The Link Between ADHD And Executive Functioning

ADHD and executive functioning deficits go hand in hand. Although some researchers view executive functioning as a separate domain, many consider executive functioning deficits to be at the core of ADHD, labeling it as executive functioning developmental disorder (EFDD). But what is executive functioning and why is it such a big deal for kids with ADHD?

Understanding the link between executive functioning and ADHD

In general, executive functioning refers to the ability to coordinate present actions toward a future goal. It is sometimes referred to as the “CEO” or general of the brain, in that these functions are responsible for orchestrating everything else that happens.

This has many ramifications for individuals as it includes:

  • time management,
  • delaying gratification,
  • planning,
  • organization,
  • sustained attention,
  • emotional control,
  • and frustration tolerance among other necessary skills.

Underlying all of these is the ability to increase or decrease one’s behavior, emotions, or thoughts to reach a goal that is somewhat distant in time.

This is why executive functions are so central to ADHD. It is the difficulty of regulating attention that causes children with ADHD to struggle. It is the difficulties with understanding time and planning for things in the future that makes them so disorganized and unprepared. It is the difficulty calming themselves when they are overwhelmed that leads to emotional outbursts and behavioral impulsivity that gets them in trouble.

It is like a business without a CEO. Employees show up and leave when they want. They take either too long or too short on tasks, make mistakes, and have no accountability. They do not coordinate their actions with other employees or with the overall goals of the business. They also do not get paid on time or know when they are going to get paid, which leads to low motivation and output. Sometimes, this lack of structure leads to an innovative idea, but most of the time, it leads to failure.

What are the subcategories in executive functioning?

Some theorists describe executive functioning as having 4 categories that are related to four pathways in the brain. These are the “what”, “when”, “why”, and “who” pathways:

  • “What”: This is “what” a person can keep in their mind as they think about something as well as the value they put on that information. These originate in the frontostriatal circuits which connect the prefrontal cortex to the midbrain structures of the basal ganglia.
  • “When”: This is how the individual plans “when” to do actions in an organized manner, and is associated with connections between the prefrontal cortex and the cerebellum.
  • “Why”: This is the emotional motivation that promotes behavior and dictates “why” we do things. This is mediated by the connections between the prefrontal cortex and the amygdala, which manages an individual’s feelings of emotions.
  • “Who”: This is involved in self-awareness and perception, or keeping track of “who” is doing something, how we are feeling in our bodies, and what to focus on in the environment.

Another way of conceptualizing executive functioning is to categorize the progression of skills that emerge through child development. As described by Barkley, these are:

  1. Self-awareness
  2. Inhibition
  3. Non-Verbal Working Memory
  4. Verbal Working Memory
  5. Emotional Self-Regulation
  6. Self-motivation
  7. Planning and Problem Solving

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ADHD Neuropsych Evaluations With Dr. Malkin

ADHD can make executive functioning tasks difficult, but not impossible to manage. A neuropsychological evaluation with Dr. Malkin can help. He will assess your student, determine the root cause of the issue, and provide guidance as to the best treatments and learning techniques for your student. Book an appointment or contact us with any questions you may have using the link below.