Tag Archives: executive function

Taking the Stroop Test

I took the Stroop test as part of my ASD evaluation and I’ve seen it recently on a list of online autism evaluation tests. While not strictly an autism test, it is often part of the test battery that is given at neuropsychological evaluations for autism.

The format of the Stroop test that I took during my evaluation was:

  • verbally reading a list of color words (blue, red, green) printed in black ink
  • verbally stating the color of a series of Xs printed in blue, red or green ink
  • verbally reading a list of color words that were printed in colored ink (i.e. RED printed in blue ink or RED printed in red ink)

The Stroop test is a test of executive function. Our brain’s natural tendency is to read words that we’re presented with; noticing the color of the ink the word is printed in is a secondary priority. The Stroop test asks us to inhibit our first instinct (reading the word) in favor of stating the color of the ink. Doing so draws heavily upon the executive functions of inhibition and attention.

Because autistic people typically have impaired executive function, we often score below average on the Stroop test. The time taken to complete the test is also seen as a measure of cognitive processing speed, another area where autistic individuals will typically have a below average result.

There are quite a few other conditions that also cause cognitive “interference” on this test, resulting in below average scores, including ADHD, dementia, brain damage, depression, schizophrenia and addiction. While the results of the Stroop test can give you some insight into your executive function abilities, it’s not strictly related to being or not being autistic.

Taking the Test

You can take a mini version of the Stroop test here.  The test site is ugly and has lots of ads that you’ll have to ignore. Read the instructions in the center of the page and click the green button when you’re ready to begin. The test has 20 items and will take a couple of minutes to complete. You’ll receive your scores on the final screen of the test.

Scoring the Test

The reason I called this a mini version of the Stroop test is because it has only 20 trials. The version of the test I took at my evaluation had 300 trials across the 3 different types of tasks, with each set of 100 having a 45-second time limit.

The online version presents 15 incongruent (ink color and word do not match) and 5 congruent (ink color and word match) trials. It then gives you a score showing your congruent and incongruent results, with number correct and the average processing time for each. Generally, most people respond more quickly the congruent pairs than the incongruent pairs.

Here are my scores for the online version:

  • Congruent: 5 Correct, avg response time: 11.78 seconds
  • Incongruent: 15 Correct, avg response time: 10.20 seconds

(Admittedly I have an advantage because I was familiar with the test format and I think my scores reflect that.)

And here are my scores for the paper version (raw score, followed by percentile – in both cases higher is better):

  • Word (color words/black ink): 82, 12th percentile
  • Color (Xs/3 ink colors): 91, 27th percentile
  • Color-Word (color words/3 ink colors): 110, 75th percentile
  • Interference (calculated from other scores): 121, 92nd percentile

If you look at both sets of scores, you’ll see that I’m better at the incongruent tasks. I got higher scores on the Color-Word and Interference scores for the paper test and had a faster average response time for the incongruent pairs on the online test.

When I saw my scores from the paper test, I was shocked by how poorly I did on the first two tasks, which felt effortless when I was taking them. I have no explanation for the disparity in my performance, except that maybe when a task is more difficult, I pay closer attention and therefore do well on it. I had a similar outcome on another “easy version-hard version” test during my evaluation which supports this supposition but there may be another explanation that has gotten by me.

The Bottom Line

How useful is the online Stroop test? I think it’s more valuable as a curiosity satisfier than an actual measure of cognitive processing. First, it doesn’t have the “priming” tasks of reading the words in black ink and naming the colors of the Xs, which create performance patterns in the brain, supposedly making the color-word task more difficult.

Second, there is no overall time limit so the test taker doesn’t feel pressured to rush through as many items as possible to complete the test in the allotted time. The response time score compensates for this a bit, but there’s no mention at the beginning of the test that one is being timed.

Finally, the number of items is too few to cause the cognitive fatigue that makes the paper test challenging.

Executive Function Strategies

I’m putting the blog on hiatus for the month of August. Some more details at the end of the post if you’re interested.

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Back in March, someone left a comment on the self-employment series asking me to share some of the ways I manage my executive function challenges in the context of work. With an amusing mix of irony and executive function fail, I’m just now getting around to writing the promised post.

