The sink is overflowing with dishes. You know you need to wash them, but the thought alone is overwhelming. Another day goes by, dishes piling higher.

You remember you have a bill to pay. You try to sign in to your account, but you’ve forgotten your password. While you wait for the password reset email, you get sidetracked. Before you know it, that initial bill is forgotten.

This is ADHD – or, more accurately, executive dysfunction – in action. The brain processes humming in the background (i.e., executive functions) that are supposed to help you organize, plan, and execute simply aren’t reliable. Following through, as a result, is a core issue for you, even when you know what you’re supposed to do.

The biggest trap many of us fall into is believing we can “build” executive function or “train away” deficits. This is actually not the most effective way to help those of us with ADHD reliably and consistently do what we need to do. Here, learn why — and what to do instead.

[Take Our Executive Dysfunction Self-Test]

The Hard Truth About ADHD Executive Dysfunction

ADHD might as well be called Executive Function Deficit Disorder. It is fundamentally a disorder that impacts how we use the brain processes that help us perform day-to-day functions and work toward short- and long-term goals.

It’s not that individuals with ADHD necessarily have fewer or less effective executive functions. The problem is that executive functioning is applied inconsistently. We see this when we’re able to hyperfocus on tasks we find interesting yet find it downright painful to focus on what we find boring.

ADHD is a deficit in reliably converting intentions into actions. Your batting average on doing the right thing at the right time is a bit lower than the batting average of most people without ADHD. The question is, how can you improve your stats?

Building a library of executive function skills is not the answer. That’s because you already know how to use a planner to keep organized. You know that reminders are helpful for forgetfulness and time management. You know you should keep a to-do list. You know that you need to eliminate distractions to focus. The problem is with putting these skills to action.

[Read: The Adult ADHD Mind – Executive Function Connections]

Success comes from creating systems and backstops to support existing executive functions and take the strain off them. It’s about setting yourself up – with honesty, self-awareness, and intention – so that you can more reliably coordinate your abilities to make the better choice an easier one.

Strategies to Support Executive Functioning and Achieve Consistency

Externalize, Delegate, and Automate

Take the load off your executive functions by outsourcing the work to reliable tools.

• Externalize to-dos with intention. Whether it’s sticky notes on the bathroom mirror, planners, white boards, voice notes, texts to self, smart speakers, location-based reminders, or recurring alarms on your phone, find a way to dump it all out of your head so you don’t have to internally manage information.
• Set up automatic payments and purchases as necessary.
• Use AirTags and other trackers on your belongings. (Keep losing your keys? Consider installing a keypad or an electronic lock.)
• Use password managers to save logins for various accounts.
• Place clocks everywhere. Digital clocks are okay, but analog clocks may help you be more aware of the passage of time.

Your Environment Matters

Seek environments that allow you to perform at your best. Ask yourself: Where do I seriously do my best work? What keeps me on track?

Be as detailed and honest as possible in your answers, and don’t assume conventional approaches are best. Perhaps your productivity spikes when you work out of a bustling coffee shop. Or maybe it’s total silence you need, found at a corner of your office building or local library. Or you may be unusually productive while taking public transportation. Perhaps it’s variety you need if staying in one spot for too long becomes boring.

A note on clutter: A disorganized environment won’t do you any favors, but it may not be worth worrying about aesthetics if you’re still able to function and get things done in a full space.

Match Tasks to Brainpower

Our energy levels and ability to focus change through the day, so plan your most cognitively demanding tasks for when you have the most brain power. That may mean after a workout, in the morning before other tasks pile up, or in the evening once the day’s responsibilities are behind you. Plan to tackle demanding tasks when your ADHD medication is most effective, not when it’s wearing off.

Cut Down on “Noise” and Friction

Temptations and distractions compete for our attention 24/7. Our executive functions help keep us on track, but why make that harder than it has to be?

• Take willpower out of the equation. Why spend lots of energy resisting your phone when it would be much easier to silence notifications, install an Internet blocker, or keep the phone in another room?
• Think signal-to-noise ratio. Our attention is directed to what is big, loud, and obvious. Consider this as you boost the signal of desired tasks – where you want your attention to go – and reduce the noise of distractions.
• Would you bet $1,000 on it? Too often, we’re overly optimistic about our ability to handle distractions and muster the discipline to get things done. Cut through the false optimism by increasing what’s at stake: Would you bet money that you’ll be able to stay focused with your phone around? That you’ll be able to leave on time without setting (and honoring) reminders? What would it take for you to confidently make that bet?

Speed Up Consequences

We’re more likely to put off doing the things we need to do when the payoffs and consequences are vague, potentially avoidable, or too far off. It’s why we end up working on large and important school or work projects at the last possible minute, when consequences for failing to turn in work are front and center.

• Make potential regret come faster. Create artificial consequences that are immediate, certain, and specific enough to spur yourself into action. Take the initiative to schedule weekly check-ins with your boss to review progress on a large project. Externalize accountability by telling a friend about what you intend to do and by when.
• Create artificial circumstances. Set up a rule at home, for example, that phones can only be used after homework is completed.

Reduce Stress and Chaos

Chaos begets chaos. More things are likely to fall through the cracks with a disorganized, chaotic life. Trying to juggle it all and scrape by further burdens your executive functions. Reduce the chaos in your life by finding order wherever you can — with routines and healthy habits — to take the pressure off sensitive brain functions that are better used on cognitively demanding tasks. Intentionally build in breathing room to your daily schedule, especially during tricky transitions.

We can all agree that exercise, sleep, healthy eating, and mindfulness benefit cognitive and emotional processes, so don’t neglect these areas. Medication helps people with ADHD do what they know, so take medication as indicated.

Maintain Motivation by Enjoying the Journey

The central question that will follow you throughout your life as you manage ADHD is, “How will I do the things I know I want to do?” The answer lies in continuing to set up good processes that will help you experience more desired outcomes than negative ones. The more success and productivity you experience in managing ADHD’s impact on your life, the healthier your self-esteem will be.

• Make processes enjoyable. The benefits of making better choices — like reviewing your notes every day, dedicating time to keep your spaces organized, filing important documents, going to sleep on time, and attending to other responsibilities — often arrive far too gradually to fuel motivation. To the extent that you can, find ways to make these processes and routines fun and easy. Reward yourself along the way for putting one foot in front of the other.
• Don’t do it for anyone else. The processes you create are for your benefit only, not for anyone else’s seal of approval. The more you remember this, the easier it will be to seek changes that improve your life, without looking to the opinions of others as motivators.
• Always credit yourself for taking positive actions. Given how much criticism and correction those of us with ADHD receive, take pride whenever you make the right choices that set you up for success (or get you closer to it). Never sell yourself short, and don’t worry about achieving perfection.
• Setbacks are inevitable. Don’t beat yourself up or catastrophize when they happen. Handle them resiliently by refusing to surrender.

ADHD Executive Dysfunction: Next Steps

• Read: What Is Executive Function? 7 Deficits Tied to ADHD
• Read: Your Executive Functions Are Weak. Here’s Why.
• Read: Intention Deficit Disorder — Why ADHD Minds Struggle to Meet Goals with Action

The content for this article was derived from the ADDitude ADHD Experts webinar titled, “Executive Function Strategies to Externalize Time, Memory, Motivation” [Video Replay & Podcast #479] with Ari Tuckman, Psy.D., MBA, which was broadcast on November 9, 2023.

