Schizophrenia and executive functioning

Executive functions refer to complex thinking processes such as the ability to make plans, to start an activity, to carry out steps of a complicated task, and to complete a task even when distracting things are going on around you. Kind of like the executive of a company, our executive functioning in many ways directs our lives.

This section focuses on executive functions, including the ability to:

• Plan and carry out a specific task
• Be flexible in how we think
• Monitor our own progress on tasks and activities.

Example:

Someone experiencing executive functioning challenges might have a difficult time working through the steps of a recipe or might need a prompt to do some basic daily activities.

Level of functioning

Someone with greater executive functioning challenges will need environmental supports to be more obvious (e.g., by making signs larger, brighter and more numerous).

Supports will also need to be placed closer to where the activity is taking place. (Example: A reminder about brushing teeth will need to be placed in the bathroom where brushing occurs, rather than in the bedroom.)

In general, someone with fewer executive functioning difficulties is able to perform daily activities with less structure, and more subtle environmental cues. (Example: The person might only need a calendar on their phone to keep organized rather than signs posted on walls all over the apartment.)

Types of functioning

The type of functioning is another important part of the picture. In their most basic terms, these problems involve either:

• Having trouble getting started or, otherwise, a hard time initiating actions and activities (sometimes referred to as apathy)
• Getting disorganized when doing tasks.

Trouble getting started

“Trouble getting started” happens when a person does not start necessary activities without being told or does not complete all the steps in a task because they have trouble starting each step in the process.

Trouble staying organized

Trouble staying organized is quite different kind of difficulty -- although the two can sometimes go together. Someone is disorganized when his or her behaviour doesn't match the situation or when the person gets easily distracted by irrelevant things in the environment.

People having these kinds of challenges tend to be agitated or edgy, have thought going off in many directions and have a hard time organizing themselves to get things done.