In the ADHD space, you've probably seen/read/heard Executive Functioning being discussed. But what exactly are executive functions and what is the link with ADHD? ADHD is commonly associated with traits like hyperactivity, impulsivity, and variable attentiveness. Executive functions can be thought of as the brain's control centre, playing a role in regulating and managing attention, focus, impulses and actions.
Executive functioning encompasses a set of cognitive processes that enable individuals to plan, organise, initiate and sustain tasks, manage time, regulate emotional/action-based impulses, and shift focus between thoughts, stimuli and tasks. These functions are primarily mediated by the prefrontal cortex and allow us to set goals, make decisions, solve problems, and manage our way through change. Because these are cognitive processes, much like our other abilities there can be fluctuations in what executive function capacities are like each day. Just because someone's able to initiate tasks well one day, doesn't mean they can do so every day!
Executive functions can be clustered into broad groups, including (but not limited to) the below. The list can vary depending on how different researchers conceptualise executive functions and group different processes together. When looking at this list, you can start to see how these skillsets underscore a lot of the daily struggles ADHDers come seeking support with.
Inhibition: The ability to regulate impulses (or 'inhibit' them as required).
Initiation: Getting started on tasks, planning out the steps that are needed for said tasks, and generating ideas/solutions.
Working Memory: Holding and manipulating information in mind, used in tasks such as following instructions, organising thoughts, and registering details.
Shift: Shifting focus between different thoughts tasks, including the ability to shift back to the original stimuli after being distracted/interrupted.
Emotion Regulation: Emotions are essentially impulses as well. Regulation of these impulses is linked to our emotional responses, reactions and moods.
Planning and Organisation: This can be thought of in terms of tasks/activities, but also in how we manage our belongings and the environments we live, work, study and play in.
The impact of struggles or differences with executive functioning on individuals with ADHD can lead to difficulties with self-organisation, time management, and planning. This can then have functional impacts like academic underachievement, work-related challenges, and friendship or relationship difficulties (many people can relate to the example of friends feeling hurt or neglected if we've forgotten to message them in a while). Impulsivity can appear like making decisions on what might look like a whim, conversational tangents, or doing things in the 'here and now' instead of the 'later'.
Taking time to assess and understanding an ADHDer's unique profile of executive functioning profile can be really helpful in collaborating on tailored and effective supports, as it means you can work together on coming up with solutions or accommodations that focus most on what impacts them in daily life. There's no manual for this and it can take trial and error and experimentation. It's super important to honour this, as a lot of ADHDers can feel like failures after having tried all the standard things like timers, diaries, and reminders. Being upfront about the trial and error in relation to their specific and individual news is powerful. Broad types of strategies that can help ADHDers improve their executive functioning capacities include:
Medication: This is the domain of Psychiatry and this blog post is not medical advice. This is for informational purposes. Medication classes like stimulants can help regulate brain chemistry and enhance executive functioning.
Environmental Modifications: Trial and error in supporting specific executive function challenges via the way tasks and environments are organised and structured can help to reduce the demand on executive functions. Working with Occupational Therapists, Psychologists and/or ADHD coaches can be helpful for this.
Assistive Technology: Using tools like digital calendars, reminders, task managers, and apps specifically designed for individuals with ADHD can support planning, organisation, and time management. They're not the solution that will make everything easier all the time, but again, can reduce the daily demand on executive function specific to tasks that an individual may find difficult.
In conclusion, the link between executive functioning and ADHD underscores the complex nature of ADHD as a neurodevelopmental profile. ADHD isn't a behavioural disorder, it's a variation of human neurology, and we can think about executive functions when understanding this neurology.
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