ADHD and Executive Functioning in Children

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 see (ADHD, a processing disorder, anxiety, or something else) and the best way to intervene.

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.  Perhaps this helps explain why many of our “adult” children are not quite connecting all the dots just yet.

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, 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 children and adults 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 our kids best by teaching skills to regulate their attention: to pay attention to the right things, at the right time, and in the right order.

Resources for Executive Functioning and ADHD

Books

  • Smart but Scattered by Peg Dawson, EdD and Richard Guare, PhD: This book focuses on Executive Functioning Skills (there is a version for teens as well).  It has some helpful quizzes that parents and children can take together.  Practical tips for helping your child build important organizational, memory, self-regulation and flexibility skills.
  • The Explosive Child by Ross Greene, PhD: This book presents a parenting and teaching strategy based on the concept that “kids do well if they can”, and that when children are not doing well, we can help them learn the skills they need.  Look closely at the skills on Dr. Green’s assessment tool: they are all skills of Executive Functioning.  Also check out: www.livesinthebalance.org.

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 articles and resources for parents with children with learning disabilities and ADHD. Take a look at their ADHD Basics article for an easy-to-understand foundation of common school challenges.
  • Understood.org has short, targeted articles related to learning and attention issues.  This website has been a favorite among my clients.

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 child’s 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 Greater Good.
  • 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.  I would recommended this app for ages 10 to Adult.
  • Born to Move: Hyperactivity can make you a star on the soccer field, but a detention-regular in school.  Students 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, or a makeup sponge.  Stress-balls are recommended for high schoolers and adults, but not young children as they can become projectiles easily!
    • Frequent and predictable (i.e. every 10 minutes) movement breaks

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

  • The Final Countdown: Students who struggle with Shift may lack a sense of time, or what “5 minutes” means.  Using a timer with a visible countdown for the last 5-10 minutes of a task can be helpful for developing this skill: from homework to the playground.
  • Your Day in Review: Students who struggle with Shift may lack the skill of predicting what will happen next, or the sense of where this 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 student make a mental map of how the time will unfold.

For difficulties with Initiating tasks:

  • Jump Start: Many parents and older students complain that starting a task is the hardest part.  This may mean the student lacks the skills to break down a task into steps, or choose the best first step.  Help this student by:
    • Talking through the steps of the assignment before starting
    • Asking the student to identify the first, or first few, steps for the task at hand
    • Give the student one step at a time to avoid overwhlem

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 students may still need support figuring out the best place to start or how to prioritize these tasks.
  • Family Calendar: Keeping a family calendar and reviewing any upcoming events may help to keep harmony in the household and support the struggling family member in planning appropriately to be able to fit in all required activities.
  • 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: Even small children can be taught to keep their own data on behavior goals.  Make a goal with your child that is specific to a skill and measurable.  For example: My goal is to raise my hand before I speak.  I can keep track of how many times I raise my hand first, and how many times I blurt out.  I can also count how many times I used a strategy (such as taking a breath or writing down my thoughts before speaking) to help me.  This is a great way to work on a goal in a non-punitive, collaborative way!
  • Estimate: Many children 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!

Questions or Comments about this page?  Send me a note!

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