Executive functioning in autism and ADHD

I am one of the many people who received a later diagnosis of autism and ADHD, when I was in my mid-20s. It was a reflective time – I now had a new lens to understand myself. I hadn't known why I struggled with so many things that most people could do with ease. As my understanding grew, I kept thinking 'If only I knew that back then, things would have been so much easier'. 

That's when the idea of my book Young, autistic and ADHD: Moving into adulthood when you're multiply-neurodivergent was born: sharing the knowledge that myself and other autistic ADHDers have picked up along the way, to help make things easier for the next generation. What follows is based around the chapter 'Executive Functioning', which discusses the differences autistic ADHDers have in this area, along with introducing strategies to help navigate daily life.

Task switching, initiation and autistic inertia 

Task initiation describes somebody's ability to start a new task; task switching is finishing one task and then start another within a relatively short space of time. For some people these are things they do without thinking about it. However, for many autistic ADHDers starting a task and/or switching to a different task can take a lot of mental effort. 

If you find task switching or initiation harder, then you may need to save your daily energy for just shopping or socialising for a few hours, rather than trying to fit everything into a shorter period of time (for example, spending an hour doing cleaning, then an hour going out to the shops and the next hour socialising with friends), which our neurotypical society often expects everyone can do automatically.

In older medical descriptions of autism, this was often described as 'resistance to change' or 'insistence on routines'. However, on a personal level I have never felt these descriptions captured neurodivergent people's reality. They were often based on assumptions that neurotypicals made from just observing neurodivergent people, rather than understanding our internal experiences in an authentic way. The use of terms such as 'resistant' and 'insistent' makes it sound as if it is an intentional bad choice we are making, which is certainly not the case here!

A more recent description of what some autistic ADHDers may experience is called 'autistic inertia'. Autistic inertia essentially describes the tendency to stay focused on one task, and difficulties related to task switching (Autistic Inertia, 2022). Even if somebody wants to start or switch to an activity they enjoy, sometimes they can't, due to autistic inertia and feeling stuck on the task or activity they are currently on. This can also apply to starting the day and getting out of bed in the morning. 

Although autistic inertia is a concept that seeks to explain the experiences of autistic people, ADHD may also affect how autistic ADHDers experience inertia, as some of us seek variety in terms of what we're doing. Some of us may not experience inertia to the same degree, or experience it less frequently than autistic people who are also not ADHDers. Some may have periods where they experience a lot more autistic inertia than others. 

As autistic inertia is a topic that has only just started to be spoken about recently, it is still not yet fully understood; however, I am fairly confident that we will all have our own unique experiences with it… like with most things related to our neurodivergence. 

Strategies 

Task switching is common in a lot of workplaces and educational settings to some degree, but it could massively vary depending on what your job involves or how your school, college or university operates. One way to get an indication of whether task switching will be a big part of a job is to read the job description and see how many different core tasks are mentioned. If you are moving on to a new college or university, it is worth asking what a timetable may look like to anticipate the amount of task switching that may be required throughout the day, to judge if it is the right learning environment for you. Also, if you are in a job interview, it is always worth asking what a typical or average day would be like in the role, as this will give an indication of how much task switching there will likely be. 

For some autistic ADHDers, having a variety of tasks to do throughout the day will suit them well due to the novelty-seeking that can come with ADHD. Others may experience difficulties with jobs of this nature because it can take significant mental effort to be constantly moving from one task to another. On a personal level, I do think that my ADHD has a role to play here as I like regularly moving from one thing to the next, but my autism means that I have a specific way of switching tasks that works for me. 

With home life, we may have a lot more control or autonomy over our time and how things are managed, meaning that we can transition between tasks and activities in a way that works for us most of the time. However, if you have pets, children or other significant responsibilities at home this will obviously be different. Although I am not a parent of a human child, I am fully aware that my cat and fur baby Milo would not be happy if I didn't feed him when he was hungry because I was in the middle of doing something. On the plus side, I am aware roughly of when Milo will be wanting food, so I can plan to some degree when I am likely to be interrupted. Once you've been responsible for another being for some time, generally speaking there will be a routine established. So although this may be hard in the beginning, over time it often becomes easier. 

There are some things that can help make it easier with task switching if we find it difficult. One example would be pre-warning for changes, which could be as simple as an app or another person reminding you when an upcoming change or transition is happening, giving you a few minutes to mentally prepare for the change rather than being expected to manage the change on the spot with no warning. How understanding our colleagues are can also make a big difference, as they may or may not assume everybody can switch between different activities at a moment's notice. We may need to explain adjustments to employers and educational institutions, so we can have as much notice as possible of any changes. 

