In addition to difficulty starting a task that seems overwhelming, executive function problems can also manifest as difficulty with stopping in the middle of a task or with suddenly changing focus. I have some mild issues of this type, in that I often get confused or frustrated when I’m interrupted unexpectedly. It’s hard for me to push a half-completed train of thought out of my mind to fully focus on something else, and it’s also hard for me to pick it back up again later.

Some autistic people have these kinds of problems on a more physical level– rather than (or along with) getting stuck on an idea or in a particular state of mind, they get stuck on physical actions. I’ve heard this called either “inertia” or “autistic catatonia”. Autistic catatonia is an officially recognized sub-type of autism in the DSM, whereas inertia seems to be a term that’s come into use among autistic people online, but they refer to the same thing.

“Catatonia” sounds like a scary word, and probably makes you think of people in comas– or at least, that’s the association I had with it when I first heard the phrase “autistic catatonia,” so I want to clear this up. In this situation, catatonia doesn’t mean being completely unable to move. It means having difficulty consciously choosing to move or stop moving. Catatonia or inertia is a breakdown in communication between your intention or desire to move, and your body’s actual movement.

Inertia can be thought of as a part of executive function problems, except specifically with the planning and execution of physical movements. People don’t normally think of physical movement as planned in the same way that we plan an essay or our daily schedule, but on some level we do plan out everything we do, even just standing up and walking to another room.

How is this different from dyspraxia? In dyspraxia the main problem is precision within movements. Dyspraxia might cause someone to stumble and fall easily while walking; catatonia might cause them to keep walking, apparently smoothly and intentionally, when they actually want to stop where they are. The term “motor planning” is sometimes used to describe the ability that’s impaired in catatonia/inertia, to contrast with “motor skills”.

Here are some descriptions of inertia written by autistic people. (Sparrow Rose Jones, and Ido Kedar.)

I’m going to diverge even further from the DSM criteria for a moment to tell you about a psychological concept that relates to autism. “Executive function” is the ability to organize, to multi-task, to make step-by-step plans and carry them out.

When you’re faced with a complicated problem and you mentally divide it up into smaller tasks, plan out the best order to do them in, and follow through on your plan until everything is finished and the problem is solved, you’re having very good executive function. When you’re faced with a complicated problem and give up because it seems overwhelming and you don’t know where to start, you’ve had an executive function failure.

Everyone’s executive function abilities vary with things like stress and fatigue— I think almost everyone has struggled with executive function problems at one point or another— but some people have worse executive function than average, even on a good day. Problems with executive function is common in autism, but they can also be a part of depression, as well as ADHD and other learning disabilities.

Executive function shows up in the DSM criteria for autism in the section that starts with “insistence on sameness”.

Many autistic people deal with executive function problems by using routines and habits. When deciding what to eat and cooking a meal seems too complicated, for instance, it gets much easier when you don’t have to make a decision because you always have the same thing for lunch, and you don’t have to think too hard about the steps of cooking it because you’ve done it so many times. Sensory processing problems also make routines more important, since options that don’t aggravate our sensory sensitivities may be hard to find.

I don’t tend to stick to a strict schedule myself unless an external one is imposed on me, but in all sorts of tasks, I do tend to find a way that works and then do it the same way every time– driving the same route between two places, always ordering the same thing at a certain restaurant, etc. When I was cooking for myself in college, I generally ate the exact same thing for both lunch and dinner 4-5 days a week– the only thing I varied was the sauce I put on the pasta.

I often feel an aversion to doing a familiar task in a different way, not because there’s anything wrong with the new way, but because learning something new and fitting it into my overall plans seems to take such a big mental effort.

