Institute courses for clinicians Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians    

Join Dr. Regan for the first episode of the new Communication Series. This first episode highlights moments of connection, such as talking in the car, going out on date night, and catching up with a friend. Tune in to hear what to avoid and what to focus on to enhance connection.    Dr. Regan's Resources: Zur Institute courses for clinicians Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians      

In this third episode of the executive function series, Dr. Regan discusses sticking, releasing, and switching gears in everyday life.  Related resources: Podcast Episode: Autism and "Just Right" Podcast Episode: Gaining Momentum for Activities Amazon: Time Timer (I don't receive any income from your purchase)   Dr. Regan's Resources: Zur Institute courses for clinicians Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians    

The Holidays and Autism: Holding Fast and Letting Go Planning a Merry Holiday on the Autism Spectrum

In this second episode of the executive function series, Dr. Regan breaks down how speed, working memory, and sequencing impact daily life.  I Love Lucy chocolate factory TV clip Executive Function Book Series by Dawson and Guare: Smart But Scattered (children's version) Smart But Scattered (Teen version) Smart But Scattered (adult version)   Dr. Regan's Master Class for Clinicians (Sept, Oct, Nov, Dec 2023) Zur Institute: Master Class   Dr. Regan's Resources Book: Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians Read the transcript:  1 00:00:05,570 --> 00:00:06,059 Hello, 2 00:00:06,070 --> 00:00:06,820 everyone. 3 00:00:06,829 --> 00:00:08,659 This is Doctor Regan. 4 00:00:08,670 --> 00:00:13,670 I'm joining you for an episode of Autism in the adult podcast. 5 00:00:14,020 --> 00:00:14,880 For those of you. 6 00:00:14,890 --> 00:00:16,260 New to the podcast. 7 00:00:16,270 --> 00:00:18,020 I'm a neuropsychologist, 8 00:00:18,030 --> 00:00:20,190 a certified autism specialist, 9 00:00:20,420 --> 00:00:25,180 and the founder and director of an autism diagnostic clinic for adolescents, 10 00:00:25,190 --> 00:00:28,940 adults and aging adults in Central Illinois. 11 00:00:29,549 --> 00:00:35,240 And today you are listening to the second episode in a series on executive function. 12 00:00:35,750 --> 00:00:47,139 And this is a topic we're covering because many of the strengths and challenges that go along with the autistic neurology fall within the realm of executive function. 13 00:00:48,849 --> 00:00:51,619 Before we dive into that topic for today, 14 00:00:51,759 --> 00:00:58,540 I'd like to thank Amanda who pointed out that my diagnostic terms in the first episode were imprecise. 15 00:00:58,830 --> 00:01:03,279 I use terms that are common in my day to day interactions with patients, 16 00:01:03,290 --> 00:01:04,819 families and physicians, 17 00:01:05,080 --> 00:01:07,900 which are the terms ADD and ADHD. 18 00:01:08,089 --> 00:01:09,099 However, 19 00:01:09,110 --> 00:01:16,800 the most precise and current terminology is ADHD predominantly inattentive presentation. 20 00:01:17,379 --> 00:01:21,389 ADHD predominantly hyperactive -  21 00:01:21,470 --> 00:01:26,199 impulsive presentation, or ADHD combined presentation. 22 00:01:27,379 --> 00:01:29,589 And I guess in reviewing that in my mind, 23 00:01:29,599 --> 00:01:32,720 I think it's similar with the term dementia, 24 00:01:32,730 --> 00:01:37,550 which is often still used in day to day language in clinical settings, 25 00:01:37,559 --> 00:01:42,690 even though the most recent and precise term is major neurocognitive disorder. 