The Myth of Executive Functioning (EF) Part IV: What Does EF Look Like in Kids/Teens with ADHD?

Welcome back to our Blog Series on Executive Functioning!

As we talked about last time, Executive Functioning, or EF, involves 2 main areas of brain processing:

  1. Inhibition of Responses: Impulse control/self-restraint (e.g., stopping yourself from making an inappropriate comment, or acting inappropriately)
  2. Awareness: Awareness of own thoughts and emotions. Also, self-speech/internalized speech (e.g., thinking to yourself about how you are going to do something, or thinking to yourself about the consequences of doing something, before you do it)

These brain processes are the basis of many other types of executive functions, listed below, all of which assist us achieve goals, act in socially appropriate ways, and complete tasks:

  1. Concentration
  2. Working Memory: holds information long enough to be processed into short term, and then long term memory
  3. Emotion Regulation: Ability to modulate emotions/emotional reactions
  4. Planning
  5. Problem Solving
  6. Time Management
  7. Self-Motivation/Self Initiative
  8. Organization

So, what happens to EF when a youth is experiencing Attention Deficit Hyperactivity Disorder (ADHD)?

ADHD interferes with EF in a variety of ways, and each youth experiencing ADHD will experience EF difficulties specific to him/her (not every person will experience all possible EF difficulties).

Listed below are a few common EF issues which can occur with ADHD:

  1. Trouble in regulating emotional reactions, and need for sensory input:

Youths with ADHD may react with a level of intensity that is out of proportion to the situation, having big emotional reactions to minor events.   Others often feel baffled as to why the youth is reacting with such intensity.  This can cause problems in developing and maintaining friendships, as peers may not want to play or socialize with him/her, due to feeling uncomfortable with their intense emotional reaction.

Another area of struggle is becoming over excited in fun situations (e.g., birthday parties, class trips, vacations, festivals, social outings/get togethers with friends, cannot fall asleep at sleepovers and keeps other kids awake). For example, in these situations, youths with ADHD may talk loudly, run or climb where not appropriate, have difficulty waiting their turn, talk excessively, and act impulsively in a variety of ways (e.g., screaming above and beyond the level of other youths, grabbing others’ things, jumping around more than their peers, running off, hanging all over other youths, acting silly and younger than their age).

Additionally, many youths with ADHD have a need for movement and sensory input (need for oral, motor, or auditory activity).  For example, they may benefit from chewing gum, doodling, fidgeting with rings/stretch bracelets/paper clips/erasers/pencil grips, and having music on at a low volume in a nearby room while completing homework.  Or, some children benefit from moving around while learning math facts or vocabulary definitions in various subjects (hula hooping, jumping on an indoor trampoline, walking on a treadmill or stepping on a stepper, only if they are of an appropriate age for this. Likewise, doing movement activities prior to starting homework, and movement breaks in between doing homework assignments or study blocks, assists them (e.g., trampoline, hula hooping, cartwheels, somersaults, swinging, tossing a heavier ball with someone, wall push-ups, chair push-ups, jumping jacks, jumping rope, etc.). They actually pay attention, and maintain effort and concentration better, if they are doing these types of movements/fidgeting and obtaining such sensory input, because their brain is seeking and needing such types of sensory and movement inputs.

  1. Difficulty in self-starting and completing tasks (particularly non-preferred tasks), and following through with directions:

Youths with ADHD frequently have trouble with initiating non-preferred tasks on their own (homework, schoolwork, chores, showering, brushing teeth, brushing hair, projects, SAT/ACT prep, doing college applications, studying for driver’s license, etc.), without at least a few prompts. They often need multiple prompts to start these types of tasks.

Moreover, they have difficulty in continuing to put forth concentration and effort to finish a non-preferred task, and only partially finish non-preferred tasks.  For example, they may start the chore of putting away their things, or emptying a dishwasher, and then become distracted by something and walk off/do something else, with the task only partly completed.  Or, they may only partly finish class work/homework, with unfinished sentences, careless mistakes, and/or skipping of items.

While completing tasks, youths with ADHD frequently need prompts/reminders to stay focused, to complete the activity. This can occur even with activities they select to do, which require sustained effort and concentration (e.g., Scout badges and pins).  Such behaviors can be frustrating and confusing for parents/extended family members, as youths with ADHD can start and maintain concentration/effort on preferred tasks for longer periods of time (e.g., Minecraft, Xbox/ phone/ devices, computer games, reading if reading is a preferred task, fantasy play).

Similarly, due to the inattention aspect of ADHD, many youths struggle with following through with directions, only finishing one part of a directive (e.g., only putting away half of a laundry basket of their clothes, only completing one part of a school assignment, partly packing their backpack).

