Objective

XXY, or Klinefelter Syndrome (KS), is a common chromosomal variation impacting neuropsychological development, including executive function (EF). This study explored everyday EF challenges, experiences in cognitively demanding contexts, and how individuals overcome difficulties.

Method

Eighty-two adults (aged 19–81; M = 48.00, SD = 15.28) with KS/XXY completed a mixed-methods online survey including the Executive Skills Questionnaire, and Occupational Self-Efficacy Scale. Open questions asked about strengths and challenges with EF, EF-related experiences in education and employment, and the ways they overcome challenges.

Results

EF difficulties ranged from minimal to severe, with 75% reporting frequent challenges in at least one domain. Challenges were more common in organisation and time management than other areas, higher in those unemployed than those employed, and inversely related to occupational self-efficacy among employed individuals. Themes highlighted the nature of cognitive and interpersonal challenges, emotional and practical consequences, and mixed success with compensatory aids and interpersonal support.

Conclusions

While EF challenges are not universal in KS/XXY, their impacts on everyday functioning, particularly in cognitively demanding settings, can be severe. Many struggle to find effective solutions, emphasising the importance of identifying effective support approaches in future research and practice.

Lay Abstract

Some people are born with unusual genetic patterns, such as the XXY variation, often known as Klinefelter Syndrome (KS/XXY). KS/XXY can affect how the brain and mind develops, especially in terms of mental organisation. This study explored the types of challenges people with KS/XXY have with mental organisation, how these affect their experiences in environments like school or work, and the strategies they use to manage them. Eighty-two adults with KS/XXY completed an online survey. Questions measured everyday mental organisation skills and confidence at work. Participants also shared their strengths and challenges in mental organisation, how their time in educational and work settings was affected by their abilities, and explained how they coped with any difficulties. While experiences varied, findings showed three quarters of those we asked had challenges in at least one area of mental organisation – especially organisation and time management skills. Those with stronger mental organisation skills tended to be more confident they could do their job well, and on average, people who had a job had stronger mental organisation skills than those who did not. Participants described mental organisation challenges with attention and memory especially and explained how these affected their emotions, interactions with people around them, and life outcomes. Some found tools like memory aids, or support from others, helpful, but success was mixed. This tells us KS/XXY can cause problems with mental organisation that make everyday life more difficult. It is important that future research and clinical help focuses on finding effective and practical solutions.