26 00:01:43,360 --> 00:01:43,650 So, 27 00:01:43,660 --> 00:01:44,410 thanks Amanda, 28 00:01:44,419 --> 00:01:51,279 I'll stick to being precise and specific in podcasts about the topic of ADHD 29 00:01:51,839 --> 00:01:55,230 And instead of using each of the subtypes, 30 00:01:55,239 --> 00:02:07,379 I will just use the term ADHD unless I'm speaking about specific features of one subtype. As we discussed in the first episode, 31 00:02:07,389 --> 00:02:16,580 executive function is really a broad term and it's includes multiple subfunctions or subcategories. 32 00:02:17,179 --> 00:02:33,800 And this is a series that I really encourage you to listen to the first episode before listening to subsequent episodes because it really went through a lot of layers of explaining executive function, ADHD, and autism ... 33 00:02:34,350 --> 00:02:37,160 how those relate or don't relate to each other. 34 00:02:38,539 --> 00:02:43,720 So the subcategories of executive function include things like attention, 35 00:02:43,990 --> 00:02:45,919 goal directed persistence, 36 00:02:45,929 --> 00:02:47,949 organization, response 37 00:02:47,960 --> 00:02:50,020 inhibition and several more. 38 00:02:50,440 --> 00:02:50,990 In fact, 39 00:02:51,000 --> 00:02:53,229 depending on what source you're using, 40 00:02:53,240 --> 00:02:57,669 there can be about 12 or so sub functions identified, 41 00:02:57,679 --> 00:03:06,410 even though there's really no complete agreement on how to list out the sub functions within executive function. 42 00:03:08,110 --> 00:03:17,000 There are two main developmental diagnoses with large executive function components and these include ADHD and autism, 43 00:03:18,710 --> 00:03:23,160 the ADHD criteria, as we talked about in the previous episode, 44 00:03:23,339 --> 00:03:28,899 only describe symptoms falling within about four of the subcategories. 45 00:03:29,720 --> 00:03:35,460 I would label these subcategories in the ADHD as organization, 46 00:03:35,500 --> 00:03:41,690 attention, response inhibition, and goal directed persistence. For example, 47 00:03:41,699 --> 00:03:50,500 "fails to give close attention to details or makes careless mistakes" is one of the criteria that can be met in ADHD. 48 00:03:50,919 --> 00:04:08,720 And I would say that, as a symptom, that falls within the subcategory of attention. "Blurts out answers before questions have been completed" is an ADHD symptom that falls within the executive function 49 00:04:08,729 --> 00:04:13,100 subcategory of response inhibition. 50 00:04:13,809 --> 00:04:20,420 So is somebody able to inhibit or stop a response until they think it through? 51 00:04:21,890 --> 00:04:31,679 So autism will present with core executive function features in some combination as well across the totality of the 12 categories. 52 00:04:31,959 --> 00:04:40,040 And these features are some of the strengths and gifts within the autism presentation. 53 00:04:40,049 --> 00:04:45,309 and also some of the challenges. In this episode, 54 00:04:45,320 --> 00:04:48,559 we're going to focus on the executive function  55 00:04:48,570 --> 00:04:53,600 sub features of working memory, speed, and sequencing. 56 00:04:54,100 --> 00:05:01,769 And I've chosen these abilities to highlight together because we often use them together to accomplish daily tasks. 57 00:05:02,059 --> 00:05:06,010 And I'm hoping that in explaining them and presenting them together, 58 00:05:06,049 --> 00:05:14,709 you'll be able to watch yourself or watch other people in your life to see how these executive function abilities work for them. 59 00:05:16,929 --> 00:05:18,720 Similar to the last episode, 60 00:05:18,730 --> 00:05:22,329 I'm going to walk you through various levels of information. 61 00:05:22,339 --> 00:05:24,940 So stick with me. 62 00:05:24,950 --> 00:05:34,839 First, I want to make a comparison between the center of the brain, which is called the subcortical areas, and a conveyor belt. 63 00:05:35,600 --> 00:05:36,329 You'll, 64 00:05:36,339 --> 00:05:41,320 you've probably heard that the brain has both gray matter and white matter. 