ADHD: What’s Executive Functioning Got To Do With It?

ADHD and Excecutive Functioning

The Importance of the Executive Functions

ADHD is described as a disorder of the prefrontal lobe of our cerebral cortex, which is the area of the brain that controls higher-order thinking. This ‘higher-order thinking’ is also known as a set of executive functions that help us to more effectively get through our day.

The specific executive functions include: Impulse control, flexible thinking and ability to shift between topics, emotional control, initiating a task, working memory (keeping thoughts in our memory and quickly acting on them before we forget), planning and prioritizing, organizing, self-monitoring (assess our own performance and measure it against some standard of what is needed or expected), and monitoring the passage of time.

The importance of examining your child’s executive functioning

Trying to determine how to treat “ADHD” can be daunting. In that respect, the diagnosis shows-up in a bunch of behaviors, there are lots of different symptoms, and it can be challenging to prioritize which behaviors and symptoms to target. However, if we look at select executive functions, as opposed to a bunch of symptoms and behaviors, then we can target treatment in a way that will be most effective, practical, and helpful.

Examples

There are lots of examples and, in that respect, check-out our Parent Resources, for our ADHD AND EXECUTIVE FUNCTIONING pamphlet that highlights specific strategies to improve each executive function. An example for time-management includes using a chore-card that lists the chore, the steps to complete the chore, the time allotted for each step, and the time the entire chore should take, then set a timer.

I hope that information helps.

Understanding executive functions is super helpful. Here is a checklist to help in determining where your child may be struggling, which targets the treatment process. More to come in the next post, specifically about emotional control.

God bless you and your kiddos!

Dr. C

 

 

 

 

 

 

 

 

 

Executive Functioning Checklist


Executive Functioning is overseen by the Pre-frontal Cortex; it’s the “command and control” center of the brain and helps to manage life tasks. It involves mental control and self-regulation. These functions allow for managing time, paying attention, switching focus, planning and organizing, remembering details, and avoiding saying or doing the wrong thing.

Which of the following executive functions do you believe need targeted for your child?

___ Inhibition and Impulse Control: Stop one’s behavior at the appropriate time, thinking before acting, and filtering-out distractions in the environment.

___ Shifting, and Flexible Thinking: Move freely from one situation to another both in thought and behavior.

___ Emotional Control: Control emotional reactions by bringing rational thought to bear on feelings.

___ Task Initiation: Ability to begin a task and to independently generate ideas, responses, or problem-solving strategies (getting started on a task…)

___ Working Memory: Capacity to hold information in mind for the purposes of completing a task (shortly after a direction, remembering the task-at-hand)

___ Planning and Prioritizing: Ability to plan how things are going to be accomplished and order the items in terms of importance.

___ Organization of Materials: Impose order on work, play, and storage.

___ Self-Monitoring: Ability to monitor one’s own performance and to measure it against some standard of what is needed or expected.

___ Monitoring Time: The ability to self-regulate based on time-constraints and have a sense of urgency. The capacity to plan for a task or goal, no matter short or long-term. The ability to accurately judge the passage of time.

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Dr. John Carosso

Dr. Carosso has more than 30 years of experience as a licensed Child Clinical Psychologist and Certified School Psychologist working in private, inpatient, outpatient, residential, school, and home settings. He is Clinical Director of Community Psychiatric Centers (cpcwecare.com), a licensed Behavioral Health Outpatient Clinic, and operates both the Autism Center of Pittsburgh (autismcenterofpittsburgh.com) and the Dyslexia Diagnostic and Treatment Center (dyslexiatreaters.com).