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Neurodiversity and Executive Function

What are Executive Functions?

Neurodiversity and Executive Function
Executive functions are a set of cognitive processes or thinking skills that are necessary to plan and organise our actions, in order to achieve our goals.
hey include basic cognitive processes such as attentional control, cognitive inhibition, inhibitory control, working memory, problem solving and cognitive flexibility. Allowing us to manage day-to-day tasks, stay safe and get things done.

Todd, who owns Pontefract Squash & Leisure Club in West Yorkshire, first lost his 85-year-old mother in April of 2020. Twenty-four days later his father died due to Covid complications. They had been married for over 60 years.

To compound matters, within a week of his parents dying, he then lost his aunts in the space of a fortnight. “It has been impossible and horrendous regarding the Covid restrictions on funerals,” he says.

Todd, a well-known business figure in the market town, was present at the double funeral for his parents. In all, he has been to eight funerals during lockdowns in the UK. He says that the rule of six limit at the crematorium meant many people in the community were standing outside for his own parents’ funeral, with the speakers not allowed to be turned on. “We couldn’t really say our goodbyes,” he adds.

No-one could have imagined the isolation in which millions of people in the UK would be expected to cope with grief and bereavement through 2020 and into 2021. Even for those without recent losses, lockdown created a vacuum in which grief – new or unresolved – rose to the surface.

To put this into perspective, the six digit numbers quoted in daily press briefings, and the red line that climbed ever upwards to the right in daily graphs equate to the most excess deaths in the UK since World War Two.

Grief is deeply personal and in the isolation of lockdown it has become deeply lonely as traditions and rituals for mourning have disappeared.

We talk with two grief and bereavement specialists at ProblemShared, Joyce Howitt and Susan Cappaert, to draw on their experience and take a look at what has emerged in related areas of research and ways to move forward.

Lost Grief Rituals

In a national survey of people bereaved in 2020, 94% said they had had to restrict funeral arrangements. Simply put, Covid-19 has changed the way we have mourned and the restrictions of the pandemic have made bereavement ever more stressful and painful.

Susan Cappaert said that this had been heartbreaking for her clients: “It has caused a lot of anger, frustration and confusion." Like so much else in this pandemic, an experience that has been so restricted that it feels watered down or token in gesture cancels out some of the benefit of being able to participate at all.

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What Makes This So Much Harder To Bear?

In some ways, the answer to this question seems obvious to our collective understanding of what has unfolded over 2020 and 2021.

The particular mix of suffering that has unfolded means that the grief which follows is likely to be complicated at a level that may be hard to shift.

Factors that complicate grief in this pandemic are myriad and have trauma, shock, a void of control or self-directed choices, and a lack of resolution in the mix.

As Susan Cappaert says, “For many bereaved, there is constant worry about someone dying alone and the only connection they had to their loved one was a daily phone call to the hospital for an update."

As Joyce Howitt says,

"Even the most basic action - touch - has been lost."

Contact with those who are ill in hospital has not been possible; it is impersonal - often reduced to as little as the sharing by healthcare workers of a patient's stats and numbers - the "obs" of interval monitoring in a hospital ward (the observations of a patient's vital signs), and as reiterated in various research, this is partly because of the time pressures on hospital staff and care providers, partly because of the pressure on resources, but also because there is little other means of contact available to gauge matters given the physical impediments of PPE gear and ventilators. This means that there has been no opportunity for those bereaved to bear witness themselves and prepare for the inevitable, nor has there been an opportunity to give comfort to the loved one or resolve any unresolved aspects to that relationship.

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The associations the bereaved may have with their loved one's physical struggle with Covid-19 can also play a role in exacerbating grief and other responses - for example the worries about a patient not breathing peacefully or dying while intubated.

"Bereavement care fell to a wide range of staff members, including some with limited experience or training in supporting bereaved people who had to rapidly develop the required communication skills," a survey of bereavement care found this year.

And then there is the added weight of conscience in accepting that there are limitations for those working the back-breaking hours in hospitals to deliver care in order to save lives in the face of what were mounting death tolls. It is a situation in which it can be hard to find an appropriate target or place to direct the anger, confusion, and lack of control that follows bereavement in these circumstances since everyone is trying their hardest.

