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Executive Function Assessments, Skills and Strategies - 057

executive function podcast Jun 04, 2018

Hey ADDers!  As adults, we need certain capabilities to succeed in life - this success being things like responsibly raising children, getting and keeping a job, managing a household and contributing to our communities.  Without these capabilities, our successes are iffy at best.  If you know that you're missing Executive Function Skills and Strategies, like Initiating, Planning, Organizing and more, then this episode is for you!!

In this episode, I talk about:

  • Flaws in Executive Function Assessments
  • Importance of both Skills and Strategies
  • First Annual 2-Day Training in CA
  • The importance of celebrating your WINS

Developing your Executive Function Skills and shifting your limiting beliefs is the fastest and most effective way to overcome ADHD limitations, find focus, gain confidence, and newfound freedom in your life!

My mission is to put an end to the worldwide needless suffering of adults with ADHD and those with under-developed Executive Function Skills - whether from ADHD, chronic depression or anxiety, trauma, addictions, or chronic illnesses.  And, you don't need a formal diagnosis to know you need help developing these executive function skills in order to greatly reduce your suffering.


Full Episode Transcript Today is Episode 57 with Dr B

Hey ADDers! Today’s episode was inspired by a question I received from Mason in CA. He shared and then asked:

· “Hi Dr B. Thanks so much for your helpful podcast. I recently found out about Executive Function Disorder and most of the symptoms resonated with me. I asked my psychiatrist about what test I should take to see if I have it. He said the test that my insurance covers is mainly done for patients with strokes and other such injuries and the waiting list is 6 months long. He didn't think it would be of much use. Is there a standard test I should look for? I've scored highly on one or two online tests I've found but I'm looking for a more official diagnosis. For peace of mind if nothing else. If you could point me to any resources in the Los Angeles area (or online) I'd really appreciate it. Thanks very much! Kind regards, Mason”

I’ll be responding to Mason’s question in a little bit. For now, if you can relate to Mason’s dilemma, then this episode is for you!!

I’ve looked at various Executive Function Skill Assessments over the years and finally decided on one to use as an informational tool, rather than for diagnostics, since I’m mostly using this tool in my coaching program. I wish the information gathered was as comprehensive as I think about Executive Function Assessment but it’s not. Most of the questions and information generated seems to target behavioral aspects rather than the thinking and feelings going on behind the scenes. And as with so many other tools I’ve used over the years, I have learned to fill in the missing pieces I’m looking for to get a more complete picture of what’s going on.

Over the past few months I’ve been gaining a lot of insights from reviewing the results of my students Executive Function Skill Assessments and teaching the development of these skills and strategies in our Working Workshops. Here are a few things I realized:

· Only knowing the behavioral evidence and not much of the cognitive or emotional evidence for each of the skills assessed is missing a huge chunk of important information.

· Based on feedback from my students, there is a greater frequency of challenges with the thinking or feelings aspects of the skills than behaviors

· Strategies aren’t being assessed, just skills, and that’s also a huge chunk of information getting missed

· As adults learning these skills and strategies, (rather than as kids), we have lots of ineffective habits or strategies to unlearn, as well as learning, integrating and sustaining the use of new, effective EF skills and strategies

· To me, overall, these assessments could be missing the mark and giving a false result that looks okay or not so bad, unless the assessor asks questions about the thinking and feeling aspects of each skill, to comprehensively assess that person’s challenges

I love becoming aware of what’s missing and filling in those gaps for better outcomes!

As adults, we need certain capabilities to succeed in life – this success being things like responsibly raising children, getting and keeping a job, managing a household and contributing to our communities. Without these capabilities, our successes are iffy at best.

About 4-5 years ago, I asked my meetup group of fellow ADDers that if they had the ability to focus when and where they needed to and could also regulate their emotions when and where they needed to, would this solve the bulk of their challenges? They thought about it and most of them said “yes.” And that was the beginning of me shifting my focus to Executive Function instead of just ADHD because those underlying core capabilities include focus, follow through, self- management, planning, awareness, flexibility, shifting, monitoring what you are doing and so on. Any of these sound familiar to you? If you’ve read anything about Executive Functions, they probably do. So, I decided to take a leap of faith and separate out ADHD from Executive Functions and focus on what can be done to improve the quality of our lives by focusing on Executive Function Skills and Strategies rather than just ADHD, especially in adults.

