Executive Functions Impaired in ADD/ADHD

TiredSoul

Warrior Mom since 2007
I think this is a good diagram/explanation of the deficits one can have with AD/HD. I plan to share it with Bubby's teachers.




Activation: organizing tasks and materials, estimating time, prioritizing tasks, and getting started on work tasks. Patients with ADD describe chronic difficulty with excessive procrastination. Often they will put off getting started on a task, even a task they recognize as very important to them, until the very last minute. It is as though they cannot get themselves started until the point where they perceive the task as an acute emergency.

Focus: focusing, sustaining focus, and shifting focus to tasks. Some describe their difficulty in sustaining focus as similar to trying to listen to the car radio when you drive too far away from the station and the signal begins fading in and out: you get some of it and lose some of it. They say they are distracted easily not only by things that are going on around them, but also by thoughts in their own minds. In addition, focus on reading poses difficulties for many. Words are generally understood as they are read, but often have to be read over and over again in order for the meaning to be fully grasped and remembered.

Effort: regulating alertness, sustaining effort, and processing speed. Many with ADHD report they can perform short-term projects well, but have much more difficulty with sustained effort over longer periods of time. They also find it difficult to complete tasks on time, especially when required to do expository writing. Many also experience chronic difficulty regulating sleep and alertness. Often they stay up too late because they can’t shut their head off. Once asleep, they often sleep like dead people and have a big problem getting up in the morning.

Emotion: managing frustration and modulating emotions. Although DSM-IV does not recognize any symptoms related to the management of emotion as an aspect of ADHD, many with this disorder describe chronic difficulties managing frustration, anger, worry, disappointment, desire, and other emotions. They speak as though these emotions, when experienced, take over their thinking as a computer virus invades a computer, making it impossible for them give attention to anything else. They find it very difficult to get the emotion into perspective, to put it to the back of their mind, and to get on with what they need to do.

Memory: utilizing working memory and accessing recall. Very often, people with ADHD will report that they have adequate or exceptional memory for things that happened long ago, but great difficulty in being able to remember where they just put something, what someone just said to them, or what they were about to say. They may describe difficulty holding one or several things “on line” while attending to other tasks. In addition, persons with ADHD often complain that they cannot pull out of memory information they have learned when they need it.

Action: monitoring and regulating self-action. Many persons with ADHD, even those without problems of hyperactive behavior, report chronic problems in regulating their actions. They often are too impulsive in what they say or do, and in the way they think, jumping too quickly to inaccurate conclusions. Persons with ADHD also report problems in monitoring the context in which they are interacting. They fail to notice when other people are puzzled, or hurt or annoyed by what they have just said or done and thus fail to modify their behavior in response to specific circumstances. Often they also report chronic difficulty in regulating the pace of their actions, in slowing self and/or speeding up as needed for specific tasks.

http://www.drthomasebrown.com/add-adhd-model/
 

ForeverSpring

Well-Known Member
I read this too a long time ago. It is also the same with Autism Spectrum Disorders (ASD), which I feel are closely related.

Part of my problems are there because of poor executive function.
 

TiredSoul

Warrior Mom since 2007
The more I look at Executive Functioning Disorder, the more it fits Bubby. ADHD does not describe the picture accurately enough. This site has some good info too:

http://learningworksforkids.com/executive-dysfunctions/

Diagnosis: Attention Deficit Hyperactivity Disorder

Impaired executive skills:

Sustained attention " has difficulty attending in the presence of distractions; has problems sustaining attention and effort levels while engaged in tasks
Working memory " has difficulty following multi-step directions; has problems remembering what he/she has read
Response inhibition " has difficulty thinking before acting
Time management " may waste time or rush through tasks, thus executing them inefficiently and ineffectively

Diagnosis: Executive Functioning Disorder


Impaired executive skills:

Task initiation " has difficulty knowing how to get started on a task and sustaining the attention and effort levels needed to complete the task
Planning " has difficulty identifying and employing strategies and systematic approaches in order to reach a goal
Working memory " has difficulty keeping things in mind and controlling attention while engaged in an activity
Organization " has difficulty organizing objects, ideas, and possessions
Flexibility " has the tendency to be rigid and to not learn from mistakes
Regulation of affect " struggles to manage feelings, actions, and frustrations
Time management " lacks efficiency in starting and completing tasks
Social thinking " has difficulty understanding his/her motivations and the thoughts and feelings of others

Diagnosis: Asperger's Disorder

Impaired executive skills:

Social thinking " struggles to understand social cues and lacks social-communication skills
Flexibility " may be rigid with regard to his/her interests; struggles with changing routines
Planning " may have difficulty thinking about all the different sides of a situation or determining where to devote his/her energy and effort

Diagnosis: Pervasive Developmental Disorder not otherwise specified

Impaired executive skills:

Social thinking " struggles to understand social cues and lacks social-communication skills
Flexibility - may be rigid with regard to his/her interests; struggles with changing routines
Planning " may have difficulty thinking about all the different sides of a situation or determining where to devote his/her energy and effort

Diagnosis: Autism

Impaired executive skills:

Social thinking - struggles to understand social cues and lacks social-communication skills
Flexibility - may be rigid with regard to his/her interests; struggles with changing routines
Planning " may have difficulty thinking about all the different sides of a situation or determining where to devote his/her energy and effort

Diagnosis: Dyslexia

Impaired executive skills:

Working memory " may struggle to keep phonemes (letter sounds) in mind when decoding/sounding out words
Working memory " may struggle to keep in mind the meaning of previous sentences in order to attain/enhance reading comprehension
Organization " may struggle to keep ideas in mind in order to understand a paragraph, story, or book
Time management " may struggle with fluency and pace while reading, causing comprehension difficulties and other issues
Sustained attention " may have difficulty sustaining the attention and effort levels necessary to support the constant practice that struggling readers require

Diagnosis: Dysgraphia

Impaired executive skills:

Time management " struggles with writing fluency and experiences difficulty due to the length of time that it takes to engage in producing written language
Organization " may struggle with organizing ideas for written materials; may have good ideas but cannot put them together in a meaningful fashion
Planning " may struggle to connect ideas in written form
Working memory " may have difficulty holding ideas in the mind while in the process of writing them down
Task persistence " may struggle to sustain the attention and effort levels necessary to complete tasks that are difficult for him/her

Diagnosis: Nonverbal Learning Disability

Impaired executive skills:

Social thinking " struggles to understand social cues and lacks social-communication skills
Flexibility - may be rigid with regard to his/her interests; struggles with changing routines
Planning " may have difficulty thinking about all the different sides of a situation or determining where to devote his/her energy and effort

Diagnosis: Social Skills Deficits

Impaired executive skills:

Metacognition " has difficulty understanding the impact of his/her behavior on others
Social thinking " may experience difficulty in observing nonverbal and social cues
Flexibility " may struggle to adapt to new or unexpected changes in social settings

Diagnosis: Anxiety

Impaired executive skills:

Regulation of affect " may struggle to manage feelings of fear, worry, and tension
Flexibility " may be rigid and experience the need to have control in situations in order to reduce tension
Task initiation " has difficulty knowing how to get started on a task; becomes concerned with whether or not he/she is doing it correctly

Diagnosis: Depression

Impaired executive skills:

Regulation of affect " struggles to manage sad and pessimistic feelings
Regulation of affect " may have difficulty managing negative self-thoughts
Metacognition " may struggle to accurately estimate his/her abilities, often underestimating him/herself
Task initiation " may struggle to get him/herself started on and energized to complete uninspiring tasks

Diagnosis: Oppositional Defiant Disorder

Impaired executive skills:

Response inhibition " may act before thinking and engage in defiant behavior
Flexibility " may be rigid with regard to his/her expectations and oppositional when things do not go the way that he/she expects them to
Regulation of affect " may easily anger with little cause/provocation

Diagnosis: Conduct Disorder

Impaired executive skills:

Response inhibition " may disregard the rights of others
Response inhibition " may act out in a violent or aggressive fashion
Flexibility " may be rigid with regard to his/her expectations and oppositional when things do not go the way that he/she expects them to
 

ForeverSpring

Well-Known Member
You bet, Jules. People in all the issues you named, with executive functioning being a factor, tend to have problems regulating their emotions, controlling impulses and with social skills. I have never been able to be pinned down exactly, but for sure I have a NonVerbal Learning Disorder (NVLD). And that causes many problems typical of Aspergers and that includes executive function problems. Can't tell you how hard it was to learn how to control my emotions, slow down my impulses and I still have problems with social skills. I think some typical parents with differently wired kids can't understand how hard it is for their kids to act "normal." I know everyone tries to understand their children. But, man, it's harder than anyone who doesn't have this problem to imagine and it takes A LOT of hard work to learn what others know instinctively.

I am thinking that maybe the big umbrella issue is really Executive Function Disorder!! :) Thanks for the interesting info, Jules.
 

InsaneCdn

Well-Known Member
For those dxes listed that note "social thinking", you will notice that the specific social impairment is different. That may be a key clue... OR, it may be that as our kids get older, some social impairments become more obvious.

Executive Function Disorder can also be the result of Traumatic Brain Injury (TBI)... it isn't necessarily "built in". It is one of the very common cross-diagnosis problems, and can stand on it's own. Just like Developmental Coordination Disorder (DCD), for example - another developmental issue, which in this case affects motor function. Remember that ALL of these dxes are just lines in the sand - some group of people agreed that this is where the line should be drawn for diagnosis A vs diagnosis B. In real life... there are many commonalities between all developmental challenges.
 

shellyd67

Active Member
Thanks for posting this Jules. I just printed it out to reference for my next meetings with difficult child's teachers.
 
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