Setting this against the backdrop of millions of people isolating at home for so much of last year and into this year, with limited social contact and restricted physical engagement with the outside world, it is a very particular context that gives rise to such intense grief.

Grief Can Be Different The World Over And That World Is Right Next Door

Although first-hand accounts of bereavement and the restrictions to our grief rituals have been played out in the media on an almost daily basis, the impact of varying cultural & religious sensitivities to bereavement is less talked about. There can be different cultural & religious emphases with regard to how to honour the departed, the number of mourners, the duration of the proper mourning period, traditions in the displays of grief and outpouring of emotion, and the rituals of the attendant physical bodily rites. Lockdown has been ever more compromising of the mourners' perceptions and hopes for the departed's journey onwards.

Another aspect to the cultural context is that the community in the U.K. which has suffered most disproportionately in terms of rate of bereavement has been the BAME communities. That these communities' share of loss is higher is in part due to the close-knit settings of extended family life in such communities which underlines the further fracturing of this community.

These communities are also broadly more likely to be involved in frontline "key worker" roles which cannot be done from home, especially with respect to healthcare. As reported in a study last year "One country, two crises", BAME groups number 44% of medical staff and 20% of nursing staff and it is these jobs where risk of infection was greatest. The first 11 doctors to die in the UK were from BAME communities.

A wider number of kin can also be affected by bereavement, due to the larger family size of BAME communities, as attested to by a study out of the United States. Those undertaking the national UK study on bereavement have also pointed out that one of their primary goals is to understand better bereavement across all population groups in order to provide more equitable bereavement support to those groups.

Understanding Different Types Of Grief As A Roadmap For Healing

The human ripple effect of bereavement means that there were at a minimum close to 4 million people bereaved in the UK on the anniversary of the first lockdown earlier this year in March, regardless of cause. The same bereavement study out of the United States that looked at differentiated weighting for different population groups put the multiplier for bereaved as high as 8 - 9 kin for every death based on factors specific to the ages of those who have died during the pandemic, being on average older and leaving behind several generations of family. This is well north of the usual bereavement multiplier of 5 kin, putting the number of bereaved well in excess of 4 million.

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“Grief is an extremely powerful emotion; it is painful and exhausting in ‘normal times’, let alone this last year", says Susan Cappaert.

There are various psychological models of grief and schools of thought about processes that someone goes through in order to heal. Even usual uncomplicated grief cannot be easily boxed into a tick box of symptoms or experience. There is "wide diversity in the timing, expression and intensity across population groups and within families".

One of the biggest barriers for neurodivergent people entering the workforce is non-inclusive interviews.Interviews typically place an emphasis on conversational ability, social skills and body language. neurodivergent candidates often show differences in these areas and so reasonable adjustments need to be considered to give them a fair chance so reasonable adjustments need to be considered to give them a fair chance.

Organisations can get ahead of the curve by adopting an inclusive approach to neurodiversity from the beginning. Here are some tips to help your company to conduct more inclusive interviews to support the neurodiverse workforce.

Before the interview

To help candidates prepare and set themselves up for success before the interview starts, here are some things to consider:

  • Provide clear directions to the interview, including photographs of streets and transport stations.
  • Provide clear instructions on how to get into the building and where they need to go when they arrive.
  • Share any interview questions in advance and allow them to bring reminder notes.
  • Allow adequate time for replies during the interview.
  • Let them know the name and job role of anyone they’ll be meeting during the interview beforehand.
  • Provide a timetable for what will happen in the interview. For example, ‘we’ll spend the first ten minutes talking about you, then spend ten minutes talking about your technical experience’.
  • If possible, provide access to a quiet space where your candidate can avoid auditory, visual, or social stimulation before and after the interview if required.
  • Ask your candidate if they’d like to be accompanied by someone they know during the interview.
  • Ask about communication preferences. Some people might prefer to support their spoken language with the option to write for example.

The right environment

Neurodivergent people often experience sensory issues. They may be distracted by noise, lights, and the surrounding environment, so if you’re hosting an in-person interview, it may be beneficial to ensure the interview room is as distraction-free as possible.

