Understand Executive Functions and its effect on people.

This blog is for anyone who wants to understand more about the Executive Functions and the troubles that are associated with them.
You will find answers to the following questions:
• What are the executive functions?
• When to use them?
• How do they work?
• What happens when they are altered?
The executive functions correspond to the necessary capacities a person has to adapt to new situations, that are non-routine, for which there is no ready-made solution.
What kind of daily routine activities use our Executive Functions?
Our daily life is filled with them:
• lacing one’s shoes
• turning on the switch when entering a room at night
• putting the ignition key to start the engine
• making coffee and more….
Their realization is based on an automatic implementation: we are not required to think about it, it only requires very little attention.
What about non-routine situations?
Every day, we are confronted with new and complex situations, for which there is no ready, automatic or immediate answer.
Example: Every day, Lisa leaves the office and takes the highway to go home. One day, she follows a truck and sees that a ladder is about to fall from it. Lisa quickly looks in her rearview mirror and decides to get on the other band at the height of the driver. She makes gestures at him, pointing to the back of the car.
This summer, John decided to go camping in Iowa. As it’s his first time, he wants to plan to avoid unpleasant surprises. So he inquires about different existing campsites. Then he chose his campsite taking into account distance from the village and the nearest shops, places to visit and existing transport (with their prices and frequencies). Finally, when he called to book his location, he insisted on the type of location desired.
In both situations, there is no ready-made solution. It is necessary to make choices, to make decisions. A plan of action must be developed and implemented.
How does it work?
The commonality between routine situations and new ones is to choose a course of action in a set of different choices.
A situation becomes routine when it repeats itself frequently in our daily life.
Therefore, the way we respond to it can become, by force of nature, automatic.
When faced with this situation again, we “activate” the pilot scenario expected in this case.
Ben returns home at the end of the day. It’s dark outside. He opens the door and presses the switch to light up the room.
 Sarah comes out of the bathroom. She puts on a shirt and button it.
Jess gets behind the wheel of her car and takes the direction of her work.  She gets on the highway.
All these actions are routine in the sense that their engagement is done automatically. Sarah does not need to think about the way she buttons her shirt.

In the psychologist’s jargon, we say that a set of actions has been selected and that you now work on auto-pilot.

It can also happen to be confronted with familiar situations in which two or more set of activities can be activated simultaneously:
Raphael repaired his lawn mower. His hands are dirty. He enters the bathroom, goes straight to the sink, runs the water and takes the soap.
In the bathroom, there are several accessories: toothbrush, razor, deodorant, nail clipper, toothpaste, … They can all be used to start an activity: brush your teeth, shave, wash, …
However, only one will be activated: wash your hands.
In this everyday situation, a system has selected the appropriate action and prevented inappropriate activities to be engaged.
In the psychologist’s jargon, this system is called the conflict resolution system. Raphael takes the soap and not the toothpaste.
On the other hand, new situations require that we grant them more attention and we respond in a more controlled way.
Mickael returns home at the end of the day. It’s dark outside. He opens the door and directs his hand towards the switch but at the same time realizes that the lamp is already on.
He quickly decides to interrupt his gesture. If Mickael could stop himself from pressing the switch, it’s because his attention was sufficiently focused on the surrounding elements.
He could detect that the light was already on and inhibit ( restrain) his movement towards the switch.
What allowed him to prevent pressing the switch is called in the psychologist’s jargon supervisory attentional system (SAS)
Scott comes out of the bathroom. He puts on a shirt and realizes that he is missing a button. In this case, he must make a decision: change his shirt, sew the button or put a sweater on top. It’s hot, Scott is in a hurry: he’s changing his shirt.
If Scott made this decision, it’s because he took into account the different constraints of the situation. Again, this is the S.A.S underpinning the decision process.
Today Sunday, Lisa decided to visit a friend. She gets behind the wheel of her car and takes the direction of her work.
As she is busy thinking about the news she will announce to her, she realizes too late that she made a mistake. She is on the highway.
What explains that Lisa took the wrong way? While driving, Lisa has her attention directed mainly at what she will tell her friend and not about the way she’s taking.
She behaved as in a routine situation: her conflict resolution system has selected the route she travels most frequently too.
This happened because she was thinking of something else and so her S.A.S was not oriented towards the selection of the route.
This is also due to the limited capabilities of S.A.S which cannot handle several tasks at the same time with the same efficiency.
As we have just seen, the S.A.S fulfills several functions. We will specify six: inhibition, working memory, flexibility, active recovery of information in memory, attention divided and planning.
The ability to refrain from producing an automatic answer, to stop the production of an answer in progress and rule out irrelevant stimuli from the current activity.
Jess is in the office of one of her friends. She realizes that she is reading the mail. She stops doing so for the sake of discretion.
Eva has made some changes to the storage space in her kitchen. She changed the cutlery’s drawer, and since a few days, she must refrain from going to get them in the old place.
Lisa and Anna manage to stay attentive to their conversation despite the fact that they hear what is being said in the next room.
Working Memory:
This ability to refresh the contents of one’s short memory (memory in which information is maintained temporarily, the time to process other information) taking into account new information transmitted to it.
At a party at her house, Raphael takes aperitifs order from his friends. The first asks for a coke while the other asks for a sprite. By the time Raphael starts to prepare the two drinks, one of them changes his mind and asks, instead of his coke,
a tomato juice.
Mental Flexibility:

