What is Executive Function - How it Relates to ADHD

Dr. Tracey Marks introduces executive functioning, a crucial set of cognitive skills. She emphasizes its relevance to ADHD, explaining that ADHD can be viewed as a disorder of executive functioning. The skills include planning, organizing, prioritizing, initiating actions, self-inhibition, self-monitoring, shifting attention, and working memory.

This skill involves global planning, anticipating task duration and effort, and thinking through multi-step processes. Difficulties in this area can lead to unpreparedness, poor time management, and focusing on trivial tasks while neglecting important ones.

Initiating actions refers to the ability to start tasks. Trouble here manifests as procrastination, a block to getting started even when aware of deadlines. Individuals may need external pressure to begin, unlike those who are self-motivated to complete tasks early to avoid stress.

Self-inhibition is impulse control, the ability to pause automatic responses and consider consequences, preventing actions like interrupting or making snap judgments. Self-monitoring is evaluating one's behavior against expectations. Impairments can lead to unawareness of one's impact on others, difficulty accepting feedback, and a repeated pattern of issues like chronic lateness.

Cognitive flexibility allows shifting attention and adapting to change; difficulties result in rigid thinking or trouble multitasking. Working memory is the ability to hold and process recent information for problem-solving and decision-making. Inadequate working memory can impair analytical thinking and prevent appropriate behavioral adjustments due to an inability to recall past patterns.

Executive functions are controlled by the frontal lobes, basal ganglia, and prefrontal cortex, where stimulant medications for ADHD act. Various conditions like depression, traumatic brain injury, alcohol consumption, and strokes can impair these functions. ADHD significantly affects executive functioning, and while medications help, many still face challenges, which cognitive-behavioral therapy can address.