65 00:05:42,929 --> 00:05:44,720 The outside of the brain and  66 00:05:45,089 --> 00:05:54,059 certain areas in the center are gray and these gray matter sections are connected by white matter tracts. 67 00:05:55,109 --> 00:06:04,440 The color white comes from the fact that there's a fatty substance called myelin covering these neuron tracks. 68 00:06:04,450 --> 00:06:13,290 And the presence of the fatty covering allows the nerve signals to travel faster than without that covering. 69 00:06:13,399 --> 00:06:19,579 So the center of the brain impacts speed of thinking and processing. 70 00:06:20,540 --> 00:06:23,829 So in conditions like multiple sclerosis, 71 00:06:23,839 --> 00:06:24,989 for example, 72 00:06:25,000 --> 00:06:27,869 where you have demyelinating, 73 00:06:28,410 --> 00:06:31,989 that is the white matter starts to degrade, 74 00:06:32,000 --> 00:06:37,029 one of the features can be a slowing of processing. 75 00:06:39,200 --> 00:06:51,100 So the first point is that speed is a function of the subcortical pathways that impact executive function and several autistic characteristics. 76 00:06:51,109 --> 00:06:55,640 So we do want to focus on this subcategory of speed. 77 00:06:57,649 --> 00:07:01,179 Another subcategory is working memory. 78 00:07:02,950 --> 00:07:05,600 What is this part of executive function? 79 00:07:05,869 --> 00:07:06,160 Well, 80 00:07:06,170 --> 00:07:08,880 even though we call it working memory, 81 00:07:09,239 --> 00:07:16,350 a neuropsychologist or a cognitive scientist might say it's actually really more attention than memory 82 00:07:16,829 --> 00:07:30,880 in that it has to do with the amount of information a person can hold within their attention without storing it by really memorizing it for later. 83 00:07:31,700 --> 00:07:35,589 So it usually doesn't end up in permanent memory. 84 00:07:35,929 --> 00:07:40,670 But we're able to hold information our in our attention. 85 00:07:41,549 --> 00:07:54,390 And some people have a really strong working memory and others really struggle with this. And you'll see different estimates probably about how large working memory generally is. 86 00:07:54,779 --> 00:08:02,779 But most times a person can hold about five plus or minus two bits of information in their attention. 87 00:08:03,679 --> 00:08:07,209 This makes sense because if you were 89 00:08:07,769 --> 00:08:12,690 using phones in the old days where we didn't have cell phones and 90 00:08:12,700 --> 00:08:14,670 phone numbers in our phone ... 91 00:08:14,970 --> 00:08:20,799 a lot of times someone would tell us their phone number or we'd look at it in a phone book and we'd have to 93 00:08:21,149 --> 00:08:26,350 kind of rehearse it in our working memory while we dialed. 94 00:08:26,359 --> 00:08:31,489 So we held seven digits ... in those days... 95 00:08:32,190 --> 00:08:38,090 in our mind while we pushed in the information to the phone. 96 00:08:40,789 --> 00:08:43,140 So let me give another illustration. 97 00:08:43,299 --> 00:08:45,469 Working memory is what we use, 98 00:08:45,479 --> 00:08:46,309 for example, 99 00:08:46,

Do you understand what Executive Function (EF) refers to and why it is important? If you have EF difficulties, have you been diagnosed with ADHD? Do you wonder if you have a diagnosis of autism or if you should have a dual diagnosis of autism and ADHD? Dr. Regan breaks down the concepts and shares about the relationship between EF, ADHD, and autism.    Executive Function Book Series by Dawson and Guare: Smart But Scattered (children's version) Smart But Scattered (Teen version) Smart But Scattered (adult version)   Dr. Regan's Master Class for Clinicians: Zur Institute: Master Class   Dr. Regan's Resources Book: Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians   Read the transcript:   1 00:00:07,670 --> 00:00:08,560 Hi there. 