Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that primarily affects executive functioning. In simpler terms, the brain of a person with ADHD develops differently from that of a typically-developing brain, and those differences make it harder to control our attention and our behaviour. I recently had a bit of hyperfocus on ADHD-related stuff, so this post is going to explain why, as a result of what I learned, I’m more convinced than ever that ADHD is primarily a disorder of executive functions, just like Russell Barkley says.
* Most of this information came from Wikipedia or the Canadian Oxford English Dictionary, 2nd ed.
The diagnostic criteria for ADHD in the DSM-5 are categorized as either inattention or hyperactivity/impulsivity.
INATTENTION AND EXECUTIVE DYSFUNCTION
| Inattentive Symptoms | Related Executive Functions | Examples |
| Makes careless mistakes/lacks attention to detail | Attentional Control Self-Monitoring | Uncorrected typos in essays and reports |
| Difficulty sustaining attention | Attentional Control Cognitive Inhibition | Daydreaming during meetings or class |
| Does not seem to listen when spoken to directly | Cognitive Inhibition Cognitive Flexibility | Spacing out during conversations |
| Fails to follow through on tasks and instructions | Working Memory Planning Goal-Directed Behaviour | Starting a task and leaving it unfinished |
| Exhibits poor organization | Organizational Skills | Maintaining a chaotic living space, desk, locker, etc. |
| Avoids/dislikes tasks requiring sustained mental effort | Attentional Control Goal-Directed Behaviour | Postponing homework as long as possible |
| Loses things necessary for tasks/activities | Organizational Skills Goal-Directed Behaviour | Searching daily for shoes, toys, keys, etc., often multiple times a day |
| Easily distracted (including unrelated thoughts) | Attentional Control Cognitive Inhibition | Going off on tangents during conversations and in written work |
| Is forgetful in daily activities | Working Memory Planning Goal-Directed Behaviour | Walking into a room and not knowing why |
Attentional Control is the ability to control what you pay attention to. It’s basically being able to concentrate.
Cognitive Flexibility is the ability to change your behaviour and thought processes based on changes in your situation or gaining information.
Cognitive Inhibition is the ability to tune out unrelated stimuli and stay on task or follow a train of thought.
Goal-Directed Behaviour is about controlling your behaviour so that you’re working towards achieving goals.
Organizational Skills are all that sorting, putting things away, etc.
Planning is the ability to think ahead and to break goals down into smaller steps.
Self-Monitoring is the ability to keep track of what you’re doing and how you’re coming across, as well as notice things like hunger, thirst, fatigue, pain, the need to use the bathroom, etc.
Working Memory is the ability to hold information in your mind so you can use it to make decisions and complete tasks.
HYPERACTIVITY/IMPULSIVITY AND EXECUTIVE DYSFUNCTION
| Hyperactive/Impulsive Symptoms | Related Executive Functions | Examples |
| Fidgets with or taps hands or feet, squirms in seat | Inhibitory Control Self-Monitoring | Clicking a pen, chewing on a pencil, constantly adjusting sitting position |
| Leaves seat in situations when remaining seated is expected | Inhibitory Control Cognitive Flexibility Goal-Directed Behaviour Self-Monitoring | Pacing while thinking or talking through an idea |
| Experiences feelings of restlessness | Self-Monitoring | Always wanting to be in motion or to move on to a new job or living situation |
| Has difficulty engaging in quiet, leisurely activities | Goal-Directed Behaviour Self-Monitoring | Playing loud games, talking loudly when indoors |
| Is “on-the-go” or acts as if “driven by a motor” | Inhibitory Control Self-Monitoring | Moving constantly, particularly the whole body |
| Talks excessively | Inhibitory Control Self-Monitoring | Talking more than others in a group |
| Blurts out answers | Inhibitory Control Cognitive Flexibility Self-Monitoring | Answering questions in class without raising hand first |
| Has difficulty waiting their turn | Cognitive Flexibility Goal-Directed Behaviour Self-Monitoring | Going straight to the head of the line without being invited |
| Interrupts or intrudes on others | Inhibitory Control Cognitive Flexibility Goal-Directed Behaviour Self-Monitoring | Starting to talk during a conversation before someone else is finished saying their piece |
Cognitive Flexibility is the ability to change your behaviour and thought processes based on changes in your situation or gaining information.
Goal-Directed Behaviour is about controlling your behaviour so that you’re working towards achieving goals.
Inhibitory Control is the ability to stop before you act so you can choose the most appropriate way to behave in a given situation. It’s got a lot to do with self-control.
Self-Monitoring is the ability to keep track of what you’re doing and how you’re coming across, as well as notice things like hunger, thirst, fatigue, pain, the need to use the bathroom, etc.
Obviously some executive functions interact with each other more than others, and that is probably what makes the difference between what type and how impaired we are. Granted, this is just conjecture, but it makes logical sense to me.
Of course, to the general public, ADHD is still just hyperactive little boys, and all of these issues we have are just signs of poor parenting, laziness, etc.
The printable for this post can be found here. It’s a copy of the symptom/executive function charts with definitions and examples, plus a blank version you can use to write down examples of your own executive dysfunction. I hope it’s helpful for you in figuring out just where you’re struggling, since knowing that can help you figure out supports.
actuallyadhd.org 