ACC and Executive Function

The Brain's Executive Function

Today I want to write about ACC and Executive Function (EF).  EF is probably the most common symptom of a collosul disorder and is seen to one extent or another in all with the disability. EFs (also known as cognitive control and supervisory attentional system) are a set of cognitive processes – including attentional control, inhibitory control, working memory, and cognitive flexibility, as well as reasoning, problem solving, and planning – that are necessary for the cognitive control of behavior: selecting and successfully monitoring behaviors that facilitate the attainment of chosen goals.

While it can be broken down into larger groups, there are eight main areas of EF:

1. Impulse Control
   Those with weak impulse control are more likely to blurt out inappropriately, more likely to engage in risky behavior.
   
2. Emotional Control
   Those with weak emotional control often seem to overreact or react inappropriately to stimulus, and have trouble dealing with criticism.  When something has gone wrong, and you have weak emotional control you may have difficulty regrouping, refocusing and getting your thoughts together.
   
3. Inflexible Thinking
   Those of us with rigid thinking don't "roll with the punches."  We get frustrated if asked to think about something from a different angle than what we think is "correct", "right" or "appropriate" (in our thinking.)
   
4. Working Memory
   Part of working memory is verbal memory (like when reciting a phone number to memorize it), furthermore working memory is the part of the brain, that is like the RAM on a computer, manipulating information both that is inputed by the user (the environment) and taken from the hard drive (the memory) and manipulating it in the present.  We may have trouble remember directions, even if you've repeated them many times.  We need things "chunked down" into smaller doable pieces in order to function better.
   
5. Self-Monitoring
   Those with self-monitoring issues may be taken totally off guard by negative feedback from others, or receiving a bad grade or a bad performance review.
   
6. Planning and Prioritizing
   Those with weak planning and prioritizing skills will not know which parts of a given project are most important, may not allow appropriate time, or gather the appropriate resources for any given thing.
   
7. Task Initiation
   Those with this weakness, may have an idea of what needs to be done, but may have an "interrupt" between volition (the will to act) and action, they may freeze up because they have no idea where to begin a given project, being overwhelmed with it's many parts.
   
8. Organizational Skills
   Those of us with weak organizational skills easily lose our train of thought, our keys, our phone etc...

You will find in people with ACC and ASD that some EFs will be more developed than others.  For example, in my case, my weakest areas are flexible thinking, task initiation, and organizational skills....while at the same time I have developed substantial (but not complete) impulse control and emotional control. (More on the developing of EFs a bit later in the post.)  There are uninformed people that think children "grow out of" EF issues.  Nothing is farther from the truth, while true that coping and learning strategies can strengthen the EF skills of someone with ACC or ASD, in some cases EFs may even get worse with age.

If your child has a specific learning disability and/or ADHD, he or she may be eligible for an Individualized Education Program (IEP) or 504 plan that puts formal accommodations in place. These may include extra time to complete tests or a positive behavior plan to help your child improve impulse control in class.  For adults going to colleges and universities one can request and receive accomodations

What are some strategies to help?

There are many effective strategies one can use in when faced with the challenge of problems with executive function. Here are some methods to try:

Some general strategies  might include:

1. Take step-by-step approaches to work; rely on visual organizational aids.
2. Use tools like time organizers, computers or watches with alarms.
3. Prepare visual schedules and review them several times a day.
4. Ask for written directions with oral instructions whenever possible.
5. Plan and structure transition times and shifts in activities.
6. Create checklists and "to do" lists, estimating how long tasks will take.
7. Break long assignments into chunks and assign time frames for completing each chunk.
8. Use visual calendars to keep track of long term assignments, due dates, chores, and activities.
9. Use management software such as the Franklin Day Planner, a PDA (personal data assistant), Microsoft Outlook.
10. Be sure to write the due date on top of each assignment.
11. Organize work space.
12. Minimize clutter.
13. Consider having separate work areas with complete sets of supplies for different activities.
14. Schedule a weekly time to clean and organize the work space.
15. Managing work
16. 
    
17. Make a checklist for getting through assignments. For example, a student's checklist could include such items as: get out pencil and paper; put name on paper; put due date on paper; read directions; etc.
18. Meet with a teacher or supervisor on a regular basis to review work; troubleshoot problems.

I want to include this Three Brain-Based Teaching Strategies to Build Executive Function in Students but I don't want to rip it off, so I'm giving you the link, the information is EXCELLENT! This information will be really helpful to parents and their children's teachers.

On a very personal note, those with EF issues can struggle greatly with self-blame and self-esteem issues.  We tend to blame ourselves for our difficulties, thinking "if I just try harder..."  I grew up in a household largely uneducated about ASD, ACC and EFs, and I was constantly badgered with "you are lazy, stupid, crazy" "you just don't try hard enough" and the like....they bashed me with that, and I continued to bash myself with it, until I learned about ASD and this mysterious congenital brain defect (ACC) that I was born with.

Please be patient with us, and understanding....

I hope you find this information valuable,

Joseph