What's the relationship between ADHD and executive functioning?
What's the relationship between ADHD and executive functioning?
ADHD is a common childhood mental health disorder, occurring in approximately 9% of school-aged children in the United States. It is a neurodevelopmental disorder and typically lasts into adulthood. There are three subtypes of ADHD: inattentive, hyperactive-impulsive, and combined.
In some ways, the relationship between ADHD and executive functioning is simple to identify: executive functioning is a part of the diagnostic criteria for ADHD, isn’t it?
As a reminder, executive functions can be grouped under inhibition (behavioral inhibition, selective attention, and cognitive inhibition), working memory, and cognitive flexibility. From these, the higher-order EF processes of problem-solving and planning develop. Below we’ll discuss how different challenges typical of ADHD directly relate to specific executive functioning skills.
Diagnostic criteria of ADHD and relationship to executive functioning
Children who have a predominantly Inattentive ADHD presentation may demonstrate difficulty organizing or finishing a task [planning], paying attention to details [selective attention], or losing and/or misplacing items needed to complete activities or tasks [planning]. They are likely to be described as “distractible” or “a daydreamer” [inhibition] and may forget details of daily routines [working memory].
A child who has a diagnosis of ADHD predominantly Hyperactive-Impulsive is likely to be described as “fidgety” or “always on the move.” They may frequently appear restless and have trouble with impulsivity [inhibition], which can result in interrupting others, grabbing things from others, or speaking at inappropriate times [cognitive flexibility]. Waiting their turn or listening to directions is often difficult for them.
Someone with a diagnosis of Combined Subtype will present with a similar mixture of symptoms from the former two subtypes.
Overall, students with ADHD exhibit more impaired performance on executive functioning measures compared to students without ADHD.
Research shows the resulting difficulty with organization and planning has a negative impact on school grades.
Why do these executive functioning deficits impact academics and behaviors?
Working memory has been identified as a core deficit of ADHD. Working memory is the temporary storage and manipulation of information while performing tasks. It is theorized that working memory impacts inhibition, because we have to hold the stimuli in our working memory before a response can be inhibited. Working memory also impacts learning and the acquisition of academic skills. Working memory is significantly worse in children with ADHD compared to children with ADHD.
Academic examples of this include holding calculations in your head while solving multi-step equations or retaining and organizing multiple topical facts while creating an argument for your paper.
Inattention and inhibition are inter-related and challenges in these areas impact organization and planning. Inhibition is the brain’s capacity to restrain or regulate strong or automatic attentional or behavioral responses. Another way to think of this is “putting on the breaks” or being able to “pause” your brain before acting. Research shows the resulting difficulty with organization and planning has a negative impact on school grades.
Some common challenges associated with ADHD include academic difficulties such as lower grades and lower scores on achievement tests and greater likelihood of grade retention, problem-solving or special education services, and school dropout. There is a high comorbidity rate with learning disorders, up to 25% of students with ADHD having received both diagnoses. Regardless of comorbid diagnoses, students with ADHD alone also demonstrate negative effects on academic and behavioral performance.
Post-high school, as they move into post-secondary schooling, training, or work, they will be in environments that are potentially drastically different from high school: there won’t be a teacher checking in on them reminding them of due dates and parental monitoring has (and should have) reduced significantly. This can put persons with ADHD at risk for not doing as well academically or in the workforce, as well as at greater risk for other types of risk-taking behaviors due to challenges in impulsivity and inhibition.
How to help your child
Knowing the deficits associated with ADHD and its impacts on executive functioning skills, early intervention and support will help your child to perform their best academically and ultimately, in life.
Students can learn strategies to accommodate their working memory and inattention. Research shows that practice is effective in improving executive functioning skills, alongside building self-knowledge and self-advocacy.
Through executive functioning coaching, Chicago Home Tutor can provide your student with support that will help them beyond the classroom: learning time management, organization tools, study strategies, and how to improve focus while still school-age will help them be successful in whatever path they choose as an adult.
For more reading, read about our executive functioning assessment, free apps to support executive functioning skills, or our article on how you know if your child needs an executive functioning coach.
About the author:
Tulin S. Akin is a certified school psychologist who has been working as a tutor and Executive Function coach with Chicago Home Tutor since 2015. Prior to CHT, she worked in public schools (elementary and high school) for eight years, after getting her specialist degree in school psychology for Illinois State University. Her articles are based on reviews of current research literature, texts for practitioners, and hands-on supports for students through college age.