2 00:00:08,569 --> 00:00:13,960 This is Doctor Regan joining you for an episode of Autism in the Adult podcast. 3 00:00:14,850 --> 00:00:16,670 I'm a neuropsychologist, 4 00:00:16,680 --> 00:00:24,350 the founder and director of an autism diagnostic clinic in Central Illinois and the parent of a teen on the spectrum. 5 00:00:25,180 --> 00:00:25,899 Today, 6 00:00:25,909 --> 00:00:31,610 you are joining me for the first episode in a new series about executive function. 7 00:00:31,989 --> 00:00:36,509 And I'm really excited for the series since announcing the topic. 8 00:00:36,520 --> 00:00:38,509 At the end of our last episode, 9 00:00:38,520 --> 00:00:45,709 I've received lots of emails from interested listeners before we dive into today's episode. 10 00:00:45,720 --> 00:00:45,990 Though, 11 00:00:46,000 --> 00:00:50,490 I wanna give a shout out to the clinicians and professionals who may be listening. 12 00:00:50,799 --> 00:01:00,610 I'm currently developing a master class with the continuing education platform called Zur Institute. 13 00:01:01,020 --> 00:01:04,010 This offering is unique for several reasons. 14 00:01:04,019 --> 00:01:05,449 One is the format, 15 00:01:06,050 --> 00:01:09,550 there will be four 2-hour webinars, 16 00:01:09,559 --> 00:01:11,949 one in each of September, 17 00:01:12,209 --> 00:01:13,099 October, 18 00:01:13,110 --> 00:01:16,180 November and December of 2023. 19 00:01:16,809 --> 00:01:23,629 And the first hour will be education while the second full hour will be reserved for discussion, 20 00:01:23,639 --> 00:01:32,519 question and answer and interaction with you about clinical questions and practice issues related to the topic for that day. 21 00:01:32,889 --> 00:01:44,419 Another unique feature of this offering will be the focus on advanced topics. So click on the link in the show notes to read more about the topics and how to sign up. 22 00:01:45,330 --> 00:01:49,569 If you are a clinician wanting beginner or intermediate courses, 23 00:01:49,599 --> 00:01:54,440 check out my other offerings on Zur or at my website, 24 00:01:54,449 --> 00:01:57,819 which is also linked through the show notes. 25 00:01:58,440 --> 00:01:59,040 All right, 26 00:01:59,050 --> 00:02:01,580 let's talk about executive function. 27 00:02:02,449 --> 00:02:07,800 I'll warn you that today's episode will require some executive function to get through. 28 00:02:08,350 --> 00:02:14,740 And I've spent a lot of time trying to make sure that I'm linking all of the themes together. 29 00:02:15,179 --> 00:02:16,649 So with that in mind, 30 00:02:16,800 --> 00:02:22,440 I want to start off with just a general definition of executive function. 31 00:02:24,440 --> 00:02:26,500 Later in our talks, 32 00:02:26,509 --> 00:02:34,229 we will cover a more precise and descriptive definition including sub elements and what we might call those. 33 00:02:35,020 --> 00:02:45,990 So executive function refers to a set of brain based abilities related to the functioning of the pathways connecting the center and the front of the brain. 34 00:02:46,679 --> 00:02:48,710 And the reason for the name, 35 00:02:48,720 --> 00:02:59,850 executive functioning is that executive is defined as having the power to put plans and actions into effect. 