  1. Poor problem solving, difficulty in planning ahead, and difficulty in thinking ahead to the consequences of his/her actions:

Youths with ADHD often have quick, impulsive reactions/responses to situations that can be inappropriate.  They frequently lack the ability to think ahead to the consequences of their verbal comments or actions, and to figure out more than one solution to a problem.  When problems happen, brainstorming a few solutions, and figuring out the steps to solve the problem, is hard for them. For example, when having a disagreement with a

peer (s)/sibling(s)/adult, such youths can only figure out one way to deal with this situation, instead of thinking of 2 or 3 solutions; they then act impulsively on the only solution they identified, which may not be effective. Furthermore, they may not learn from mistakes/consequences initially, continuing to do the same negative behaviors, even with repeated consequences.

Another area of struggle involves planning ahead for projects, tests, taking the ACTs/SATS, driving, and applying for colleges; youths with ADHD have may have difficulty in preparing for/doing these tasks over time, waiting until shortly before the deadline to start.  They then experience stress and feelings of being overwhelmed, resulting in avoidance, shutting down, crying, and/or yelling, as well as worsening of inattention and problem solving/ planning/ organizational issues.

Likewise, when faced with more challenging schoolwork/homework/projects/tests, or a challenging sports/social/recreational situation, they may become overloaded/frustrated/angry, and may give up easily, because they have trouble with figuring out an effective way to manage that situation.

  1. Poor awareness of own emotions, poor perspective taking, and poor awareness of how one’s comments/actions/behaviors affect other people.

Due to lacking such awareness, youths with ADHD frequently do not realize how what they are saying and doing negatively affects others.  For example, they often do not realize their loud voice volume, that they have made an inappropriate comment, their interrupting, the negative effect of their impulsive behaviors, and that they are talking excessively about a preferred topic without allowing others to talk.

Similarly, taking the perspective of others is a struggle for them, leading to difficulty in understanding why others feel a certain way in response to their comments/behaviors.  Therefore, they may be confused as to why others are becoming frustrated/annoyed with them, OR they completely lack any awareness that others are becoming annoyed/frustrated with them.  All of this can cause them to appear unempathethic, and to look like they do not care about how they treating others.

Moreover, children with ADHD may have difficulty figuring out, and understanding their own feelings, and trouble identifying and expressing their own emotional reactions to situations.  Consequently, coping with, and working through, stressors and problems can be challenging for them.

Directly below are parts I, II, and III of the series that were written throughout the past year. Thank you so much for joining into our series on EF in ADHD, and take care,

Leah Murphy, Psy.D

 

Cited References:

Barkley, Russell, A. (2013). ADHD: Executive Functioning, Life Course, and Outcomes Management. Premier Education Solutions

Barkley, Russell, A. (2013). Taking Charge of ADHD, Third Edition: The Complete, Authoritative Guide for Parents. Guilford Press, NY, NY

The Myth of Executive Functioning (EF) Part III: What Does EF Look Like in Youths with ADHD?

Welcome back to our Blog Series on Executive Functioning.

As we talked about last time, Executive Functioning, or EF, involves 2 main areas of brain processing:

  1. Inhibition of Responses: Impulse control/self-restraint (e.g., stopping yourself from making an inappropriate comment, or acting inappropriately)
  2. Awareness: Awareness of own thoughts and emotions. Also self-speech/internalized speech (e.g., thinking to yourself about how you are going to do something, or thinking to yourself about the consequences of doing something, before you do it)

These brain processes are the foundation for many other types of executive functions, listed below, all of which assist us achieve goals, act in appropriate ways, and follow through with tasks:

  1. Concentration
  2. Working Memory: holds information long enough to be processed into short term, and then long term memory, for remembering information in the future
  3. Emotion Regulation: Ability to regulate emotions/emotional reactions
  4. Planning
  5. Problem Solving
  6. Time Management
  7. Self-Motivation/Self Initiative
  8. Organization

So, what happens to EF when a youth is experiencing Attention Deficit Hyperactivity Disorder (ADHD)?

ADHD disrupts EF in a variety of ways, and each youth experiencing ADHD will experience EF difficulties specific to him/her (not every person will experience all possible EF difficulties/disruptions).

Listed below are some common disruptions in EF which youths with ADHD experience:

1. Trouble with following more than one direction at a time, and in following through with multi-step directions: For example, when a youth is directed to get dressed, brush hair, and brush teeth, a child sees a book/toy/other item of interest on the way, and then starts reading or playing with toy in the middle of the floor, possibly while only half dressed.

Similarly, when asked to complete chores/responsibilities/tasks, they may need multiple prompts and reminders to stay on task and finish.  And, they may leave several tasks partially unfinished.

