Many people with Autism have deficits in Executive Function (EF). EF refers tot he brain's ability to organize information and regulate your thoughts and actions. Some people refer to EF as the 'brain's secretary.' Without a well developed EF, people are unable to organize all of the information they receive and thus have difficulty planning out and completing even the most activities without becoming overwhelmed. This can lead to individuals resisting activities even when there is positive incentive for completion. for people with a poorly developed EF, the effort and emotional stress associated with doing activities requiring organization and planning exceeds and positive consequence they may receive for completion. This avoidance is often more powerful and negative consequences for incompletion as well.
Fortunately, there is a method helping people with poorly developed EF to complete activities and develop skills. Applied Behavior Analysis (ABA) therapist call this a Task Analysis. A task analysis refers to breaking an activity down into a series of short discreet steps. These steps are then put on a picture or word list for the person to use as a reference. This allows the person with an EF deficit to only have to think about one small step at a time. Organizing thoughts or keeping track of multiple steps is not required saving the individual from being overwhelmed and making them more likely to attempt and complete the activity. For example if one wanted to make a task analysis for washing your hands, it look like this:
1. Turn on cold water 1/2 turn
2. Turn on hot water 1/2 turn
3. Place both hands under faucet.
4. Squirt soap on hands.
5. Rub hands with soap.
6. Place hands under faucet again.
7. When soap is off, dry hands with towel.
8. Turn off water.
This can be modified to meet the person's needs. Some may need pictures or less words, but this type of approach can be used for not only simple tasks like this, but for more complicated tasks as well (.e.g. school assignments, chores, work activities, finances, etc.). In general if a person with EF deficits is resisting a task it is likely because they perceive the task as either too larger or too difficult. Often times a task analysis can make the activity seem less daunting.
The other key aspect of the task analysis is the list itself. Having the reference list with the individual steps is highly important. It allows the person to see the steps so they do not have to think about them. It also helps because the person realizes that if they forget a step they can refer to the list. This further creates a sense of independence because if the person has access to the list (and understands it) they do not have to rely on others to tell them what to do. If a person can complete a task independently that they were once not able to do, the sense of accomplishment is often greater than any reward or incentive that is given.
Steven C. Altabet, Ph.D.