How Does ADHD Affect Executive Function?

Executive function refers to the function of the brain involved in organization, activation, integration and help manage other functions. Therefore, those who have problems with the executive function will struggle to regulate behavior, get organized, and achieve long-term goals. Everyone may have strong and weak aspects of executive functioning which may affect the work or relationship. However, for individuals with ADHD, these challenges tend to be more serious and more numerous compared with those without ADHD. 

Researchers identified six main areas of executive functions that can be impaired in those with ADHD: activation, effort, memory, focus, emotion, and action.  Some individuals with ADHD may have troubles with one, while others with more of these areas of executive function.  It is believed that genetics and damages to the prefrontal cortex area of the brain may contribute to executive dysfunctions. Luckily, the executive function can be improved with the right therapy. First, it is important to identify which area is affected and then take action. Read on to learn what are the signs of poor executive functioning and solutions to improve different areas of executive functioning.

 What are signs of poor executive functioning and what are the solutions? 

Russell Barkley, Ph.D., is one of the key researchers who spent decades exploring the link between executive functioning and ADHD. The signs of poor executive functioning will depend on which area is affected. 

  • Activation. If activation is impaired, a person will have difficulties with time management, get motivated and stay organized. 

The solution to improve this executive function is to create and maintain a well-structured, organized system in all areas of life. For example, children will have to maintain an organized backpack and periodically clean up. Having a morning and bedtime routine is important. The alarm clock should be set up to wake up and go to sleep at the same time every day, including weekends. A calendar with a checklist placed on the mirror can be a great reminder of the daily tasks. 

  • Focus. If this executive function is deficient, a person will have trouble maintaining attention when there are various distractors in the environment such as cell phone or TV. 

The solution is to create an environment with limited or no distractions at all. For example, having a quiet, separate room in the home to use for homework or work. While some music can be a distraction, listening to soft, classical music in the background can actually help with focus and concentration. Their schedule should include periods of break, using a timer. Children with ADHD need more breaks than those without ADHD. 

  • Effort. When impaired, this executive function is associated with difficulties maintaining the effort (mental effort) as well as day time sleepiness. Waking up in the morning is also difficult. 

The solution is to have a clear reward system in place. If you complete the task on time you get a reward which can be watching a TV show or a special treat (make sure it is not high sugar, processed food). The mental effort can also improve and daydreaming episodes decrease if you add some stretching or a short 5-minute workout during the breaks. Having a strict bedtime routine helps adjust the sleep-wake cycle and waking up easier in the morning. 

  • Emotion. Executive dysfunction affecting emotions typically show up as  feeling overwhelmed, negative emotions, mood swings and having troubles bouncing back to healthy emotions. 

The solution is self-awareness, understanding, identifying, and naming those emotions and feelings. For children, it is important to use simple language “Do you feel hurt? Do you feel upset? Do you feel angry?”. Validate those feelings and acknowledge that feeling frustrated or sad is normal at times. 

The solution is to use a phone calendar or notes with reminders about things that are important like deadlines for work, school assignments, or doctor appointments. Schools can also provide additional help, as they have special programs to address these issues and help a child succeed. 

  • Action. Challenges with this executive function translate into problems with impulse control. 

One of the best solutions to address these difficulties is mindfulness meditation. Even a few minutes daily can have a positive impact on impulse control and decrease anxiety levels. Parents can have an honest conversation with children, as these behaviors also have an underlying cause- does the child have a special need that requires attention? Are there any factors that contribute to changes in behavior? 

Getting help from a therapist can further help because it is important to learn to adapt, take extra steps to plan and organize work, and control emotions. Children with ADHD need to know they can rely on support from parents and teachers. Here is a quick quiz available for children, teachers, and adults to identify the strengths and the weaknesses related to executive function.