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 descr