ADHD and Executive Functioning in Adults

Executive Functioning and ADHD (Attention Deficit Hyperactivity Disorder) are not the same – but they are very closely related.  So much so, in fact, that it is hard to talk about one without the other.

Executive Functions act as your brain’s “Chief Executive Officer”: just as a large company needs good leadership to function, your brain’s executive team needs to be alert to produce your best work.  Executive Functions are critical to learning, interacting with others, controlling behavior, and becoming an independent person.

Many of the behavioral symptoms of ADHD stem from a core deficit in Executive Functioning skills.  Inattentiveness and hyperactivity may also be present in those with physical, psychological or processing disorders.  A full assessment can help you figure out the cause of the challenges you experience (ADHD, a processing disorder, anxiety, or something else) and the best way to find help.

Executive Functioning

The Executive Functions include:

  • Impulse Control: the ability to think before you act
  • Emotional Regulation: the ability to monitor and control your emotional reactions
  • Shifting: the ability to switch from one activity to another, or adjust when plans change
  • Initiating: the ability to start a task or assignment
  • Planning: the ability to think through the steps towards a goal
  • Organizing: the ability to keeps things in a logical order or location
  • Working Memory: the ability to keep one piece of information in mind while doing something else; i.e. keeping your whole “to-do” list in mind while completing one task at a time
  • Self-Monitoring: the ability to think about and analyze your own actions

This set of skills becomes more and more important as we get older.  When we are young, our parents act as surrogate “executives”.  As adolescents and adults, we need to do these things for ourselves.

The part of the brain that houses our Executive Functions keeps developing well into our 20s. This is why many of us struggle when we first get to college, or are on our own for the first time.  Once we don’t have the external “executive” directing our actions, it’s hard to transition to being your own boss!  (Turns out the boss has a lot of responsibility!)

Not everyone who struggles with Executive Functioning has ADHD, but everyone with ADHD struggles with Executive Functioning.  Understanding your “executive’s” strengths and weaknesses is key to overcoming challenges associated with attention, task completion, impulsive behavior, organization and planning.

A Note About ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is commonly understood as “not paying attention” – but that’s not the whole story.  

People with ADHD most often are paying attention to too much, not too little.

In fact, we can even go as far as to say that people with ADHD do not struggle with paying attention – they struggle with knowing where to put their attention.  So it’s not about “paying more attention”: it’s about “paying attention to the right things”.

Therefore, we can help ourselves best by learning skills to regulate and direct our attention: to pay attention to the right things, at the right time, and in the right order.

Resources for Executive Functioning and ADHD

Books

  • Taking Charge of Adult ADHD, by Russel Barkley: One of the leading experts in ADHD, Dr. Barkley presents a practical guide with many self-assessment tools and skill-building exercises.
  • More Attention, Less Deficit, by Ari Tuckman:  This book is written specifically for individuals who tend to jump around and read in pieces.  It reads like a compilation of articles, all with important information from etiology to treatment options.  Click here for a sample chapter.

Websites

  • Chadd.org is a universal resource for both children and adults who struggle with attention difficulties.  Their site includes parent training, workshops, advocacy, and support resources.
  • LDonline.org offers many fantastic articles and resources. Take a look at their ADHD Basics article for an easy-to-understand foundation of common school challenges.  You may also wish to check out their Adults with Learning Disabilities page.

Recommendations for Basic Skill Building

These are some of the most common recommendations for students who struggle with Executive Functioning and ADHD. Depending on your specific difficulties, we will develop an individualized plan as part of your assessment.

For difficulties with Impulse Control and Emotional Regulation:

  • Breathe into it: Mindfulness and other meditative practices are key to learning skills to control our actions and regulate our emotions.  Resources are available at www.greatergood.berkeley.edu.
  • Can You Feel it?: Both children and adults benefit from learning to use an extended feelings vocabulary to both recognize and express their internal world.  StopBreatheThink.org has a great app for both monitoring physical and emotional well-being, as well as guided meditations.
  • Born to Move: Hyperactivity can make you the life of the party, a passionate student, or a “real go-getter” at work; but it can also mean impulsive mishaps have you as a regular on the probation list. Individuals with an overflow of energy may benefit from:
    • A standing desk
    • A “fidget tool”, or something innocuous to have in their hands during class or work time; i.e. silly putty, pipecleaners, stress ball or even a make-up sponge.
    • Frequent and predictable (i.e. every 20 minutes) movement breaks such as 5 push ups, a walk around the block, or some jumping jacks
    • Volunteering to facilitate the meeting or take notes, which often means you get to stand up and have an active way to participate

For difficulties with Shifting from one idea or task to another:

  • Good Enough Goals: Before starting a task, set an end time and a completion goal.  It may be helpful to set an “ideal” goal, as well as a “good enough” goal: if you’ve only reached your “good enough” goal by the end of the time, you’ve given yourself permission to leave the task where it is.  Similarly, set a “soft stop” and a “hard stop” time.  For example, “I’d like to stop about 6pm, but at 6:15, no matter what, I’m done.”
  • Your Day in Review: Individuals who struggle with Shift may struggle with an intuitive sense of where an activity fits in with the rest of the day.  Reviewing today’s schedule at the beginning of the day, or the order of events before an activity, can help the you make a mental map of how the time will unfold.  Talk yourself through it to prepare your brain for the Shifts ahead.

For difficulties with Initiating tasks:

  • Jump Start: Many adults complain that starting a task is the hardest part.  This may mean difficulty with breaking down a task into steps, or choose the best first step.  It may be helpful to:
    • Talk through the steps of the assignment with a friend or family member before starting.
    • Challenging yourself to identify the first, or first few, steps for the task at hand.
    • Name the first step, and then do only that step – this can prevent you from feeling overwhelmed.  Often, the task as a whole seems impossible, but the individual steps are not.

For difficulties with Organization and Planning:

  • Make a List: Old school but so true – the best way to get through a complex task is to write it down.  Use post-its, a white board, a Task app, or the palm of your hand to write down the steps you will need to get this task done.  Keep in mind, many individuals may still need support figuring out the best place to start or how to prioritize these tasks.  It may be helpful to ask a close friend or family member for their input on where to start.
  • Draw it Out: When drafting a paper or essay, our words can confuse us, or perhaps the ideas come so quickly it’s difficult to keep them in order.  Trying drawing out your ideas on a whiteboard.  Drawing accesses a different part of your brain, and the white board is easy to erase when things are not in the right place.  Post-its are also extremely helpful for organizing and re-organizing ideas for a paper or project.

For difficulties with Self-Monitoring:

  • Collect Data: Make a goal for yourself that is specific, measurable, and attainable.  For example, if I find myself talking too much at parties, I may set a goal for myself to ask 5 questions of the other person before sharing information about myself.  This can help me bring awareness to some of my impulsive behaviors and change the ones that are not working for me.
  • Estimate: Many people with Executive Functioning deficits have significant difficulty estimating the amount of time a task will take.  On your to-do list, make predictions of how much time each task will take.  Adjust the times as experience informs your estimates.  You will start to see patterns that will make you better and better at this skill!

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