Executive Functions by Barkley

 Russell A. Barkley, a well known expert on ADHD, wrote Executive Functions: What They Are, How They Work, and Why They Evolved, to answer four questions:

What is the definition of Executive Function (EF)?

Barkley examines EF as an evolutionary set of processes that assist humans with survival. Because there are so many humans with a large variety of settings, different skills are preferred throughout the populace. Through a examination he describes EF as a series of levels  of skills. Overall he defines the skills set as  "the use of self-directed actions so as to choose goals and to select, enact, and sustain actions across time toward those goals usually in the context of others often relying on social and cultural means for the maximization of one's longer-tern=m welfare as the person defines it to be."(p. 176)

How are existing theories of EF inadequate?

Current theories often lump EF or as he goes on to describe it self-reliance (SR) into one pool of skills. In practice it appears they develop and are seen in a series of steps of skills.

Pre-executive	Attention, memory, spatial and motor functions, primary emotions and motivations
Instrumental self-directed	Self-directed attention (self-awareness), restraint, sensory-motor action, private speech, appraisal (emotion-motivation), play (innovation and problem solving)
Methodical-self-reliant	Use of methods to achieve goals, self-management across time, self-organization and problem solving, self restraint, self-motivation, regulation of emotions, social independence and predation , and social self-defense
Tactical-reciprocal	Use of tactics- nested sets of methods- to attain goals Daily social exchanges Group living, beginning of economics Social interdependence
Strategic-cooperation	Use of strategies- nested sets of tactics to achieve long term goals Arrangement of social cooperatives with division of labor Acting in unison to achieve a common goal Origin of larger settlements
Extended-utilitarian	Use of principles Pursuit of long-term self-interests with the ability to put others needs/interests first Preference for delayed long term consequences Origin of cities, states, countries

 Barkley 2012, p 63

As people develop a sense of time, something people with ADHD tend to have difficulty with, they are able to attain higher levels of complexity along the spectrum of EF/SR skills. As such it is irrational to expect people to be able to develop higher order skills like using strategies when they do not have robust foundations of lower level skills like attention. To combat this, Barkley feels the only rational treatment is medication.

What are the purposes of EF?

Barkley sees the major function of EF as solving the problems of group living with unrelated people.

How to assess EF?

Barkley acknowledges that current tools used to measure EF are inadequate since often the problem is not one of knowing how to, but one of implementing the how to in the context of everyday life. Far too often tools used to measure EF do not really measure EF, or they measure it completely out of context. As Barkley notes, "Just knowing about self-regulation will not automatically translate into actual self-regulation." (p. 200)

People need to assess the skills in the context in which they need to be utilized. 

Barkley indicates that this is not a book for interventions but does offer some guidance. First, in order to intervene, medication needs to be utilized. This remedies innate neurological issues that cause problems. The he suggests that people look at recognizing the temporal unawareness of people with EF weaknesses and provide short, small and immediate reinforcers for motivation. Further, skills need to be taught at the point of performance. Teaching a discrete skill in a therapy room is all well and good, but without environmental modifications and practice in the relevant environment, training will have little benefit.

This book is not an easy read. It is written for practitioners, coming in between grade 13 and 16 for readability. It demands an understand of a basic level of neurophysiology. That said, it does create a structure for understanding EF skills that is important.

Stop coddling our neurodivergent kids

Seth Perler's TEFOS was absolutely wonderful at introducing me to people who are making things happen in the executive function universe. One of the people that I really enjoyed was Shane Thrapp of Creating Order out of Chaos. His recent posts about coddling hit a nerve with me. "The hidden dangers of overprotecting your neurodivergent child" and "Age-appropriate independence building for neurodivergent children" both help define the challenge and offer strategies for overcoming coddling. As a teacher I have seen coddling for all students, not just the neurodivergent ones. Since the pandemic there has been a rash of grade inflation to "help" our kids adjust. Some schools prevent seniors from receiving a failing grade. Parents step in at every opportunity to make the way easier for their children. 

 For kids with ADHD and ASD these behaviors can be worse. Parents want to help their kids, but sometimes this takes the stance of insulating our children from all challenges. True, finding the balance between accommodations and doing it all is a fine line at times. When parents are tired their ability to handle the chaos an unregulated child might cause is limited and doing it yourself seems like the easy way out. But when we do this, we actually hamper our children's opportunity to develop life skills and independence. I love the way Thrapp puts it:

Coddling in families with ADHD and autistic children often disguises itself as necessary support. It's doing your child's homework because they're having a sensory meltdown rather than teaching them to identify their overwhelm signals and take breaks. It's constantly speaking for them in social situations instead of helping them develop scripts and communication strategies. It's removing all unexpected changes from their routine rather than gradually building their tolerance for flexibility within structured frameworks."

With my son, we used to call it "girding our loins" as we waded in to challenging situations that we needed to get through. When we noticed that he had never given his order at a fast food restaurant, but had done so at sit down restaurants, we had our chance. We were on a road trip. My husband and I placed our order, our daughter was required to do so and then it was his turn. Yes, he spent 45 minutes avoiding ordering. There were tears, loud statements that he would go hungry and pleading. We stood firm and, eventually, he was able to use the skills he had to place the order and enjoy his meal. It was not comfortable as a parent. We were stared at by other customers. But in the long run, he learned a valuable skill that he uses to this day. 

 When working on executive function skills or sensory tolerance, it will take longer to develop than with the neurotypical. Habits can take between about 3 weeks to months to form for neurotypical people depending on the complexity of the habit and amount of ingrained training/experience the habit is trying to overcome. Think up to 3 times as long to form habits for our ADHD children. For example, for average students it takes them 2-3 years to develop proficiency with a planner. This includes monitoring, guidance and reinforcement. For our neurodivergent folks it might take 6-9 years to learn. When our instruction in school ends, our neurodivergent folks are still just beginning to learn the new skill and are no where near ready for independence. This works for other skills as well. It can take a long time to get there with lots of frustration along the way. Celebrate the small wins. It is worth it. Thrapp notes, "Remember, your job as a parent isn't to make your child's life perfect, it's to prepare them for independence in a world that won't always accommodate their needs automatically. "