Executive dysfunction explained

What is executive dysfunction?

The ‘executive function’ is a collection of ‘higher thinking’ skills. Some examples include problem solving, flexible thinking, organising, decision making, multi-tasking, self-monitoring and planning.

Even when we don’t consciously realise it, we rely on these skills when working, completing daily chores, cooking, driving and other everyday activities.

Executive dysfunction can therefore cause various challenges and issues for brain injury survivors.

A simple task?

Here are two scenarios that illustrate executive dysfunction...

Let’s think about a fairly ‘ordinary’ everyday task of having dinner.

Firstly we use our decision-making skills to decide on what it is we are going to eat. 

After we have decided, we plan the steps involved in preparing the meal, we gather the ingredients we need, decide what we are going to do with each one, plan to cook them so that we can serve everything at the same time. Part of this is to sequence things in order of what we are going to do.

While cooking, there may be several things going on at once... we multitask to address these things at the same time. Something may begin to overcook or burn, we address this by problem-solving.

And all of this relies on being motivated enough to cook in the first place!

Executive dysfunction may cause difficulties with deciding what to have for dinner.

It may be helpful to limit choices to make it easier, for instance choosing between two meals. You could also plan meals in advance to take away the need to make a decision on the day. Buying a recipe book or printing a recipe, and ticking each step as you go along might help with problems with planning or sequencing. Try to plan for delicious and interesting meals to improve motivation, or consider cooking for others as another motivating factor! Set timers to help with keeping on track.

Reminding others around that you will need to concentrate and switching off distracting noise such as radios and television sets can allow you to remain better focused, which can help with multitasking.

Your top tips for coping with executive dysfunction

We asked our online community to give their top tips for coping with executive dysfunction. Here’s what they shared...

1. Take your time

"Never rush... it is the number one enemy of executive dysfunction. If you think it will take one hour, allow a minimum of 1.5 hours. If you get finished earlier than expected, it is a win-win."

"I give myself plenty of time to do things and not to rush around, and I also try to write things down so I don’t forget."

"My biggest thing is having flexibility in the day, so I don’t get overwhelmed and can take my time."

Forgiveness and validation... it’s OK that I struggle sometimes, I’m doing well.

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2. Surround yourself with supportive people

"I do what I can and the stuff I can’t I’m very lucky to have a partner that does. I think who surrounds you is a huge key to recovery. You need people who lift you up, because then you start to lift yourself."

Every day brings difficulties but with the right kind of support network (family, friends and even professionals) things do I suppose get a little easier.

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3. Take notes

"I find note-taking really helps. I tend to use my phone for notes and memos."

My diary is so important... reflecting on conversations I’ve had straight after and try to work out if I could be more flexible in my thinking (doesn’t always work but keep trying). Lists, shopping lists, job lists, always put things in your diary as soon as they come up.

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4. Have a routine

I am VERY rigid with my thoughts/actions. I find it difficult to be spontaneous and prefer to stick to a daily/weekly routine which can be boring but helps me to remain calm and collected (most of the time!).

You can find out more on our main executive dysfunction after brain injury page, or explore the links below for personal stories and details of the support that is available.