I need advice on helping someone with autistic executive dysfunction to remember to finish what they started, for safety and disabled access.

[Yeshuasdaughter]

I know an amazing young woman. She is funny, intelligent, helpful, and kind. She is a hard worker. She volunteers to do things rather than needing to be told. She does a lot to help me and does chores without being asked to do so.

But often, through no fault of her own, as she is autistic like me, she will be in the middle of a task, and if this task is interrupted, or if she is tired, she says she will finish cleaning up in fifteen minutes or tomorrow morning. As soon as that task is walked away from, it is forgotten, and the things end up sitting there. I believe that in autism this is called "Executive Dysfunction". I suffer from it too, in other ways.

Earlier this evening, after dodging project piles on the floor, I nearly tripped over a stack of canned foods she meant to put away over a week ago, and then within seconds, when I was trying to pull something out of a drawer that was overloaded with the wrong things, the dresser toppled, and nearly knocked over a large utility shelf.

I am a wheelchair user, so it's important for safety, as well as access of all the rooms, that there aren't half-finished tasks stacked up on the floor, blocking areas or items that I need to get to. Especially if I am up and walking, I don't want to hurt myself or knock anything over. The house doesn't have to be perfect by any means. My house is tidy, but honestly, it's always a little messy. And that's okay. I like a house that's lived in- a little bohemian clutter. But the floor piles block access and are dangerous.

How do I teach a very high functioning autistic young adult to keep the floors tidy for disabled access? Moreso, as a person with symptoms of Executive Dysfunction due to Autism, how do I make sure that she doesn't forget a project she needed to finish?

 

[AuAL]

It drives me nuts when I go to the drawer to get a pair of scissors and there are no scissors in the drawer. Then I have to search through the house to find where someone put them down after using them.

My executive function isn’t the greatest in many situations but one thing I believe in is “the job isn’t finished until the tools and materials are all where they belong.” This can be extended as “to finish a job, the workspace (room, table, shelves, etc.) must be as tidy as when you started.” This is a habit you will find many adhere to, because it makes for efficiency and safety in the workplace. Often, that is where the habit is drummed into you - in the workplace.

There is a clue here - these habits begin under tutelage. This is very often difficult to achieve in a family situation - it has been my experience that you can’t make it happen by telling, but only by showing. Setting an example/modelling good habits (which can be accompanied by commentary “now first we put this away, then we do this”.) It works best if the learner is motivated - nothing like learning good habits when you’re learning carpentry from grandad.

How you put these ideas together to help your daughter I’m not sure. An outside teacher - to take the family dynamic out of the picture - might help. Failing that, is there a craft she might like learning from you?

 

[Hypnalis]

@Yeshuasdaughter

It doesn't matter why this is happening. That "cause and effect" path is literally going to lead to your wanting to "cure" an ASD symptom

Get her to put up a fairly large whiteboard, make a grid with magnetic strips, have a section for tasks shifted to the next day, make it clear they default to "Priority 1" for the following day's tasks.

Even though the "why" doesn't matter, the "what" is worth considering:
* Clearly she imagines she'll remember the deferred task, but she actually doesn't. Some people are like this - it's not worth your while trying to fix it directly
* She's not prioritizing well at the start of the working interval. If she was, she'd see the waiting tasks. She probably has a semi-fixed routine, or waits to be told what to do.
If she's used to your telling her what to do, she has indirectly, and probably inadvertently, delegated the task of tracking her unfinished work to you. It's a bad habit, but as above, it's not easily or quickly fixed, so don't try (yet).
* Ignoring the results and consequences of forgotten half-done tasks is probably just a manifestation of the two points above plus "Aspie Avoidance". Let it go for now.

So new rules for her:
1. She must record unfinished tasks on the whiteboard. No exceptions, no excuses. Make sure it can be done fast
2, She must (possibly together with you) plan her first few tasks for the working period, taking previous unfinished tasks into account

And for you:
1.Help her with prioritizing, at least for a while. If she worked this way naturally the issue would never have occurred. But literally half the planet has these weaknesses - that's why well-organized people are always popular
2. Watch for overload, and if needed help her plan through it. She probably deals with too much work via denial (that may be how she can ignore the evidence of incomplete tasks - she integrates them into "normality")
3. Watch for her doing things too well - i.e. staying with normal standards when it's better go for "good enough, but as fast as possible". "Perfection is the enemy of good".

If you're not doing so, find a way to reward her. Cash is easiest/fastest if you have spare, but recognition, helping her with any life or school issues, skills transfer, etc are equally good or better.