One of the reasons I’ve been avoiding writing this is that I couldn’t figure out how to approach it. Should it be a list or a narrative? Does it need examples? How detailed should it be? There was also the nagging fear that maybe all of my executive function hacks are plain old common sense.

Back when I was fourteen and an aspiring doctor, someone recommended that I read “The Making of a Surgeon” by William Nolen. It was a memoir of Nolen’s progression from med school student to surgeon and I excitedly dug into it, hoping for insight into what med school would be like. Only to be disappointed when one of the first grand bits of wisdom that the author offered was how he learned to do multiple chores at one time–literally to pick up records, drop off samples and get his lunch all in the same trip rather than making three separate trips from his unit to do each errand individually.

I remember lying on my bed thinking, “How on earth did this man get into such a prestigious medical school?” It seemed like a no-brainer to me that if you had three things to do, the best option would be to do them in a geographically efficient sequence.

At the risk of some of you having these same kind of thoughts about my executive function hacks, here are some of the strategies I use at work and day-to-day life.  Continue reading Executive Function Strategies

Let Me Repeat Myself

In the comments on the Why Talking is Hard post, a few people mentioned that they have a tendency to repeat themselves when speaking and, oh boy, can I relate to that. I’ve spent a lot of time thinking about my tendency to say things over and over to someone, because it’s a rather embarrassing habit to have as an adult.

The underlying causes are probably a bit different for each of us, but I’ve come up with a few ideas about why autistic people are often prone to repetitive speech:

Poor inhibition

This feels like the most obvious culprit. Once we get started on a favorite subject, look out. We just can’t seem to stop, even when it’s obvious that the other person is getting bored or uncomfortable. Part of infodumping is often going over the same facts or stories repeatedly, as if we aren’t sure the other person is really grasping why this subject is so freakin’ awesome.

Poor inhibition is a component of impaired executive function–a plain old lack of ability to put the brakes on speech. Infodumping or monologuing about a special interest feels closely related to poor inhibition. Repeating the same information within an infodump is likely an extension of the phenomenon that leads to infodumping in the first place.

Basically it’s all one big case of “Help–I’m talking and I can’t stop!”

Perseveration

This is more of a “broken record” kind of repetition. It’s asking someone the same question or making the same statement over and over, even though the other person has already answered or acknowledged it.

I do this a lot to The Scientist, especially in relation to making plans.

“Let’s run tomorrow morning.”

Ten minutes later: “Tomorrow is a running day, right?”

A half hour later: “I want to run in the morning. Oh, wait, I said that already, didn’t I?”

Which doesn’t stop me from wanting to say it another ten times as the evening wears on. With practice I’m learning to silently think the question or statement and then remind myself that it’s already been answered. That works in a mostly-but-not-always kind of way.

This aspect of repetitive speech feels like lack of inhibition combined with compulsive thinking.

Catastrophizing

This is the one that eventually earns an exasperated “Would you just let it go already?!” response from whoever happens to be unlucky enough to be on the receiving end. It’s the kind of repetition that other people quickly tire of because it comes across as irrational and anxiety-laden. A worst-case scenario that just won’t die.

Catastrophizing = poor inhibition + perseveration + anxiety.

Normally, when I repeat myself in a perseverative way, the other person’s response temporarily quiets the need to do it again. But when I’m catastrophizing, the other person’s response is unfulfilling and I continue to say the same thing in different ways, trying to elicit a more reassuring response. Which is impossible, because no response other than “yes, that highly unlikely disaster is sure to happen” would be satisfying.

Short term memory deficit

This one occurred to me while watching the videos that I made for my attempt at video blogging. At times, I simply forget that I’ve already said something or made a point. I forget what I was talking about, have talked about or wanted to talk about and get stuck in a loop of similar thoughts that keep coming out in slightly different ways.

I also noticed that I echolalically repeat myself, reusing phrases or words within a conversation. It’s hard to say why–maybe as touchstones or because they’re caught in my conversation buffer. The funny thing is, it’s rarely the same words or phrases that get repeated from one conversation to the next.

Missing social cues

I think sometimes I repeat myself because I’m not getting the social communication cues to confirm that the other person has heard me. I need very obvious cues, like verbal affirmation. The cues that work for typical people–sustained eye contact, affirmative body language–are usually lost on me.

