Executive (Dys)Functioning: What it is, its Relation to ADHD and Some Strategies
Executive functioning is how we plan, make decisions, follow steps and processes, focus our attention and balance different tasks. It incorporates a set of skills which help us to learn, work and complete tasks. There is so much we couldn’t do without them.
Think about your daily tasks. Even getting out of bed and getting ready for work requires you to follow a sequence of tasks, plan what to do next, prioritise the things you have time for, and manage your time so you don’t get to work late. You are using executive function skills the minute you get out of bed.
We all have different strengths and challenges, and for some of us our executive functioning skills can be more dysfunctional than functional. This is true for people with ADHD in-particular, as ADHD is well known for its effect on executive functioning and self-regulation (Rosello et al., 2020). Children with ADHD are approximately 2-3 years behind in development in certain areas of their brain (such as the prefrontal cortex, responsible for our executive functioning) than their peers (Berger et al., 2013). Adults with ADHD are thought to only develop 75-80% of their executive functioning capacity compared to their non-ADHD peers (ADHD Australia, 2019). This means that we can find many of these executive function skills harder - though not necessarily all of them to the same extent.
10 executive functioning skills (and what dysfunction could look like):
Planning and prioritising = establishing aims & goals, organising & prioritising tasks and breaking down into steps.
difficulty prioritising tasks
difficulty breaking down tasks
being unable to work out what steps will help you achieve a goal
Time management = awareness of time, setting time limits and meeting deadlines, using time effectively.
poor sense of time
difficulty being on time
difficulty planning for future events
difficulty sticking to time schedules
Working memory = remembering and recalling information needed to complete a task, following instructions.
difficulty processing and recalling information
forgetting instructions especially if given multiple
Organisation = following processes to stay on top of things and keep things in order, organising tasks.
difficulty making decisions
trouble following processes and keeping order
losing things
difficulty balancing multiple tasks
Impulse control = resisting inappropriate impulses or sudden urges, thinking through decisions.
acting on impulse without thinking things through
difficulty considering outcomes of behaviour beforehand
Task initiation = ability to start a task without procrastination.
difficulty starting a task
procrastination
missing deadlines
Self-monitoring = awareness of own emotions and behaviour, ability to evaluate and reflect on self.
difficulty recognising emotions and needs
difficulty setting goals
difficulty reflecting on progress or errors
Self-regulation = keeping emotions in check, regulating thoughts and responses, responding to needs effectively.
poor control of emotions which interferes with tasks
allowing frustration to dictate decisions
Flexible thinking = adapting or responding to change by revising thoughts or plans.
difficulty adjusting plan when there is an unexpected change
inability to shift attention when needed
poor problem solving
Attention and focus = focusing for the duration of a task without being distracted.
difficulty completing tasks
easily distracted
difficulty shifting attention between tasks
focusing too much on one thing
Can you see how poor executive functioning can affect so many areas of an individual’s life? It is helpful for us to test out strategies, to try to develop ways of managing to make things a bit easier.
Some strategies which may help executive functioning:
Break down big tasks into smaller chunks - brain dump first onto paper if it is hard.
Use a priority grid - four squares of ‘urgent’ ‘not urgent’ ‘important’ and ‘not important’ and put each task/action into either urgent/important, urgent/not important, not urgent/important and not urgent/not important.
Visualise time with clocks and timers.
Establish a daily routine.
Have an accountability buddy.
Make information visual or external, for example using planners, post-it-notes, symbols, lists and whiteboards.
Ask for information or instructions to be written down.
Identify just one step you would need to do first and just do this.
Remove possible distractors such as your phone and ask someone to hold you accountable for this.
Use a calendar or planner and make it fun with highlighters or stickers etc.
Use apps or reminders such as Alexa, phone alarm, sticking a list on your mirror etc.
Write a pros and cons list before making any major decision.
Establish responses that give you time to think when something is asked of you, for example ‘I need to check my diary’.
Set aside regular time to reflect, e.g. journalling, peer discussion, therapy.
Consider how your thoughts, emotions and behaviour influence outcomes.
Set reminders to check you have eaten, drunk water, been to the loo and met your needs.
Practice meditation, stimming, visualisation or anything that helps you to feel calm.
Practice imagining fully accepting the situation and what the outcome would be.
Talk through the situation with someone for another perspective.
Find a way to make a task urgent, novel, based around your interest or competitive (read around the interest-based nervous system here).
Learn what helps you to focus, like music, pomodoro technique, body doubling or fidgeting.
Do you struggle with any of these executive functioning skills? Are there any strategies which you find helpful?
References:
ADHD Australia (2019). The role of executive functions. www.adhdaustralia.org.au/about-adhd/the-role-of-executive-functioning-in-adhd.
Berger, I., Slobodin, O., Aboud, M., Melamed, J. & Cassuto, H. (2013). Maturational delay in ADHD: evidence from CPT. Frontiers in Human Neuroscience, 7(691). https://doi.org/10.3389/fnhum.2013.00691
Harvard University (2023). Executive function and self-regulation. https://developingchild.harvard.edu/science/key-concepts/executive-function/
Maskell, L. (2023). ADHD: an A-Z. Jessica Kingsley Publishers.
Rosello, B., Berenguer, C., Baixauli, I., Mira, A., Martinez-Raga, J. & Miranda, A. (2020). Empirical examination of executive functioning, ADHD associated behaviors, and functional impairment in adults with persistent ADHD, remittent ADHD, and without ADHD. BMC Psychiatry, 20(134). https://doi.org/10.1186/s12888-020-02542-y