ADHD/Executive Dysfunction

Attention Deficit/Hyperactivity Disorder (ADHD) is a developmental disorder characterized by an ongoing pattern of inattention, hyperactivity, and/or impulsivity that interferes with functioning at home and at school. ADHD is quite common, and survey studies suggest that approximately 5% of children have ADHD.

There are three subtypes of ADHD:

  • Predominantly inattentive presentation

  • Predominantly hyperactive/impulsive presentation

  • Combined presentation

Inattention manifests as mind wandering, lacking persistence, difficulty sustaining focus and disorganization. Hyperactivity manifests as excessive motor activity, fidgeting, and talkativeness. Impulsivity manifests as hastiness, risk-taking, taking action without forethought, seeking immediate rewards, inability to delay gratification, social intrusiveness, and making important decisions without consideration of long-term consequences.

Though ADHD may continue into adulthood, the disorder begins in childhood, and several symptoms must have been present before age 12 to qualify for a diagnosis. Also, manifestations of the disorder must be present in more than one setting (e.g. difficulties present at school and at home).

Individuals with ADHD frequently have deficits in executive functioning. Executive functioning is a set of mental skills that help you get things done. Some important executive functioning skills are:

  • Organizing

  • Planning

  • Initiating tasks

  • Staying focused

  • Regulating emotions

  • Keeping track of what you’re doing

ADHD may be mild enough that there are no more than minor impairments in functioning or severe enough that there is marked impairment in functioning. Regardless of severity, however, ADHD must be treated. Individuals with untreated ADHD frequently have co-occurring language, motor, and social delays; low frustration tolerance and irritability; impaired academic and work performance; and co-morbid mood, conduct, and/or substance use disorders.