If I don’t get the expected verbal affirmation, I keep repeating what I said until I’m sure the other person is getting my point. Closely related to this is the difficulty I often have in actually making my point verbally. In way, my repetition is an attempt to edit my spoken words after the fact, which I don’t think is how talking is supposed to work.

You Are Getting Very Sleepy

Note: The annual Autism Positivity flashblog is being held again this April 30th. Visit the website to find out how you can participate.

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For the past few weeks I’ve been getting ready to move. That’s meant making lots of phone calls to change over utilities and insurance and such. And packing. Lots of packing. Of course packing also means deciding what to keep and what to toss and what to donate, plus a good amount of organizing and reorganizing. Because, you know, it’s important that my entire file cabinet go into the box in the best possible order, with not a single scrap of unnecessary paper cluttering up my system.

I’m happy to say that nearly everything on my list is done. Which is good, because the moving truck arrives in less than forty-eight hours. I’d also like to say it all got done smoothly and according to plan, but that would be a lie.

You see, I have this thing that happens when an anxiety-inducing event is imminent: I suddenly feel very very sleepy. I don’t just mean that I feel a little tired–I mean I feel 2 AM tired.

Mostly it happens before social events. The Scientist will be busily showering and shaving and choosing an outfit and I’ll be calculating down to the minute how late I can start getting ready.

Fortunately, it doesn’t take me long to make myself presentable. That means I can safely put off getting ready until the last ten minutes before we need to get out the door. Any sooner and I’ll be all ready to go while simultaneously wanting to lie down on the couch  and take a quick nap.

The strange thing is, even when it’s happening, I know the tired feeling is an illusion. It’s my brain trying to get my body to play enabler, to somehow avoid the anxiety-inducing event. Some people get butterflies in their stomach or a need to pace. I get a sudden urge to hibernate in a blanket fort for a week or two.

sleepy2

So in addition to all of the usual chaos of getting ready to move, I’ve been trying to outsmart the sleepy feeling. Not surprisingly, actually sleeping doesn’t work. In most cases, it isn’t even an option because the thing I need to do is both imminent and time sensitive. But even with most of the moving tasks, where I could grab a nap and then do them later, there is no actual sleeping to be had. Because if I lie down, all I’m thinking about is the task I should be doing. So then I’m both sleepy and annoyed with myself for procrastinating.

It helps a bit to think of the feeling as something other than sleepy–to call what it really is, which is some sort of defensive withdrawal. When I look at it that way, I understand intellectually that I don’t need or want to sleep. I also know from experience that the best “cure” is to do the anxiety-producing thing. Often, I simply need to get started and the feeling clears.

To get the stuff on my moving list done, I used a lot of the same tricks I use to manage my executive function deficits: lists, rewards, schedules, telling myself that I just have to call one insurance company instead of all three or pack up a box of clothes, which is easy, rather a box of dishes, which is harder. Once I get on the phone or haul out the packing materials and tape and boxes, it’s much easier to just keep going. It’s the getting started–getting past that initial wall of do not want–that’s the real trick.

Addendum

When I told The Scientist that I planned to write about this topic, he suggested that I also write about, “the way you yawn when you’re bored during a conversation.” My yawning habit (for lack of a better description) has long been a source of annoyance for both of us. The Scientist assumed I was bored but not telling him; I was flummoxed whenever he brought it up because I usually wasn’t  feeling bored when it happened.

yawn

Coincidentally, a New Yorker article about the science of yawning popped up on my Tumblr dashboard within hours of the The Scientist’s suggestion. Buried beneath a lot of other more complicated theories is the suggestion that in addition to yawning when we’re bored, tired or hungry, we sometimes yawn when we’re anxious. That makes sense to me. Yawning definitely helps me clear my head and it gives my nervous system a poke, both of which help me stay focused. Coincidentally, that’s a pretty accurate description of the effects of stimming too.

These days I mostly catch myself before I yawn during important conversations. When that familiar feeling creeps up, I get up to pace or intentionally engage in a stim that has the same effect as yawning. But it was interesting to learn that there are all sorts of theories about yawning and they aren’t all centered around boredom or fatigue.