The ability to move from one behavior to another depending on the requirements of the environment.

Sarah prepares the ingredients for a chocolate cake using her scale and scoop.
She follows the indications of the recipe. She first weighs .5lb of chocolate then measures 1 cup of milk and then weighs 2 cups of sugar …
Eva is a sixth-grade student. She does her math homework and is being asked to perform alternately an addition followed by subtraction.
Ben is a teacher. He puts away his exam’s sheets. He throws the question sheets into the bin, makes a pile in front of him with the copies and insert, in the other direction, between each copy, the corresponding draft sheets.
Active recovery of information in one’s memory

The ability to actively and effectively search information contained in your memory.

Ruth made a list of things to buy at the supermarket. In the store, she realizes that she forgot to take it with her. Some things come back to her right away. But on the other hand, she has to make a big effort to remember the rest.
She remembers that while writing the list, her husband told her about a meatloaf, but she does not know why … she remembers the ingredients she needed to make it happen.
Now she is almost certain to have everything but one thing … but which one? Since she does not know what it is anymore, she walks the different aisles of the store, hoping to find what she misses. She goes past the tomatoes, stops: she ended up
finding what she was looking for.
Divided Attention:
The ability to be attentive to two activities at the same time, which allows you to do both simultaneously.
Steve can hold a conversation while watching TV news pictures.
As usual, Laura prepares the meal while having an animated discussion with one of her children.
John repeats his history class while playing on his computer.

The ability to organize a series of actions in one optimal sequence to achieve a goal.

Kenny invites 25 people for dinner in his home. He plans to serve an appetizer, a dish, and a dessert. The goal is for the dishes to arrive hot at the table. While preparing, he will have to take into account the cooking time of the different dishes, the time of arrival of his guests and time they will spend on the aperitif …
Meryl has a dentist appointment at 4 pm; it is 2 pm. She decides to run some errands: she must go to the dry cleaner pick up some shirts, get some milk from the grocery store and buy a book for her brother’s birthday. To lose as little time as possible and to be on time for her appointment, she decides the order in which she will carry out her errands.
People suffering from a breach of the executive system meet, daily, difficulties to adapt to the family, social and professional life and to manage new situations.
However, some alterations may occur in people without brain injury but to a lesser extent.
Below you will find an illustration of the difficulties in Executive Functions that can be met by people who had a cerebral accident, cranial traumatism or degenerative disease of the nervous system. In healthy people, system malfunctions of the executive functions occur much less frequently. Their intensity is lower. Therefore, occasional malfunctions are less disabling.
Alterations of one’s inhibition
These are manifested by difficulties in preventing oneself from having inappropriate actions.
When she visits her friends, Pauline cannot help but read the mail she sees on the table.
John is in a supermarket with his wife. He takes a loaf and goes to the machine to cut the bread. His wife asks him not to cut it. Johns continues his action: he advances towards the machine.
Ben is at the restaurant with his wife. They plan holidays. Many times, Ben intervenes in the conversation of the table next to them.
Jess has finished preparing the dinner. She throws peelings of potatoes, carrots, the stalks of celery, take the packet of butter to store it in the fridge but throws it into the bin.
Alterations of the working memory
They manifest themselves by the absence of a replacement of the old information with new information
The information that was stored in this memory a few seconds ago is not replaced by current information. In this case, the person continues to act in function of old information and not new information as she should.
Rob receives a phone call from his friend Charles, who gives him an appointment next Saturday at 7:30 pm He tells him about his son’s sports activities. He then remembers that he has to pick him up at 7 pm at his basketball training. He proposes to Robert to postpone the appointment to 8 pm. After hanging up, Robert notes in his agenda 7:30 pm.
The secretary announces to Steve that she is exceptionally on leave the next day. They discuss another matter, and while leaving, Lucas tells her to see you tomorrow anyway.
Alterations to flexibility

