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: 

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Hello,

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everyone.

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This is Doctor Regan.

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I'm joining you for an episode of Autism in the adult podcast.

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For those of you.

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New to the podcast.

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I'm a neuropsychologist,

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a certified autism specialist,

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and the founder and director of an autism diagnostic clinic for adolescents,

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adults and aging adults in Central Illinois.

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And today you are listening to the second episode in a series on executive function.

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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.

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Before we dive into that topic for today,

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I'd like to thank Amanda who pointed out that my diagnostic terms in the first episode were imprecise.

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I use terms that are common in my day to day interactions with patients,

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families and physicians,

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which are the terms ADD and ADHD.

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However,

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the most precise and current terminology is ADHD predominantly inattentive presentation.

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ADHD predominantly hyperactive - 

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impulsive presentation, or ADHD combined presentation.

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And I guess in reviewing that in my mind,

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I think it's similar with the term dementia,

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which is often still used in day to day language in clinical settings,

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even though the most recent and precise term is major neurocognitive disorder.

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So,

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thanks Amanda,

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I'll stick to being precise and specific in podcasts about the topic of ADHD

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And instead of using each of the subtypes,

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I will just use the term ADHD unless I'm speaking about specific features of one subtype. As we discussed in the first episode,

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executive function is really a broad term and it's includes multiple subfunctions or subcategories.

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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 ...

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how those relate or don't relate to each other.

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So the subcategories of executive function include things like attention,

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goal directed persistence,

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organization, response

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inhibition and several more.

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In fact,

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depending on what source you're using,

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there can be about 12 or so sub functions identified,

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even though there's really no complete agreement on how to list out the sub functions within executive function.

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There are two main developmental diagnoses with large executive function components and these include ADHD and autism,

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the ADHD criteria, as we talked about in the previous episode,

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only describe symptoms falling within about four of the subcategories.

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I would label these subcategories in the ADHD as organization,

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attention, response inhibition, and goal directed persistence. For example,

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"fails to give close attention to details or makes careless mistakes" is one of the criteria that can be met in ADHD.

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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

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subcategory of response inhibition.

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So is somebody able to inhibit or stop a response until they think it through?

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So autism will present with core executive function features in some combination as well across the totality of the 12 categories.

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And these features are some of the strengths and gifts within the autism presentation.

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and also some of the challenges. In this episode,

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we're going to focus on the executive function 

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sub features of working memory, speed, and sequencing.

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And I've chosen these abilities to highlight together because we often use them together to accomplish daily tasks.

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And I'm hoping that in explaining them and presenting them together,

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you'll be able to watch yourself or watch other people in your life to see how these executive function abilities work for them.

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Similar to the last episode,

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I'm going to walk you through various levels of information.

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So stick with me.

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First, I want to make a comparison between the center of the brain, which is called the subcortical areas, and a conveyor belt.

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You'll,

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you've probably heard that the brain has both gray matter and white matter.

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The outside of the brain and 

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certain areas in the center are gray and these gray matter sections are connected by white matter tracts.

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The color white comes from the fact that there's a fatty substance called myelin covering these neuron tracks.

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And the presence of the fatty covering allows the nerve signals to travel faster than without that cov