36 00:03:00,860 --> 00:03:04,710 So a CEO for example, 37 00:03:05,240 --> 00:03:14,669 is the chief executive officer of a business company and is in charge of directing the tiers of the company, 38 00:03:14,679 --> 00:03:16,250 the regional officers, 39 00:03:16,259 --> 00:03:17,059 managers, 40 00:03:17,070 --> 00:03:18,270 direct workers, 41 00:03:18,490 --> 00:03:24,440 directing all the pieces to work together toward the same goal. 42 00:03:24,970 --> 00:03:33,339 So these pathways of the brain help the parts of the brain work together to achieve a goal. 43 00:03:34,259 --> 00:03:38,360 Another image that I like is the symphony conductor, 44 00:03:38,899 --> 00:03:42,190 directing all the instruments in the orchestra, 45 00:03:42,199 --> 00:03:46,130 even if all the instruments are performing perfectly, 46 00:03:46,240 --> 00:03:48,300 if there's no conductor, 47 00:03:48,679 --> 00:03:56,179 there's no unified sound with melody and movement and this synchrony of sound. 48 00:03:56,399 --> 00:04:04,309 So the sounds don't come together to create a moving and meaningful piece of music without the conductor. 49 00:04:05,039 --> 00:04:09,100 So executive function is like the symphony conductor, 50 00:04:09,490 --> 00:04:14,199 it should bring all of the working parts of the brain together to perform. 51 00:04:14,210 --> 00:04:17,049 So that something meaningful happens. 52 00:04:18,998 --> 00:04:19,688 As I said, 53 00:04:19,699 --> 00:04:22,848 executive function is a set of brain skills, 54 00:04:22,859 --> 00:04:24,408 it's not one skill. 55 00:04:25,160 --> 00:04:29,929 And as we understand what the center of the brain, 56 00:04:30,109 --> 00:04:37,130 the subcortical areas of the brain and the connections through the center with the front of the brain, 57 00:04:37,140 --> 00:04:38,350 the frontal lobes. 58 00:04:38,809 --> 00:04:42,209 When we understand what these areas are in charge of, 59 00:04:42,220 --> 00:04:46,820 we refer to those set of abilities as executive function. 60 00:04:46,829 --> 00:04:53,149 So these executive function abilities hang together anatomically in the brain. 61 00:04:53,540 --> 00:04:56,640 So through that subcortical frontal system, 62 00:04:57,339 --> 00:05:04,059 so the number one point is that executive function refers to a series of skills, 63 00:05:04,070 --> 00:05:05,519 not one skill. 64 00:05:05,850 --> 00:05:10,190 And these skills are linked with anatomy, 65 00:05:10,200 --> 00:05:13,290 with the subcortical frontal systems of the brain. 66 00:05:13,609 --> 00:05:21,279 And the skills help the brain produce a meaningful synchronous um behavior or, 67 00:05:21,290 --> 00:05:22,489 or product. 68 00:05:24,070 --> 00:05:24,470 Now, 69 00:05:24,480 --> 00:05:32,950 let's talk about the diagnosis of AD D and A DH D and just for simplicity's sake, 70 00:05:32,959 --> 00:05:33,920 from now on, 71 00:05:33,929 --> 00:05:39,920 I'll really just refer to these as AD D but I'm referring to both diagnoses. 72 00:05:41,269 --> 00:05:45,839 This diagnosis was introduced in the diagnostic manual, 73 00:05:45,850 --> 00:05:57,970 the DSM - III in 1980 it was important because it described a developmental neurologic condition of executive function. 74 00:05:58,950 --> 00:06:02,820 So executive function was not a new concept, 75 00:06:02,989 --> 00:06:10,739 but the diagnosis of ADD was the one that captured this developmental piece. 76 00:06:11,190 --> 00:06:22,299 So here we have a diagnosis then that we can use to describe a difficulty that an individual has based on their developmental wiring. 77 00:06:22,309 --> 00:06:26,200 The way that the brain system has developed, 78 00:06:26,239 --> 00:06:38,600 the way they're wired in the executive function areas of the brain don't finish their anatomic development until about the age of 20 or 21. 79 00:06:38,980 --> 00:06:39,440 So, 80 00:06:39,450 --> 00:06:40,799 anatomically, 81 00:06:40,989 --> 00:06:45,730 executive function is still developing until about that age. 82 00:06:47,119 --> 00:07:02,500 So the number two point is that ADD was a notable addition to the diagnostic manual in 1980 because it represents a diagnosis for executive function difficulties that are developmental in nature. 