So, in line with a part of today’s episode, do you know the difference between a Skill and a Strategy? Simply put, a Skill is an acquired ability to do something, and a Strategy is an approach or a systematic plan or way of doing something that is used to achieve a particular outcome. I keep reading articles that talk about developing Executive Function Skills, which I agree is very important, however, what about the Strategies? And when I find articles that say they are going to talk about Strategies, they are still talking about Skills.

I decided that having the Strategies is as important as having the Skills; in fact, it could even be more important because even if you have all the Skills but don’t know how to use them effectively to get your desired outcome, then you are still challenged. I’ve heard the expression about adults like us that we often know what to do but still can’t do it. Seems like it’s another way of saying that we might have the skills but not the strategies to get where we want to go. By this I mean Strategies such as how to initiate or get started, how to shift your state from one of resistance to one of embracing what’s in front of you, how to inhibit catastrophic or ruminating thinking or how to actually create and follow a plan, even though you know what a plan is and understand how one is created.

I bet you’ve created lots of Strategies in your lifetime – from how you tie your shoe laces, to how your leave your home, to how you prepare a meal or eat, to how you get your errands all done. Some of your Strategies may work well for you and others may fail you miserably; but they are Strategies or ways you do something to try and achieve a particular outcome.

I’ll give you an example of a Strategy I created for myself to get my errands done. I make a list of all of the errands I need to accomplish that require driving my car. I PLAN to do them on a particular day (skill), at a particular time by making them an “appointment with myself” on my calendar (skill & strategy). I know that I am good at keeping appointments so this is how I handle everything that needs doing, not just errands; it’s one of my many strategies.

But back to errands… Now that there is a date and time to do the errands, I need a Strategy to get them all done in the time that I have allotted for them. The criteria I use to prioritize which errand I run first, second, third and so on is the distance from where I am starting (facts and a strategy). Whichever errand is the farthest away is the first one I take care of. And then I work my way back to my starting point with the next farthest one and so on. My reasoning for this Strategy is that if I run out of time and am not able to complete all of my errands in the time I have allotted, the ones that are left to do are so close by that I can easily make time to run out and get them done. That would not be the case if I started with the closest ones first and left the ones farthest away for last. I used to use that Strategy and it never worked well for me. My current Strategy works great!

I’d love to hear about your Strategy for getting your errands done; feel free to email them to me at [email protected]

And what about your emotions and the role they play in your ability to learn new Skills and Strategies? If you are dysregulated a lot of the time, with feelings of overwhelm or other negative, intense emotions, it’s going to be difficult for you to learn organizational skills and strategies. It would be better to first learn skills and strategies to help you regulate yourself before moving on to learning organizational skills and strategies. You would be setting yourself up for greater success rather than possible failure or defeat.

I want to spend a few more minutes talking about my thoughts on the impact of your emotions and feelings on your executive functioning. The development of your executive function skills and strategies begins in childhood and can be derailed by many different occurrences such as family trauma, chronic illness or a non-scaffold style of teaching them; by this I mean a non-supportive style or environment. I feel your executive functioning can be hugely impacted by run away emotions – especially those that are often times strong negatives such as fear, anger or sadness. If you embody them, rather than just allowing them to pass through for those 90 seconds or so, they can take root and you can become them. You can become “fear” or “anger” or “sadness” in an ongoing way that can last a lifetime. Or, you can realize that you actually do have some say in how your emotions impact you and what you decide to think or feel about your emotions or other things in your life. That’s actually a lot of power, if you believe it, and if you learn how to work with it.

Summing up…what you focus on grows, both in strength and magnitude. And since you are the meaning maker of your life experiences, you want to be mindful about what you allow yourself to focus on. You may not feel that you have control over where your mind wanders off to and yet you do. You might currently have a mind that is untrained or unruly like a 2-year old, however, with the right training your mind can become your friend and lead you where you want to go, rather than astray.

Today’s episode was created in part in response to Mason’s question as well as my thoughts about Executive Function Assessments and the skills and strategies you need to develop in order to live a fully functional adult life, as well as offering you hope; real hope. How much time do we have? Not much. So let’s get to it.

