In looking at quality of life for an Autistic person one cannot stress enough the importance of Executive Functioning skills. Professionals now say that EF skills is even more important than cognitive IQ for success in the world. This Social Domain article shows us an interesting social skills hierarchy.... This picture, along with the relatively new understanding that autism is really more about context blindness than about lacking theory of mind, makes one start to really wonder.... Add to it all now the fact that we know those suffering from ASD will also have some sensory processing issues but, even more importantly, some EF issues.

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When I first was introduced to my "Little" and other autistic people, I saw that I was very different in one very distinct way. The difference is that I have the ability to problem-solve, be motivated towards long- and short-term goals, and emotionally regulate better than many of them. Upon research, I learned that these abilities all fit neatly into a neuro-bucket of skills typically referred to as Executive Functioning (EF) skills. I also learned that EF skill deficits come in 3 flavors. There is ADHD, ADHD-I and finally ADHD-NOS. The ADHD-NOS type of EF deficit is a secondary EF skill deficit and is typically the flavor of EF failures that one experiences in ASD.

A secondary ADHD (or ADHD-NOS) deficit is most noticeable by a fairly large swing of abilities in the EF skills areas. In my own case, I have very strong EF skills when I am at my farm or my desk at work and there are no distractions otherwise in my life. This (coupled with my IQ) is what allows me to do the work that I do in high tech. But when I am thrust into an environment that is overwhelming to me, I cannot connect two coherent thoughts. My anxiety goes through the roof, I lose my ability to problem solve and emotionally regulate, and things fall down from there. I work hard on honing these skills as they are essential to our growth as human beings, but I must also understand my limits in different scenarios and try to find ways to advocate for my weaknesses when they happen.

Some people with autism have true ADHD and never experience high levels of EF skills. It is hard to really know which type one has, but it is my observation that some people do well with ADHD-type medication and perhaps there is a correlation there.

I assert that these skills are THE skills that we should work on in order to improve the quality of all of our lives. I discovered an article recently that backs my assertion 100% and ties EF skills to social skills (the very skills we supposedly lack):

Executive function and the promotion of social–emotional competence

One of the questions I usually ask at presentations to teachers/parents is how many of them experience this weird phenomenon whereby they notice that on some days/situations, their student or child will have AMAZING social skills or people skills. Nearly every single hand goes up. So my question then is if they really think that this person does not know social skills or people skills so much as cannot access them. In my opinion, we are "missing the boat" by not looking at this general area and focusing on these skills.

Researching again, what exactly is "social competency" and how does it play in the world of autism? If you use the definition in the link, you will see that leadership is the highest order in the social domain....

Logically, one may then conclude that autism is not a "social skills" disorder as one might otherwise believe. In fact, there are MANY autistic adults serving in roles as leaders while many NTs are not. If "leadership" or being a leader is at the top of the social hierarchy, how can this be possible for people who haven't ability? Think about it.... When my EF and sensory processing skills are in the toilet, I can neither process words, see objects nor speak. I can follow gross motor movements, but otherwise my world is a different world. Once these skills are returned to me, I can then discern objects, connect to people and engage. I still will not be able abstract many of your concepts, but I am human and there will be connection. Taking care of EF and sensory processing issues will get me to this world as an autistic person.

I am not the first person to make the claim that social skills are NOT where it is all at. A recent article in Autism Aspgerger's Digest on context blindnesssays exactly the same thing.

The idea that people with ASD lack social skills and social cognition is based on years-old studies involving younger subjects with autism who also had lower cognitive abilities. Today we are beginning to recognize that ToM correlates significantly with IQ, especially verbal IQ, meaning that today’s growing population of higher functioning people on the spectrum may not be accurately represented. Recent studies with more able adults with high functioning autism or Asperger’s Syndrome have shown that their social cognitive abilities are far better than we used to think. This research suggests that a shift in thinking may be needed. Specifically there is a difference in the social potential (social cognitive ability) of people with ASD and their social performance (mind reading in real life).

Only Dr. Peter is going about it all wrong from this brilliant conclusion. His idea is that we add context to social skills training, thereby making the material infinitely more complex for us to have to parse. Instead, what we need to do is add ADVOCACY to social skills training and teach our youth about that. We need to:

1. Understand that NT culture is different than ours and recognize context issues (awareness and EF skills training)
2. Inhibit knee-jerk reactions of anger (EF skills)
3. Know when we are being bombarded by too much info (again awareness) to process correctly and use "advocating socially" techniques.


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Breaking EF down... (work in progress section)

I have taken the material presented by Dr. Russell Barkley as the definition to use for my own understanding of EF. My colleague uses a more complex definition, but I will stick with this one as I think it is a nice delineation.


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The exciting thing about viewing EF in this way is it really breaks down the "what" of the symptoms that we often see in people. With this picture, I can grade my perception of abilities for each of these blocks and then target specific therapies for the weak areas, which will allow me to measure my success.

Why is all this detail important? In the grand scheme of "risk versus benefit" to a person who suffers from a pervasive disorder, the training of EF skills has the highest risk of shutting that person down. One can very methodically and carefully select which therapies to work on that actually impact the ROOT CAUSE of a symptom, as opposed to treating the symptom. For example, a child who is suffering from emotional regulation may present as "rude" or act out in ways that are not expected in a group setting (NT or ASD). Without this breakdown, the reaction from the caregivers will be to teach the child the way to act appropriately (teaching them to not yell or to not throw things and punishing them) in just that situation. This is highly insulting and humiliating to the ASD person. We KNOW that it is inappropriate and we already feel guilty (sometimes as we are doing this). Ultimately, attacking the symptoms via behaviors will break down our self-esteem. The ROOT CAUSE will, however, point to a bigger bucket under these symptoms called emotional regulation and can be best worked on via an understanding/awareness of emotions. There are a lot of great tools existing today to help a person regulate emotion, and through vigilant work with these tools, the little outbursts will take care of themselves over time.

While I have chosen to view EF within the constraints listed by Dr. Barkley, it is just as valid to use those of any other leading expert. This page lists an excellent summary of the current experts on this topic, who have their own lists that may make better sense to you. The point is that by breaking down and understanding the finer detail, you will be better equipped to select therapies that address root cause.

Resources for EF:
Executive function and the promotion of social–emotional competence (how EF ties to social functioning)
Evolutionary Perspectives on the Prefrontal Cortex (very updated and pertinent)
One of the best general EF articles ever
Easy to read intro to EF
General Tools recommendation from Psychology Today (Good overview and suggestions)