Planning, Sequencing, Organising

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" Nora and i were discussing her messy bedroom.  She said she would like it to be cleaner and neater. I asked her to picture her room and tell me what it would take to be the way she wanted it. She ticked off on her dingers, "I'd have to make the bed, and pick up all the clothes off the floor, and clear off the top of the desk, and vacuum, and throw away the newspapers and junk mail." I remarked that she knew what to do to clean the room, but she answered that she wouldn't know where to begin. So I asked her to tell me again the things that had to be done. Again she ticked them off on her fingers, in the same order. I said, 'So now you know what to do." Her list amounted ot a very competent analysis of the necessary steps to clean the room. But she looked at me with a completeley blank stare and said, again, that she had no idea how to clean the room. For Nora, a description of the room that she could picture in her mind bore no relation to knowing how to go about cleaning the room.

The example above illustrates the way in which the executive functions cannot be separate. Part of Nora's problem was an initiation issue: she couldn't begin the project. But she couldn't begin because she couldn't organize the project in her mind. she couldn't think of sequential steps even though she created a list when asked. She didn't even realize that a list is a sequence. Most importantly for understanding this deficit, she could answer questions about cleaning her room, but she couldn't ask herself the same questions as a way of getting started an analyzing the problem. The brain deficit is largely in not realizing there is an analysis to be done.

......

Asking the clients, in a logical manner, what it would take to have the things they want stimulates good, reasonable answers. This is because they are generally not impaired in intellectual ability. But because they aren't organized in their analytical an thinking skills, they fail to ask the same questions of themselves. An, amazingly, after such a conversation, they return to the wishful thinking and failure to analyze their circumstances, as if the conversation ahd never happened. "

- "Adults on the Autism Spectrum: Leave the Nest, Achieving Supported Independence" by Nancy Perry

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