Understanding ADHD from Executive Functioning Perspective
What Are Common Executive Functions for an Individual?
Sustained Attention: The ability to maintain focus on a task or activity over a prolonged period.
Selective Attention: The ability to concentrate on specific information while ignoring irrelevant or distracting information.
Attention Control: Essential for focusing on relevant information and ignoring distractions.
Inhibitory Control: Crucial for self-control, resisting distractions, and maintaining focus.
Response Inhibition: The ability to suppress inappropriate or non-productive actions or responses.
Behavioral Inhibition: The ability to inhibit inappropriate behaviors or responses in social and task-related contexts.
Impulse Control: Crucial for resisting short-term temptations and making thoughtful decisions.
Self-Regulation: Overall ability to manage behavior, emotions, and thoughts to achieve long-term goals.
Working Memory: Vital for holding and manipulating information necessary for complex tasks and daily problem-solving.
Emotional Regulation: Crucial for managing emotions, maintaining interpersonal relationships, and overall mental health.
Planning and Organization: Key for setting goals, strategizing, and efficiently managing resources and time.
Task Initiation: Important for overcoming procrastination and starting tasks promptly and efficiently.
Self-Monitoring: Key for assessing performance and making necessary adjustments.
Adaptability: The capacity to adjust to new conditions or changes in the environment.
Cognitive Flexibility: Important for adapting to new situations and changing perspectives.
Behavioral Flexibility: Important for adapting behavior to new or unexpected circumstances.
Task Switching: Important for managing multiple responsibilities and adapting to changes in tasks.
Goal Setting: The ability to define and articulate specific, achievable, and measurable objectives.
Goal-Directed Persistence: Important for maintaining efforts towards achieving long-term goals despite obstacles.
Strategic Thinking: The ability to think long-term and plan for future challenges and opportunities.
Prioritization: Important for identifying the most important tasks and focusing efforts accordingly.
Sense of Time: Necessary for accurately estimating time and managing deadlines.
Time Management: Crucial for meeting deadlines, managing schedules, and allocating time effectively.
Decision Making: Important for making choices that impact daily life and future outcomes.
Problem Solving: Necessary for finding solutions to everyday challenges.
Insight: The capacity to understand one's own behaviors, emotions, and thoughts, and their impact on oneself and others.
Judgment: The ability to make considered decisions or come to sensible conclusions based on available information.
Abstract Thinking: The ability to understand concepts that are not concrete or specific, and to think about complex ideas.
Concept Formation: The ability to organize information into meaningful categories and to develop rules and ideas based on these categories.
Metacognition: Crucial for thinking about one's own thinking and improving cognitive processes.
Error Monitoring (Error Detection and Correction): The ability to detect and respond to errors during task performance.
Critical Thinking: The ability to analyze facts, generate and organize ideas, defend opinions, make comparisons, draw inferences, evaluate arguments, and solve problems.
Information Processing Speed: Important for quickly perceiving, interpreting, and responding to information.
Motivation Regulation: Necessary for maintaining motivation to complete tasks and achieve goals.
Persistence: Necessary for sustaining effort and interest over time.
Conflict Resolution: The ability to mediate disputes and find mutually acceptable solutions.
Empathy: The ability to understand and share the feelings of others, which is crucial for social interactions and relationships.
Social Cognition: Crucial for understanding social cues and managing social interactions.
Creativity: The ability to think outside the box and generate new and innovative ideas.
Visualization: The ability to create mental images or scenarios to understand and solve problems.
Resource Management: The ability to efficiently and effectively use available resources, such as time, energy, and materials, to achieve goals.
How ADHD Affects Each Executive Function
1. Sustained Attention
Definition: The ability to maintain focus on a task or activity over a prolonged period.
Impact of ADHD: Individuals with ADHD often struggle to maintain focus on tasks or activities for extended periods, especially if the task is not engaging or rewarding. They may become easily distracted, lose interest quickly, or feel restless.
2. Selective Attention
Definition: The ability to concentrate on specific information while ignoring irrelevant or distracting information.