For example teaching her how to overcome the issues you posted about will be extremely valuable for her in the medium term. You can't change her nature, and she can't "see" her own faults (an unfortunate side effect of avoidance/denial).
But you can share practical techniques, and teach her indirectly ("learning by doing" is very effective for most people).

 

[marc_101]

I agree with @Hypnalis, but the most concrete the better. Maybe together you can come up with to-do lists and agreements about what it means to complete a task? A checkbox could help.

I'd start slowly. And maybe make it a game?

 

[Judge]

You might start here:

Ask Marydee: Should Executive Function Skills be Taught Explicitly?

An interesting question was recently posed to me: Should executive function skills be explicitly taught as a distinct part of a school curriculum?This question was raised recently by an educational therapist who was enrolled in my course, the Teaching the Seeing My Time Program. She shared her...

executivefunctioningsuccess.com

Though there have been a number of times in my life when I was skeptical of the very idea of training to enhance one's executive functioning. That for the most part it was a skill that one either had or didn't have. Something I occasionally observed in training employees in corporate time management. Where the bulk of it focused on prioritizing tasks.

Then again there is one consideration that always stood out beyond all others. One's ability to hone their own sense of self-discipline. Obtainable for some, daunting for others. Interesting that this article mentions discipline in terms of being that "elusive attribute".

Developing Discipline

Four ideas toward that central but often elusive attribute.

www.psychologytoday.com

 

[GypsyMoth]

Hi Yeshuasdaughter,

I live with a very nice young man who faces similar difficulties. If I ask him to take the garbage out, then sure, within the next several days he'll eventually take it out. I don't get fussed over it. If my roommate--his mom--gets fussed over it (because by then it's overflowing), well, she has a bit more clout than me and he'll usually take it out that day. But it's not like he's not taking it out to shirk the task--he just gets distracted and it falls off his radar.

Something he uses to help stay on task is ToDoIst. You can use the app for free for as long as you want. The paid version is $4 per mo. It works like an activity ledger and the activities can be prioritized or shared. I've just recently signed up for it and can report that there is a bit of a learning curve to it--so far I haven't been able to update my list regularly or check the app regularly enough for it to be helpful. But when I get a free moment and because I think it could be helpful, I am wanting to learn how to use it better.

My mom has permanent brain damage. This means that not only does she have no executive function, she also has short term memory loss. She copes with it by writing everything down. She has a notebook that she brings everywhere--doctor's offices, the grocery store, when she's on the phone--and she is still able to care for other people because she doesn't try to remember everything anymore (she can't); she writes her thoughts down. She used to be a highly competent RN, so it's been very difficult for her to make the adjustment. And, she's continually seeking outside advice for how to cope with her disabilities better.

What I find both my mom and my young friend deal with in spades is managing negative self talk. Really, I think negative self-talk is worse than forgetting a task mid-stride because it berates and tears down. How I manage those conversations with my mom is to be patient with her, to ask her how what she's saying actually lines up in degrees to the thing she forgot, and if she's really being fair to herself. For my mom, it's got a lot to do with forgiving herself for not being the person she full well remembers she was.

For my young friend, I take more of an 'it's done, it's okay to move on' tactic. I've been trying to get him to interrupt his negative self talk and acknowledge that whatever it was he did, that that was done to the best of his ability. And whatever was left undone, then if he can get to it, great--and if not, then he knows someone will come alongside and helps to fill in the gap. (His mom's approach is a bit more impatient!)

Have you sat down and talk with your daughter about this? I'm sure you have--you have always struck me as a very thoughtful person. It might help to remind her how much you value her being able to help you, even by doing simple things like picking up after herself. I wouldn't make it a confrontational conversation but one that can encourage her to rise up to being her best-self, too. Ask her if there are things you can be doing to help remind her about things she's made commitments to. Maybe it's a texted reminder, a list app, or a spiral bound notebook.

Anyway, I hope there might be something here that encourages you and/or you find useful. One last thought, and this one is a bit of a reality check. If your daughter is able to find work someday, she will want to overcome her ability to follow through on commitments she makes if she's going to want to keep her job. It's a great concern I have for my young friend, and it's something that my mom, with her brain damage, will never be able to overcome.

 

[GypsyMoth]

Another idea came to mind. Some advice my young friend recently received was to make a household activity list on a white board and to hang it in the kitchen. So, he and his mom did that. The list is there, there are some activities on the list, and just the other day I noticed that some of the items have been erased as they've been accomplished.

Whether or not this idea is helpful to you, I wanted to point out that not everything that needs to be done needs to be in the same place. The list in the kitchen has more like household maintenance things on it--change the lightbulbs sort of things--whereas how he uses ToDoIst is to manage day-to-day activities.

