Understanding executive function and how to support staff in the workplace

submitted by Sandy Slade, Registered Social Worker, Employment Support Worker with the Canadian Mental Health Association-PEI Division, and the Founding Executive Director of ADHD PEI.

What are you going to have for supper tonight?

This question will be our guide into the concept of executive functioning. What it is, what it looks like, and how you can help those who may struggle with it.

This seemingly simple question is actually very complex. Are you cooking? Do you have the ingredients you need? Can you remember the recipe? Can you get it ready in time to be done before you have to leave for your child’s hockey practice?

One part of your brain is needed to complete the task itself. But a different part of your brain figures out those other questions. That part of the brain is your executive function.

Executive function is a generic term that refers to a variety of different capacities that enable purposeful, goal-directed behavior, including behavioral regulation, working memory, planning and organizational skills, and self-monitoring.” – Dr. Donald T. Stuss

We have moved from the industrial economy to the knowledge economy, and now many of us have moved to remote work. The nature of modern life places an ever-increasing burden on everyone’s executive functions. This is where Neurodiverse people run into problems in the workplace. Many of the conditions which fall under the Neuro-Diversity umbrella impact executive functions directly, including ADHD, Autism, and Tourette’s.

Everyone has experienced issues with executive functioning during periods of high stress, anxiety, grief, or an extended period of sleeplessness. Many people may be experiencing more difficulty with their executive functioning during the pandemic.

It is the severity that is the difference for those living with neuro-developmental conditions. For example, someone under high stress may forget their wallet at a store. In contrast, before starting treatment for ADHD my debit card had to be replaced more than eight times in one year.

Activities such as preparing meals, getting to appointments, or managing money are referred to as instrumental activities of daily living. ADHD, autism, and many other conditions that impact the executive functioning system are on a spectrum from barely noticeable to being almost unable to function independently in the community.

Advice for employers

If your employee discloses that they have an executive function disorder, or you may suspect they do, there are a lot of interventions that can make things easier. Here are some evidence- based interventions and accommodations that are easy to implement:

1. Provide clear bullet-point instructions in writing, preferably no more than three. Do this after a meeting in which a lot of different things were discussed. Send their teammate an email with the three key tasks that need to be accomplished.
2. Work with them to set up a good environment that cues the brain to what needs to be done including reminders, a to-do list, or task management software that works for them.
3. Allow flextime. Everyone is expected to fulfill the required duties of their position. But as we have seen throughout the pandemic, how they get them done best might be different for each person.

If you notice that someone is always running a bit late, or forgot it was your birthday, or forgets your name for the third time, it likely wasn’t intentional. It may have just been an executive function malfunction.