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Wednesday, March 28, 2007

Executive function! Where is it when you need it?

So it's first thing in the morning and you need to get the children ready for school. Why should this be so incredibly difficult? Short of getting everyone up at four in the morning, how are you ever going to get them ready on time? Dress them in their school uniform when they go to bed the night before perhaps?

How often do you need to issue a simple verbal instruction? Dare we count? How often do we count? Do you count? Do you count and curse under your breath? How many children do you have, as that might affect the outcome? Do any of them have any kind of disability that might affect the result? What kind of disability? Is the disability relevant to their ability to follow through?

Lets take a couple of small examples, such as ‘put your socks and shoes on,’ or in the alternative, ‘clean your teeth and brush your hair.’ Pretty simple language, you’d have to be a complete idiot not to understand either or those right? There again, maybe you just have a bad child, a disobedient / no respect for elders and betters kind of a child? Let's ignore the fact that both are two step instructions and the complications they induce.

Perhaps you just have a day dreamer, the kind that just can’t stay on task and are easily distracted? Could be that they’re just sleepy, got out of the wrong side of the bed or they’re not early birds but night owls?

How do you get this kind of rabble to pay heed? I should ‘wake up and smell the…..tea!’ but they’re American and still small. Very well, we’re in America so perhaps I should crack the whip and yell “ya hoo!’ and well I might, but first I’ll have to become competent with my lasso to round them up in the first place. Lets face it, I’m failing fast around here.

Now I would be the first to admit that I hate jargon, as well as all that psychobabble, but sometimes, if one can grasp the meaning, it can work as a kind of short-hand, that helps focus a parent’s addled brain. In this particular instance, for current purposes only, we can think of executive function as the ability to
A] formulate plans
B] take action on those plans
C] delay action when need be
D] operate on multiple levels
E] integrate all of the above and move between them

So that’s why short hand can be a good idea. [Ref 1] The concept of "ideation" may be more palatable.

So why exactly am I torturing you with all this guff? Well, if you’re like me, you don’t have the time to research complex subjects written in technical language. Additionally, whilst originally I did research everything I could find on the subject of autism, my knowledge has always been a bit spotty. Also, what was of crisis level relevance a while back, can sometimes wane, before it rears up again to bite you when you least expect it. Lastly, I need to remind myself of the basics that are so all encompassing.

There is nothing like watching your child put a second set of clothes on over the first set, his brother's set, that he's already put on like a corset, to remind you of quite what you're dealing with. Or there is the child that puts his underwear on over the trousers, when he's not pretending to be a superhero.

I should add that a claim of "executive dysfunction," should not be used as an excuse for being grumpy, as "abfh"
so elegantly describes.

To finish, let me give you another tiny example. After listening to the instruction ‘put on your socks and shoes,’ a few seconds later, he remarked “my hole! It has a sock!” He said this to his father, not the ether. He held up the offending sock at the same time that he spoke, to help reference his audience. He recognized that it was a sub standard sock and chose to communicate this information verbally, rather than having a meltdown, or alternatively, cared sufficiently to mention it at all. When he used the words that he did, he had them the wrong way around, but he used words like ‘my’ and ‘it,’ which he usually skips completely. He didn’t yell, nor mutter sotto voce, attempt to repeat it louder and or give up and have a meltdown.

Yes, I know it’s really tiny in the great scheme of things, but there are so many teeny tiny little bits and bobs for him to keep together at the same time, it's not surprising if the odd chunk remains out of his grasp! But with a smidge of understanding from a parent, minuscule miracles can drown you every day.

It would appear that a "significant" percentage of parents of autistic children, have similar difficulties! So maybe we need to therapize ourselves first?

[Ref 1] Helping a Child with Nonverbal Learning Disorder or Aspergers Syndrome by Kathryn Stewart, Ph.D.

I read this book a few years back because of the ‘non-verbal’ tag because no-one was chatting very much around here.


Anonymous said...

Our very favorite timer is a lemon. You twist the middle of the lemon and it starts ticking like some kind of citrus bomb. Very "Get Smart" somehow.

I have to laugh. I wish that I were calm about some of the morning nonsense on a consistent basis. My aspie continually puts on his clothes over his pjs and has to be corrected, has been known to go 30 minutes with his underwear half pulled up and staggering around with his knees tied together with super-undies because he simply got distracted mid pull. My autie will generally dress himself because the steps are so consistent. But getting the aspie dressed in the morning would cause Mother Theresa to despair.

As you seem to illustrate, we set the timer and try to get it done. And slowly, it is getting better! I have some hope that he will dress himself eventually without major intervention. Maybe even show up at work someday with all his clothes on, and no pjs peeking out from underneath.

The Jedi Family of Blogs said...

Having recently overcome this chronic difficulty with my (almost) 11-year-old, I can chime in that timers are the cat's pyjamas! The one we use goes off at 10 & 5 minutes to the final going-off, with different sorts of beeps, so they're distinguishable, which helps to bring the dreamer back to reality before it's too late. Brendan has definitely been known to put things on in the wrong order (no brothers around to filch clothes from, thankfully :), but he's gotten much more reliable with age... Once again, I don't know how you do it with 3 kids at home, but I'm really glad you write about it!


Reading what you had to say today it suddenly hit me( I can be a bit slow!) how different 'put your shoes and socks on' is to 'put your socks and shoes on'. I could imagine Beauty putting on her shoes and her socks over!

Anonymous said...

I must be a crappy ASD Mother b/c... I've never actually worried about it.

My eldest gets up, gets his clothes, goes to the bathroom, gets dressed, brushes teeth, gets breaky... probably has been nagged 100 times at this pt... but by now it's about 7:45 and it's time for breaky. 8:15 we read his story for his daily reading book, back to the bathroom, meds and out the door.

Youngest on a school day is lucky to get put on the potty.. eldest comes first unfortunately and we only have one bathroom...doesn't help the toiletting fiasco at the moment... I get his clothes... He undresses, puts goodnight in the garbage, gets dressed, has breaky... and has been nagged about half the number of times as the eldest.

Littlest has his breaky on the table by the time he's dressed waiting for him. Eldest puts in his toast - he now butters his own too... cringe... but he does it.

And I start making lunches. 8:05 littlest is gone every other day. 8:35 eldest is gone every day.

Started at around 7am when they get us up.

I don't know.. never worried about it... never planned it. We just do it.


kristina said...

Must say am impressed by all the timers you have----the time before school was once my biggest struggle with Charlie. Combination of good sleep at last (thanks to melatonin), me getting Charlie up early enough so he can lie in bed and wake up, and JIm putting him on the bus---and Charlie really liking school----have made the difference. Jim doesn't get all anxious like I do---I think Charlie always sensed my worry that he'd miss the bus etc..

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