How ADHD Impairs Executive Functioningby Eileen Bailey Health Writer
What is Executive Function?
Executive function is a relatively new term, often used by researchers, mental health providers and other experts to describe the cognitive abilities needed to accomplish daily tasks as well as learning. Sheldon Horowitz, Ed.D., Director of Professional Services at the national Center for Learning Disabilities (NCLD), describes it this way, "Executive functioning involves activating, orchestrating, monitoring, evaluating, and adapting different strategies to accomplish different tasks...It requires the ability to analyze situations, plan and take action, focus and maintain attention, and adjust actions as needed to get the job done."
Specifically, executive function provides the ability to self-regulate and monitor our behaviors through:
Planning and organization
Keeping track of time
Being able to accomplish more than one thing at a time
Recalling past knowledge and using it in a current situation
Evaluating progress and changing course when needed
Completing tasks or work on schedule
Understanding and engaging in group dynamics, including waiting turns during conversations
Seeking out additional resources or information or asking for help when needed
Ability to control emotions
Problems with executive function often become more apparent as children enter elementary school and must learn to complete assignments work in groups with other children and meet demands of schoolwork, homework and additional responsibilities at home. Deficits in executive functioning can cause problems at any age, however.
Executive Functioning and ADH
Parents of children with ADHD will tell you that the problems their children experience often do not fit neatly into the categories described diagnostic criteria for ADHD. Difficulties in social situations, in planning long-term assignments and completing work on a daily basis may go beyond the descriptions but are often a source of daily frustration.
Chris Dendy M.S., in an article titled, "Executive Function...What is This Anyway", explains that executive function deficits in children with ADHD can create problems in several areas, including:
Getting started and finishing work
Writing essays or reports
Working math problems
Being on time
Completing long-term assignments
Planning for the future
According to Ms. Dendy, deficits in executive function help to explain why so many children with ADHD, although intelligent, have difficulty in school and may barely pass some classes, even though their IQ would indicate their ability to easily grasp the subject matter.
Ms. Dendy further identifies several areas in school children with ADHD often have problems:
Impaired Working Memory and Slow Processing Speed. These skills are important areas of executive function and are often seen as deficits in children with ADHD. These skills, however, are extremely important in the academic setting of school as well as later in life in the work environment. Specifically, writing essays and completing math problems can be negatively impacted when a child has difficulties in these areas.
Written Expression. Writing essays and completing reports requires a number of executive functioning skills. It requires students to recall information previously learned, capture and hold new ideas, organize thoughts and ideas, retrieve grammar, spelling and punctuation rules and combine all of this information into a logical format.
Completing Math Problems. Math problems, or memorizing math facts, such as the multiplication tables, require students to use analytical skills, remember and recall information previously learned and remember numbers and information in the current math problem.
Previously, ADHD was thought of as "hyperactivity" or the inability to pay attention, but as more and more research is completed, it becomes obvious that there is many more challenging and complex difficulties associated with ADHD, especially if executive functioning deficits are present as well.
Tips for Helping Children with Executive Functioning Deficits
Break assignments down into steps or chunks, with a written plan for completing the assignment
Use organizational aids to help in organizing thoughts and ideas and to daily planners to help in keeping assignments organized
Use time organizational aids such as alarms and watches
Provide directions written as well as orally
Provide transitional time in between activities or assignments
Make use of "to do" lists
Create a visual calendar to help with time management
Create a working area at home that is free of clutter and distractions and regularly schedule time to reorganize
Create checklists for completing homework and longer assignments, include important information such as due dates and test dates as well as routine tasks such as gathering supplies
Create a system of communication between parent and teacher to help prevent missed assignments or failing grades due to deficits in executive functioning
As a child grows and matures, it is important to remember that their needs may also change. Parents and teachers should review the needs of the student on a regular basis to determine if accommodations and modifications should be adjusted to fit the child's needs and to help ensure current and future successes in school.
"Executive Function Fact Sheet", 1999-2009, Author Unknown, National Center for Learning Disabilities
"Executive Function: A New Lens Through Which to View Your Child", 2007, Oct, Kristin Stanberry, GreatSchools.net
"Executive Function...What Is This Anyway", 2002, Chris A. Zeigler Dendy, M.S., ChrisDendy.com