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“Executive function” is used frequently when explaining ADHD, but do you really know what this term means? Do you understand how ADHD fundamentally affects executive functions? Let’s start by getting clear on what executive functions are, what they aren’t, and which approaches are not considered executive functioning strategies.

The better you understand how executive functions operate, the better you will be able to design strategies that will help you get things done more reliably. A lot of this involves externalizing executive functions — creating better work environments, making important tasks or items stand out, pre-emptively reducing distractions, delegating certain tasks to better tools, making consequences quicker and more certain, and staying motivated by focusing on an effective process.

In this webinar, you will learn about:

• A more useful and sophisticated way of thinking about executive functions
• Why ADHD makes it harder to consistently convert intentions into actions
• The treatments and interventions that improve executive functions — and those that don’t
• How to tweak your environment, choose the right tools, set up the right blockers, consider consequences, and hold onto a resilient mindset

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.

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More on Executive Functions and ADHD

• Download: Is It Executive Function Disorder?
• Read: 7 Deficits Tied to ADHD
• Read: ADHD Minds Are Trapped in Now (& Other Time Management Truths)

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Meet the Expert Speaker

Ari Tuckman, Psy.D., MBA, is a psychologist who specializes in the diagnosis and treatment of ADHD. He is the author of More Attention, Less Deficit, and Understand Your Brain, Get More Done. (#CommissionsEarned) Dr. Tuckman also has a podcast about ADHD that has over six hundred episodes and more than 2 million downloads and speaks about succeeding with ADHD at CHADD each year. He is a former vice president of ADDA and practices in West Chester, Pennsylvania, where he works with adults and adolescents with attention challenges.

#CommissionsEarned As an Amazon Associate, ADDitude earns a commission from qualifying purchases made by ADDitude readers on the affiliate links we share. However, all products linked in the ADDitude Store have been independently selected by our editors and/or recommended by our readers. Prices are accurate and items in stock as of time of publication.

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Intention deficit disorder is not a real diagnosis but a term I used to describe what I believe is a central struggle of attention deficit hyperactivity disorder (ADHD): difficulty in accomplishing one’s goals.

Think of ADHD as a performance disorder. People with ADHD know what they need to do, but they struggle – greatly, at times – to transform intention into action, whether that’s preparing for a test or finalizing an important project at work. It’s an issue directly tied to the executive function difficulties inherent in ADHD. And yet, this very real challenge of ADHD is often mistaken for laziness and lack of motivation, which many breed low self-esteem and even depression.

Unpacking Intention Deficit Disorder: The ADHD Struggle to Perform

1. Executive Dysfunction Affects Behavior and Performance

The self-regulation problems inherent in ADHD stem from deficits in executive function, or the mental skills that allow us to initiate and carry out actions toward a future goal.

The executive system lives in the brain’s frontal lobe, and it is responsible for putting into action the knowledge that lives in the back of the brain. But ADHD separates these two parts of the brain like a meat cleaver.

In ADHD brains, intention and action are disconnected. This is why people with ADHD seem unlikely, unable, or unwilling to carry out behaviors that they know may be good for them. It is also why they are often unable to act effectively on what they know.

[Take This Self-Test: Executive Function Deficits]

2. Executive Dysfunction Muddles Time

Executive dysfunction also creates issues with time, timing, and timeliness of behavior. People with ADHD are often “time blind,” and they struggle to organize large, hierarchically sequenced behavior across time.

3. Intention Deficit Turns Everything Into a Crisis

As people with ADHD are nearsighted to time, they will often wait until the future is imminent to take action. That means that so long they perceive the future to be “out there,” an I-don’t-have-to-deal-with-it-yet outlook will prevail. Hence the almost universal experience of procrastination.

This far-away feeling of future events often means that people with ADHD are often only able to take action at the 11th hour, when time is all but running out. In a race to make a deadline, they may put things together in a slapdash manner. Or they may deliver high-quality work – at the cost of burnout and exhaustion.

The inability to organize and prioritize to the delayed future means that everything inevitably becomes a crisis with a too-near deadline.

[Read: 6 Secrets to Goal Setting with ADHD]

4. Intention Deficit Looks Like Laziness

Future-directed behavior is intentional behavior. When there’s often a sizable gap between intention and action, the term “intention deficit disorder” feels more accurate than “attention deficit hyperactivity disorder,” I think.

But those without ADHD often have very little patience for the short-sighted decisions of individuals with ADHD. They view these outcomes as avoidable, and attribute them to laziness, carelessness, poor time-management, lack of motivation, and moral failure instead of what it really is: executive dysfunction.

Intention Deficit Disorder: Turning Intention Into Action

Many people mistakenly believe that skill-building – in the form of time-management tips, self-motivation skills, etc. – will help people with ADHD bridge the gap between intention and action.

But in the field of neuropsychology, we know that the best way to treat a performance (i.e., executive) disorder is by targeting the point of performance, or the place and time across various settings of a person’s life where they are failing to act on what they know. Targeting the point of performance largely involves changing environments to facilitate performance. The following are key point-of-performance enhancements that work for people with ADHD:

1. Externalize time

Executive dysfunction renders internal cues unreliable, hence “time blindness” among people with ADHD. External representations of time — like calendars, white boards, visual timers (like the Time Timer), and other tools — may help guide behavior more reliably and effectively.

2. Bring the future to the present

If people with ADHD tend to wait until the future is imminent to act, then pushing the future back a few notches can help spur action. Dividing long-term goals into smaller, contiguous steps is one way to ensure constant action on an overall goal.

3. Ensure motivation along the way

Along with breaking up tasks into manageable chunks, people with ADHD will benefit from what I call motivational prostheses to sustain action toward a goal. The following are a few ideas:

• short breaks in between longer bursts of work
• body doubles, or accountability partners
• visualizing rewards and positive outcomes

Intention Deficit Disorder and ADHD: Next Steps

• Read: The Mystery of ADHD Motivation, Solved
• Read: ‘Procrastivity’ — Why the ADHD Brain Chooses the Less Important Task
• Read: Do You Shine Under Pressure? How to Manufacture a Sense of Urgency
• Listen: How to Turn Intentions Into Action

The content for this article was derived with permission from Dr. Russell Barkley’s lecture, “The Neuroanatomy of ADHD” delivered during the Centre for ADHD Awareness, Canada’s (CADDAC) annual ADHD Conference (2009).

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To improve any executive function, practice is critical. EFs need to be continually challenged — not just used — to see improvements. (That goes for both children and adults.)  However, EF training and practice alone will not achieve the best results. EFs blossom most when we lessen things that impair them (like stress or sadness) and enhance the things that support them (like joy or feelings of belonging).

Executive Functioning Skills: Overview and Activities

There are three core EFs.

1. Inhibitory Control

Inhibitory Control at the Level of Behavior

Inhibitory control of behavior is self-control or response inhibition – resisting temptations, thinking before speaking or acting, and curbing impulsivity. Discipline and perseverance – staying on task despite setbacks or boredom and delaying gratification — require inhibitory control.

