Deconstructing Executive Function Disorder

frustrated by EFD

Executive Function Disorder (EFD)

Executive function refers to a set of mental skills that include working memory, flexible thinking, and self-control. These skills are essential to managing our daily life. They help us:

  • Manage time
  • Pay attention
  • Switch focus
  • Plan and organize
  • Remember details
  • Avoid saying or doing the wrong thing
  • Do things based on our experience
  • Multitask

These skills start developing around 2 years old and are fully formed by the age of 30.Problems with executive function can make it hard to focus, follow directions, and handle emotions, among other things.

An executive function disorder impairs some of these skills, which can affect a person’s ability to manage and organize themselves to achieve goals. Currently, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) doesn’t recognize executive function disorder (EFD) as a specific mental health condition. Instead, executive function issues are considered to be symptomatic of other neurological, mental health, and behavioral disorders, e.g., – ADHD, bipolar disorder and depression,.

The Causes of EFD

There are several potential causes of of executive function impairment, including:

  • Heritable neurological conditions such as  ADHD, depression, or learning disabilities
  • Injury to the front of the brain
  • Damage from Alzheimer’s disease or strokes
  • Childhood physical and / or psychological trauma resulting in brain developmental issues

Symptoms of EFD

Symptoms of EFD can vary from individual to individual. Symptoms can include problems with:

  • Managing time and keeping schedules
  • Planning projects or starting activities
  • Organizing physical living or working space
  • Constantly losing personal items
  • Handling frustration or setbacks
  • Memory recall
  • Following directions
  • Regulating emotions or behavior

How EFD is Diagnosed

Because executive function problems aren’t recognized as an official illness, there is no standard set of diagnostic criteria available to clinicians. However, there are tests to gauge the effectiveness of someone;s executive function. These include:

  • Barkley Deficits in Executive Functioning Scale (BDEFS) – This tool helps screen for problems with executive function tasks like organization, self-restraint, motivation, emotional control, and time management. It can provide information on how the person acts over a period of time, too, as opposed to other tests, which only provide in-the-moment information.
  • Comprehensive Executive Function Inventory (CEFI) – This scale is used to measure executive function strengths and weaknesses in kids from 5 to 18.
  • Conners 3-Parent Rating Scale – This tool measures behavior in kids ages 6-18. It helps identify learning problems in specific subjects, like reading, spelling, math and also in terms of broader concepts like memory.
  • Comprehensive Executive Function Inventory (CEFI) – compares a person to a norm group using parent, teacher, and self-report assessments

Treatment options can include therapy, coaching and even changing your living or working environment. But awareness is the first step to treatment.



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