5/18: Executive Function and Routine

I’m going to diverge even further from the DSM criteria for a moment to tell you about a psychological concept that relates to autism. “Executive function” is the ability to organize, to multi-task, to make step-by-step plans and carry them out.

When you’re faced with a complicated problem and you mentally divide it up into smaller tasks, plan out the best order to do them in, and follow through on your plan until everything is finished and the problem is solved, you’re having very good executive function. When you’re faced with a complicated problem and give up because it seems overwhelming and you don’t know where to start, you’ve had an executive function failure.

Everyone’s executive function abilities vary with things like stress and fatigue— I think almost everyone has struggled with executive function problems at one point or another— but some people have worse executive function than average, even on a good day. Problems with executive function is common in autism, but they can also be a part of depression, as well as ADHD and other learning disabilities.

Executive function shows up in the DSM criteria for autism in the section that starts with “insistence on sameness”.

Many autistic people deal with executive function problems by using routines and habits. When deciding what to eat and cooking a meal seems too complicated, for instance, it gets much easier when you don’t have to make a decision because you always have the same thing for lunch, and you don’t have to think too hard about the steps of cooking it because you’ve done it so many times. Sensory processing problems also make routines more important, since options that don’t aggravate our sensory sensitivities may be hard to find.

I don’t tend to stick to a strict schedule myself unless an external one is imposed on me, but in all sorts of tasks, I do tend to find a way that works and then do it the same way every time– driving the same route between two places, always ordering the same thing at a certain restaurant, etc. When I was cooking for myself in college, I generally ate the exact same thing for both lunch and dinner 4-5 days a week– the only thing I varied was the sauce I put on the pasta.

I often feel an aversion to doing a familiar task in a different way, not because there’s anything wrong with the new way, but because learning something new and fitting it into my overall plans seems to take such a big mental effort.

I also strongly prefer to plan out where I’m going in advance, any time I leave the house by myself. If someone I know is with me, I have no problem with letting them set the agenda or even change plans suddenly, but if I’m in any way in charge of deciding what we do, I find it very stressful to have to make things up as I go. It’s overwhelming in exactly the same executive-function-fail way as taking an exam I’m not prepared for, or having an unexpected problem come up just before a deadline– I don’t know where to start, I’m anxious about doing well and about not wasting time, and it’s tempting to just shut down and give up.

In my experience, the best way to deal with this feeling is to let go of the worry that hesitating makes me look bad, or that I’m taking too much time. I need to reassure myself that there’s no hurry, take a moment to calm down, and then go over the situation slowly, step by step.

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