Now back to being an adult with ADHD or Executive Function Challenges and my thoughts on Executive Function Assessments, my answer to Mason’s question as well as another story with some action steps and a favorite quote of mine.

So recapping from earlier - Mason, a listener in CA, asked whether or not there is a standard test that he should look for with regard to Executive Function Disorder since his psychiatrist doesn’t have a recommendation for him.

· Thank you for your question Mason, and for being part of the stimulus for this episode.

o There is no one test that is conclusive for evaluating executive function deficits. Taking a comprehensive history and utilizing other information from your life as well as from others who know you well all contribute to making a conclusive diagnosis or at least a much better one.

o And I am sorry that your insurance only covers one executive function test, which is for patients with strokes or other injuries, and that the waiting list is 6 months. A review of the literature indicates that there are many tests that are used to assess for executive function deficits or dysfunction. You didn’t indicate which test your psychiatrist was referring to, so I am at a loss there to comment on that part of your email to me.

o Since there doesn’t appear to be a “gold standard” for assessing for executive function deficits, the results will definitely vary according to the assessment tool that is used. And, the results could be questionable from the assessment itself given the lack of adequate assessing of thinking and feelings connected with the skills.

o I recently added a self-report assessment tool as a membership benefit for students in the ADDventures in Achievement program. As I said earlier, I’m using this tool as strictly informational, not diagnostic, since it’s a coaching program, not therapy. I wanted to have a tool to provide me with insights about how my students perceive their executive function skills and to help them understand the degree of deficit or dysfunction. Again, not for diagnostic purposes, but rather to differentiate between all the students who all say they experience difficulty Initiating or getting started, and then see the range of degrees of deficit or dysfunction that exists in the group. That helps me to teach to the needs of my students rather than assume that everyone’s inability to get started is the same, which it is not. And neither are the reasons for their inability to get started. These reasons were not part of the assessment but teased out by me with specific questions to more deeply understand their real challenges.

o What I’ve learned after reviewing the assessment results is that the majority of them have a lot of issues with executive function skills and strategies rather than their ADHD, which is no surprise to me – just confirms what I’ve suspected for some time. And now, since I’ve recently remodeled the program, I target each of the executive function skills assessed, one by one, as well as adding in my own work with strategies, which is wonderful. Feedback from current students tells me that this methodology is solid, so that they and you can live beyond ADHD or Executive Function Deficits.

So Mason, if you want to know a specific test to confirm a diagnosis of Executive Function Disorder or Deficit, I can’t really offer that. However, if you resonate with the absence of these skills and feel that learning these skills would make a significant difference for you, then I suggest you go for it. Seriously! Having or not having a diagnosis won’t prevent you from learning the core fundamental skills and strategies that can improve the quality of your adult life significantly. Whether you work with a local professional or choose to enroll in the ADDventures in Achievement program, I highly recommend that you learn these skills and strategies. They are the foundation or core capabilities of successful adult living. And, for your peace of mind, learning to trust what you sense about yourself and feel is right for you is important. Just because one professional doesn’t agree with you doesn’t make your sense about yourself wrong. So, the action steps I suggest are:

· FOCUS on making a list of which skills you feel you are missing. You can easily find a list of Executive Function skills online and check off those you resonate with

· FOLLOW THROUGH on finding a local professional to work with; someone who has expertise in understanding and teaching these skills. Or, put your information in the form on my website, ADDventures in Achievement and I’ll call you within 24-48 hours so we can chat about my program and whether or not it’s a good fit for you

· SELF-MANAGEMENT of your thinking and feelings while you are working on the behavioral aspects of these executive function skills, so you don’t get derailed

I want to transition to a short story about Maria and her challenges with Getting Started or Initiating, since it’s an executive function skill that many of you struggle with.

· Maria was 42 years old and had a “to-do list” of both personal and professional things that haven’t gotten started or finished going back about 5-10 years now.

· She felt tremendous shame about all that hadn’t been done and much of it never even was attempted because she was too embarrassed to ask anyone how to do what needed doing, since she felt she should know by her age.

· So Maria’s list just kept getting longer and she kept her secret of not knowing many things to herself; she just couldn’t face others knowing she lacked so much know-how.