Many children, especially those with ADHD or other conditions that impact executive functioning, may have insufficient inhibitory control and thus struggle to curb a behavior they know is wrong or unhelpful. Parents and others may incorrectly assume that this indicates “bad” behavior or a discipline problem when it simply indicates immature inhibitory control.

Inhibitory control of behavior (self-control) improves with activities like the following.

Activities That Improve Inhibitory Control of Behavior

• Games like Simon Says (great for all ages).
• Dramatic play acting (to practice inhibiting acting out of character).
• Playing music with others (to practice waiting until it’s your turn to play).
• Performing a comedic routine (to practice trying not to laugh at your own jokes).
• “Buddy reading,” where children pair up and take turns being the reader or listener. The listener receives a simple line drawing of an ear to help the child remember to listen and not speak. (This activity is part of the Tools of the Mind curriculum).

[Get This Free Download: A Guide to Building Foundational Executive Functions]

Inhibitory Control at the Level of Attention

Inhibitory control of attention is focused or selective attention. It’s the ability to resist distractions so you can focus, concentrate, and pay attention, and to sustain that focus even when the material is boring (sustained attention).

Activities That Improve Inhibitory Control of Attention

• Perhaps the quintessential activity for challenging inhibitory control of attention (selective attention) is singing in a round.
• Listening to stories read aloud should improve sustained attention as it requires listeners to work to keep their attention focused without visual aids, such as pictures on the page or puppets acting it out. We found that listening to storytelling improves sustained auditory attention more than does listening to story-reading where the illustrations are shared after each page is read.
• Activities that challenge balance as well as focused attention and concentration:
  • Walking on a log.
  • Walking on a line. Similar to walking on a log, this activity is as challenging for young children as walking on a log or balance beam is for adolescents and adults. To increase the challenge, children can try to do this while balancing with something on their heads or racing with an egg in a spoon.
  • Walking with a bell and trying not to have it make a sound can be a fun activity for a group of people of all ages. (It is also great for calming down.)
• Activities that challenge fine and gross motor skills as well as focused attention and concentration (It’s a general principle that motor development and cognitive development are fundamentally intertwined.³):
  • Household and kitchen chores such as pouring a liquid, spooning beans or peas, carrying a tray full of filled glasses, peeling a vegetable, threading a needle, sewing, etc.
  • Other ideas: beading, juggling, etc.

[Read: Executive Dysfunction, Explained!]

2. Working Memory

Working memory is the ability to hold information in the mind and to work or play with it. Just holding information in the mind without manipulating it is short-term memory; not working memory. Working memory enables us to:

• Mentally play with ideas and relate one idea to another
• Reflect on the past or consider the future
• Remember multi-step instructions and execute them in the proper order
• Remember a question you want to ask as you listen to the ongoing conversation
• Make sense of anything that unfolds over time, as this requires holding in mind what happened earlier and relating that to what’s happening now

Activities That Improve Working Memory

• Perform mental math, like calculating discounts or totals while shopping or calculating scores during a bowling match.
• Play a storytelling memory game in a group, where one person starts the story, the next person repeats what was said and adds to the story, and so on.
• Hearing stories may improve working memory, as it requires the listener’s working memory to remember all the story’s details and relate that to new information as the story unfolds without the help of visual aids. Storytelling has been found to improve vocabulary and recall in children more than does story-reading,⁴ which is important because vocabulary assessed at age 3 strongly predicts reading comprehension at 9-10 years of age.⁵
• Similarly, performing spoken-word or slam poetry should help working memory and attention.

A Note on Computerized Cognitive Training

CogMed® is the computerized method for training working memory with the most and the strongest evidence. But even CogMed® shows little or no transfer to any skill not practiced while doing CogMed® (even quite similar skills)⁶ and benefits are no longer evident two years later.⁷

3. Cognitive Flexibility

Cognitive flexibility includes the abilities to:

• See an issue or situation from different perspectives
• Think about something in a whole new way (“thinking outside the box”)
• Take advantage of a sudden opportunity
• Find a way to succeed despite unexpected problems or barriers
• Admit you were wrong after you receive new information
• Seamlessly adjust to change or the unexpected

Activities That Improve Cognitive Flexibility

• Engage in improvisational activities, like theater, jazz, and dance, which are unsurpassed for encouraging and nurturing creativity and adjusting on the fly.
• Play think-outside-the-box games. Come up with creative, unusual uses for everyday objects. You can eat at a table, for example, but you can also hide under it, use it as a percussion instrument, or cut it up for firewood – the list is endless.
• Find commonalities between everyday items and make a game of it. Example: How is a carrot like a cucumber? (Shape.) Like an orange? (Color.) Like a potato? (Both grow underground.)
• Teachers and parents: Invite children to help you solve a real problem that you are genuinely unsure how to solve. They’ll love the challenge and will feel great pride in helping an adult.

Examples of Activities That Improve All Executive Functions

• The arts (music, dance, theater, etc.)
• Sports, especially open-skill sports like soccer or basketball
• Traditional martial arts, which emphasize self-control, discipline, and character development. One study showed that children who practice taekwondo saw greater gains in all dimensions of EFs studied compared to children who took standard physical education classes.⁸ Our huge systematic review of all methods tried for improving executive functions found that mindful movement activities (like martial arts, qigong, and tai chi) show the very best results for improving EFs of all the different methods tried.⁹
• Wilderness survival
• Woodworking
• Cooking
• Caring for an animal or animals
• For younger children, social pretend play

Each of these activities requires planning, cognitive flexibility, perseverance, and creative problem-solving — indeed, all the EFs.

Note: Parents and teachers must draw very explicit analogies between these activities and academic subjects if they want to see skills transfer, as it is not always obvious to children that a skill used in one context applies to another.

Executive Functions: The Roles of Stress and Self-Esteem

State of mind impacts executive functioning skills more than most people realize. The best methods to improve EFs encourage participants to:

• believe in themselves and their ability to improve your EFs,
• relax (reduce the stress in their life or how stressed they feel about it), and
• increase the joy in their lives.

Stress and Executive Functions

Executive functions depend on prefrontal cortex (PFC), a part of the brain responsible for orchestrating thoughts and actions to align with internal goals.

When we are stressed, we can’t think clearly or exercise good self-control. One reason for that is that even mild stress floods PFC (but not the rest of the brain) with dopamine, essentially taking PFC offline. Stress also disrupts functional communication between PFC and other neural regions,¹⁰ such as the amygdala. The amygdala sends out alarm signals when it detects danger, real or perceived. It is PFC that calms down the amygdala when there is really no danger, or when the danger has passed. But when communication between PFC and the amygdala gets disrupted, PFC’s “calm down” signal to the amygdala doesn’t get through.¹¹ So the amygdala keeps firing and the person remains in a stressed, hyper-vigilant state.

