Executive Functioning & ADHD
When I first heard the term Executive Functioning I thought What is THAT? Of course ADHD people have bad executive functioning, I can't even find a matching pair of socks, never mind run a company! So, I googled it and found out that executive function isn't something the CEO of a company does. It is how EVERYBODY functions, to do everything they do- everyday. From planning dinner, to knowing to wash the laundry before you dry it, to estimating how long it will take you to get ready for work in the morning, how we express emotions, how we remember things...everything you and I do, requires executive function. These set of functions of the brain continuously work together, very fast and without conscious effort.They help us manage many tasks of daily life. These functions show up in basic forms in young children as they become more independent and begin to do things for themselves and as the brain matures throughout childhood, adolescence and early adulthood, they gradually become more complex. the maturity of our executive functioning is how we essentially mature through our lives. A child of 2 has less executive functioning than a child of 10, and the 10 year old compared to a 15 year old, etc etc. Science shows that human brains continue to mature in executive functioning well into our mid 20's. People with ADHD Have a Dysfunctional Executive Functioning Everyone has occasional impairments in their executive functions, but people with ADD experience much more difficulty in development and use of these functions compared to others of the same age and developmental level do without ADHD do. Research shows that a child with ADHD can usually have an executive functioning level of a child up to 5 years younger than their age. So a teenager of 15 with ADHD may have the executive functioning skills level of a 10 year old in some areas. But, even those with severe ADHD and poor EF can have some activities where their executive functions work very well. So, that 15 year old may have constant difficulty with ADHD symptoms in most areas of their life, but when it comes to a few special interests like playing sports/video games or playing an instrument, doing art or building things, their ADHD symptoms are absent. This phenomenon of “can do it here, but not most anyplace else” makes it look like ADHD is a simple problem of lacking willpower or laziness; but it isn’t. These impairments of executive functions are usually due to inherited problems in the chemistry of the brain’s management system. Dr. Thomas Brown of Yale University studies Executive Functions extensively in ADHD people. He found comparisons between the ADHD-diagnosed and non ADHD participants in his study in each age group showed EF impairments that can be recognized and divided into six areas of executive functions. The Brown Model of Executive Functions Impaired in ADD-ADHD Within more than 25 years of research with children, adolescents and adults who have ADD/ADHD, Dr. Brown developed an expanded model to describe the complex cognitive functions impaired in ADD/ADHD. His model describes the executive functions areas I list below: Activation: organizing tasks and materials, estimating time, prioritizing tasks, and getting started on work tasks. People with ADHD have difficulty with excessive procrastination. Often they will put off getting started on a task, even a task they recognize as very important to them, until the very last minute. It is as though they cannot get themselves started until the point where they perceive the task as an acute emergency. This is due to disregulation in levels of Dopamine in the brain. Only when the emergency arises and the dopamine boosts in the brain, will we usually have the ability to start on a task. Focus: focusing, keeping focus, and shifting focus to tasks. Some ADHD people describe their difficulty in sustaining focus as similar to trying to listen to the car radio when you drive too far away from the station and the signal begins fading in and out: you get some of it and lose some of it. They say they are distracted easily not only by things that are going on around them, but also by thoughts in their own minds. In addition, focus on reading poses difficulties for many. Words are generally understood as they are read, but often have to be read over and over again in order for the meaning to be fully grasped and remembered. Effort: regulating alertness, sustaining effort, and processing speed. Many with ADHD report they can perform short-term projects well, but have much more difficulty with sustained effort over longer periods of time. They also find it difficult to complete tasks on time, especially when required to do detailed explanitory writing. Many also experience chronic difficulty regulating sleep and alertness. Often they stay up too late because they can’t shut their brain off. Once asleep, they often sleep like they are dead to the world and have a big problem getting up in the morning. This is due to once again how the brain makes and regulates dopamine. Emotion: managing frustration and balancing emotions. Although the DSM-IV does not recognize any symptoms related to the management of emotion as an aspect of ADHD, many with this disorder describe chronic difficulties managing frustration, anger, worry, disappointment, desire, and other emotions. Many describe their emotions as taking over their thinking, making it impossible for them give attention to anything else. They find it very difficult to get the emotion into perspective, to put it to the back of their mind, and to get on with what they need to do. As a mom Of an ADHD child I say let it go a lot when emotions become unbalanced in our home, and my kids need help to manage anxiety and frustration. And for myself, it has taken me a along time to develop the ability to regulate my own emotions to an appropriate level for the given situation. Memory: utilizing working memory and accessing recall. Very often, people with ADHD will report that they have adequate or exceptional memory for things that happened long ago, but great difficulty in being able to remember where they just put something, what someone just said to them, or what they were about to say. That is what working memory is. ADHD people often describe difficulty holding one or several things in their brains while attending to other tasks. This is how I can burn grilled cheese sandwiches while running the sink to wash dishes. Poor working memory...I TOTALLY forget I am even making grilled cheese sandwiches! [caption id=attachment_497667834 align=alignleft width=740] This XKCD cartoon is titled ADD and shows a great visual explanation of the dysfunction in (working memory) executive functioning of an ADHD person.[/caption] In addition, people with ADHD often complain that they cannot pull out of their memory, the information they have learned when they need it. This is the area at work when an ADHD student's brain goes blank during a test. Action: monitoring and regulating self-action. Many people with ADHD, even those without problems of hyperactive behavior, report problems in regulating their actions. They often are too impulsive in what they say or do, and in the way they think, jumping too quickly to inaccurate conclusions. People with ADHD also report problems in monitoring the context in which they are interacting. They fail to notice when other people are puzzled, or hurt or annoyed by what they have just said or done and thus fail to modify their behavior in response to specific social situation. They also have difficulty in regulating the pace of their actions, in slowing down and/or speeding up as needed for specific tasks. there is real neurological science behind Executive Function impairment in ADHD and it is complex and multi-faceted I have learned a LOT from Dr Thomas Brown's books and he is considered a true pioneer in our growing understanding of ADHD. If you are interested in reading more in depth information on ADHD and Executive functioning, you can purchase his books on amazon through the links below. If you are only going to buy one book,I highly recommend Smart But Stuck If you have issues concentrating like I do, get the audiobook version by clicking on my amazon affiliate link here: Smart but Stuck: Emotions in Teens and Adults with ADHD:The Audiobook Dr. Brown is a clinical psychologist who received his Ph.D. from Yale University and maintains a private practice in Hamden, Connecticut specializing in assessment and treatment of high-IQ children, adolescents and adults with ADHD and related problems. He is an Assistant Clinical Professor of Psychiatry at the Yale University School of Medicine and is Associate Director of the Yale Clinic for Attention and Related Disorders.For more information on his work with ADHD and Executive Function you can check out Dr Thomas brown's website here This article was written on Feb 21st, 2015 by SuperADDmom and provided for informational purposes only, as a resource for www.superaddmom.com-Copyright 2015. 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