What is executive dysfunction?

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Learning points

An understanding of what executive dysfunction means.
Awareness of the different terms used to describe executive dysfunction, and what it might look like.
An understanding of why it’s important for social care practitioners to know about executive dysfunction.

Definition of executive dysfunction
How problems with executive functions arise
Clinical populations where executive dysfunction may be observed
How might problems present?
Case examples
Why might we see those with executive dysfunction more in social care?

Definition of executive dysfunction

When someone has difficulty with the group of cognitive skills known as executive functions they are said to be experiencing executive dysfunction.

You might read of problems with executive functions being called executive inefficiencies (particularly if there are only minor issues), frontal lobe dysfunction, executive dysfunction, dysexecutive functioning or disordered executive function. The term executive capacity might also be used when thinking about executive skills in the specific context of the Mental Capacity Act 2005 (MCA) and someone’s decision-making capacity.

How problems with executive functions arise

Executive functions develop over childhood (particularly towards late adolescence, see the TED talk below by Sarah-Jayne Blakemore, professor of psychology and cognitive neuroscience at the University of Cambridge) in conjunction with frontal lobe maturation (Anderson et al, 2001) and decline with age-related loss in pre-frontal brain regions (the front part of the frontal lobe) (Ferguson et al, 2021). Neuro-imaging suggests that tasks requiring executive functioning skills primarily activate the frontal lobe, but also activate neurocircuitry connected to other brain areas such as the parietal lobe and the cerebellum (Collette et al, 2005; Bellebaum and Daum, 2007).

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