The understanding of ADHD has evolved over time. While ADHD was once defined as a behavioral disorder, the National Institute of Mental Health (NIMH) now defines it as a “brain disorder that interferes with functioning or development.”
Dr. Russell Barkley, author of Taking Charge of ADHD: The Complete, Authoritative Guide for Parents, explains that ADHD is an executive-function disorder rather than an attention disorder. Executive functions, he says, are the mental processes that we use to set goals and modify our behavior to reach those goals. When you effectively use your executive functions, you plan how you can change and improve your future. Self-regulation is a big part of executive functioning.
The following are the major skills involved in executive functioning.
Self-awareness. This skill is the ability to self-direct and sustain attention to a task. It also involves the ability to shift attention from one task to another. Those with ADHD often have a hard time sustaining attention for an extended period; they are easily distracted not only by external stimuli but also by their own thoughts.
Inhibition means self-restraint. People with ADHD who have deficits with inhibition might consistently act impulsively, blurt out answers, interrupt others during conversations, or consistently jump to conclusions.
Working or short-term memory. Nonverbal working memory refers to the ability to hold a visual image in your mind. Verbal working memory can also be thought of as internal speech. You use your verbal working memory as a type of inner monologue to help guide yourself through tasks or decisions. People with ADHD often have a difficult time with short-term working memory; for example, they might easily recall something that happened several years ago but have trouble remembering where they put their cell phone a few minutes ago.
Emotional self-regulation. This describes the ability to change your emotional state by using your self-awareness, self-talk, and visual imagery. When you are upset or frustrated, you might talk yourself through the situation, for example, you might say, "I can do this if I keep trying," "This isn't so bad," or "I can get through this like I have gotten through other rough times." Our self-talk helps put the situation in perspective and calm over-fraught emotions.
Self-motivation. This indicates the ability to motivate yourself to complete a task in the absence of consequences. This can also refer to self-monitoring actions and modifying behaviors when needed. For people with ADHD, this is often difficult. They might start a project with enthusiasm only to quickly lose interest or become distracted and completely forget about the task.
Planning and problem-solving. This involves manipulating information in our minds in different ways to come up with a process to complete a task or a solution to a problem. This might be related to problems with working memory; it is difficult to manipulate information in different ways if you have trouble keeping the information at the forefront of your thoughts. It can also relate to focusing on the big picture and having difficulty seeing the steps needed to reach the conclusion.
Most people with ADHD have deficits in at least some of these areas, if not all, but in varying degrees; for example, you might have more difficulty with attention and emotional regulation but might be good at problem-solving. By understanding your strengths and weaknesses in each of these skills, you can better develop strategies for managing symptoms of ADHD and continue to build the specific executive-function skills that might be underdeveloped.
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