Addendum to the Addendum

The article I linked to above also mentions that autistic people are less likely to be contagious yawners. I’m curious whether autistic readers think this is true? I’m very susceptible to contagious yawning, to the point that I yawn when my dog yawns. In fact, I’ve been yawning pretty much constantly while researching, writing and proofreading the last two sections of this post.

 

Taking the Cognitive Style Test

Take a Test Tuesday is back! It’s hard to believe it’s been more than a year since the last Take a Test Tuesday post. In that interim some new tests have popped up online that look interesting so I thought it would be fun to bring back the Tuesday posts for a few weeks. So let’s get started.

This week I took the Life Experiences and Your Cognitive Style test at the awesome Test My Brain website. The tests at Test My Brain are all part of ongoing research, so by taking them you learn some interesting tidbit about yourself and you get to help researchers answer important questions.

The question that this test is trying to answer appears to be how does childhood trauma relate to impulsivity and attention difficulties later in life? This idea has been floating around for nearly a decade. It’s unclear whether adult ADHD may be linked to traumatic childhood experiences or childhood trauma can cause symptoms similar to ADHD in adults. If you want to read more about the research that’s been done on that topic, this article has a lot of links.

The reason this test got me all excited is because the first part of it is a shorter version of the ADHD test that I took during my Asperger’s assessment.  Continue reading Taking the Cognitive Style Test

Executive Function Summary

Some of you mentioned that it would be nice to have a concise summary of the key elements of executive function impairment to share with family members and others. So I made a thing!

This slideshow requires JavaScript.

You’ll need javascript to view it. You can pause the slideshow by hovering your mouse over it and then clicking the pause button.

I also created a new Executive Function page with links to the Executive Function Primer posts plus the slideshow and some introductory text.

Executive Function Primer (Part 4)

This is part 4 in a series about executive function. After wrapping up the discussion of regulatory functions with some thoughts about Cognitive Flexibility, it talks a bit about some models of EF and how the various pieces fit together.  Looking for the other parts? Part 1 |  Part 2 | Part 3 

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Cognitive Flexibility

Cognitive flexibility is all about change. Changing your mind. Changing your opinion. Changing your beliefs. Coping with change. Understanding why change happens.

In a more formal sense, it’s the ability to shift your thinking or attention is in response to changes in the environment or situation (such as new rules, information, demands or goals). If you’ve ever wondered where the autistic tendency toward rigid thinking and routine comes from, this is it. Change requires cognitive flexibility. It’s not necessarily that we don’t want to do things differently. Impaired executive function makes it harder to adapt to change by forming new thought or behavior patterns.

Variation in executive function capacity can explain why one day it’s not a big deal if the bus is five minutes late or your favorite shirt is in the laundry but on another day, this kind of small disruption to routine triggers a meltdown. What appears to be a fit of irrationality is actually a failure of the prefrontal cortex to cope with change in the expected way.

Cognitive flexibility also refers to considering multiple aspects of a situation at the same time, such as seeing opposing points of view or multiple characteristics of an object. When you think about it, there is little difference between “lack of empathy” or “impaired theory of mind” and impaired cognitive flexibility. Not seeing the other person’s point of view can be as simple as having difficulty seeing multiple aspects of a situation at the same time.

Finally, cognitive flexibility includes task switching, which is sometimes listed as a separate component of executive function. Difficulties with task switching are what make it hard to stop playing World of Warcraft and start making dinner. Or to pick up where you left off on a task after being interrupted. Poor task switching is also why people will often say that autistic people are so good at doing repetitive tasks. It might be more accurate to say that we’re not very good at stopping.  Continue reading Executive Function Primer (Part 4)

Executive Function Primer (Part 3)

This is part 3 in a series about executive function. It looks at the regulation functions that are related to initiating, monitoring and inhibiting our actions and thoughts. Looking for the other parts? Part 1 |  Part 2

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The second category of executive function components, regulation, includes cognitive flexibility and the initiation, monitoring and inhibition of actions. These executive functions are primarily related to how we interact with our environment.

Inhibition

When you think of inhibition, you probably think of the common usage which means a feeling of self-conscious restraint. The inhibition related to executive function is somewhat different. It refers to our ability to block or suppress a thought or action, either consciously or subconsciously.

Biologically, inhibition takes place in three different realms: motor inhibition, cognitive inhibition and emotional inhibition. It’s quite possible that you’ve never even thought about inhibition in this way and yet it has a huge impact on your daily life.