Here are some suggestions for getting the setting right:

  • Provide a notebook in case your candidate wants to make notes. This can help them organise their thoughts when giving detailed answers.
  • Invite them to move around during the interview, or factor in short breaks, if your candidate finds it difficult to sit still for periods of time.
  • Don’t expect eye contact. Neurodivergent individuals may find this uncomfortable, or it may impact their concentration.
  • If possible, provide fidget toys or stress balls to reassure your candidate by making them feel more comfortable and to reassure them that you are neuro-inclusive company.

Fair Questions

Neurodivergent candidates may struggle with open-ended and hypothetical questions, and with switching between formal and informal tones. It may also take them longer to process questions. Quick thinkers can talk rapidly and get distracted, so they may stray off topic.  

Here are some suggestions when preparing interview questions for neurodivergent candidates:

  • Be specific with your questions. For example, ‘what information governance processes did you use in your last job?’ may elicit a better response than, ‘what would you do to look after people’s data?’
  • Consider asking focused questions rather than generalised ones. For example, ask for specific examples instead of saying ‘can you give more detail?’  
  • Be prepared to accept literal responses. For example, if you ask, ‘how did you approach your last role?’ you may get a literal answer like, ‘by bus and then I walked.’
  • Try to avoid long questions that contain multiple clauses. Your candidate may have difficulty focusing and waiting for the question to be finished, especially if they struggle with processing information.
  • Multiple choice and psychometric tests can be discriminatory. It’s much more beneficial to provide an alternative style of assessment.
  • For written tasks at interview, 25% extra time is a reasonable accommodation to allow for processing and answering questions.
  • Be prepared to prompt your candidate or repeat your question if you need more information, and let them know when you have enough information.
  • Ask the candidate if they would like any reasonable adjustments for their interview.  

Considering neurodivergent jobseekers is a shift away from old-fashioned thinking, where the interview process was mainly designed with ‘neurotypical’ candidates in mind. It’s important to understand bias and be aware that we can all function in different ways, and that performance in an interview does not necessarily reflect on how a person will perform in the role.

To make sure you retain your neurodivergent talent it will be necessary to apply these principles throughout the onboarding and retainment process too. Make sure your workplace is neuro-inclusive by offering continued support from the beginning of their contracted time with you, as well as beforehand during the interview process. This should include additional support for the individual through any required assistive technology, workplace adjustments, and by making sure that all your staff are aware of and understandneurodiversity and have inclusive attitudes from the start.

Sensory Sensitivities

Autistic children may have varying degrees of sensory sensitivities to their environment especially when it comes to structured environments such as school or college. Loud noises, unpleasant smells and bright lights can be over whelming for them, often leading to exhaustion which can trigger further anxious feelings about their performance in the classroom.

Changes in routine

There are multiple transitions in a child’s day that could bring on anxiety, examples can include changing out of pyjamas into school uniform, changing classrooms frequently throughout the day and transitioning from work to leisure mode at break times and home-time.


The pressures of fitting-in and being socially accepted can be challenging for a young autistic individual. Lack of structure in the playground and pressure to join in with small talk can make breaktimes the most dreaded part of the day.    

Autistic children are more vulnerable to bullying, often learning to mask at an early age in order to appear ‘normal’. This can cause extreme anxiety for anticipation of bullying and can in turn take its toll on mental health and well-being.  

Self esteem

Feelings of failure about not reaching expected norms and potential can have a very detrimental effect on an autistic child’s self-esteem and exasperate performance anxiety. Being told to ‘concentrate’, ‘try harder’ and ‘overcome challenges’, that are part of a child’s autistic identity can be a burden and effect feelings of self-worth.  

When executive functioning is compromised, there can be challenges in planning, prioritisation, organisation, impulse control and staying on task.

What are Executive Function Challenges?

Everybody is different in their executive functioning strengths and challenges, and neurodivergent individuals can have very varied ‘spiky profiles’  

People may have challenges in relation to the following areas of executive functioning:


  • Getting going - especially when initiating uninteresting tasks. This is referred to as inertia
  • Procrastination - getting past thinking about the task to doing the task
  • Poor time management - not being able to foresee how long a task will take  
  • Thinking you need to do something but not remembering what it is.