He also uses a Calendar (Outlook?) and I think ToDoIst items can be sent to display on your Google Calendar, but I'm not quite sure--you'd have to look into that further if it's of interest to you. BTW, Google Calendars can be shared, too. The point, though, is to establish a habit. Once a habit or routine is in place, then it becomes easier to just consult and do what she's set up for herself for that day to do.

 

[Aspychata]

I also am good at not remembering things l hate doing like paying IRS complete balance, and budgeting for that outcome. So perhaps trying to make sure you deal with the anxiety of certain tasks, like scheduling dentist appointments with my daughter or my partner makes it bearable. Lol
The biggest task for your helper is no piles on the floor, or move it to the side if temporary. That should be on a note on the front door that she sees before she leaves. You can't put 20 things to do on that list, just put anything that may cause a dangerous situation. I really like all the suggestions, like the ToDoLst as mentioned by @GypsyMoth .

 

[AuroraBorealis]

Another thought I had: Trying to get yourself sorted if you suffer from executive dysfunction AKA are simply a scatterbrain (here...) can seem incredibly daunting. There is a high probability that she is already aware of the issue (unless you never talked about it in the past) and maybe even feels very guilty or ashamed for it. I hope that she doesn't, but it's very possible that she does.

If you live together (and it sounds like it), maybe also work out a space where "your rules" are, and a space where she can stay cluttered. Now, it's easier for some people to do "all or nothing", so if it's easier for her to work on this with the entire flat/house being included in getting organized, then of course that's fine too. But maybe, if that seems just too daunting, give her like one room where she doesn't need to pay attention to things lying around and can just be her old, cluttered mess. At best, that's a room you don't need to get into often. On days when she feels like she can't do it, she can just stick to that room and not worry about getting it messy.

Everyone needs a bit different strategies. For example, I never worked with a whiteboard because we don't have one and I am more of a notebook person, so I make my lists and tasks in my planner. BUT this planner needs to lay open all the time at a place where I often see it. If it's stacked in some drawer or in a bag, I won't look at it until days later when I've already forgotten a dozen things. This is something she needs to be on board with as well, because you need HER input when it comes to figuring out strategies, because what might work for one person might not work for another.

 

[Au Naturel]

one thing I believe in is “the job isn’t finished until the tools and materials are all where they belong.” This can be extended as “to finish a job, the workspace (room, table, shelves, etc.) must be as tidy as when you started.” This is a habit you will find many adhere to, because it makes for efficiency and safety in the workplace. Often, that is where the habit is drummed into you - in the workplace.

This reminded me of something. My son-in-law works in construction. He has worked for several companies.

According to him, hand tools are considered disposable, while power tools are only slightly less disposable. Buying a hammer every few jobs may be cheaper than worrying about properly caring for it. Buying a new hand saw is quicker than cleaning the rust off and sharpening the old one. (Actually, nothing ever gets sharpened.) The rust accumulates because tools are left on-site, right where they were being used at the end of the shift. Taking care of tools takes "nonproductive" time and the contractor would have to pay for it.

 

[AuAL]

This reminded me of something. My son-in-law works in construction. He has worked for several companies.

According to him, hand tools are considered disposable, while power tools are only slightly less disposable. Buying a hammer every few jobs may be cheaper than worrying about properly caring for it. Buying a new hand saw is quicker than cleaning the rust off and sharpening the old one. (Actually, nothing ever gets sharpened.) The rust accumulates because tools are left on-site, right where they were being used at the end of the shift. Taking care of tools takes "nonproductive" time and the contractor would have to pay for it.

I’ve had tradies use MY tools in similar fashion, borrowing them with asking and leaving them outside. I was not amused. OK, I can understand “on the job” habits like this these days when labour costs have outstripped tool costs, but in my own “workshop” the labour is free but the tools aren’t. I guess old habits die hard.

 

[Au Naturel]

I’ve had tradies use MY tools in similar fashion, borrowing them with asking and leaving them outside. I was not amused. OK, I can understand “on the job” habits like this these days when labour costs have outstripped tool costs, but in my own “workshop” the labour is free but the tools aren’t. I guess old habits die hard.

There's a larger issue of a disposable economy at work here. The disposable ethic creates costs that are not priced into the equation because they are not easily quantified and are easily shifted onto society as a whole. Pollution is almost always a case of creating a cost that gets paid for by everyone but the polluter.

 

[Aspychata]

My ADHD friend was very aware of the fact they couldn't complete tasks. I suggested notebook, and putting notes on the wall. That helps unless they lose the notebook. They started too many projects in their house, so that threw them off. I understand it's difficult. I take my ability to multitask for granted. Now l have a better understanding of listening to those that deal with this. My friends always have this or bipolar or both.