83 00:07:04,059 --> 00:07:05,190 Now, 84 00:07:05,399 --> 00:07:19,910 I want to talk about the relationship between executive function and AD D executive function is not specific to ADD or ADHD. 85 00:07:20,690 --> 00:07:23,239 So the difficulties in that domain, 86 00:07:23,540 --> 00:07:26,559 they're not specific to this diagnosis. 87 00:07:26,570 --> 00:07:36,290 We're discussing executive function is one of the most sensitive brain functions to any kind of stress, 88 00:07:36,299 --> 00:07:39,619 whether that is physical or psychological. 89 00:07:40,049 --> 00:07:45,429 One of the first things to show difficulty is going to be executive function. 90 00:07:47,630 --> 00:07:56,119 It's often the first thing to become difficult and the last thing to resolve or heal after some type of challenge. 91 00:07:57,390 --> 00:07:58,829 For example, 92 00:07:59,089 --> 00:08:02,600 if an 80 year old has a bladder infection. 93 00:08:02,609 --> 00:08:11,040 What's probably the most sensitive cognitive function that's going to be disrupted first ... executive function. 94 00:08:11,739 --> 00:08:25,959 And if someone is recovering from a traumatic brain injury and they've gone through rehab and it's two or three months after ... what's probably the residual problem that's still kind of healing up. 95 00:08:25,970 --> 00:08:26,299 Well, 96 00:08:26,309 --> 00:08:28,679 that would be executive function as well. 97 00:08:31,179 --> 00:08:39,059 So there may be developmental differences in executive function and that's what we discuss 98 00:08:39,070 --> 00:08:41,969 when we talk about the diagn

Have you ever struggled over whether to accept an invitation or opportunity? Should I say yes, or no? Join Dr. Regan as she discusses the importance of identifying goals and asking "what might that look like" before making a final decision.    Previous podcast episodes mentioned: Attention Deficit Disorder and Autism: Similarities and Differences Dr. Regan's Master Class for Clinicians: Zur Institute: Master Class   Dr. Regan's Resources Book: Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians   Read the transcript: 1 00:00:07,670 --> 00:00:08,520 Hi there. 2 00:00:08,529 --> 00:00:13,520 This is Doctor Regan joining you for an episode of Autism in the Adult podcast. 3 00:00:13,760 --> 00:00:15,029 I'm your host. 4 00:00:15,039 --> 00:00:18,739 I'm also a neuropsychologist, author and speaker, 5 00:00:19,000 --> 00:00:24,719 a certified autism specialist and the parent of a teen on the autism spectrum. 6 00:00:25,850 --> 00:00:29,040 You are joining me today for an episode entitled, 7 00:00:29,049 --> 00:00:30,620 "what might that look like?" 8 00:00:30,909 --> 00:00:35,240 One of the things that clients and families often ask me is, 9 00:00:35,250 --> 00:00:39,909 "should we plan on this" or "should I say yes to this?" 10 00:00:40,189 --> 00:00:40,669 Now, 11 00:00:40,680 --> 00:00:48,659 this could mean being the best man at a family wedding or taking a family vacation to a cabin in the woods. 12 00:00:49,419 --> 00:00:53,509 It could mean accepting a full time job in an office setting. 13 00:00:54,299 --> 00:00:55,029 Now, 14 00:00:55,529 --> 00:00:58,509 my response is rarely yes or no, 15 00:00:58,520 --> 00:01:01,270 but rather "what might that look like?" 16 00:01:02,590 --> 00:01:05,519 So before we jump into the topic for today, 17 00:01:05,529 --> 00:01:09,559 we are coming up to the third anniversary of this podcast, 18 00:01:09,879 --> 00:01:19,639 the first episode launched on August 7th 2020 it highlighted similarities and differences between autism and ADD or ADHD. 19 00:01:20,050 --> 00:01:20,379 Now, 20 00:01:20,389 --> 00:01:33,279 this premiere episode is one of the most popular of the podcast and I plan to expand this topic into a series after today's episode which will further define executive function, 21 00:01:33,550 --> 00:01:41,050 its presentation in autism and ADD, and resources for harnessing the power of executive function. 