blogThe 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