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ADHD: Attention Deficit Hyperactivity Disorder

Executive Functions

Margaret V. Austin, Ph.D.

ADHD symptoms are strongly associated with impaired executive function (EF). Recall, the term executive function refers to a higher-order set of skills and abilities, such as analyzing information, prioritizing information, etc. In fact, Russell Barkley, a well-known expert in the field, calls ADHD a "disorder of EF." (Barkley, 2009)

Research has found that executive functions (EF) are the product of the frontal lobes and serves two basic purposes:

1. organization; and,

2. Self-regulation.

Examples of EFs include the ability to: gather and evaluate information; plan and organize time; direct attention and sustain focus; store and retrieve information; and, shift from one activity to another with ease. Self-regulation refers to an individual's ability to purposefully manage emotions and behavior. It is an action directed toward oneself in order to alter a behavior that would naturally occur in response to an environmental trigger. Common examples of self-regulation include: controlling one's temper; resisting junk food; and, continuing to work on a project, even when bored or tired. In a sense, the brain's EF does the same sorts of tasks as a high-ranking business executive (e.g., CEO): plan, organize, evaluate, set goals, and adapt to changing needs and circumstances. The rest of the brain operates like workers who follow the CEO's directions. People with ADHD have difficulty with both this type of self-directed behavior, and organization in general.

The concept of EF has generated a great deal of ADHD research. This is particularly true with respect to frontal lobe functioning. EFs are considered higher-order thinking abilities that develop more fully as people mature. Individuals with ADHD (including adults) appear to have impairments in EF. Many studies have been developed to examine the relationship between EF and ADHD.

Researchers have found that although brain function is biological, EF skills can be taught. This discovery may be helpful in reducing ADHD symptoms that are due to impaired EF. However, understanding of this topic has become more complicated. Tests designed to identify EF limitations identified problems in only 35% of ADHD individuals tested (Barkley, 2011). Other studies used a different method, called rating scale studies. This method uses self, and family member observations of skills, abilities, and challenges. These studies identified as many as 98% of ADHD individuals with a functional impairment in daily living. While these findings cast doubt on our current methods of testing for EF deficits, they bolster our recognition that ADHD is associated with EF impairment. Many researchers now accept that EF impairment can create many difficulties. Therefore, research continues to develop effective methods for teaching these important skills.

Other brain research suggests that individuals with impulsive and hyperactive forms of ADHD are more responsive to immediate rewards, than to delayed rewards. These folks are more likely to become overactive, rather than passive, while waiting for some reward to occur. For example, a good grade for a well-written paper comes after the paper is finished. This delayed reward would not be sufficiently motivating for most people with ADHD. This might explain why longer projects, that require sustained attention, are difficult for those with ADHD. For people with ADHD, rewards are motivating when they occur early in the activity. Rewards should reoccur during longer tasks to sustain motivation and effort. Interestingly, some research indicates that children with ADHD seem to respond poorly to punishment. In other words, punishment does little to inspire behavioral change for those with ADHD. Instead, it may leave them feeling confused or angry. These findings support the concept that individuals with ADHD have a unique learning style. Thus, they may require more creative and non-standard teaching methods.


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