ADHD and Executive Functioning

The hallmarks of ADHD are inattentiveness, impulsiveness, and hyperactivity. While the latter is often easy to spot in children, the other features can be subtle, especially in adults. Restlessness, procrastination, disorganization, trouble meeting deadlines, and interrupting can all be soft signs of ADHD. While most people display these symptoms periodically, persons with ADHD show them frequently across many domains of their life and often suffer underachievement and stressed relationships as a result.

While executive function disorder generally accompanies ADHD, it is sometimes a separate issue. The executive functions are a set of mental skills that help the brain organize and act on information. Executive functions enable people to plan, organize, remember things, prioritize, pay attention, and get started on tasks. They help the mind keep track of time, multitask, and analyze ideas. A person uses his or her executive functions to solve problems of all kinds. People with a weakness in executive functioning will generally struggle when facing novel tasks.

I work from a model of the executive function system created by clinical psychologist Russell Barkley. His research has helped me develop seven coordinated interventions for treating ADHD and Executive Function Disorder:

• Diagnosis and medication
• Attention training
• Information-processing training
• School or workplace accommodations
• Academic or work skills training
• Family-systems tuning
• Cognitive-behavioral therapy

Some of these interventions stimulate the growth of attention-control and executive functioning, and some compensate for them. Research has shown that people with attention and executive function deficits have persistent difficulty adopting new strategies and habits at school, home, or the workplace. However, experiments at the University of Kansas suggest that once people with ADHD or executive function disorder change their beliefs about their ineffective school or work strategies, they are very likely to change their approach. That’s why cognitive-behavioral therapy is often key to creating lasting change.