Our brains are constantly inhibiting–or failing to inhibit–thoughts and actions. To focus attention on one thing, we have to inhibit countless other distracting inputs (remember the top-down and bottom-up attention systems as well as selective attention). To call up a desired piece of information from memory, we have to inhibit the retrieval of millions of irrelevant bits of information. To change a behavior we have to inhibit habitual actions. And sometimes, to get through a difficult situation, we have to inhibit our emotional reactions (or, if you’re alexithymic, consider the opposite case–your emotions are involuntarily inhibited, perhaps in part because of dysfunctional inhibition).

When you think about it, a lot of autistic traits could be traced back to poor inhibition. Infodumping, even when we know the other person has lost interest. Catastrophizing long past the point where it’s logical. Blurting out what we’re thinking only to regret it a split second later. Spending the day lost in a special interest when we really did mean to get all those chores done. Even stimming could be viewed as poor motor inhibition. What if all people have a natural tendency to stim, but neurotypical people are just better at naturally inhibiting their motor function?

Extreme difficulty with inhibition can lead to impulsivity, which is more characteristic of ADHD than autism, but can be present in both. Often, impulsivity is mistaken for problem behavior and met with punishment as a means to extinguish the problem. Like other aspects of dysfunctional EF, poor inhibition isn’t something that can be fixed by simply trying harder or having more self-discipline. Support can help. Accommodations can help. Understanding can help. Practice can help. Punishment and shaming only hurt.  Continue reading Executive Function Primer (Part 3)

Executive Function Primer (Part 2)

This part 2 in a series about executive function. It looks at the remainder of the organizational functions that were introduced in part 1 : problem solving, verbal reasoning, working memory and attention.

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Problem Solving

Problem solving is another umbrella term, encompassing the activities related to identifying and overcoming obstacles to reach a predefined goal. Probably the most complex cognitive process that we engage in, it draws on nearly all of the other aspects of executive function.

Here is the traditional problem solving cycle, with related EF components in parentheses:

  1. Identify the Problem (attention, initiation of action, monitoring of actions, working memory)

  2. Define the Problem (cognitive flexibility, reasoning, working memory)

  3. Form a Strategy (planning, reasoning, cognitive flexibility)

  4. Organize Information (working memory, attention, reasoning)

  5. Allocate Resources (planning, initiation of actions, inhibition, cognitive flexibility)

  6. Monitor Progress (attention, working memory, monitoring of actions, inhibition)

  7. Evaluate Results (working memory, reasoning, planning)

For me, that list is missing a very critical step: Recognize That a Problem Exists. Because this is where I often run into trouble with problem solving. I’m pretty good at reasoning out solutions to a defined problem. Not so good at actually recognizing the presence of a problem. And that’s executive function too.

And again there is an ironic twist lurking under the surface here: when someone else is having a problem, what is the default autistic response? Fix it! Come up with a plan! Whether they want us to or not.

We are instinctive problems solvers, but only when it comes to other people’s problems, it seems. Maybe because we wish other people would do this for us? Executive function is such a strange beast.  Continue reading Executive Function Primer (Part 2)

Executive Function Primer (Part 1)

I’ve written a lot about executive function, but I realized recently that I don’t have a post that explains what EF is. I set to write one post and 4000 words later, I have a short series. This is part one. The three remaining parts will be posted over the next two weeks.

So what the heck is executive function, anyhow?

Executive function is a broad term that refers to the cognitive processes that help us regulate,  control and manage our thoughts and actions. It includes planning, working memory, attention, problem solving, verbal reasoning, inhibition, cognitive flexibility, initiation of actions and monitoring of actions.

That’s a nice concise definition, in theory, but what does EF look like in real life?

In practice, executive function is a slippery concept. Sometimes it looks like responsibility. Sometimes it looks like self-discipline. Sometimes it looks like being a competent adult.

If you have poor EF, people might mistake you for being disorganized, lazy, incompetent, sloppy, or just plain not very bright. Why? Because executive function encompasses so many essential areas of daily living. Nearly everything we do calls on areas of executive function. Cooking. Cleaning. Parenting. Work. School. Self-care.  Continue reading Executive Function Primer (Part 1)