I also strongly prefer to plan out where I’m going in advance, any time I leave the house by myself. If someone I know is with me, I have no problem with letting them set the agenda or even change plans suddenly, but if I’m in any way in charge of deciding what we do, I find it very stressful to have to make things up as I go. It’s overwhelming in exactly the same executive-function-fail way as taking an exam I’m not prepared for, or having an unexpected problem come up just before a deadline– I don’t know where to start, I’m anxious about doing well and about not wasting time, and it’s tempting to just shut down and give up.

In my experience, the best way to deal with this feeling is to let go of the worry that hesitating makes me look bad, or that I’m taking too much time. I need to reassure myself that there’s no hurry, take a moment to calm down, and then go over the situation slowly, step by step.

It’s hard for me to say much about this, because it doesn’t affect me very strongly, but many autistic people have problems with coordination. (Edited to add: I wrote variations on the words “This can also be caused by other conditions…” so many times that I apparently forgot them in this entry. Along with being associated with autism, dyspraxia is a diagnosis in itself, and can caused by all sorts of other things.)

If you’re a doctor, this is called “fine motor skills” when it comes to small, precise movements like tying a knot, and “gross motor skills” when it’s larger things like hitting a baseball or balancing on one foot. Sometimes the term “dyspraxia” is used as a general word for problems with motor skills. There’s some debate about whether dyspraxia should be a diagnosis in its own right, or whether it only happens as a part of other conditions like autism and ADHD. Like I mentioned earlier, dyspraxia contributes to problems with language for some autistic people. Pronouncing words clearly (and also writing legibly) takes a lot of precise movements, and people with significant dyspraxia-type problems can have trouble physically forming words even if they know what they want to say.

Personally, I have pretty good hand-eye coordination and fine motor skills most of the time. I sometimes look awkward when I’m startled or trying to move very quickly— I tend to move very stiffly and use more of my body than I really need to— but I can usually succeed at things like catching something thrown at me, even if I look silly in the process.

Here are some posts (by Cynthia Kim, and by Judy Endow) about dyspraxia/motor skills problems from autistic people who do experience them.

One of the confusing things about autism, and about cognitive disabilities in general, is that something that seems like the same problem from the outside can actually be caused in several different ways. I already talked about the difficulty I have with conversation because of auditory processing, but difficulty with language, regardless of medium, can also be an autistic thing. (As a general rule, I’ve found, there is no limit to the variety of oddly specific things the human brain can have trouble with. Suspend your disbelief.)

Some autistic people have trouble using language, any kind of language, which is separate from any problems they may have with hearing or vision (or with the physical abilities required to speak or write). Some say that they simply don’t think in words, and translating their thoughts is complicated. Some find one form of language easier than others— e.g. they understand written words better than spoken words, or they can use sign language fluently but have trouble speaking with their voice. It is entirely possible for a person’s brain to be better at spoken language than other forms of language, but autism tends to be associated with difficulty speaking or understanding spoken words. A delay in learning to speak as a child used to be one of the main criteria for autism, although it isn’t necessary for diagnosis anymore.

Apart from my trouble with background noise, I don’t generally have difficulty understanding other people’s words or writing (what are called “receptive language” abilities) but I do have trouble putting my own thoughts into words (“expressive language”). One clue that I have problems with language as well as with hearing is that background noise, especially noise that involves people talking, not only makes it hard for me to hear, it makes it hard for me to read and write, too. The words I’m hearing seem to override the ones I’m reading, or writing, or trying to compose in my mind. I often can’t help but listen— and forget what I was thinking— even if what I hear is as unimportant as a TV program I don’t want to watch, or a stranger’s conversation in a restaurant.

I also find it hard to speak when I’m tired (especially when I’ve been socializing, listening and talking a lot) and I’ll sometimes only speak to briefly answer questions. I don’t often reach a point where I can’t talk at all, and usually that doesn’t last very long for me, but the truth is I have more trouble with expressive language than I seem to. Because the things I do say sound reasonably normal, people assume I’m naturally shy or quiet, when the truth is that putting my thoughts into words fast enough to keep up with a conversation is difficult for me.