ADHD & Executive Functions: Emotional Control!

ADHD Emotional Control

Diagnostic Criteria

So, here is the DSM-V diagnostic criteria for ADHD. We are pretty familiar with these symptoms and recognize the impact they can have on a child’s life. Look them over for a quick review, and then we’ll discuss whether there is something missing from this list?

The diagnostic criteria for ADHD:

Inattention

Six or more:

__ failing to pay close attention to details or making careless mistakes

__ problems sustaining attention in tasks or play activities

__ often not appearing to listen

__ having trouble following through with directives or fails to finish tasks

__ being less than well-organized and poor time management

__ reluctant to engage in tasks requiring sustained mental effort

__ losing things

__ being easily distracted by extraneous stimuli

__ forgetful

Hyperactivity and Impulsivity

Six or more:

__ being fidgety or taps hands, squirmy

__ often leaves seat when remaining in seat is expected

__ often runs or climbs when not appropriate to do so

__ Unable to play quietly

__ moving around excessively and always being ‘on the go’

__ talking excessively

__ blurts out answers

__ having problems waiting for turns

__ having a tendency to interrupt and intrude at times

These signs need to be seen prior to 12 years of age and notably impacting a person’s life.

The missing piece!

It is becoming increasingly apparent that emotional dysregulation is such a primary aspect to ADHD that there is consideration of adding that specific symptom to the list of criteria. We don’t often think of emotional outbursts being related to ADHD symptoms, but they are. In fact, a secondary though related symptom is also very common; a hypersensitivity to rejection or redirection. I’ll be many of you are all too familiar with that aspect of ADHD even though it’s not part of the criteria.

Interesting impact of medication and behavioral modification

Medication often helps to improve attention and concentration, but an interesting additional effect is that kids often appear calmer and more at ease, even when faced with being told ‘no’ and when frustrated. That’s a reflection of the medication’s impact on that specific executive function of emotional control.

Hope that helps

It’s important to understand the scope of symptoms and executive functions associated with ADHD. If not, then we tend to feel confused, we can’t target treatment, and may even pursue unnecessary secondary diagnoses. If we know what we’re looking for, it’s easier to grasp, and then it’s easier to treat. God bless you and your kids.

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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).