What Are the Effects of Impaired Executive Functions?

Executive function is a set of cognitive skills that are needed for self-control and managing behaviors.

The executive functions’ role is similar to a conductor’s role within an orchestra. The conductor manages, directs, organizes, and integrates each member of the orchestra. They cue each musician so they know when to begin to play, and how fast or slow, loud or soft to play, and when to stop playing. Without the conductor, the music would not flow as smoothly or sound as beautiful.

Types of Executive Function

There are several primary types of executive functions. These functions each play their own important role, but also work in conjunction with one another to monitor and facilitate goal-directed behaviors.

The basic areas of executive function are:

• Attentional control: This involves an individual's ability to focus attention and concentrate on something specific in the environment.
• Cognitive flexibility: Sometimes referred to as mental flexibility, this refers to the ability to switch from one mental task to another or to think about multiple things at the same time.
• Cognitive inhibition: This involves the ability to tune out irrelevant information.
• Inhibitory control: This involves the ability to inhibit impulses or desires in order to engage in more appropriate or beneficial behaviors.
• Working memory: Working memory is a “temporary storage system” in the brain that holds several facts or thoughts in mind while solving a problem or performing a task.

There are also a number of higher-level executive functions that rely on the basic lower-level functions. Some examples of higher-order executive functions include problem-solving, reasoning, fluid intelligence, and planning.

What Executive Function Involves

Executive functions play an important role in many different areas of life.

What Happens If Your Executive Function Is Impaired?

The executive functions play a critical role in a person's ability to function normally. When there are problems with these skills, people may struggle with different areas of life, including school, work, and relationships.

For example, problems with executive function are common when people have ADHD. Declines in executive function are also a feature of dementia and may appear early in its course.

People may experience problems in several key areas, including:

• Organizing, prioritizing, and initiating tasks: People with deficits in this area of executive functioning have difficulty getting materials organized, distinguishing between relevant and non-relevant information, anticipating and planning for future events, estimating the time needed to complete tasks, and simply getting started on a task.
• Focusing, maintaining, and shifting attention: People who are easily distracted miss important information. They are distracted not only by things around them but also by their own thoughts. They have difficulty shifting attention when necessary and can get stuck on a thought, thinking only about that topic.
• Regulating alertness, sustaining effort, and processing speed: People who have a hard time regulating alertness may become drowsy when they have to sit still and be quiet in order to listen or read material that they find boring. It is not that they are over-tired; they simply cannot sustain alertness unless they are actively engaged. In addition, the speed at which they take in and understand information can affect performance.
• Managing frustrations and regulating emotions: People with impairments in this area of executive functioning may have a very low tolerance for frustration, such as when they don’t how to do a task. They can also be extremely sensitive to criticism. Difficult emotions can quickly become overwhelming and emotional reactions may be very intense.
• Using working memory and accessing recall: Working memory helps an individual hold information long enough to use it in the short term, focus on a task, and remember what to do next. If people have impairments in working memory, they may have trouble remembering and following directions, memorizing and recalling facts or spelling words, computing problems in their head, or retrieving information from memory when they need it.
• Monitoring and self-regulating action: When people have deficits in the ability to regulate their behavior, it can significantly impede social relationships. If people have difficulty inhibiting behavior, they may react impulsively without thought to the context of the situation, or they may over-focus on the reactions of others by becoming too inhibited and withdrawn in interactions.

Other Effects of Executive Function Deficits

Difficulties with executive functions can affect people in different ways and to differing degrees of severity. Some problems that people may experience if they have executive function deficits include: 

• Anxiety when routines are disrupted
• Always losing belongings
• Always being late due to poor time management
• Difficulty prioritizing things that need to be done
• Difficulty switching between tasks or multitasking
• Problems completing tasks
• Trouble controlling impulsive behaviors

Many people struggle with one or more of these areas, but that does not necessarily mean that they have a mental health condition or learning disability. If problems with these skills are interfering with your ability to function normally or harming your relationships, it is important to talk to your doctor or mental health professional. Your difficulties might be caused by an underlying condition such as ADHD.

Ways to Improve Your Executive Function

People aren't born with executive function skills. They are something that develops as the brain grows. Such skills continue to develop and mature well into a person's teens and twenties.

Many people find it empowering to understand why they are struggling with their relationships, work, or school. Others feel sad or angry that they struggle with tasks that other people seem to do effortlessly.

The good news is there are things that you can do to improve your executive functioning and manage weaknesses that you have. Strategies that can help include:

• Break up large tasks into small steps.
• Create checklists for things you need to do.
• Give yourself time to transition between activities.
• Make a schedule to help you stay on track.
• Use a calendar to help you remember and plan for long-term activities, tasks, and goals.
• Use visual aids to help you process and understand information.
• Write down due dates or important deadlines and put them in a visible location.

Another thing that you can do is find ways to manage your stress levels. Stress can have a detrimental impact on executive functioning, so look for stress relief activities that work for you.

Request Accommodations

If you have a diagnosed condition such as ADHD, you can also request accommodations at school and work that can help. Accommodations are designed to support you in the specific areas where you struggle.

A few examples of accommodations include a reduced amount of homework (e.g., if the class is asked to do 20 math problems, you would be asked to do 10), extra time taking tests, help with reading assignments, permission to record lectures, and help with class notes.