Executive Function in Neurodiverse Adults

What Went Wrong and How to Rebuild It?

You’re not lazy, and you’re not broken. You may be living with executive functioning difficulties rooted in trauma, neurodivergence, or missed developmental scaffolding.

Introduction

Executive functioning (EF) refers to the brain’s self-management system. It is the set of skills that help us plan, organise, start tasks, regulate emotions, and adapt flexibly to change. For many adults, especially those with ADHD, autism, bipolar, dyslexia, complex trauma, or personality disorders, these processes don’t come easily.

Despite insight, effort, or motivation, many adults find themselves stuck in patterns of disorganisation, emotional reactivity, and shame. This article explores how executive functioning develops in childhood, how early disruptions can shape adult functioning, and what can be done to support EF later in life.

What Is Executive Function?

Executive function is not the same as intelligence or willpower. It is a set of interrelated skills that allow us to:

• Stay focused on tasks and hold goals in mind

• Pause before reacting or responding

• Adjust flexibly when plans change

• Monitor our behaviour and correct course when needed

• Sequence actions and manage time effectively

  
  

Research shows that EF develops during childhood through co-regulation, routine, and relational scaffolding. When those developmental foundations are unstable, due to trauma, neurodivergence, or inconsistent / misattuned caregiving, executive function may be underdeveloped, even into adulthood.

What Happens When EF Doesn’t Fully Develop?

Adults with disrupted EF development often experience:

• Working memory gaps: losing track of plans, forgetting steps mid-task

• Impulse control difficulties: overreacting emotionally, interrupting, acting without thinking

• Cognitive rigidity: difficulty adapting to change or switching attention

• Emotional overwhelm: spiralling into shame or paralysis after setbacks

• Time disconnection: struggling with sequencing, planning, or future-based thinking

These challenges may be misunderstood as laziness, disorganisation, or poor emotional control, both by others and the individual themselves. But EF dysfunction is often developmental, not characterological.

Misdiagnosis and Shame

Executive dysfunction in adults is frequently misinterpreted, particularly in those who mask well or perform at a high level in some areas.

• Common misdiagnoses include:

• Anxiety or depression without exploring underlying EF delays

• Personality disorders, particularly in women with ADHD or masked autism

• Laziness or irresponsibility, especially in trauma survivors

These misdiagnoses can deepen shame, leading to self-criticism: “I know what to do, why can’t I just do it?” Understanding executive function as a neurodevelopmental and relational process, not a moral one, can be a powerful shift in therapy and self-concept.

Executive Function Across the Lifespan

The table below illustrates how EF skills develop in childhood and what it looks like when these systems remain underdeveloped in adulthood.

Executive Function Domain	Childhood Role	Adult Dysregulation When Impaired
Working Memory	Following multi-step instructions, integrating input	Lost tasks, inability to hold goals in mind, overwhelmed easily
Inhibition	Pausing, waiting turns, resisting impulses	Reactivity, “blowing up,” acting before thinking
Cognitive Flexibility	Adapting to change, shifting play strategies	Rigidity, mental stuckness, poor emotional recovery
Self-Monitoring	Learning from mistakes, noticing internal cues	Shame cycles, repeated failures, confusion about progress
Planning & Sequencing	Anticipating, preparing steps ahead	Chronic disorganisation, poor time use, delayed life goals

Everyday Consequences of EF Breakdown

At Work

• Missed deadlines or disorganised workflows

• Mental fatigue or zoning out in meetings

• Emotional overreaction to feedback or ambiguity

In Relationships

• Interrupting or struggling to stay present

• Arguments triggered by impulsivity or defensiveness

• Forgetting plans or commitments despite care

  
  

As a Parent

• Difficulty creating consistent routines

• Overwhelm in managing multiple child needs

• Reactivity or shutdown under emotional strain

  
  

How to Support Executive Function in Adulthood

EF systems can be rebuilt. This doesn’t happen through pressure or perfectionism, it happens through clear scaffolding, environmental support, and relational attunement.

At Work

• Use visual planning tools: colour-coded calendars, whiteboards, post-it sequences

• Break tasks into first steps, not abstract goals

• Schedule short, predictable breaks to manage attention and energy

  
  

In Relationships

• Use structured scripts for emotional pauses and repair

• Practise naming body cues before emotional reactions escalate

• Use joint reflection: “What just happened there, and what might help next time?”

In Parenting

• Create micro-routines: simple, repeatable sequences that reduce decision fatigue

• Use visual prompts and timers to support transitions

• Narrate your own regulation: “I’m feeling overwhelmed, so I’m taking a breath before we keep going”

  
  

Final Thoughts

Executive function is about far more than productivity: it’s about holding yourself together in time, space, and identity. For adults who didn’t get the scaffolding they needed, the path forward isn’t about pushing harder. It’s about learning to work with your brain, not against it.

Written by Kirstan Lloyd, Clinical Psychologist

Founder of the Helix Centre, a UK-based psychology and psychotherapy practice specialising in neurodiversity, mental health, and therapeutic assessment. This article was written by Kirstan with the support of AI research tools and is grounded in recent literature from psychology, health science, and applied mindfulness practice.

References

• Etokabeka, E. (2025). Executive Function in Childhood: Long-Term Outcomes and Adult Dysregulation. Futurity Education Journal.

• Anderson, L. (2025). Increasing Knowledge of the Benefits of Adaptive Exercises for People with Neurodivergence. Adapted Physical Activity Quarterly.

• Arioli, M. et al. (2025). Executive Function and Auditory Error Monitoring in ADHD: ERP Evidence for Impaired Inhibition. Archives of Clinical Neuropsychology.

• Letby, J. et al. (2025). The Letby Model: A Diagnostic Complexity Framework for High-Stakes Cases Involving Emotional Dysregulation. Journal of Clinical Forensic Psychology.

• Groce-Volinski, R. et al. (2025). Sensory Processing Differences and Participation in Autistic Adults. Occupational Therapy in Mental Health.

• Malhotra, A. et al. (2025). Alexithymia and Sensory Integration in Autistic Young Adults. Frontiers in Psychology.

• Larivière, S. et al. (2025). What Strategies Do People with BPD Use to Maintain Their Well-Being and Performance at Work? BPD and Emotion Dysregulation.

• Staccio, K. et al. (2025). Workplace Instability and Shame in Adults with Borderline Personality Traits. Work, Personality & Society.

  
  

(Note: References were used for conceptual framing and clinical accuracy. This is not an academic article.)