Many of us were taught that people perform better on challenging cognitive tasks when they feel a bit on edge or are under a bit of pressure. The truth is that stress, even extremely mild stress, impairs the executive functions of most people.¹²

Strategies and Ideas to Reduce Stress

• Stable routines, predictability, consistency, and clarity about what is and is not permitted all reduce stress.
• Treat mistakes as a natural consequence of learning and stretching one’s abilities. A growth mindset instills confidence and teaches us to view failed attempts as learning opportunities.
• Self-compassion teaches us that we don’t have to be perfect.
• Ask for help. The western emphasis on self-reliance is wrong and destructive for our mental and physical health. Everyone needs help now and again.
• Exercise in almost any form acts as a stress reliever,^{13 14} as does being in nature.^{15 16}
• Movement-based mindfulness (like tai chi, and taekwondo)^{17 18 19} shows the best results for improving EFs over other methods, according to our comprehensive review.⁹
• Pets improve mood and reduce stress. Studies show that the presence of a dog in the classroom (whether in preschool, grade school, or university) or in the workplace reduces stress and improves attention and performance.^{20 21 22}

For Children

• Communicate loud and clear that you believe in that child and expect him or her to succeed. If we expect a child to succeed, that child often will, and if we expect a child to not do well, unfortunately the child often won’t. (Pygmalion effect.²³) Children often internalize our expectations of them, and their own expectations for themselves can become self-fulfilling prophecies.²⁴ What if we told children with ADHD, for example, that a particular test has been designed to be ADHD-friendly, and on this particular test, those with ADHD score as well or better than those without ADHD? Or, what if we told children that ADHD is an advantage for x, y, and z reasons and we know they’ll succeed in life?
• Assign responsibilities to make children feel important and show that you believe in them.
• Emphasize that everyone makes mistakes and that errors are part of learning and improving.
• Focus on strengths.
• Give do-able challenges. Pride, self-confidence, and joy come from succeeding at something difficult. Sports and other activities allow children to have the experience of repeatedly conquering challenges through effort and practice. It is critical important that the challenges be do-able, however.
• Be patient. Feeling rushed can contribute to stress. Give children time and space to figure out how to solve problems on their own.
• Overall, support your child’s emotional, social, spiritual, and physical well-being. All of these parts are fundamentally interrelated and affect one another.²⁵

How to Improve Executive Functions: Next Steps

• Free Download: Common Executive Function Challenges — and Solutions
• Self-Test: Could You Have an Executive Function Deficit?
• Read: It’s Easy to Hover Over a Child with Executive Function Deficits. Don’t.

The content of this article corresponds, in part, to the ADDitude ADHD Experts webinar titled, “Optimizing Executive Functions in Children and Adults with ADHD” [Video Replay & Podcast #383] by Adele Diamond, PhD, FRSC, FAPA, FAPS, FSEP, which was broadcast live on December 14, 2021.

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Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Sources

¹ Hendry, A., Jones, E. J. H., & Charman, T. (2016). Executive function in the first three years of life: Precursors, predictors and patterns. Developmental Review, 42, 1–33. https://doi.org/10.1016/j.dr.2016.06.005

² Alloway, T. P., & Alloway, R. G. (2010). Investigating the predictive roles of working memory and IQ in academic attainment. Journal of Experimental Child Psychology, 106(1), 20–29. https://doi.org/10.1016/j.jecp.2009.11.003

³ Diamond A. (2000). Close interrelation of motor development and cognitive development and of the cerebellum and prefrontal cortex. Child Development, 71(1), 44–56. https://doi.org/10.1111/1467-8624.00117

⁴ Gallets, M. (2005). Storytelling and story reading: A comparison of effects on children’s memory and story comprehension.” Electronic Theses and Dissertations. Paper 1023. https://dc.etsu.edu/etd/1023

⁵ Hart, B., & Risley, T. R. (1995). Meaningful differences in the everyday experience of young American children. Paul H Brookes Publishing.

⁶ Simons, D. J., Boot, W. R., Charness, N., Gathercole, S. E., Chabris, C. F., Hambrick, D. Z., & Stine-Morrow, E. A. L. (2016). Do “brain-training” programs work? Psychological Science in the Public Interest, 17, 103-186.

⁷Roberts et al. (2016). Academic outcomes 2 years after working memory training for children with low working memory: A randomized clinical trial. JAMA Pediatrics, 170(5), e154568. https://doi.org/10.1001/jamapediatrics.2015.4568

⁸ Lakes, K. D., & Hoyt, W. T. (2004). Promoting self-regulation through school-based martial arts training. Journal of Applied Developmental Psychology, 25(3), 283–302. https://doi.org/10.1016/j.appdev.2004.04.002

⁹ Diamond, A. & Ling, D. S. (2019). Review of the evidence on, and fundamental questions about, efforts to improve executive functions, including working memory. In J. Novick, M.F. Bunting, M.R. Dougherty & R. W. Engle (Eds.), Cognitive and working memory training: Perspectives from psychology, neuroscience, and human development (pp. 143-431). NYC, NY: Oxford University Press. ISBN:978-0199974467. Available for free download at: https://www.devcogneuro.com/Publications/Diamond_Ling_2020_efforts_to_improve_EFs_whole_chapter.pdf

¹⁰ Liston, C., McEwen, B. S., & Casey, B. J. (2009). Psychosocial stress reversibly disrupts prefrontal processing and attentional control. Proceedings of the National Academy of Sciences, 106, 912-917. doi:10.1073/pnas.0807041106

¹¹ Wei, J., Zhong, P., Qin, L., Tan, T., & Yan, Z. (2018). Chemicogenetic Restoration of the Prefrontal Cortex to Amygdala Pathway Ameliorates Stress-Induced Deficits. Cerebral Cortex, 28(6), 1980–1990. https://doi.org/10.1093/cercor/bhx104

¹² Zareyan, S., Zhang, H., Wang, J., Song, W., Hampson, E., Abbott, D., & Diamond, A. (2021). First Demonstration of Double Dissociation between COMT-Met158 and COMT-Val158 Cognitive Performance When Stressed and When Calmer. Cerebral Cortex, 31(3), 1411–1426. https://doi.org/10.1093/cercor/bhaa276

¹³Williamson et al. (2001). Mood change through physical exercise in nine- to ten-year-old children.Perceptual Motor Skills. 93(1), 311-316.

¹⁴ Herring, M. P., O’Connor, P. J., & Dishman, R. K. (2010). The effect of exercise training on anxiety symptoms among patients: A systematic review. Archives of Internal Medicine, 170(4), 321-331.

¹⁵ Faber Taylor, A., & Kuo, F. E. (2009). Children with attention deficits concentrate better after walk in the park. Journal of Attention Disorders, 12(5), 402-409. doi:10.1177/1087054708323000

¹⁶ Hartig, T., Mang, M., & Evans, G. W. (1991). Restorative effects of natural environment experiences. Environment and Behavior, 23(1), 3-26. doi:10.1177/0013916591231001

¹⁷ Gothe, N. P., Keswani, R. K., & McAuley, E. (2016). Yoga practice improves executive function by attenuating stress levels. Biological Psychology, 121, 109-116.

¹⁸ Wang et al. (2014). The effects of tai chi on depression, anxiety, and psychological well-being: A systematic review and meta-analysis. International Journal of Behavioral Medicine, 21(4), 605-617.