· She also didn’t initiate when it came to cleaning up after herself, which seemed like a simple enough task. She left those tasks incomplete because she imagined that it would take forever to clean up and she didn’t want to waste her time. In reality, it doesn’t take that long to do any of the things she left undone, but her mind had her convinced otherwise.

Back Story

· Not getting started can look like procrastination and yet procrastination is just another symptom, not the source.

· Getting to the root of why you don’t or can’t get started is more important than just labeling it procrastination, which achieves nothing

· If you don’t or can’t because you are missing important information or steps to take, you need to get that information or steps so you can move forward.

· If you don’t or can’t because you feel frozen, you need to understand the source of your frozenness so you can get unstuck and move forward.

· It’s important to be looking at the right problem so you can get to the right solution.

Action Steps

· Focus on understanding to the real problem so you can get to the real solution

· Follow Through on what you learn about your situation and yourself with an action plan and steps mapped out to take to make a significance difference with your problem

· Self-Management of what you are thinking and feeling about being open to yourself about the real problem and compassion for yourself as you embark on making the necessary changes

I hope Mason’s and Maria’s stories and action steps offer some value for you.

Shifting gears here - I want to take a moment to acknowledge all of you for continuing to listen to my show and find me during this period of returning to the platform. I know the episodes aren’t consistent right now, as they were before, and I’m doing the best I can right now to produce new episodes, as I am able. I hope to return to a more consistent production schedule again in the future.

One thing that would help me produce episodes more easily and consistently are your questions for Ask Dr B. It’s much easier and faster for me to respond to your questions than to create episodes from scratch. Just saying…in case you have questions for me.

I am grateful to be back and thank you for your loyalty and support.

And you know that it wouldn’t be a Dr B episode if I didn’t talk about celebrating your WINS, big and small, since they are such an important part of my philosophy. If you’ve been celebrating your WINS then you know that you can shift your feelings and thinking with this practice; you seriously can. And since what we pay attention to grows, paying attention to what’s right instead of what’s wrong helps to generate more of what’s right. And when you acknowledge and celebrate your WINS with a full heart of appreciation and authenticity, you are giving yourself a priceless gift.

Please don't short-change yourself by thinking that it’s pointless or stupid to reward yourself for all the little things that you’re “supposed to do.” That couldn’t be further from the truth. Are you really going to make yourself wait until something HUGE happens to celebrate? Does something HUGE happen everyday? Probably not! But the kind of WINS I talk about can and often do. And from what I see, they are an absolute necessity to getting yourself out of the emotional ditch of whatever ails you and into a better attitude and way of living. Based on the feedback I get, this regular practice of celebrating WINS is changing lives for the better.

Each of us is like a puzzle with so many pieces that need to put together to form the picture of our life and if we get overwhelmed by all the pieces we see in front of us and never put the picture together, it’s a huge loss for everyone. So, please… It’s your responsibility to put your picture together and if you need some help, ask someone – ask me!! And remember…hindsight is for learning from and shaping your behaviors for the next time, rather than beating yourself up about. The past is gone and you can learn from it if you think of it that way. And if you feel that your past is following you into the present, I have to ask you if it is what you’re focused on instead of how you can benefit from your past, because what you focus on grows which means that if your focus is on the mistakes of the past, they are going to become bigger than life to you and contaminate your present time moments.

So, what’s it going to be for you today? What are you going to celebrate? Maybe you’ve started working on developing your ability to “get started” more easily, and are exploring what stops you; that’s certainly a WIN. Perhaps you’ve put your life in perspective and realize that for all that has happened to you, you are doing well; that’s a wonderful WIN. Maybe you’ve started a gratitude practice where you acknowledge and journal about at least one thing a day that you admire about yourself and are grateful for; that’s definitely a WIN. You get the point; celebrate all of them; big and small. And none of this “half-hearted celebrating”; you’ve got to mean it. If you’ve been Inhibiting your emotions, it’s time to release a little of that control. Exaggerate your emotions. YES!!!! WOW!! AWESOME!! You want your acknowledgement and celebration to register in your neurology with the power to move you and shift your state. Many of us need a higher level of stimulation or intensity for things to register. So, if that’s you, give that to yourself and exaggerate your celebration so you can actually feel it.

