So, just what do we know about ADHD and Executive Function?
"What" you see when you observe a child with ADHD are symptoms. That we can label them as "fidgety" or "impulsive" or "inattentive" only tells us what we are observing. What is more critical to providing successful supports is understanding "why" these symptoms are occurring. These symptoms are occurring because executive functions have not yet matured. |
|
Points to ponder:
If ADHD is a disorder of self-regulation, not a disorder of inattentiveness, how does it change how we think about it? |
The development of executive functions is part of normal brain maturation. As brains develop, executive functions come online. But for students with ADHD brains, the development and maturation of the brain is delayed. Russell Barkley suggests we think of children with ADHD functioning like children 3 to 5 years younger than their chronological age. They are developing executive function skills, just not as quickly as typical peers.
What does this mean?
So, say you are having an issue because Jason, a 4th grader, is not remembering to turn in his homework. All the other fourth graders do it on their own. What's up with Jason? Subtract three, four, or five years, and think again about Jason as a student with first grade (or lower) level skills in remembering to turn in his homework.
|
It might be that Jason needs that same type of environmental accommodation in fourth grade as a first grader needs. He needs this because his EF skills are delayed because of his diagnosis of ADHD. This is much like when a student with visual impairments needs larger font in order to be successful. See? Accommodations are critical for students with ADHD to experience success!
I've spent some time looking at executive function from the point of view of Russell Barkley. But other experts explain executive functioning differently. Dr. Thomas Brown suggests that cognitive difficulties: the syndrome of executive function impairments, are the core of ADHD. His categories are:
1. Activation: organizing, prioritizing, and activating to work
2. Focus: focusing, sustaining, and shifting attention to work
3. Effort: regulating alertness, sustaining effort, and processing speed
4. Emotion: Managing frustration and modulating emotions
5. Memory: Utilizing working memory and accessing recall
6. Action: Monitoring and self-regulating action
1. Activation: organizing, prioritizing, and activating to work
2. Focus: focusing, sustaining, and shifting attention to work
3. Effort: regulating alertness, sustaining effort, and processing speed
4. Emotion: Managing frustration and modulating emotions
5. Memory: Utilizing working memory and accessing recall
6. Action: Monitoring and self-regulating action
Want to take a side trip?
If, like me, you enjoy "experts" arguing their theories, click the button over to the right to read an article written by Dr. Brown.
|
Enjoy an excerpt from Thomas Brown's book on ADHD. He addresses the myths that surround ADHD. Click here to see the excerpt.
|
Barkley (1997) proposes that a lack of response inhibition is the primary and distinguishing factor of those with ADHD. Response inhibition refers to a child's ability to prevent himself from performing a behavior (response) or to stop an ongoing behavior. Response inhibition is the earliest executive function process to develop.
Examples of poor response inhibition:
*Interrupting while someone else is speaking (we call it impulsivity, right?)
*Forgetting to raise one's hand and blurting out an answer (more impulsive behavior)
*Being unable to stop while running through the house (we call this hyperactivity)
*Getting stuck in an activity or "zoning out" (is this inability to focus or distractible?)
According to Barkley, this inability to control one's responses begins when a child is learning to internalize language (thinking verbally, instead of talking out loud). This is especially related to self-direction (telling oneself to do something, such as "Stop", "Concentrate", "Focus", or "Calm Down"). Barkley argues that children with ADHD are not able to direct their behavior internally, the same way other children do because of how their brain has developed. For example, children learn to direct themselves verbally, repeating known expectations and rules to themselves. This "external" or out-loud behavior gradually becomes "internal" or silent. Barkley proposes that children with ADHD have difficulties with this process of speaking to themselves to manage their behaviors.
For Barkley, this combination of inability to prevent habitual behaviors and responses caused by the inability to internalize language, self-direction, rules and expectations, leads to the symptoms and struggles of ADHD. These are executive functions that are failing to develop on time.
Examples of poor response inhibition:
*Interrupting while someone else is speaking (we call it impulsivity, right?)
*Forgetting to raise one's hand and blurting out an answer (more impulsive behavior)
*Being unable to stop while running through the house (we call this hyperactivity)
*Getting stuck in an activity or "zoning out" (is this inability to focus or distractible?)
According to Barkley, this inability to control one's responses begins when a child is learning to internalize language (thinking verbally, instead of talking out loud). This is especially related to self-direction (telling oneself to do something, such as "Stop", "Concentrate", "Focus", or "Calm Down"). Barkley argues that children with ADHD are not able to direct their behavior internally, the same way other children do because of how their brain has developed. For example, children learn to direct themselves verbally, repeating known expectations and rules to themselves. This "external" or out-loud behavior gradually becomes "internal" or silent. Barkley proposes that children with ADHD have difficulties with this process of speaking to themselves to manage their behaviors.
For Barkley, this combination of inability to prevent habitual behaviors and responses caused by the inability to internalize language, self-direction, rules and expectations, leads to the symptoms and struggles of ADHD. These are executive functions that are failing to develop on time.
Talk to me!As you go through the website, I want you to think about what you're learning. Think about children and adults with ADHD that you know. Does this information about ADHD being a delay in the development of executive functions explain their learning and behavior more fully?
Don't just read the material; think about it. I went pretty slow at first when reading the material, matching the information up to children I knew. I spent a lot of time saying, "If I knew then, what I know now...." |
|