¹⁹ Wang, C. W., Chan, C. H., Ho, R. T., Chan, J. S., Ng, S. M., & Chan, C. L. (2014). Managing stress and anxiety through qigong exercise in healthy adults: a Systematic review and meta-analysis of randomized controlled trials. BMC Complementary and Alternative Medicine, 14, 8. https://doi.org/10.1186/1472-6882-14-8

²⁰ Barker, S. B. et al. (2016). A randomized cross-over exploratory study of the effect of visiting therapy dogs on college student stress before final exams. Anthrozoös, 29(1), 35–46. https://doi.org/10.1080/08927936.2015.1069988

²¹ Gee, N. R., Church, M. T., & Altobelli, C. L. (2010). Preschoolers make fewer errors on an object categorization task in the presence of a dog. Anthrozoös, 23, 223-230. https://doi.org/10.2752/175303710X12750451258896

²² Barker, R.T., Knisely, J.S., Barker, S.B., Cobb, R.K. and Schubert, C.M. (2012), Preliminary investigation of employee’s dog presence on stress and organizational perceptions. International Journal of Workplace Health Management, 5(1), 15-30. https://doi.org/10.1108/17538351211215366

²³ Rosenthal, R., & Jacobsen, L. (1968). Pygmalion in the classroom: Teacher expectation and pupils’ intellectual development. NY: Holt, Rinehart, & Winston.

²⁴ Good, C., Aronson, J., & Harder, J. (2008). Problems in the pipeline: Women’s achievement in high-level math courses. J of Applied Dev Psych, 29, 17-28

²⁵ Diamond A. (2007). Interrelated and interdependent. Developmental science, 10(1), 152–158. https://doi.org/10.1111/j.1467-7687.2007.00578.x

Hi MMRMom:

I’m thrilled to be answering your question as we spend a lot of time in our Order Out of Chaos community talking about executive age. Let me explain.

If your son has ADHD, then he also has executive functioning challenges. (If you need a crash course on EF, please check out either ADDitude’s many articles and resources or my website, orderoochaos.com.) And the challenges you describe above – disorganization, inability to activate on one’s own, even the “perception” of laziness – are all controlled by our executive functions.

[Get This Free Download: A Guide to Building Foundational Executive Functions]

“Executive age” refers to a person’s age based on how their brain is working. Individuals with executive functioning challenges are, on average, approximately 30 percent behind their peers in executive age. Though your son is 10 years old chronologically – and he might be 10 academically or athletically as well – if he is challenged with organization, activation, and weak memory, he is going to behave as a 7-year-old when performing tasks that require these skills.

How you support him and, more importantly, what you expect from him should be different than for a 10-year-old child without ADHD.

Now I know you mentioned that you know all the “tricks.” Therefore, I’ll just offer one piece of advice: Focus on your son’s brain and what he’s capable of instead of on his behavior. Helping your son strengthen his executive functions requires learning new behaviors, developing unique strategies, and practicing a great deal of patience. As his “coach,” you’ll want to help him identify his struggles so he can work to overcome them.

And I also invite you to check out one of my previous columns that dives into the perception of “lazy” behavior that is a warning sign that your child is feeling overwhelmed.

Good Luck.

Executive Age with ADHD: Next Steps

• Free Download: Common Executive Function Challenges — and Solutions
• Read: What Parents Misunderstand About Executive Function
• Read: Your Child Is Not Giving You a Hard Time. Your Child Is Having a Hard Time.

ADHD Family Coach Leslie Josel, of Order Out of Chaos, will answer questions from ADDitude readers about everything from paper clutter to disaster-zone bedrooms and from mastering to-do lists to arriving on time every time.

Submit your questions to the ADHD Family Coach here!

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To succeed in school, at work, and in life itself, your executive functions need to be sharp and working well. What are ‘executive functions,’ exactly? The abilities to reason and creatively problem-solve, to exercise self-control and resist temptations, to think before you speak or act, to stay focused and concentrate, and to exercise the flexibility to see things from different perspectives and adapt to change. The good news is that executive functions can be improved at any age.

Stress (even mild stress) seriously impairs executive functions. Mindfulness practices that involve movement (such as t’ai chi or taekwondo) have been especially successful in improving executive functions. School programs such as Tools of the Mind, MindUP, Montessori, and PATHs also help to optimize executive functions. Like mindful movement practices, they train and challenge diverse executive function skills and reduce stress in many ways.

Almost any activity improves executive functions if it challenges you, and you enjoy the activity enough to keep working at it and pushing yourself. The most successful programs involve more instructor-trainee interaction than offered by most computerized training.  Having a supportive mentor who firmly believes in you and the efficacy of the program, and who genuinely cares about you, is critical to the success of any program in improving executive functions.

Recommendations for children or adults with ADHD who want to optimize or improve their executive functions include:

• Commit to doing an activity you really love that requires, trains, and challenges executive functions – it could be a practicing traditional martial art, performing with a band, or pursuing photography, dance, orienteering, gardening, etc. – try to push yourself outside your comfort zone.
• Take steps to reduce stress in your life – for example, try to avoid stressful situations or defuse them, try to maintain a regular routine and put things in the same place so you can find them, follow a mindfulness or yoga practice, spend more time out in nature or with a pet, and remember that no one is perfect, so don’t be so hard on yourself.

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More on Executive Functions

• Free Download: Common Executive Function Challenges — and Solutions
• Self-Test: Could You Have an Executive Function Deficit?
• Self-Test: Could Your Child Have an Executive Function Deficit?

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Meet the Expert Speaker:

A leader in two fields, psychology and neuroscience, Adele Diamond, Ph.D., FRSC, helped pioneer a now flourishing interdisciplinary field called “developmental cognitive neuroscience.” As the Canada Research Chair Tier 1 Professor of Developmental Cognitive Neuroscience at the University of British Columbia, Dr. Diamond studies how executive functions can be modified by the environment, modulated by genetics and neurochemistry, derailed in disorders, and improved by effective programs and interventions. Her work has helped change medical practice for the treatment of PKU (phenylketonuria) and for the inattentive type of ADHD, and it has impacted early education worldwide.

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In families living with ADHD, parents tend to base their interactions and expectations on their child’s expressive language and cognitive abilities. They tend to think their child can make rational, mature decisions because of their ability to articulate themselves and make a compelling argument. They cannot.

The end result is that parents tend to get sucked into an argument, negotiation, or reasoning vortex because they are mistaking their child’s expressive language and cognitive abilities for maturity, and they are completing overlooking their child’s lagging executive functioning and emotional maturity. When they try to appeal to their child’s intellect, they get sucked into never-ending arguments.

Instead, aim to meet your child where they fall in terms of executive functioning and emotional maturity with the intention of helping them develop those skills that are often lagging in children with ADHD.

WATCH THE FULL VIDEO BELOW

Deficits in Social Maturity and Executive Function: Next Steps

• Find: Help for Socially Immature Kids with ADHD
• Answer: Is My Teen’s ‘Laziness’ Actually a Sign of Executive Dysfunction?
• Understand: Why Younger Friends May Be the Best Kind for Kids with ADHD

DO YOU HAVE A QUESTION FOR RYAN WEXELBLATT?
Ask your question about ADHD in boys here!

Ryan Wexelblatt, LCSW is the facilitator of the ADHD Dude Facebook Group and YouTube channel.

