I’ve discussed how many of the differences associated with autism—and often ADHD as well—connect back to executive function: the brain processes that help us organize, remember, shift attention, and manage tasks. Understanding and having compassion for these differences can go a long way toward reducing misunderstanding and frustration, especially in close relationships. But insight alone isn’t always enough. The next step is figuring out how to work with these brain differences in everyday life. In this last article, we’ll look at some practical supports and strategies that can make executive function challenges easier to manage, helping create systems that work with the brain rather than constantly fighting against it.
Since executive function is the common thread tying together these two conditions, I will mention at least a few supports that can be helpful. There are many possible interventions to help ADHDers and people with autism get along in a neurotypical world and/or with a neurotypical partner. For the sake of brevity, I will mention several strategies that I believe are relatively overarching and effective: point of performance, physical reminders, and easing transitions.
But briefly, before I get into those, perhaps one of the most important things for neurotypicals –and especially neurotypical partners–to differentiate is that whatever EF differences exist, they are brain limitations and not matters of “will,” “effort,” or “caring.” These include such things as not completing tasks (often from distraction, and sometimes overwhelm), not remembering to do things (poor working memory), lack of follow-through (poor working memory and lack of scaffolding), problems with planning and organizing, etc.
Of course these can all be very frustrating for the neurotypical partner especially. However it’s crucial to know that while these things can be improved with strategies and external supports, they will always be there to some extent, will always be quite variable, and are largely out of the person’s control. Compounding the problem is the fact that the remedies (mostly creating workarounds and backup systems) are also challenging because even getting these things in place relies heavily on executive function. Often folks with EF weakness will need coaching–and sometimes extensive coaching–to get strategies in place and rehearsed enough that they become habit. (Again, beware thinking of it in terms of willpower or discipline). Even then, they will be variable, but hopefully “improved enough” for the neurotypical partner to accept for the most part.
The first two ideas come from one of the most widely recognized experts on ADHD, Russell Barkley, PhD. I don’t necessarily recommend his books because in an effort to be “realistic,” I think he goes too far and strikes an unnecessarily discouraging tone. However, he has a great insight that “intervention needs to happen at the point of performance.” Because one of the most consistent weaknesses in low EF people is working memory, they often are not able to hold in memory what needs to be done at a specific point in space and time (the point of performance). There may be other EF and psychological processes that interfere, but here I’m going to use working memory as a placeholder for all those things.
So for example, let’s say the neurotypical partner asks the ADHD or autistic partner to make an appointment with the doctor. Simply reminding the neurodivergent partner is not sufficient–even multiple times–because the instruction does not get converted into internal memory in a way that is reliably accessible at the time and place where that partner could take the action.
This brings up Barclay’s second insight, which is that physical reminders are most helpful. Not only do they help with the problem of working memory, but they also can help with a second difficulty that often comes into play, which is making the desired action salient for the low EF person. As mentioned, prioritizing is hard for low EF people, and especially prioritizing things that are not their individual priorities (which may be hard enough!).
Physical reminders include things like audible alarms, sticky notes, physical calendars or planners, and whiteboards. These are the kinds of things that I have referred to as scaffolding, and many low executive function people find these very useful. Although again, they need to be implemented over time so that they become habitual, and remember things will never achieve a “perfect” ideal. (Praise progress, not perfection!) Some recommend, for example, having whiteboards in every room so the checklists pertaining to that room can be prominently displayed and available. Other whiteboards can be used for overall planning, etc.
When I talk about transitions, I’m mostly talking about transitions from one kind of activity to another. Frequently, the most difficult is going from work or some absorbing activity to some sort of social interaction. This could be as simple as one person working on the computer and the other person interrupting to ask a question, or as complex as getting ready to leave the house for a vacation. These kinds of transitions can be problematic even for relatively neurotypical folks, but for ADHDers and probably even more so for autistic folks, they can present major challenges.
The general problem for these neurodivergent groups is that it takes time for them to mentally adjust from one phase or context to another. This is a larger scale version of disengaging from one focus to shift to another. Working at home has put this problem in the spotlight because the work environment is no longer protected the way it might be in an office setting. Not only are the boundaries more permeable, but work may need to be interrupted for household demands. I’ve had software engineers who describe being completely engrossed in their work and juggling many interrelated threads of process, to the extent that an unexpected interruption can require half an hour or more to find their way back to that delicate multidimensional point.
Such interruptions or unexpected transitions (even such as the transition to dinnertime) can be extremely jarring for these folks, resulting in an angry outburst. For the neurotypical, the transition may not seem unexpected because it is a daily routine or it seems obvious. But for these neurodivergents (as well as some avoidant-insecure people), when they are in a certain zone, their subjective experience is one of a timeless present in which the future and past are virtually non-existent. To have that timeless mode pierced by the reality of what feels like an unwanted demand can be very dysregulating.
A variety of things can be helpful here. First, for others to develop and retain understanding and awareness of this problem and the significance of transitions for the neurodivergent person. Secondly, establishing guidelines and agreements about when it’s okay to be interrupted or not, and possibly the use of physical signals. For instance a flag on a little stand, or a closed door can indicate when the person is busy and cannot be interrupted (short of an emergency, which also should be defined and agreed upon as much as possible).
Conclusion
Hopefully this series has helped shed some light on these variations of neurodiversity and the shared constellation of executive function differences. Perhaps the most important thing to keep in mind is that every individual is unique and has their own set of strengths and challenges, many of which are flip sides of the same coin. Especially in intimate relationships, seeking understanding and acceptance of core differences–and being able to negotiate collaboratively how to manage them together–is key. This is critically true for understanding those differences that are largely, if not entirely, hard-wired and not a matter of intent, effort or will.
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Resources:
The Essential Difference – Simon Baron-Cohen
ADHD 2.0 – Edward Hallowell
https://www.additudemag.com/
Robert believes the keystone to successful relationships is being able to know your own thoughts, feelings and behavior at multiple levels, while also being able to understand, empathize with and reflect your partner’s thoughts, feelings, and behavior. In this way he helps you “attune” to each other and begin to heal the emotional stumbling blocks that are keeping you stuck or disconnected as a couple.