I have also heard of people leaving a few minutes early from a meeting/class in a busy work or educational setting to avoid key transition times, sidestepping the sensory overload of several hundred other people moving between rooms at once and allowing more time to manage each change throughout the day. Also, if I have a busy day of meetings, I try to make sure that I have at least some time in between each (about 15 minutes), as I struggle with instant task switching; having that breathing space allows me to mentally prepare to change my focus. 

One autistic ADHDer opened up about how having better understanding of their ADHD helped them to work out how they could start tasks. 

"Right now yeah, I am probably not struggling with it myself as much. Whereas before, I would tell myself, I'm lazy and I just couldn't be bothered. Whereas now I know I'm dopamine deficient, and find, you know, maybe if I have some dark chocolate or do some stretches or just move my body around for like 10–20 minutes, it will give me enough dopamine to then mean that I can motivate myself to go and do that task that I didn't want to go and do before. Yeah, it's just sort of learning to be more accepting of the challenges that I face. That's what's really helped."

There is a theory that lower levels of dopamine (a chemical messenger in the body) is why ADHDers may seek novelty or can struggle with motivation (Levy, 1991). So for this particular autistic ADHDer, the key is finding ways to boost their dopamine levels to help them to start tasks they could not find the motivation to start initially. 

When it comes to organisation in general, another autistic ADHDer I spoke with shared what has helped them manage daily tasks, and the importance of recognising how our energy levels can also impact our ability to carry them out: 

"Planning and organising is something I've gotten a lot better at as I've gotten older – if I'm given much more time than other people would typically need. I've noticed that 'simple' tasks, things which take other people very little time or energy, turn out to be complicated undertakings for me; I need to break them down into smaller steps, AND factor in the time that I'll get distracted or need to take breaks so I won't get bored." 

As doing tasks which involve executive functioning can take a lot more energy for us (compared to neurotypical people), it is important that we do factor in any breaks and the amount of time we need to complete the task, as this will likely differ. 

Time blindness 

Our differences in executive functioning in the areas of impulsivity, task switching and sequencing may contribute to us experiencing something called 'time blindness' which is often associated with ADHD. Time blindness is when people (mainly ADHDers) struggle with having a sense of time when it comes to completing tasks and activities throughout the day. As a result we may be running late all the time, or leave things to the last minute without intentionally doing so. For example, we may miss the bus to school or work because we got distracted by social media on our phones or the TV during our morning routines (this has happened to me more than once!). 

Although time blindness may not be something you have experienced, as we become older and more independent, we often become more responsible for managing our time, meaning we experience the impact of time blindness for the first time as young adults. So the question is, what can help with time blindness? 

Strategies 

In terms of the strategies people can use to help with time blindness, some people try to do things in advance, to avoid the risk of running out of time in the future. An example might be preparing your lunch the evening before you have school, college, university or work, rather than doing it as part of your morning routine. Having a few less things to do in the morning means that if you are starting to run late with your morning routine, it will be less likely to have an impact on the rest of your day (as there will be fewer things you need to do before a certain time). 

A similar tool that can help some autistic ADHDers with time blindness is aiming to get something done before the deadline or arriving before the time they are due to be somewhere. This is often what I do, as I like to have the comfort of knowing that if I start running late for something, I have some 'cushioning time', where even if I am running a bit late, I will still get there by the time I need to be there. I just won't be as early as I thought I may have been. This is why I am always super early if I have a certain train to catch. 

Having cues in our lives can also help us keep on track if we struggle with time blindness. Visual reminders where we need them to do certain tasks (e.g. having a sticky note on the fridge of all the tasks you need to do in the kitchen during the morning and/or evening), or tools such as flow charts, can be helpful for keeping track of time as well as the things we need to do. Cues to help us keep track of time don't just have to be visual either! We can use things such as timers, alarms and notifications on our phones to help remind us when to do tasks at certain points throughout the day. If you have somebody you trust enough, you can also ask them to remind you of certain things or keep track of time. It is all about finding what works best for you. 

If a workplace has flexible working hours, this can be a great lifeline, as if we are running late, it gives us the flexibility to start work later than usual, or we can work at a time that is easier for us. If this would make a big difference for you, then it is worth looking for employers that offer flexible working or ask for it as an adjustment. Also in schools and education environments, an adjustment some autistic people have is leaving their class a few minutes early, to avoid the sensory overwhelm of busy corridors when transitioning from one classroom to the next one – this accommodation could also work if you have time blindness as it can help you get to where you need to be at the right time! 

If you are struggling with these executive function issues in education or work, try asking for support and adjustments such as those I've mentioned. These strategies can all be incorporated and adapted in different environments, to help make things that bit easier. 

• Sarah Boon is a neurodiversity advocate and author.