Executive functioning is a term used to describe the processes that happen in the pre-frontal cortex of the brain — its operating system. Anybody who has ADHD has lagging executive function skills. Sometimes it can appear that they do not if they are really motivated and learn how to compensate early, but essentially ADHD is lagging executive function skills.

A child with ADHD has a two- to three-year delay in their executive function skills, which means a 7-year-old has the executive function skills of a 4- or 5-year-old. A 13-year-old’s EF age is between 10 and 11, and a 19-year-old’s EF age is about 16. Would you send a 16-year-old off to college? That is something you need to take into consideration when planning for post-high-school options, for example.

Your expectations for your son or daughter need to match their EF age. To help them improve their executive function skills, change the way you use language and implement strategies to build skills and cultivate independence. The sooner you start this, the better.

Kids cannot improve their executive function skills on their own by watching a webinar or reading a book. Parents have to create the scaffolding and change the way they use language if they want to see improvement in their child’s EF skills.

[Free Download: Boost Your Teen’s Executive Functions]

Executive Function Deficits Common in Kids with ADHD

1. Difficulty with self-directed talk, or what I call a child’s ‘brain coach.’ We all have an internal dialog in our heads. When someone’s brain works with ADHD, the volume on this brain coach is turned down too low if it’s something that is not interesting to them.

2. Non-verbal working memory. Kids with ADHD have difficulty with future thinking skills, which is why it doesn’t work to say, “If you do all your chores this week, you can have extra video game time this weekend.” The time horizon is too far into the future for them, so the reward feels too abstract.

[Free Download: How Executive Dysfunctions Manifest at School]

If your child has ever done their homework but forgotten to hand it in, it’s because she didn’t visualize herself handing in the work. If your son just sits there in the morning and you have to guide him through each step of getting ready, it’s because he’s not visualizing himself doing that routine.

3. Sensing the passage of time. If your child ever lacks a sense of urgency or spends more time complaining about a chore than it would actually take to do the chore, that is because he has difficulty sensing the passage of time. Typical strategies like visual timers or checklists may keep a child on track, but it will not help them build stronger executive function skills.

4. Ability to sustain attention to non-preferred tasks or subjects. ADHD is not an inability to pay attention. When someone with ADHD finds something interesting, they can fully pay attention and even notice details that others don’t see. That can really help them in life, particularly when they find a career path that works for them. If your son ever starts yelling at you and gets really upset when you tell him it’s time to get off video games, that is not a behavior issue; it is an executive function — he wasn’t prepared for the transition from a preferred task to a non-preferred task.

Common Misperceptions of Executive Function Among Parents

1. Intelligence has nothing to do with executive functioning, so please don’t say things like “You’re so smart; why do you always forget to hand in your homework?” It’s also not helpful to say things like, “Think before you act,” because you’re asking your child to do something that their brain is not capable of doing yet.

2. Lagging executive function skills often appear behavioral in nature to the untrained eye. Counseling or talk therapy is not going to address lagging EF skills.

3. It’s natural for parents of kids with ADHD to act as their executive functioning, but this creates prompt-dependence, which means kids become over-dependent on their parents to act as their executive functioning rather than developing their own. The problem with this is that it can further delay the development of EF skills. Kids learn that, if they act helpless, things will be done for them.

It’s never too late for your son or daughter to improve their EF skills and develop independent. When kids realize their abilities and that they can do tasks independently, it builds their confidence.

WATCH THE FULL VIDEO BELOW

Executive Function and ADHD: Next Steps

• Self-Test: Signs of Executive Dysfunction in Kids
• Read: The Testing Ground for Executive Functions? Sixth Grade
• How to: Bridge Executive Function Gaps in Middle School

DO YOU HAVE A QUESTION FOR RYAN WEXELBLATT?
Ask your question about ADHD in boys here!

Ryan Wexelblatt, LCSW is the facilitator of the ADHD Dude Facebook Group and YouTube channel.

Sleep deprivation causes greater impairment in attentional regulation and emotional control among adults with subclinical ADHD symptoms than it does among those with low ADHD symptoms, according to a study published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.¹ “Subclinical” refers to symptoms of ADHD not severe, numerous, prevalent, or debilitating enough to merit a diagnosis, according to the DSM-5.

The study included 180 participants ages 17-45 without an ADHD diagnosis who were assessed for inattentiveness and emotional instability, and then randomly assigned to receive a night of normal sleep or total sleep deprivation. The subjects then performed a computerized Stroop task that measured executive function and emotional control.

Researchers found that sleep deprivation caused impairment on all tasks. Subjects with higher levels of baseline inattention demonstrated increased cognitive conflict reaction after sleep deprivation but not after normal sleep. This relationship persisted after controlling for baseline cognitive conflict reaction time and emotional instability. In other words, participants with symptoms of inattention were more vulnerable to sleep deprivation and exhibited greater executive function impairment than did those with low ADHD traits.

Researcher Predrag Petrovic, M.D., Ph.D., of the Karolinska Institute in Stockholm, Sweden, explained the importance of these findings: “We know that young people are getting much less sleep than they did just 10 years ago. If young people with high ADHD traits regularly get too little sleep, they will perform worse cognitively and, what’s more, their symptoms might even end up at a clinically significant level.”

Sources

¹Floros O, Axelsson J, Almeida R, et al. Vulnerability in executive functions to sleep deprivation is predicted by subclinical attention-deficit/hyperactivity disorder symptoms. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging. (Oct. 2020) https://www.sciencedirect.com/science/article/pii/S2451902220303086?via%3Dihub

An infant’s attentional behaviors can predict later symptoms of attention deficit hyperactivity disorder (ADHD or ADD). What’s more, non-social sensory attention in infants — actively exploring the sensory feaures of an environment — is significantly related to later ADHD symptom severity, according to findings from a recent study in the Journal of Attention Disorders.¹

Researchers analyzed data from First Year Inventory v. 2.0 (FYIv2.0) surveys completed by 229 parents when their children were 12 months old. The FYIv2.0 was considered in relation to parent-reported executive function (EF), and used to create the following three attention-based constructs representing social and nonsocial elements of infant attention that could help predict typical and atypical patterns of development:

• Responding to Social Attention (RSA)
• Initiating Social Attention (ISA)
• Nonsocial Sensory Attention (NSA)

When their children were 54 months old, the same parents completed reports of their children’s ADHD symptomatology and EF abilities. The “ADHD Rating Scale IV – Preschool Version” was used to measure ADHD symptomatology and the “Childhood Executive Functioning Inventory,” at 26-item parent report inventory, was used to measure executive function.

Researchers found that all three 12-month attention variables were significantly related to EF at 54 months. Non-social sensory attention (NSA) was the FYIv2.0 attention variable most consistently associated with later ADHD and EF behaviors. Researchers stated “this may be explained by the fact that the items in the NSA construct refer to behaviors that include visually examining, acting on or exploring nonsocial stimuli including objects, body parts, or sensory features of the nonsocial environment.” Additionally, a significant difference was found between boys and girls in parent reported EF, with girls rated significantly better in both working memory and inhibitory control.

These findings contribute to professional understanding of the longitudinal relationship between infant attention and symptoms of ADHD in toddlers. Additional research that explores associations using laboratory-based measures could better inform early intervention efforts.

