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Executive Dysfunction: Take Two

I have more to say on Executive Function after listening to all the responses to my last post. Many of them came via social media or from private emails, but apparently it was timely, as the most repeated comment to me was that people were in the same boat with their children in trying to figure out what diagnoses they’d get, since they see some similar issues. Accurate labels are important and having one which we can dive into the definition of together is proving endlessly helpful for my family. Honestly, I expected to hear that no one had ever heard of it, but it appears that the short list of behaviors that I listed for my son, Morgan, are actually more common than I assumed. It is a constant battle of his brain against just about everything I know and I parent him differently now than I did 10 years ago.

But first, a clarification: everyone has an executive functioning part of their brain. When it doesn’t work properly it’s called Executive Dysfunction or Executive Function Disorder. During puberty, the frontal part of the cortex of the brain is in the maturation stage. It’s important to take a moment here and mention that this is all about the brain. Everything about how he behaves and responds to people and various stimuli is connected to how his brain processes. Puberty seemed to have lasted a long time with him, but by the time he should have been through it, I missed a lot of these connections.

This is when I noticed that Morgan wasn’t progressing as were his peers. He never participated in school functions like dances or football games and he preferred to be alone. As the youngest child in the family, Morgan liked being by himself, but this seemed problematic once it dawned on me that he never called or texted anyone, detested all sorts of social media (a high schooler without Facebook? What? That’s crazy talk!), and only hung out with family at home.

There are steps to everyone’s executive functioning part of their brain and, from what our doctor told us, they take on tasks the following way: first, they analyze it and then plan how to address it; organize how to execute it; develop their own timelines for it; adjust (if necessary); and finally, complete it. For the most part, this is how my brain works even though I rely on sticky notes and writing things down that I never have to look at again. For Morgan, the hardest part is adjusting. He just can’t shift when things don’t go according to the plan set before him. He becomes agitated when the shifting happens and he will question repeatedly until his brain can handle the change. School, therefore, has been a trying exercise in his shift patience. This picture was taken almost 10 years ago and getting him to sit still long enough to take it was a battle. It’s been like that ever since. Here are a few things I’ve learned along the way.

1. Communicate with school.

From the time Morgan was in 2nd grade I found myself typing letters to his teachers, begging them to get to know him better before they’d even met. On the first day of school, I’d send the note to his teachers telling them the best ways to get work out of him. He likes to be read to, I’d say. Make sure you give him some important job in the classroom, I wrote yearly. Let him have  physical breaks after the hard work his brain is doing in the classroom, I pleaded.

More often than not, teachers make the classic mistake of punishing a child for classroom behavior by taking away recess. My free advice to those who choose that route: Do so at your own peril. My child is way too active and in need of physical movement. Aren’t all children? Consequences for misbehavior have to be much more creative for children like this. Mallory, on the other hand, was the easiest kid to break. I could break her down with just a look and she would tell on herself. But Morgan was far more difficult and it appeared as if he didn’t care, so I felt the need to punish harder.

2. Do a lot of research. TV and movies included. 

Many of my friends have suggested that I start watching Parenthood, the television series, to see a good representation of a kid with Aspergers. Initially, that’s what I thought he had when we made the appointment to see a new psychiatrist. I knew who Temple Grandin was, but I didn’t think that Morgan was autistic, nor was he functioning at her level. Mallory made a point of telling me to watch Extremely Loud and Incredibly Close. Not for the young boy in it, who clearly has some form of autism, but because she told me, “You’re the mom in that movie. That’s what you do for Morgan.” She was right, of course. In that movie, based on the book by Jonathan Safran Foer, Oskar’s mother, played by Sandra Bullock, is me. The way she goes before her son in every situation, always warning people about what to expect. When my son got his job earlier this year it was because I knew the manager and had an explicit conversation about Morgan’s idiosyncrasies. If people don’t know what to expect, I think they just come away with a feeling that he’s trying to be difficult. He’s not. I can promise you that.

3. There are some serious plusses to having a unique child.

Morgan doesn’t lie because lying requires thought processes that are too difficult to maintain and it’s exhausting for him. One of the best things about having an inability to plan or adjust means that everyone else always know what behavior to expect. Another thing he does well is manage his money and has a great memory for that. He can tell you to the penny what he’s got in the bank. We tease him that he’s the richest person in the house because he saves it all and doesn’t frivolously spend. He also has the heart of a philanthropist. For example, he brought home two names from the Angel Tree at his school because, as he defended:  “What? It’s the right thing to do, mom.” That concrete, black-and-white thinking can be a benefit to his understanding of things like social justice.

4. Sometimes, the first diagnosis doesn’t fit. (and 4a, Keep a Journal)

The singular diagnosis of ADHD never really captured all of him and that’s why I started keeping a journal about him and looking into everything that my friends suggested. I didn’t journal just to chronicle behavior specific to Executive Function, but because these are things that are important to note when seeing a therapist or doctor or anyone with whom you’re working for the benefit of your child.

5. Executive Function Disorder can present like Aspergers or being “on the spectrum.”

The social parts of his issues made me take him to the doctor under the pretense of seeing if he had Aspergers. There is an awkwardness to his speech style and sometimes he grunts or makes these nonverbal noises instead of answering a question. As an educator who sits in on a lot of IEP meetings, I assumed that’s what he had even though it all didn’t fit. While EFD can be a part of ADHD, that didn’t fit him entirely, either. It’s important to keep at it. Even though he’s a senior now, I could have ignored my suspicions and assumed that he was just difficult and never grew out of ADHD and, for him, that would have been a mistake. This gives me a clear roadmap now.

As with anything that’s new, I am still learning. Sure, I have some guilt about this taking so long and not figuring it out until he was 17, but I learned that even that is common because parents expect that all those developmental delays will catch up sometime. As his mom, I just hoped that it would finally happen. Like everything, this is a journey, and, as a writer, I’ll have to write my way through it. I hope you’ll join me.

Battling brain photo credit to Yao Hoong Tang

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