A Day in the Life of an Individual with Executive Functioning Issues 

Meet Carl, a 21-year-old with executive functioning issues. This doesn’t mean he isn’t smart. It means his brain’s self-management system has trouble getting organized and getting things done.

Executive functions are an important set of mental skills. To see how trouble with these skills affects people like Carl in educational, recreational, vocational and residential settings, take a look at a typical day in his life and how it can be changed through the use of assistive technology:

Transition or young adult without CreateAbility’s solutions Transition or young adult with CreateAbility’s solutions
Carl’s circle of support printed picture lists and checklists for him to follow each day at home, and his boss made a laminated binder that he can flip through when he gets stuck. This took a lot of time and effort to create, and so even though the home and work schedules and processes have changed over the last few months, these documents have not been updated. This is confusing to Carl, but he tries to get by. Previously, the residential staff in his group home defined the various morning tasks for Carl to get ready in the morning, as well as the chores for him to perform when he arrives home.

A team, consisting of his therapist, direct support staff defined the various areas in Evalu8Now that Carl needs to keep in check, such as his diet and activity level to help Carl manage his diabetes, and behavioral health issues (such as anger, depression, anxiety, and sleep quality). These are seamlessly presented on his CreateAbility Coach App.

7 a.m.

As Carl tries to remember his morning routine, he darts out the door, but knows he’s forgetting something. Ah, that’s it—his lunch box. He runs back inside to get them, but he ends up leaving his backpack on the kitchen counter as he races back out to catch the bus.

He sprints past the checklist that helps him remember what he needs for each day. But it’s too late: The bus is about to pull away. He’s going to miss it again….

Related executive function challenges: Organization, using working memory

7 a.m.

In addition to following his morning routine with MeMinder, Carl answered the morning questions presented on his CreateAbility Coach app as he ate his breakfast.

Carl then grabbed his lunch box and backpack as he headed out the door to catch his ride to work.

Carl always has his checklist with him, as the MeMinder talking pictures to-do list and his CreateAbility Coach app both run on his favorite mobile device.

8 a.m.

Carl’s class instructor notices that Carl is late again and didn’t turn in his take home quiz. She asks Carl about this and he tells her that he did the assignment but forgot it at home when he forgot his backpack.

Carl’s instructor asks, “Who has a good answer to the first question I gave you yesterday about last night’s reading assignment?” Carl squirms, hoping he won’t be called on. He didn’t write the questions in his planner and has no idea how to answer them.

Related executive function challenges:  Organization, focus

8 a.m.

Previously, Car’s instructor checked CreateAbility’s IEP section in BEAM, to see that his tutor helped him last night. She posts a note to the circle-of-care on the next assignment and due date.

 

Carl arrives to class on time and turns in his take home quiz.

 

Because the link to the reading assignment was in BEAM, Carl’s tutor reminded him of his reading assignment, and he was prepared in case he is called on in class.

11 a.m.

Carl’s supervisor reminds Carl that this is the second time this week that he has forgot his binder to work, as this was in his backpack too.

He tells Carl to try and shadow one of the other employees in the stock room today.

His boss calls Carl’s job coach and reports the problems he is having with Carl’s performance.

Related executive function challenges: Organization, focus

11 a.m.

Previously, Carl’s boss dictated the work assignments for Carl into CreateAbility’s cloud service which did a task analysis and created the incremental steps, sequences and chaining between each step. These are automatically delivered to Carl’ MeMinder App.

Carl’s job coach was pleased at how quickly he was able to fade and turn his attention to other employees. Carl’ boss has also been impressed with how organized, reliable and consistent he has been with each new assignment.

Since he has been using MeMinder, Carl also seems more focused, and less likely to get stuck on a task with the built-in timers for each step that gently instructs him to move on.

12 p.m.

It’s the best part of the school day: lunch! But Carl hogs the conversation, talking way too loud and too much about his video games. He doesn’t notice how annoyed his friends are getting.

Related executive function challenges: Keeping track of what you’re doing, self-control

12 p.m.

It’s one of Carlo’s favorite parts of the day, where he gets to hang out with his friends at lunch.

Carl is getting much better at self-control and listening to others versus hogging the conversation. This is because Carl has been practicing proper behaviors in group settings with his CreateAbility Coach App that offers assessments and interventions.

He is more in tune with other people’s emotions. When it’s his turn to talk, he keeps better track of what he’s doing and does not talk too much or too loudly.

4 p.m.

In soccer, Carl is so focused on getting the ball that he doesn’t keep in mind which direction he’s supposed to run once he gets it. He quickly heads for the nearest goal and kicks the ball—right into his own team’s net.

Related executive function challenges: Shifting focus, thinking flexibly

4 p.m.

On his way to soccer practice after work, Carl listens to a recording of his coach that gives him clues on his position, how to kick properly, and how to tell the direction of their goal. He also listens to an intervention on how to shift focus and think flexibly.

Later, when playing, he was prepared on how to shift focus, and knows which way to run, and when the ball comes to him, he knows where to kick it.

6 p.m.

Back at home, Carl isn’t happy when the residential staff tells him to turn off the TV and set the dinner table. When he thinks he’s got it right, his roommate makes fun at him for once again forgetting to give each person a cup. He was already frustrated with his day, and with missing his TV show and getting made fun of again – Carl loses his cool and screams at his roommate.

Related executive function challenges: Managing frustration, keeping emotions in check

6 p.m.

Carl isn’t happy when the residential staff tells him to turn off the TV and set the dinner table. He still gets frustrated with his day sometimes, and now he will be missing his TV show.