Sources

¹Stephens, R. L., Elsayed, H. E., Reznick, J. S., Crais, E. R., & Watson, L. R. (2020). Infant Attentional behaviors Are Associated With ADHD Symptomatology and Executive Function in Early Childhood. Journal of Attention Disorders. https://doi.org/10.1177/1087054720945019

Executive functioning deficits persist well into adulthood for individuals with ADHD, according to a new study¹ in the Journal of Attention Disorders that affirms the clinical theory that executive dysfunction is a core symptom of attention deficit hyperactivity disorder.

The small Norwegian study looked at attentional processing capacities — namely pre-attentive and executive functioning — in a group of people with and without ADHD over a 23- to 25-year period. Pre-attentive processing — the basic, preliminary stage in the brain whereby auditive and visual stimuli is analyzed — is not as well understood in relation to ADHD as is executive functioning — the controlled brain processes (like working memory) that allow us to integrate information and select optimal actions — the researchers said.

These two processes, according to the researchers, exist on “contrasting ends of [the] ‘attentional processing continuum.’”  Because pre-attentive processing deficits may be precursors for brain function deficits of a higher order (like executive functioning), the study aimed to “gain insight into the long-term changes in attentional capacity” for “a clearer conception of attention dysfunction in ADHD.”

The participants, 19 male individuals with attention deficit hyperactivity disorder (ADHD or ADD) and 26 individuals without, were assessed in pre-attentive and executive functioning tasks. Researchers measured their responses to varying visual stimuli (backward masking task) and their ability to recall specific digit sequences while ignoring others (digit span distractibility test), respectively. The participants were given these assessments at three distinct points: once at around 14 years of age (study published in 1999)², 13 years later at the first follow-up (study published in 2010)³, and at another follow up (current study) 23 to 25 years after the initial assessment.

This third stage of the study found that, even two decades after their initial assessment, individuals with ADHD exhibit greater deficits in working memory than do participants without ADHD, “suggesting a continuation of this neuropsychological deficit,” part of the study reads. ADHD participants scored roughly 10 to 15 points lower (out of 100) on executive function measures compared to the non-ADHD participants.

The participants with ADHD did not display any deficits in pre-attentional measures compared to the individuals without ADHD; this was true for all stages of the study. The ADHD group, however, did see a significant drop in performance between the second and third stages of the study. This finding, according to the researchers, suggests that “age exerts an influence on pre-attentional performance, but only for the ADHD individuals.”

No significant association between executive attention and pre-attention measures was found at this stage, contradicting previous studies that suggest an interrelatedness between the two. The researchers say this finding suggests that lower-order brain processes do not necessarily determine executive dysfunctions in ADHD, and “implies that ADHD in adulthood is primarily characterized by an impaired top-down control (in which case working memory deficits are the primary problem).”

While the study’s strengths, according to the researchers, are reflected in its long follow-up time, its high participant retention rate, and its research into pre-attention, the study is limited by its small sample size and the fact that the ADHD group consists of only males, among other factors.

“Young adults with ADHD in their mid-20s continue to be afflicted with working memory/executive attention deficits in their mid-30s,” the researchers concluded, adding, “Overall, the results are in relative consonance with Barkley’s (1997)⁴ theoretical framework, suggesting executive functions as a core deficit in ADHD.”

Sources

¹ Torgalsbøen, B. et. al. (October 2019). Pre-attention and Working Memory in ADHD: A 25-Year Follow-Up Study. Journal of Attention Disorders. doi.org/10.1177/1087054719879491.

² Øie, M., Rund, B. R. (1999). Neuropsychological deficits in adolescent-onset schizophrenia compared with attention deficit. The American Journal of Psychiatry, 156, 1216-1222. doi:10.1176/ajp.156.8.1216

³ Øie, M., Sundet, K., Rund, B. R. (2010). Neurocognitive decline in early-onset schizophrenia compared with ADHD and normal controls: Evidence from a 13-year follow-up study. Schizophrenia Bulletin, 36, 557-565. doi:10.1093/schbul/sbn127

⁴ Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychological Bulletin, 121, 65-94.

A recent study in the Journal of Attention Disorders¹ has confirmed the validity of a well-known executive functioning rating scale commonly used, in part, to diagnose attention deficit hyperactivity disorder (ADHD or ADD) in children and adolescents.

The Barkley Deficits of Executive Functioning Scale – Children and Adolescents (#CommissionsEarned) (BDEFS-CA), a tool created by Russell Barkley, Ph.D., in 2012, was examined by researchers who found that the evaluation is effective in measuring executive function deficits, and an “excellent” screening device for ADHD. The researchers noted that the study, which involved 100 Canadian children between the ages of 8 and 14 with and without ADHD, was prompted by the lack of an independent review of the scale since its release. Dr. Barkley is a member of ADDitude’s ADHD Medical Review Panel.

To arrive at their findings, the researchers tested three core areas of the BDEFS-CA evaluation: the validity of its questions; how it measured up to existing, well-established tools; and how well it identified children with and without an ADHD diagnoses. Participants, for example, were given a test that closely resembles the BDEFS-CA. The evaluation itself, additionally, was compared to the Conners Comprehensive Behavior Rating Scales. A significant, positive correlation was found between the two evaluations.

Researchers said the results of their study also work to bolster a largely accepted yet controversial notion in the scientific community — that executive dysfunction is at the root of ADHD.

“The BDEFS-CA is effective as a screener for ADHD despite containing no explicit items regarding observable ADHD behaviors, showing that EF [executive function] scores alone differentiate children with and without ADHD,” part of the study reads.

The findings, furthermore, should be used to signal a shift in how ADHD is assessed and diagnosed, the researchers said.

“Clients would be better served by clinicians conceptualizing ADHD as a disorder of underdeveloped EF skills as opposed to solely being defined by symptoms of inattention and hyperactivity/impulsivity.” They added: “Conceptualizing ADHD as a disorder of EF may shift the common understanding of ADHD from being primarily a behavioral phenomenon to one that is neuropsychological in nature.”

Sources

¹ O’Brien, A. M., Kivisto, L. R., Deasley, S., & Casey, J. E. Executive Functioning Rating Scale as a Screening Tool for ADHD: Independent Validation of the BDEFS-CA. Journal of Attention Disorders. (2019) https://doi.org/10.1177/1087054719869834

#CommissionsEarned As an Amazon Associate, ADDitude earns a commission from qualifying purchases made by ADDitude readers on the affiliate links we share. However, all products linked in the ADDitude Store have been independently selected by our editors and/or recommended by our readers. Prices are accurate and items in stock as of time of publication

“ADHD is a cognitive disorder,” says Thomas Brown, Ph.D., “a developmental impairment of executive functions — the self-management system of the brain.”

This is a sentiment echoed by more and more experts in the ADHD community, including Mark Bertin, M.D., who says, “The most practical way to view ADHD, from my point of view, is as a developmental delay in executive function.”

Generally, executive functions are the cognitive or mental abilities that people need to actively pursue goals. They direct actions, control behavior, and motivate us to achieve our goals and prepare for future events. Executive functions help us plan projects, chart timelines, prioritize tasks, and hit deadlines.