Impact of ADHD: ADHD can make it difficult to filter out irrelevant information and focus on what's important. Individuals may find it hard to ignore distractions in their environment, leading to challenges in concentrating on specific tasks.
3. Attention Control
Definition: Essential for focusing on relevant information and ignoring distractions.
Impact of ADHD: ADHD often impairs the ability to control where attention is directed. Individuals may have trouble focusing on relevant information while ignoring distractions, resulting in inconsistent performance and difficulties in completing tasks.
4. Inhibitory Control
Definition: Crucial for self-control, resisting distractions, and maintaining focus.
Impact of ADHD: Inhibitory control is frequently impaired in ADHD. This can manifest as impulsivity, where individuals act on whims without considering the consequences, and difficulty in resisting distractions or temptations.
5. Response Inhibition
Definition: The ability to suppress inappropriate or non-productive actions or responses.
Impact of ADHD: People with ADHD often struggle with response inhibition, leading to impulsive behaviors and difficulty suppressing inappropriate or non-productive actions.
6. Self-Regulation
Definition: Overall ability to manage behavior, emotions, and thoughts to achieve long-term goals.
Impact of ADHD: ADHD can significantly impair self-regulation, making it challenging to manage emotions, control impulses, and maintain consistent behaviors toward achieving long-term goals.
7. Working Memory
Definition: Vital for holding and manipulating information necessary for complex tasks and daily problem-solving.
Impact of ADHD: Working memory deficits are common in ADHD, leading to difficulties in holding and manipulating information, which can affect complex task performance and problem-solving abilities.
8. Emotional Regulation
Definition: Crucial for managing emotions, maintaining interpersonal relationships, and overall mental health.
Impact of ADHD: Emotional regulation is often impaired in ADHD, resulting in intense emotional responses, mood swings, and challenges in maintaining stable interpersonal relationships.
9. Planning and Organization
Definition: Key for setting goals, strategizing, and efficiently managing resources and time.
Impact of ADHD: Individuals with ADHD often have difficulties with planning and organization, leading to poor goal setting, inefficient strategies, and challenges in managing time and resources effectively.
10. Task Initiation
Definition: Important for overcoming procrastination and starting tasks promptly and efficiently.
Impact of ADHD: ADHD can make task initiation challenging, with individuals often procrastinating and finding it difficult to start tasks promptly.
11. Self-Monitoring
Definition: Key for assessing performance and making necessary adjustments.
Impact of ADHD: Self-monitoring deficits in ADHD can lead to difficulties in assessing one’s performance accurately and making the necessary adjustments to improve outcomes.
12. Cognitive Flexibility (Mental Flexibility)
Definition: Important for adapting to new situations and changing perspectives.
Impact of ADHD: ADHD can impair cognitive flexibility, making it difficult for individuals to adapt to new situations, shift perspectives, or change strategies when needed.
13. Goal Setting
Definition: The ability to define and articulate specific, achievable, and measurable objectives.
Impact of ADHD: Goal setting can be challenging for individuals with ADHD, who may struggle to define, articulate, and pursue specific, achievable, and measurable objectives.
14. Prioritization
Definition: Important for identifying the most important tasks and focusing efforts accordingly.
Impact of ADHD: ADHD often affects prioritization skills, leading to difficulties in identifying and focusing on the most important tasks, which can result in inefficient use of time and resources.
15. Sense of Time
Definition: Necessary for accurately estimating time and managing deadlines.
Impact of ADHD: Individuals with ADHD frequently have an impaired sense of time, which affects their ability to estimate time accurately and manage deadlines effectively.
16. Time Management
Definition: Crucial for meeting deadlines, managing schedules, and allocating time effectively.
Impact of ADHD: ADHD often leads to poor time management skills, making it difficult for individuals to meet deadlines, manage schedules, and allocate time effectively.
17. Decision Making
Definition: Important for making choices that impact daily life and future outcomes.
Impact of ADHD: Decision making can be compromised in ADHD, with individuals potentially making impulsive or poorly considered choices that impact daily life and future outcomes.
18. Problem Solving
Definition: Necessary for finding solutions to everyday challenges.