22 00:01:42,199 --> 00:01:43,089 Secondly, 23 00:01:43,099 --> 00:01:46,930 I want to inform clinicians about an upcoming master class. 24 00:01:46,940 --> 00:01:52,069 I'm offering through Zur Institute about autism across the lifespan. 25 00:01:53,190 --> 00:02:04,459 I received so many emails and messages through my website about people seeking autism informed clinicians to provide them with diagnostic input information, 26 00:02:04,470 --> 00:02:08,919 education and solutions for roadblocks they may have encountered. 27 00:02:09,649 --> 00:02:17,270 So the bottom line is that more clinicians are needed to serve individuals who are searching for this specialization. 28 00:02:17,600 --> 00:02:28,779 And my response has been to offer multiple courses through Zur Institute. It's a continuing education site for clinicians. 29 00:02:29,330 --> 00:02:36,809 My goal is to equip clinicians across various regions to assist individuals in their communities. 30 00:02:36,860 --> 00:02:39,320 When this type of service is needed, 31 00:02:39,979 --> 00:02:51,729 the master class offering will focus on advanced topics and it starts in September space is limited and I'll have the link in the show notes. 32 00:02:52,360 --> 00:02:55,449 So let's jump into our topic for today. 33 00:02:56,380 --> 00:03:10,369 The autistic individual may have opportunities to accept or decline invitations and the invitation may be to enter an advanced academic program rather than the basic program. 34 00:03:10,789 --> 00:03:13,770 Perhaps the invitation is to travel. 35 00:03:14,429 --> 00:03:24,199 The invitation may be to lead a group such as being the best man at a family wedding or presenting research to professionals. 36 00:03:25,720 --> 00:03:33,619 My experience is that there's value in viewing the invitation not so much as a yes or no question. 37 00:03:33,889 --> 00:03:35,369 Do I accept this? 38 00:03:35,380 --> 00:03:36,580 Do I say no. 39 00:03:36,759 --> 00:03:38,880 But by asking ourselves, 40 00:03:38,889 --> 00:03:40,410 what might that look like? 41 00:03:41,149 --> 00:03:41,710 A yes, 42 00:03:41,720 --> 00:03:47,160 no view would be to see the invitation as a formed and complete package. 43 00:03:47,289 --> 00:03:51,080 So if I say yes to being the best man, 44 00:03:51,089 --> 00:03:53,080 I will plan the bachelor party, 45 00:03:53,089 --> 00:03:54,240 make a speech, 46 00:03:54,380 --> 00:03:55,020 toast, 47 00:03:55,029 --> 00:03:56,509 the couple at the reception, 48 00:03:56,520 --> 00:04:00,869 et cetera saying no to the invitation means I'll, 49 00:04:00,880 --> 00:04:03,440 I won't participate in these activities. 50 00:04:03,990 --> 00:04:05,360 But instead of a yes, 51 00:04:05,369 --> 00:04:06,589 no mindset, 52 00:04:07,100 --> 00:04:11,199 we can often talk through alternatives by asking, 53 00:04:11,210 --> 00:04:12,919 what might that look like? 54 00:04:13,300 --> 00:04:14,990 What might it look like to say? 55 00:04:15,000 --> 00:04:15,729 Yes, 56 00:04:16,170 --> 00:04:19,630 in a way that works for me and for the people around me. 57 00:04:22,149 --> 00:04:26,200 The first point to think about is what is the ultimate goal? 58 00:04:26,209 --> 00:04:28,320 What is the desired outcome? 59 00:04:29,779 --> 00:04:36,600 The goal for a vacation with family members may be to have relaxing experiences, 60 00:04:36,660 --> 00:04:43,480 to see natural landscapes that you've never seen and to connect with other family in a meaningful way. 61 00:04:44,829 --> 00:04:50,709 The goal for presenting your research to professionals may be to advance your career, 62 00:04:50,720 --> 00:04:57,040 make professional connections with others and highlight your role in the work that's been done. 63 00:04:58,730 --> 00:05:09,549 Identifying what a good outcome would look like is empowering because it helps us identify a handful of core foundational objectives. 