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Executive Dysfunction

What is it?
Executive dysfunction disorder affects the individual's ability to make goals or carry out plans to reach a goal. Also, people with Executive Dysfunction will often get stuck on small details and as a result, they cannot achieve their goals. Executive dysfunction most often results from damage to the frontal lobes.

What is it?
Watch the following introductory videos. Click the video icon when ready.

play video  Transcript 1. Executive dysfunction and detail-related problems.
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Dementia will affect many parts of the brain, including the frontal, which house up to 33 percent of the cortical regions of the brain. One of the problems is Executive Dysfunction. In this case, people tend to get stuck on small details. They become so involved with the detail that they have difficulty sitting back and putting it into its proper context. For example, I could hold up my tie, which has a pattern of small circles on it, and ask the client to tell me what this object is. They might say, "A lovely button." The person with Executive Dysfunction gets stuck on a small detail, such as a circle in the pattern on my tie, which does indeed look like a button. They have difficulty shifting back and putting it in context and saying, "This is a button-like thing which is part of a thing called a tie." When the client has these types of problems, the environment can be very confusing to them. For example, if there is a red non-smoking sign, people with Executive Dysfunction will get stuck on the detail of the red circle with the red bar across it, and will interpret the sign to mean "Do not Enter".Outside an elevator, there are up and down arrows. But the actual button to press to get the elevator to come to you, is a smaller button on the bottom. People with Executive Dysfunction get stuck on a salient detail, the arrow which points up. They want to go up, so they press on the up arrow, which is the wrong thing to do. Here, the environment is very confusing, and could be difficult for them to manage. Once you understand that, you can help them manage within their environment.

play video  Transcript 2. Looking at someone's environment and possible causes of confusion.
<a href="../pages/executivetip.wmv">Download movie</a>

One way of coping with Executive Dysfunction is to try to put yourself in the place of the person who has those types of cognitive deficits. Look at the environment and try to find out what could be confusing or disabling in the environment.For example, people with Executive Dysfunction will arrive at one of those fancy, automatic doors and be totally confused. However, if there happens to be a very concrete doorknob right beside it, they'll go for the doorknob because they were attracted to this very salient feature. Even though the doorknob is redundant, they will use it to go in through the door. If you don't understand there is this type of break down, you might try to make things easier, but by trying too hard to make things easier, you might make them more confusing.


Study the examples below to see how the surroundings can affect a person with Executive dysfunction.

A person with Executive dysfunction will focus on detail and may interpret the image below to be "8" instead of "3".

A person with Executive dysfunction may interpret the image below to mean, "Do not enter" instead of "No smoking".

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