Impact of ADHD: ADHD can impair problem-solving abilities, making it harder for individuals to find effective solutions to everyday challenges.
19. Judgment
Definition: The ability to make considered decisions or come to sensible conclusions based on available information.
Impact of ADHD: Impaired judgment is common in ADHD, leading to difficulties in making considered decisions or arriving at sensible conclusions based on available information.
20. Insight
Definition: The capacity to understand one's own behaviors, emotions, and thoughts, and their impact on oneself and others.
Impact of ADHD: Individuals with ADHD may have reduced insight into their behaviors, emotions, and thoughts, and how these impact themselves and others, leading to repeated patterns of problematic behavior.
21. Abstract Thinking
Definition: The ability to understand concepts that are not concrete or specific, and to think about complex ideas.
Impact of ADHD: Abstract thinking can be challenging for those with ADHD, making it harder to understand non-concrete concepts and think about complex ideas
22. Concept Formation
Definition: The ability to organize information into meaningful categories and to develop rules and ideas based on these categories.
Impact of ADHD: ADHD can hinder the ability to organize information effectively, leading to difficulties in developing and applying meaningful categories, rules, and ideas.
23. Metacognition
Definition: Crucial for thinking about one's own thinking and improving cognitive processes.
Impact of ADHD: Metacognitive skills are often impaired in ADHD, making it challenging for individuals to reflect on and regulate their own thinking processes and cognitive strategies.
24. Error Monitoring (Error Detection and Correction)
Definition: The ability to detect and respond to errors during task performance.
Impact of ADHD: Individuals with ADHD may struggle with error monitoring, resulting in repeated mistakes and difficulty in making necessary corrections to improve performance.
25. Critical Thinking
Definition: The ability to analyze facts, generate and organize ideas, defend opinions, make comparisons, draw inferences, evaluate arguments, and solve problems.
Impact of ADHD: ADHD can affect critical thinking abilities, making it harder to analyze information, organize thoughts, evaluate arguments, and solve problems effectively.
26. Information Processing Speed
Definition: Important for quickly perceiving, interpreting, and responding to information.
Impact of ADHD: Slower information processing speed is common in ADHD, leading to delays in perceiving, interpreting, and responding to information.
27. Goal-Directed Persistence
Definition: Important for maintaining efforts towards achieving long-term goals despite obstacles.
Impact of ADHD: ADHD often impairs goal-directed persistence, making it challenging to sustain efforts toward achieving long-term goals, especially when facing obstacles.
28. Impulse Control
Definition: Crucial for resisting short-term temptations and making thoughtful decisions.
Impact of ADHD: Impulse control is typically compromised in ADHD, leading to difficulties in resisting short-term temptations and making thoughtful, deliberate decisions.
29. Behavioral Inhibition
Definition: The ability to inhibit inappropriate behaviors or responses in social and task-related contexts.
Impact of ADHD: Individuals with ADHD often struggle with behavioral inhibition, resulting in inappropriate or impulsive actions in social and task-related contexts.
30. Motivation Regulation
Definition: Necessary for maintaining motivation to complete tasks and achieve goals.
Impact of ADHD: ADHD can make it difficult to regulate motivation, leading to inconsistent effort and challenges in maintaining motivation to complete tasks and achieve goals.
31. Persistence
Definition: Necessary for sustaining effort and interest over time.
Impact of ADHD: ADHD often affects persistence, resulting in difficulties sustaining effort and interest in tasks over time, particularly if they are not immediately rewarding.
32. Adaptability
Definition: The capacity to adjust to new conditions or changes in the environment.
Impact of ADHD: Adaptability can be impaired in ADHD, making it harder for individuals to adjust to new conditions or changes in their environment.
33. Behavioral Flexibility
Definition: Important for adapting behavior to new or unexpected circumstances.
Impact of ADHD: ADHD can hinder behavioral flexibility, making it difficult to adapt behavior appropriately in response to new or unexpected circumstances.
34. Conflict Resolution
Definition: The ability to mediate disputes and find mutually acceptable solutions.