They are manifested by difficulties in passing from one behavior to another depending on the environmental requirements.

Stephanie attends a meeting. The debate is lively. She is unable to follow the thread of the conversation disturbed by the rapid changes of interlocutors.
Saturday afternoon, Rob goes to midtown to shop. He visits several shops and pays each time with his credit card. At the end of the afternoon, he goes to the market. He hands his credit card. He knows, however, that you can only pay in cash at the market.
John corrects his dictation while Bert and his mother translate sentences into French. When Lou asks how a word is spelled, his mother translates it into French, instead of spelling it in English.
Alterations of active information retrieval in long-term memory
They are manifested by significant difficulties in remembering events from the past, most often close. However, it’s possible to remember to find these events with some hints.
These difficulties may also concern general knowledge acquired formerly.
Ted talks with his wife. She talks to him about the last weekend with the family in the mountain. Ted says first that he does not remember it. His wife then describes the house
that they had rented for the occasion and the fountain that Ted had noticed. Ted can then remember who was there, what they had eaten at the evening meal, and the Sunday afternoon walk.
Alterations of divided attention

They are manifested by difficulties in performing two tasks at the same time while each of the tasks can be performed individually without difficulty.

Joan likes to walk in the forest. Since his accident, walking requires more concentration, but he can do it when he’s not disturbed. When he walks with
other people who talk to him, he tends to stop to answer; he sometimes loses his balance or stumbles. If he stays focused, he cannot keep up with the conversations
around him or answer the questions correctly.
Rina goes to the park with her children. She settles on a bench. Her children run on the playground, she watches them. A lady sits next to her and starts a conversation. After
10 minutes, Rina realizes she was not looking at what her children were doing anymore.
Planning alterations

They are manifested by difficulties in organizing a series of actions in an optimal sequence to achieve a goal.

The alterations can be found at different levels:
Maintaining one goal: It’s time, Pierre goes to the kitchen to prepare dinner. He looks out the window and notes that the lawn is not mown. He takes out his clipper and cuts the grass.
Plan and choose the different plans of actions that will achieve the goal: Since his accident, Sean is no longer able to plan his appointments. He does not program his alarm correctly and doesn’t wake up according to the first activity of the morning. He can not manage to calculate the time needed to be ready on time and the time it takes him to his activities: toilet, breakfast, getting dressed, ride, …
Choose the best course of action:
Johns starts by preparing the main course. It’s a simmered dish for which the preparation takes 25 minutes and 60 minutes cooking time. During the cooking time, instead of preparing the entrees(30 minutes), he waits until the 60 minutes are up.
Initiate an action plan while taking into account the changes and incidents for achieving the goal
Julia goes to the movies with a girlfriend. The session is at 5:15 pm. They decided to meet at 5:10 pm in front of the cinema. She is waiting for the 4:55 pm bus. Not seeing it arrive, she consults the schedule and finds out that it is the summer schedule. The next bus is at 5:10 pm. Instead of calling her friend so that she would already take the tickets, she sits down and waits for the next bus.
For more information on Executive Functions and tips on how to improve them, follow us on http://www.MrMizrahi.blog

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