Working memory:

  • Like a computer scratch disk - allows you to hold information in your mind while making links.
  • Challenges with short term memory - remembering what has just been said or remembering a sequence
  • Processing different streams of information - like listening to someone while remembering you need to remember your keys, for example.

Emotional and impulse control:

  • Not having internal prompts to remind you what task you need to do next, in order of importance  
  • Getting frustrated at yourself for forgetting to do important things, especially when others see you as lazy or incompetent  
  • Difficulties regulating alertness to complete hard tasks when the interesting parts have been done.
  • Finding it hard to shut off your busy brain which can affect sleep patterns
  • Experiencing RSD (Rejection Sensitive Dysphoria) which can be extremely debilitating  
  • Being impulsive and not considering the context  
  • Difficulty adjusting and graduating your pace, or changing gear. This can lead to an all or nothingmindset.


  • Challenges sustaining focus
  • Difficulties shifting from one task or topic to another  
  • Slower gaining information and losing focus easily

Hindsight and foresight:

  • Harder learning from past experiences and then repeating the same actions again and again
  • Difficulties with predicting future challenges

Time awareness:

This has been called “time blindness” by Psychiatrist Russell Barkley

  • Remembering to put appointments into your diary
  • Allocating the appropriate time to a task
  • Splitting a task into parts and recognizing how long each will take

Developing strategies to make everyday life easier

The good news is that once we recognise our executive function challenges, we can develop strategies that reduce the negative impact to help make everyday life easier.  

You may already have some personal strategies in place. Here are some that might be helpful if you haven’t already considered them:

Check your barometer  

Throughout the day check in with yourself. How are you coping? Do you need to take time out? Do you need a drink or something to eat? When we are tired, hungry or overloaded it can make it harder to manage new information or juggle multiple tasks.

Minimize clutter  

Make sure your workspace isn’t too distracting. Separate similar items into groups.  Use colour coding and visual prompts to help organise information on reminder charts or visual diaries.

Visualise and prioritise tasks

Use a wall-planner that visually highlights appointments, deadlines and daily tasks. Use colour coding to prioritise tasks. Create a list of actions at the beginning and end of each day and mark priorities. Carryover lists to the following day.

Take regular breaks

When in hyperfocus mode it can be difficult to remember to take a break which can lead to burnout, and if atask is uninteresting, it can be difficult to complete. Try the Pomodoro method to improve concentration. Work for 10 minutes then take a  5-minute break and increase the time if appropriate.  

Break down overwhelming tasks

If a task feels too big to handle break it down into small parts using the Kan Ban Method where you can break down large tasks visually into small parts, on post-its. Remember to congratulate yourself as you move forward, however small it is.

Make it more interesting

Try to automate ‘boring’ tasks and choose some pleasure stuff after more tedious tasks.

Increase dopamine levels

Choose some music that helps you to focus. Take regular breaks, you could even try dancing around if you feel stuck and try again.

Reminders and alarms

Use timers and set alarms to remind yourself when your deadlines are. Put all tasks and appointments into an electronic diary as soon as you know about them. Set reminders before the deadlines rather than at the deadline itself.

See the bigger picture

Try and gain an understanding of how all the different aspects of work link together in a  project or assignment. If you work as part of a team understand how your work links with others.

Supportive software

There are various types of software and apps that can help with planning, organisation and processing.

For example, Mind-mapping software, such as Inspiration and Mind Genius may be useful to map out ideas and workflow effectively or using text-to-speech and speech-to-text software could help speed up the processing of large documents.

Setting various reminders and alarms on your phone can be useful too. For things such as appointments, it can work well to set a reminder for the day before, then an hour before, giving you time to plan if necessary.

Be kind to yourself

It is not surprising that these differences can often impact on other factors such as self-esteem, energy levels and base level stress. Gaining an understanding of ourselves and the reasons why we find some things more difficult can really help in the management of this.  

Some days will be harder, or you will feel less motivated, and that’s ok. Practice your strategies and remember to always be kind to yourself and find what works for you.