So, Carl grabs his phone and taps on the CreateAbility Coach App to help him get a clearer picture of the situation. After going through the guided self-regulation exercises, he taps on MeMinder again to remind him of the sequence of steps to properly set the table and other chores.

Carl still gets frustrated with his roommates sometimes, but he has been practicing on managing frustrations, keeping emotions in check, building relationship and self-management skills while he was in calm (teachable) states.

Now Carl can go to his favorite place, his room, and tap on the CreateAbility Coach App to help him reframe the frustrations of the day and re-focus his thoughts on actions that are in alignment with his goals.

7:00 p.m.

After lots of prodding from his tutor, Josh sits down to do his homework. But he doesn’t know where to start. Instead of doing the book report or the math problems that are due tomorrow, he surfs the web to find a topic for his science report that’s due next week. Then he takes a break to play a video game.

Related executive function challenges: Setting priorities, starting tasks

7:00 p.m.

After dinner and chores, Carl sees that he still needs to complete his homework. He would sure rather play video games. However, because Carl has been practicing with setting priorities and initiating tasks with his tutor and his CreateAbility Coach app, he realizes that he will be better off when his homework is completed on time.

Because CreateAbility’s cloud also includes tracking of Carl’s support system as part of his IEP, each person in his support plan knows what to do, and when to do it. Tutors know when their skills are needed for each subject.

8 p.m.

When Carl finally starts his assignments with his tutor, his mind keeps jumping from one thought to another. He can’t figure out what to write and only gets one sentence down on paper before he gives up for the night. He thinks he can do more on the way to school tomorrow—even though he’s never gotten anything done while riding the bus.

Related executive function challenges: Paying attention, staying on task, organization

8 p.m.

MeMinder and CreateAbility Coach help Carl practice paying attention, staying on task, and organization.  Carl selects the anxiety relief mindfulness exercise, which helps him focus on the now, and calm his thoughts.

He is now ready to work with the tutor on his assignments.

Later, Carl prepares for the next day by laying out his clothes and packing his lunch.

Midnight

It’s way past his bedtime. Carl is exhausted. He tries to go to sleep, but he can’t shut off his brain. He keeps worrying about disappointing so many people throughout the day and getting teased by his teammates for kicking the ball into the wrong goal.

Related executive function challenges: Anxiety, keeping emotions in check

Midnight

Carl is sleeping. Two hours before bedtime he used his Evalu8NOW app to help him prepare his mind and his environment for a good night’s rest. As he crawled into bed, he tapped the CreateAbility Coach app and selected Sleep. This app turned off the screen as a gentle voice auto advanced through a gentle mindfulness technique to help him release the days tensions and thoughts.  This helped him nudge his mind into acceptance and peace.

On-going

Carl’s circle of support worry that Carl may lose another job or need to find a different housing arrangement. Things just don’t seem to be working out with the current plan and environment.

On-going

His circle of support routinely monitors Carl’ progress on the job, at home, school and the community. The rich reporting and documentation from CreateAbility’s cloud provides the information for the team to make informed decisions during the periodic conferences.

About Executive Function

Many people who learn and think differently have trouble with executive function. Many individuals with ADHD or post brain injury struggle with it.

These difficulties don’t mean they aren’t smart. Brain differences make it hard for people like Carl to focus, set goals, get started, and stay on task. This includes things like doing chores, work tasks, homework and daily routines.

These kinds of struggles are often misunderstood. Others may think that people with executive function issues are just being lazy or aren’t capable of doing more. But with the right support, people with executive functioning issues can thrive.

There are lots of ways to help at work, home and in school. Support can help people like Carl get organized and stay on top of assignments. It can also help them feel less stressed and more confident.

More About Executive Function

Executive functioning issues are difficulties with a set of mental skills that are key to learning. Kids who have trouble with executive function often struggle with working memory, flexible thinking, and self-control.

What Are Executive Functioning Issues?

Some people describe executive function as “the CEO of the brain.” That’s because these skills are what let us set goals, plan, and get things done. When people struggle with them, it affects them in all aspects of life.

Trouble with executive function isn’t a diagnosis or a learning disability. But it’s common in kids who learn and think differently. All kids with ADHD have trouble with it. And lots of kids with learning disabilities struggle with executive function.

The three main areas of executive function are:

  • Working memory
  • Cognitive flexibility (also called flexible thinking)
  • Inhibitory control (which includes self-control)

Executive function is responsible for a number of skills, including:

  • Paying attention
  • Organizing, planning, and prioritizing
  • Starting tasks and staying focused on them to completion
  • Understanding different points of view
  • Regulating emotions
  • Self-monitoring (keeping track of what you’re doing)

Signs That an Employee or Roommate is Struggling With Executive Function:

Trouble with executive function can affect people in different ways. Some individuals may have difficulties in only one or two areas, or in all of them. The difficulties often look like the signs of ADHD. That’s because ADHD is a classic example of a problem with executive function.

People struggling with executive skills may:

  • Have trouble starting and/or completing tasks
  • Have difficulty prioritizing tasks
  • Forget what they’ve just heard or read
  • Have trouble following directions or a sequence of steps
  • Panic when rules or routines change
  • Have trouble switching focus from one task to another
  • Get overly emotional and fixate on things
  • Have trouble organizing their thoughts
  • Have trouble keeping track of their belongings
  • Not be able to manage their time

Acknowledgements:

This young adult perspective was Adapted from an NCLD infographic and an article on a day in the life of a 6th grader, based on the work of Thomas E. Brown, PhD.

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