And listen…you’re not broken or defective or less than! You’re YOU! You have gifts and talents that you may not think much of, like you’re really great at cooking or have a generous spirit or you bring a sense of humor and lightness to situations, because those talents aren’t paying the bills. I get it. And yet these are things that are really great about you and need to be appreciated.

And just in case you don’t think that you should celebrate those things that are really easy for you and “no big deal,” – please… celebrate them because they may not be difficult for you but that doesn’t mean that they aren’t difficult for many others or that you haven’t achieved something meaningful. Celebrate!!! Okay?

You are a precious “human being” whose value is a given; because I am not talking about you as the “human doing” that most of society views you as. And you may be missing some skills that have been making your life very difficult up to now, and yet skills can be learned. Please know that I am not making light of your struggles or unhappiness; not at all. I want you to know that there are answers to your struggles. You may need to make some changes, and you may be in the very early stages of making those changes. If you are willing to be a student of your own life and develop a deeper understanding of yourself and how you are put together, and offer yourself a lot of compassion and patience, plus the time, effort and energy it’s going to take to make the necessary changes, these things can happen for you. I know this is true because my students are learning skills they’ve been missing most of their life and it’s amazing to share in the transformation of their thinking and behaviors and aha moments.

Please don’t let yourself be one of the 80% of people who don’t ever make it to more permanent change or even the 80% who want to change but never actually end up making the changes they want for many different reasons. There is training and support available to you to ensure, to the best of my ability, that you don’t become one of the 80% who don’t make it. Rather, that you are one of the 20% who do.

The longer I work with adults with ADHD and EFD, the more clear I become that it’s the EFD and not the ADHD that is the most disruptive element. All the executive function skills and strategies are necessary to live a productive and successful adult life. Without them, there is ongoing struggle. With them, the struggle and drama fade into the past. That’s why ADDventures in Achievement has morphed into the program it is today. I started with an eye toward focus, follow through and self-management and realized along the way that I was really talking about EFD and not so much about ADHD. I shifted my focus, re-modeled the program, and now teach executive function skills and strategies to bright, creative adults with these challenges. More specifically, if you have challenges with getting started or organizing your stuff or keeping current on your mail or tasks or remembering and following through on the many aspects of managing an adult life, with or without kids, I can help you build the skills and strategies you need.

This is a unique program and community of adults, and it’s my policy to speak with everyone who is interested in enrolling, so we can determine together if this program is right for you. So, if you’re interested in learning the skills and strategies you are missing, put your information in the form on my home page and I’ll contact you by phone or Skype within 24-48, depending on when I receive your information. We’ll chat about your challenges, what you’re seeking to achieve, and whether or not ADDventures in Achievement can help you get where you want to go. This program is definitely the place to be if you need help understanding what’s been holding you back and want to learn the skills and strategies to help you break free of your stuckness. And – if you like in person training and can make to CA this August – I’ll be hosting the first annual 2-day training here in CA on Executive Function Skills and Strategies for students of ADDventures in Achievement.

A Favorite Quote: Richard G. Scott said, “Don’t give up what you most want in life for something you think you want now.” So, the question I have for you at this point of our journey together is, “What do you most want in life, and what are you doing right now to get it for yourself?” I hope you are taking steps every day towards your heart’s desire. And, if you need some support or skills or strategies to reach your goal, be sure to reach out and let’s chat. Perhaps ADDventures in Achievement is the place you can become that person with the support of our community and the training I provide.

That’s about it for today and my thoughts on executive function assessments and the core skills and strategies we need to thrive as adults in today’s world.

It means a lot to me to know that your life is getting a little bit better every time we get together. I do hope that you will take some positive action because for things to change, you have to change. And that means taking action. Remember, there’s a PDF transcript of this episode in the resources. Plus, I’d love to get to know you in the community group I created on Facebook or in the ADDventures in Achievement program.

If you benefited from today’s episode, take action now and share this show with your friends and family so they can benefit too. Ratings and reviews are important because they let me know what you think of what I share with you. You can rate the show with the click of a mouse and not have to write a review, or you can do both.

Whatever actions you take will ripple out into the world and impact the course of your life as well as that of others you may never know. And if you don’t want to have to remember to look for new episodes, just subscribe and the newest episode will be in your feed as soon as it’s released.

So thanks for listening… Until the next time… Bye for now…


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