Executive Functioning Issues

ADHD

What is it? A brain-based condition that makes it hard for Weaknesses in key mental skills that are responsible
kids to concentrate, use working memory, for attention, memory, organization and time
organize and manage themselves. They may also management, and flexible thinking. Kids with ADHD
be impulsive or hyperactive. These are all issues struggle with these skills. But so do some kids with
with executive function. learning issues who don’t have ADHD.

Signs you may  Has a hard time paying attention  Has a hard time paying attention
notice
 Has difficulty with self-control  Has difficulty with self-control

 Has trouble managing emotions  Has trouble managing emotions

 Has difficulty holding information in working  Has difficulty holding information in working memory
memory
 Has trouble switching easily from one activity to another
 Has trouble switching easily from one
activity to another  Has trouble getting started on tasks

 Has trouble getting started on tasks  Has problems organizing his time and materials

 Has problems organizing his time or  Has difficulty keeping track of what he’s doing
materials
 Has difficulty completing long-term projects
 Has difficulty keeping track of what he’s
 Has trouble with thinking before acting
doing
 Is easily distracted and often forgetful
 Has difficulty completing long-term projects
 Has trouble waiting his turn
 Has trouble with thinking before acting
 Has problems remembering what he’s been asked to do
 Is easily distracted and often forgetful

 Doesn’t seem to listen when spoken to See more signs of executive functioning issues.

 Has trouble waiting his turn

 Fidgets excessively

 Acts as if he’s “driven by a motor”

 Interrupts others and talks excessively

See more ADHD symptoms.

Possible social Impulsivity and trouble managing emotions may Trouble remembering what he’s been asked to do
and emotional cause difficulty making and keeping friends. can cause problems in social relationships. Not
impact Frequent negative feedback for acting out or not thinking flexibly can make it hard to be flexible
paying attention can impact self-esteem and with others. Poor self-control and self-monitoring
motivation. It can result in kids feeling “bad” or can cause problems with friends.
“no good.”

Professionals  Pediatricians, neurologists, developmental-  Pediatricians, neurologists, developmental-

who can help behavioral pediatricians, nurse behavioral pediatricians, nurse practitioners,
practitioners, psychiatrists: Diagnose ADHD psychiatrists: Refer patients to specialists who can
and prescribe medication. Can also look for evaluate for executive functioning issues, along with
other issues, like anxiety. Pediatricians may other learning issues. Can diagnose ADHD and
 refer patients to psychologists (or pediatric prescribe medication for it (there are no
neuropsychologists) for more complete medications just for executive functioning issues).
evaluations. Can also look for other related issues, like anxiety.

 Clinical child psychologists: Diagnose ADHD  Clinical child psychologists: May evaluate
and mental health issues that may co-occur, for executive functioning issues as part of a
like anxiety. May also evaluate for learning full evaluation for learning issues. Provide
issues, including issues with executive behavior therapy to teach kids to manage
function. Provide behavior therapy to teach their actions and interactions. Provide
kids to manage their actions and cognitive behavioral therapy to help with
interactions. Provide cognitive behavioral emotional issues. May also diagnose for
therapy to help with emotional issues ADHD and mental health issues that may
related to their ADHD. co-occur, like anxiety.

 Pediatric neuropsychologists: Evaluate for  Pediatric neuropsychologists: Evaluate for executive

learning issues. That includes tests that look functioning issues as part of a full evaluation for
at executive function. May also evaluate for learning issues. May also evaluate for ADHD and
ADHD and common mental health issues common mental health issues that might co-occur.
that might co-occur.
 Educational therapists and organizational
 Educational therapists and organizational coaches: Work on organization and time
coaches: Work on organization and time management skills.
management skills.

What the school Accommodations under a 504 plan or an IEP. Child Accommodations under a 504 plan or an IEP. Child might be
may provide might be eligible for an IEP under the category of eligible for an IEP if he has a learning disability or ADHD.
“other health impairment.”
Examples might include:
Examples might include:
 Tutoring or coaching that teaches executive
 Tutoring or coaching that teaches executive functioning skills
functioning skills
 Help with organization skills
 Help with organization skills
 Extra time on tests for kids whose problems with
 Extra time on tests executive function cause them to have
slower processing speed
 Preferential seating
 Preferential seating
 Opportunities for the student to repeat and
rephrase important information  Specific academic skill strategies; these might
include reading comprehension strategies, asking
 Additional structure to the day with routines questions, predicting, summarizing and organizing
and predictable transitions thoughts for writing
 Tasks that have been broken down into their  Positive reinforcement and encouragement to
smaller components increase confidence
 Multisensory teaching techniques  Structured teaching of complex academic skills;
multiple opportunities for practice and
 Increased structure and expectations for
reinforcement
learning activities
 A “road map” to solve various problems with
See more accommodations for ADHD. examples that explicitly detail each step
 See more accommodations for executive functioning issues.

What you can do  Create daily routines and rituals to provide  Create daily routines and rituals to provide structure.
at home structure.
 Practice self-regulation skills.
 Practice self-regulation skills.
 Model appropriate social behavior.
 Model appropriate social behavior.
 Teach time management skills.
 Set rules and stick to them.
 Give advance warning of upcoming transitions.
 Break tasks into smaller chunks.
 Have him talk through difficult tasks. Model thinking
 Allow for frequent breaks. aloud during planning and problem-solving situations.

 Have clear expectations for behavior and  Improve monitoring skills by asking him to evaluate
prepare him in advance for new experiences. his performance. Review the accuracy of his
evaluation with him.
 Give frequent feedback.
Explore specific strategies to help your child with executive func
 Provide positive reinforcement for positive
issues at home.
behavior.

Explore specific strategies to help your child with

ADHD at home.

ADHD AND EXECUTIVE FUNCTIONING