What Executive Functioning Actually Is: Understanding the Lens of ADHD
By: Madison Martinez, LCSW
ADHD. It’s a term you’ve probably heard many times. Maybe at school, work, social media, a doctors office, or in passing. ADHD stands for Attention-Deficit/Hyperactivity Disorder, and when most people hear the term, they immediately think about difficulties paying attention or not being able to sit still. While this is true in some cases, for many children, teens, and adults with ADHD the real struggle is in executive functioning.
In short, “Executive functioning helps us to problem solve, organize tasks, pay attention, make decisions, manage time, exhibit self-restraint and use our working memory,” (Cahill, 2019). While many individuals with ADHD struggle with executive functioning skills, they can sometimes be labeled as being too lazy, not caring, being defiant, having no motivation, or not trying hard enough. Deficits in executive functioning make everyday tasks feel extremely overwhelming to individuals, even when they want to do said task.
To break down what executive functioning is, we’ll be referring to the ‘Brown Model of Executive Functions Impaired in ADHD’ (Brown, 2013). In this model, there are 6 clusters that all work together to help manage everyday life tasks.
Cluster #1- Activation: This looks like the ability to organize, prioritize, estimate time, and begin work.
Have you ever told your child to “Go clean your room,” or given yourself a mental reminder to “Fold the laundry,” and watched them struggle to begin, or find yourself struggling to start? When referring to ADHD, the brain may be struggling to organize the steps, prioritize what comes first, or activate enough mental energy to begin. Here are a couple helpful support ideas to prevent overwhelm next time a task needs to get done:
-Break tasks into very small steps (Go pick up 5 pieces of trash, now go pick up 5 toys, fold all the pants or do all the blue items etc.)
-Use a visual checklist
-Try starting the first step with someone in the room
Cluster #2- Focus: This looks like the ability to focus, sustaining focus, and shift focus to tasks.
Can you recall a conversation with your kid asking them “Look at me please,” “My eyes are up here,” or even with an adult saying “Get off your phone I’m trying to talk to you”? This may be happening because individuals with ADHD struggle to regulate their attention consistently. They may do said request for 1-2 minutes and then you may be reminding them again and again. This is because their brain is seeking stimulation or high interest. Communication topics or tasks without those can feel mentally exhausting. Here are a couple of helpful support ideas to increase focus ability:
-Add movement breaks into tasks
-Use timers or short work intervals
-Make tasks more interactive/engaging by using funny voices, being characters, or incorporating a game/challenge.
Cluster #3- Effort: This looks like the ability to regulate alertness, sustain effort, and processing speed.
Have you ever been in a social situation where your social battery seems to be going down a lot quicker than everyone else's? Or have you ever noticed one child may complete tasks quicker than another child, both of whom exhibit different behaviors after? That’s because an individual's brain with ADHD is using substantially more energy to maintain their attention, regulate impulses, and stay organized throughout their day. Here are a couple of helpful support ideas to support effort ability:
-Incorporate rest or decompression time into your day
-Avoid over scheduling
Cluster #4- Emotion: This looks like the ability to manage frustration and modulate emotions.
ADHD strongly affects emotional regulation; emotions may feel bigger and harder to manage. This looks like explosive reactions to small problems, crying easily, sensitivity to criticism, or difficulty calming down once upset. What’s actually happening is their nervous system has become too overwhelmed making it difficult to regulate. Here are a couple of helpful support ideas to help regulate emotions:
-Connection before correction (make sure you have a good relationship with the person before focusing on the problem)
-Stay calm during escalation (tone of voice, facial expressions, body language)
-Validate emotions/experience without reinforcing behaviors.
Cluster #5- Memory: This looks like the ability to utilize the working memory and access recall.
Individuals with ADHD often have a hard time holding information in their minds long enough to use it. This looks like forgetting quickly, losing track of time and belongings, forgetting to do homework, chores, deadlines, or important events or constantly repeating the same question. What’s actually going on is their brains are struggling to hold and manage the information they’re receiving long enough to complete the task. Here are a couple of helpful support ideas to increase memory recall:
-Use visual reminders
-Write things down as a list
-Create consistent routines and systems
Cluster #6- Action: Lastly, this looks like the ability to monitor and regulate self-action.
Individuals with ADHD often struggle with impulse control and pausing before saying or doing. This looks like blurting out, interrupting others, making impulsive decisions, or acting before thinking. This happens because their brain is struggling with slowing down enough before reacting. Here are a couple of helpful support ideas to increase action skills:
-Use a model such as stop, think, and do
-Use calm redirection when impulsive behaviors show up
-Keep expectations realistic for development and age
ADHD is more than struggling with attention, not having motivation, or your child choosing to be difficult. It is much deeper than that. It affects the brain's ability to manage everyday tasks, their emotions, and their energy. Next time you notice someone with ADHD struggling, we challenge you to ask, “What support might help them and their brain succeed,”? This question shift is extremely important because that individual isn’t lacking effort, they are often working twice as hard just to keep up. In addition, if you find that you’re having trouble finding ways to support yourself or a loved one with these struggles, please reach out to us at Become You Therapy. We’d love to help support you on your journey.
Resources: ADHD in Teens and Youngadults: A mindfulness workbook to keep you anchored by Melissa Springstead Cahill, PsyD (Book)
The Brown Model of Executive Function Impairments in ADHD (website)