64 00:05:10,029 --> 00:05:12,640 And when we work toward those objectives, 65 00:05:12,649 --> 00:05:17,220 we can release some of the trappings that may be part of the activity, 66 00:05:17,230 --> 00:05:23,959 but they're really not core to what we're going after for the individual, 67 00:05:23,970 --> 00:05:26,440 considering a full-time office job, 68 00:05:26,470 --> 00:05:31,089 he may decide that the foundational goals would be to have work stability. 69 00:05:31,510 --> 00:05:34,140 If he's currently doing consulting work, 70 00:05:34,149 --> 00:05:35,200 for example, 71 00:05:35,290 --> 00:05:35,769 he would, 72 00:05:35,779 --> 00:05:45,109 he may want more of a predictable salary and to have his name associated with a company that has a respected reputation in his field. 73 00:05:46,239 --> 00:05:53,489 So the first step you can focus on is determining what would be a good outcome. 74 00:05:54,480 --> 00:06:02,549 What would it look like in this situation to really dive in and also to feel like things went well. 75 00:06:04,519 --> 00:06:10,970 The first step you should focus on is determining what a good outcome would look like in this situation. 76 00:06:11,589 --> 00:06:15,779 What would a good outcome for participating in the wedding look like? 77 00:06:16,140 --> 00:06:21,519 What about going on a family vacation or accepting an office job? 78 00:06:22,910 --> 00:06:32,970 The second part after we've identified what the core features we're going after are those core foundational goals? 79 00:06:33,179 --> 00:06:35,000 We can ask ourselves, 80 00:06:35,010 --> 00:06:36,459 what might it look like? 81 00:06:36,470 --> 00:06:41,559 What might the situation look like that would allow for those outcomes? 82 00:06:42,480 --> 00:06:44,950 So let's go back to the examples. 83 00:06:45,410 --> 00:06:49,690 The gentleman invited to be best man at an out of town family wedding. 84 00:06:49,700 --> 00:06:51,200 Let's call him Joe. 85 00:06:51,790 --> 00:06:54,510 He may realize his instinct is to say, 86 00:06:54,519 --> 00:06:55,160 no, 87 00:06:55,679 --> 00:06:58,809 he knows that he gets overwhelmed in crowds. 88 00:06:58,820 --> 00:07:09,809 He dislikes being the center of attention and he relies on routine and specific favorite activities to remain grounded in daily life. 89 00:07:10,170 --> 00:07:24,489 He feels pulled in different directions because he wants to support his family member and he knows that it's really an honor to be asked to connect with the couple in this way at the ceremony. 90 00:07:25,890 --> 00:07:28,390 So Joe and his family may want to discuss, 91 00:07:28,399 --> 00:07:31,570 what would it look like for you to be best man? 92 00:07:31,809 --> 00:07:36,630 What might it look like for Joe to be best man in a relational, 93 00:07:36,640 --> 00:07:38,899 satisfying and meaningful way? 94 00:07:38,940 --> 00:07:44,929 But in a way that also offers him the freedom and the space to take care of his needs. 95 00:07:45,790 --> 00:07:46,920 So at this point, 96 00:07:46,929 --> 00:07:57,320 there is a commitment to the core goals and there is flexibility with the trappings that might otherwise go along with a wedding ceremony. 97 00:07:59,109 --> 00:08:00,369 In the case of the wedding, 98 00:08:00,380 --> 00:08:02,769 Joe may have a separate hotel room, 99 00:08:02,779 --> 00:08:07,369 so he has a quiet alone space to regroup as needed. 100 00:08:08,350 --> 00:08:20,239 Joe may know that he is grounded and centered when he gets pressure inputs in his muscles and joints and he