Russell Barkley, Ph.D., who has been at the forefront of exploring the relationship between ADHD and executive dysfunction, says,”In my experience with ADHD, those with the condition have great difficulty using executive functions (self-directed actions) for self-regulation and attaining their goals. This is due to a delay in the development of, or an injury to, those brain networks that create EFs and self-regulation.”

“It is not that the individual does not know what to do. It is that somehow it does not get done.”

When executive functions fail, people have difficulty with:

1. Self-awareness
2. Inhibition
3. Non-verbal working memory
4. Verbal working memory
5. Emotional self-regulation
6. Self-motivation
7. Planning and problem solving

In this video, from his ADDitude webinar titled “ADHD Plus: Diagnosing and Treating Comorbid Conditions in Children,” Dr. Mark Bertin explains what executive dysfunction means for people with ADHD:

Learn More About Executive Dysfunction:

1. Take This Test: Could You Have an Executive Function Deficit?
2. Take This Test: Could Your Child Have an Executive Function Deficit?
3. Take This Test: Do You Have a Working Memory Deficit?
4. Take This Test: Does Your Child Have a Working Memory Deficit?
5. Quiz: Do You REALLY Know the Signs of an Executive Dysfunction?
6. Download Is It Executive Function Disorder?
7. Research Treatments for Executive Dysfunction
8. Read Executive Function Disorder, Explained!
9. Listen to “How ADHD Affects Executive Function in Adults and Kids” — an Expert Webinar with Russell Barkley, Ph.D.

Our brains comprise two systems: the automatic and the executive. The automatic system guides 80 to 90% of our activities every single day; the executive system guides the remaining 10 to 20% and requires purposeful, regulatory effort. As many with ADHD know, this system of executive functioning can be exhausting; it requires frequent mental pauses and ceaseless self-regulation.

Executive function is so taxing, in part, because it comprises seven distinct brain activities — two of which are verbal working memory and non-verbal working memory (which hinges on visual and spatial acumen). Both types of working memory influence the amount of effort and type of actions required to modify what our brains would do automatically. The stronger your working memory, the less work your brain must take on with each new challenge.

The importance of working memory is growing within the study ADHD, according to Dr. Russell Barkley, author and clinical professor of psychiatry at Virginia Commonwealth University Medical Center. He calls working memory your brain’s GPS — an essential system that guides and directs actions, and which is commonly weak in people with ADHD. Dr. Barkley explained this GPS theory in depth in a joint presentation with ADHD coach Jeff Copper during an Attention Talk Radio podcast earlier this year. During their talk, Barkley and Copper shared strategies for offloading working memory stresses in the ADHD brain.

How Working Memory Powers Executive Function

Like a GPS booting up for a new voyage, the brain begins any new task by referring to its maps — those sensory images logged and stored in non-verbal working memory, Barkley says. It next tunes in to its instructions, the verbal commands and “inner voice” stored in verbal working memory. The visual images of the non-verbal working memory help the brain to act, and the verbal working memory becomes its guidance system.

[Take This Test: Do You Have a Working Memory Deficit?]

When a brain is storing and synthesizing both types of working memory effectively, it begins to work a lot like Waze or Google Maps — determining the relevance of new information as it arrives and altering the plan in real time to get us to our destination better or faster. It becomes a more powerful tool for self-regulation, for goal-setting and for working around obstacles in our paths. But to an already overwhelmed brain, all of this working memory can be a lot to process. Because of that, Barkley suggests a strategy called “externalizing” that gets the information out of the brain and into an external environment by transforming both the sensory and the verbal working memory into a physical manifestation. This helps the brain to become less taxed.

Below, Barkley and Copper offer five strategies for strengthening your working memory and externalizing information so that your brain can effectively plan and coordinate tasks without expending the extra effort.

Digital isn’t always the best solution.

To lessen the burden on your working memory, begin by simply writing things down with pen and paper. Yes, your phone is often nearby, but using technology for all such memory tasks is “… misguided for ADHD in many ways,” Barkley says. Smart phones, tablets, and smart watches – which may be lost, drained of battery life, and not synced – may lead to more stress than they relieve. Instead, Barkley says, “Let’s go low tech. Let’s go back to paper and pencil.” Use an ADHD-friendly notebook as the external storage device for your working memory. Use imagery, not just language; make to-do lists; keep your schedule; make goals – but do it on paper.

When you do use tech, use it wisely.

For example, Copper suggests snapping a photo of the outfit you’ve laid out for an upcoming trip so that you can recall it quickly from your offloaded, externalized working memory – now in the form of a photo – while balancing other priorities during your trip.

[Click to Read: Is Your Disorganization Out of Control?]

Map it out.

Returning to the GPS metaphor, Barkley suggests creating a work (or mind) map. This works well for those who achieve better results with visual cues – particularly when working on longer written projects or reports. Creating an image of something can be easier and faster to retrieve because it can be instantly imagined. For example, sticky notes can make great low-tech systems, because they can be moved around as we think through an assignment, allowing for quick categorization, scheduling, detailing, and rearranging without expending more mental energy. Sometimes, a picture really is worth a thousand words.

Simplify your workspace.

When it comes to controlling distractibility and impulses, working memory is often fragile. Barkley recommends limiting your workspace to only what’s involved in the project at hand. He even suggests that some students and professionals benefit from using two computers – one with games, social media and the web, and one that is stripped down, for work only. A software application that blocks browsing is another tactic that can limit online distractions and keep projects – and working memory – on track.

Take time to discover what’s right for you.

We can’t all commit to the same systems and expect powerful, individualized results – one size does not fit all. According to Barkley, research shows that, in the average ADHD brain, verbal working memory is twice as strong as visual working memory. For some, however, this isn’t the case. Artists, architects, and others who are visually inclined generally find that the opposite is true. (Some even find that their tactile, auditory, and olfactory senses may be harnessed to lighten the load on working memory.)

[Free Expert Download Available: Unraveling the Mysteries of Your ADHD Brain]

Like those with attention deficit hyperactivity disorder (ADHD or ADD), people with executive dysfunctions often experience time blindness, or an inability to plan for and keep in mind future events that aren’t in the near-term. They also have difficulty stringing together actions to meet long-term goals. This is not an attention problem in the present tense, but rather a sustained attention problem.

[Related Self-Test: ADHD in Adults]

When a person has weak executive functions in certain areas, he or she may have trouble analyzing, planning, organizing, scheduling, and completing tasks. People with executive dysfunction and/or commonly lack the ability to handle frustration, start and finish tasks, recall and follow multi-step directions, stay on track, self monitor, and balance tasks (like sports and academic demands). Remediating the area of deficit reduces academic or work difficulties. If this sounds familiar, take this self-test.

This self-test is designed to determine whether you show signs of executive dysfunction. If you have concerns about executive dysfunction, see a health professional for a thorough evaluation. This self-test is for personal use only.

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Executive Dysfunction in Adults: Next Steps

1. Take This Test: ADHD Symptoms in Adults
2. Take This Test: Do You Have a Working Memory Deficit?
3. Research Treatments for Executive Dysfunction
4. Read Executive Dysfunction, Explained!
5. Take This Test: Do You Have Emotional Hyperarousal?
6. Download Is It Executive Function Disorder?
7. Find: ADHD Specialists or Clinics Near You