Impact of ADHD: Conflict resolution skills may be impaired in ADHD, leading to difficulties in mediating disputes and finding mutually acceptable solutions.
35. Empathy
Definition: The ability to understand and share the feelings of others, which is crucial for social interactions and relationships.
Impact of ADHD: Empathy can be affected in ADHD, making it challenging to understand and respond to the feelings of others appropriately.
36. Social Cognition
Definition: Crucial for understanding social cues and managing social interactions.
Impact of ADHD: Social cognition deficits in ADHD can lead to difficulties in understanding social cues and managing social interactions effectively.
37. Creativity
Definition: The ability to think outside the box and generate new and innovative ideas.
Impact of ADHD: While ADHD can sometimes enhance creativity, it can also lead to difficulties in channeling creative ideas into structured, productive outcomes.
38. Visualization
Definition: The ability to create mental images or scenarios to understand and solve problems.
Impact of ADHD: ADHD can impair visualization skills, making it harder to create and manipulate mental images or scenarios for problem-solving.
39. Strategic Thinking
Definition: The ability to think long-term and plan for future challenges and opportunities.
Impact of ADHD: Strategic thinking can be challenging for individuals with ADHD, who may struggle with long-term planning and anticipating future challenges and opportunities.
40. Resource Management
Definition: The ability to efficiently and effectively use available resources, such as time, energy, and materials, to achieve goals.
Impact of ADHD: ADHD often leads to poor resource management, making it difficult to use time, energy, and materials efficiently and effectively to achieve goals.
41. Task Switching
Definition: Important for managing multiple responsibilities and adapting to changes in tasks.
Impact of ADHD: Task switching can be impaired in ADHD, resulting in difficulties managing multiple responsibilities and adapting to changes in tasks smoothly.
Common Diagnostic Symptoms of ADHD
Primary Symptoms of ADHD
Inattention:
Difficulty sustaining attention in tasks or play activities.
Often does not seem to listen when spoken to directly.
Often does not follow through on instructions and fails to finish schoolwork or duties.
Difficulty organizing tasks and activities.
Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort.
Often loses things necessary for tasks or activities.
Easily distracted by extraneous stimuli.
Forgetful in daily activities.
Hyperactivity:
Fidgeting or tapping hands or feet, squirming in seat.
Leaving seat in situations where remaining seated is expected.
Running or climbing in inappropriate situations.
Unable to play or engage in leisure activities quietly.
"On the go" or acting as if "driven by a motor."
Talking excessively.
Impulsivity:
Blurting out answers before questions have been completed.
Difficulty waiting for their turn.
Interrupting or intruding on others.
Secondary Symptoms of ADHD
Emotional Dysregulation:
Frequent mood swings.
Irritability and short temper.
Low frustration tolerance.
Social Difficulties:
Trouble maintaining friendships.
Social isolation due to hyperactive or impulsive behavior.
Difficulty interpreting social cues.
Academic and Occupational Challenges:
Poor academic performance due to inattentiveness and disorganization.
Challenges in the workplace due to missed deadlines and errors.
Tertiary Symptoms of ADHD
Mental Health Issues:
Higher prevalence of anxiety disorders.
Increased risk of depression.
Co-occurring conduct or oppositional defiant disorders.
Behavioral Problems:
Increased risk of substance abuse.
Risk-taking behaviors.
Noncompliance with rules.
Family and Relationship Issues:
Strained family relationships due to unmanaged symptoms.
Marital problems for adults with ADHD.
Potential Symptoms of ADHD
Physical Symptoms:
Sleep disturbances.
Coordination difficulties.
Cognitive Symptoms:
Poor working memory.
Difficulty with executive functioning tasks such as planning and decision-making.
Comorbid Conditions:
Learning disabilities.
Speech and language delays.
Sources
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Barkley, R. A. (2014). Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment (4th ed.). New York, NY: Guilford Press.
National Institute of Mental Health. (n.d.). Attention-Deficit/Hyperactivity Disorder (ADHD). Retrieved from NIMH
Centers for Disease Control and Prevention. (n.d.). ADHD Symptoms and Diagnosis. Retrieved from CDC