Or, youths do not understand assignments/test instructions/projects with many steps, and become confused, anxious, and/or frustrated and angry with such tasks.

2. Easily distracted and difficulty remembering information: Due to the inattention and problems with working memory, youths with ADHD may often lose items, even favorite items, as well as forget where they have placed even prized possessions.

Likewise, they have trouble finding papers in their desk, binders, back pack, and folders.  They may not be able to find assignments they have completed, or repeatedly forget to turn in an assignment to the teacher.

Additionally, a youth can miss information in a situation, and remember a situation in a way that it did not occur.  He/she may then rigidly insist that a situation occurred in a way it did not, or that a person made a certain comment, which was never stated.

Furthermore, youths may miss directions/instructions and, therefore, complete tasks incorrectly, or become confused/stressed/anxious because they do not understand how to complete a task.

3. Poor Awareness/Understanding of Time, and Poor Time Management: Youths with ADHD often have no sense of time. They may overestimate how long a task will take, and, therefore, resist or argue about completing chores, responsibilities, and homework, stating “It will take forever, it will take too long.”

And, conversely, youths with ADHD also underestimate how long tasks will take; as a result, they may not leave enough time to complete projects or tests.  Instead of spreading out bigger projects or studying over a length of time, they may wait until a day or two before, and then experience feelings of stress, anxiety, and being overwhelmed, because they do not have enough time to complete the project, or to study.

In addition, youths with ADHD often have difficulty being on time for school or other events, meeting deadlines, completing tests in the required amount of time, and completing tasks in a timely manner.

4. Excessive talking and Frequent Interrupting: Youths with ADHD often talk excessively, due to ADHD preventing the inhibition of responses; they could talk 5-10 minutes without pause, and others are not able to have a chance to talk.

Moreover, they often talk at length about a preferred topic, which may not be of interest to others.  This is coupled with frequent interrupting of others, when others try to talk.

Such behaviors are frequently frustrating for peers, friends, and family members.  And, due to ADHD interfering with their awareness, they often are not aware/do not realize others are becoming frustrated.  Consequently, this leads to problems in making and keeping friends.

Until October for the fourth and final part of the series,

Leah Murphy, Psy.D

Licensed PA Psychologist

 

 

Cited References:

Barkley, Russell, A. (2013). ADHD: Executive Functioning, Life Course, and Outcomes Management. Premier Education Solutions

Barkley, Russell, A. (2013). Taking Charge of ADHD, Third Edition: The Complete, Authoritative Guide for Parents. Guilford Press, NY, NY

The Myth of Executive Functioning (EF) Part II: What Does EF Look Like in Child/Teen ADHD?

Welcome back to our Blog Series on Executive Functioning!

As we talked about last time, Executive Functioning, or EF, involves 2 main areas of brain processing:

  1. Inhibition of Responses: Impulse control/self-restraint (e.g., stopping yourself from making an inappropriate comment, or acting inappropriately)

 

  1. Awareness: Awareness of own thoughts and emotions. Also self-speech/internalized speech (e.g., thinking to yourself about how you are going to do something, or thinking to yourself about the consequences of doing something, before you do it)

These brain processes are the basis of many other types of executive functions, listed below, all of which assist us achieve goals, act in socially appropriate ways, and complete tasks:

  1. Concentration
  2. Working Memory: holds information long enough to be processed into short term, and then long term memory
  3. Emotion Regulation: Ability to regulate emotions/emotional reactions
  4. Planning
  5. Problem Solving
  6. Time Management
  7. Self-Motivation/Self Initiative
  8. Organization

So, what happens to EF when a person is experiencing Attention Deficit Hyperactivity Disorder (ADHD)?

ADHD interferes with EF in a variety of ways, and each person experiencing ADHD will experience EF difficulties specific to him/her (not every person will experience all possible EF difficulties).

Listed below are a few common EF difficulties caused by ADHD:

1.  ADHD interferes with the executive function of concentration and putting forth quality effort on non-preferred activities. Consequently, ADHD causes problems in staying focused upon, and putting forth quality effort towards, less interesting/enjoyable activities.

So, even though youths experiencing ADHD can focus upon interesting/enjoyable activities for long periods (e.g., TV/movies, electronics, computer games, preferred building/play activities, preferred reading, etc.), these youths struggle with completing schoolwork, chores, projects, and job work.

Some examples of ADHD, EF attention difficulties youths may experience include:

* Rushing through school work, chores, or job work

*Often making silly/careless mistakes, even when they actually know the information

*Difficulty showing the math work product when doing math problems

*Trouble adding details into their schoolwork and conversations

*Frequently only do the bare minimum of schoolwork/chores required, and work is of a lower work quality

  1. ADHD disrupts the executive functions of organizing, planning, sequencing (prioritizing, doing things in order), and tracking (being able to follow what is going on– e.g., being able to follow what: a teacher is saying, what others are saying in a conversation, what is happening in a game with other kids).

Therefore, when given instructions/assignments/projects/tests with more than a couple of steps and parts, youths with ADHD may not be able to figure out the instructions or how to do the task and become overwhelmed/stressed/frustrated/ angry.

 

Even clothes/shoe shopping can become difficult and stressful, for they are looking at a lot of shoes or clothes in large area, and they do not have the executive functions to figure out which items to try on first, in which order. Rather, it looks like an overwhelming amount of items to try on, and they cannot figure out which items to try on first and how to order/sequence the shopping.

 

Similarly, when entering a social situation (e.g., birthday party, middle/high school orientation, family parties), with many people and a few activities going on at once, youths with ADHD may not be able to figure out where to go, with whom to talk with, or what to start first, and then what to do next, because they cannot order and sequence these events. As a result, they may freeze, look confused, and/or become stressed/irritated/overwhelmed.

 

Likewise, youths’ bags, binders/notebooks, desks, or personal areas are frequently messy, and when they complete schoolwork and chores, it is often completed in a disorganized/messy way.

 

  1. ADHD leads to difficulty in learning social and conversation skills. Youths with ADHD have difficulty tracking/following social interactions. Consequently, they may miss information (what people are saying, facial expressions, body language such as crossed arms) when talking/interacting with others; as a result, they may misunderstand/misinterpret what is said to them, or they may not understand what is happening in games, play with others kids, or conversations with others. At times, they become angry and stressed re: their misperceptions.

Also, due to the executive functioning disruptions caused by ADHD, youths with ADHD do not learn social skills and conversation skills via natural observation/social interaction and social modeling with others as most children do, and they are frequently behind socially.

For example, youths with ADHD may have trouble knowing and explaining their own and others’ emotions, understanding why others react the way they do, and taking the perspective of others. Similarly, many youths with ADHD do not understand the way in which their words, voice tone, facial expressions, body language, choices, actions, and behaviors affect friends, family, and others in their world.

Likewise, the ability to do back and forth reciprocal conversation can lag behind. Instead, youths with ADHD often tend to just talk about their own interests a great deal, without realizing that others are becoming frustrated/annoyed by their lack of reciprocal conversation and constant, or excessive, talking.

 

Tune back in, at the end January, to learn more about ADHD and EF in children and teens.

Until January,
Leah Murphy, Psy.D

Licensed PA Psychologist

Center For Psychology & Counseling

 

Make sure to check out our post by Matthew Muchler about the Holidays coming in December.

Cited References:

Barkley, Russell, A. (2013). ADHD: Executive Functioning, Life Course, and Outcomes Management. Premier Education Solutions

Barkley, Russell, A. (2013). Taking Charge of ADHD, Third Edition: The Complete, Authoritative Guide for Parents. Guilford Press, NY, NY

The Myth of Executive Functioning: What is Executive Functioning?

You may have heard the term “Executive Functioning” and wondered what it meant. This is a term which is being used more and more frequently.

So, let’s start de-mystifying Executive Functioning, which we will call EF going forward.

EF is primarily proccessed in the Frontal Lobe of the brain, in the Pre-Frontal Cortex.

EF involves 2 main areas of brain processing:

  1. Inhibition of Responses: Impulse control/self-restraint (e.g., stopping yourself from making an inappropriate comment, or acting inappropriately)
  2. Awareness: Awareness of own thoughts and emotions. Also self-speech/internalized speech (e.g., thinking to yourself about how you are going to do something, or thinking to yourself about the consequences of doing something, before you do it)

These brain processes are the foundation for many other types of executive functions, listed below, all of which assist us achieve goals, act in appropriate ways, and follow through with tasks:

  1. Concentration
  2. Working Memory: holds information long enough to be processed into short term, and then long term memory
  3. Emotion Regulation: Ability to regulate emotions/emotional reactions
  4. Planning
  5. Problem Solving
  6. Time Management
  7. Self-Motivation/Self Initiative
  8. Organization

Without these types of EF processes, decisions are made quickly in the moment without thinking of the consequences, and it is very difficult to multi-task, complete even simple tasks, follow social conversations, and understand social cues: and, this is some of what can happen when ADHD disrupts Executive Functioning.
Check out September’s blog to learn more about how ADHD impacts EF. 

Until September,
Leah Murphy, Psy.D

Licensed PA Psychologist

Center For Psychology & Counseling

 

 

Cited References:
Barkley, Russell, A. (2013). ADHD: Executive Functioning, Life Course, and Outcomes Management. Premier Education Solutions/