Perhaps you have heard of executive functioning skills (EFS). These are known as the cognitive skills that help us plan, prioritize, and carry out complex tasks beginning as early as age 2 and building upon into our 30s.
Executive function is the cognitive process that organizes our activities and thoughts, manages time efficiently, prioritizes tasks, and makes decisions. The skills in this area are used to help us create structure and strategies for managing projects and determining how to move forward on each task or project we need to complete.
What is executive dysfunction, and what causes executive dysfunction in adults and children with ADHD?
What Are Executive Functioning Skills?
Executive functioning is an important responsibility of the brain. It’s essential for higher reasoning skills, cognition, memory, and other important functions. These functions involve your cognitive control over your behavior, allowing you to choose and pursue goals in your life.
Executive functions involve conscious thought, and they are essential for time management, meeting deadlines, recalling information, and making decisions. Executive functions are important for many common tasks you may go through in your daily life.
Neurodevelopmental disorders, substances, and mental health problems affectinh your executive functions can get in the way of social and occupational functioning.
There are five basic areas involved in executive functioning:
- Attentional control. This concerns your attention and focus. Attentional control allows you to maintain focus on something specific around you. If this is impaired, you may strive to concentrate on specific tasks.
- Cognitive flexibility. This is also called mental flexibility. Cognitive flexibility is your ability to switch between tasks or activities that require your focus. It also allows you to mentally process multiple thoughts at the same time.
- Cognitive inhibition. At any given moment, your senses can attune to millions of different sensations and stimuli. Cognitive inhibition allows you to tune out incoming information that is unnecessary or irrelevant.
- Inhibitory control. This may also be called impulse control. It involves the ability to manage and resist impulses to self-regulate your behaviors.
- Working memory. Working memory is your brain’s short-term storage system for incoming information. It’s important for thoughts and facts you need to problem-solve.
If someone has trouble with their executive functioning skills, they may find it difficult to focus, handle emotions, follow directions, and complete tasks.
Types of Executive Dysfunction in People With ADHD
Executive dysfunction is related to several areas of life, some of which are where self-control is needed.
Executive dysfunction can create problems with working memory, which can cause major challenges in life. You may forget small details in day-to-day life or even significant events.
Organization, Planning, and Time Management
In order to function effectively in daily life, you need to be able to plan and prioritize tasks and give yourself enough time to complete them. This entire process can be inhibited by executive dysfunction.
Executive dysfunction can make someone feel disorganized. They may have trouble making and sticking to plans, and they may take what seems to be longer than necessary to complete tasks.
Attention and Concentration
Executive dysfunction can make it hard to maintain concentration. Even when a person puts in extra effort to concentrate on something, they may move to another task, sometimes without realizing what they’re doing.
Behavior and Emotion Control
How we behave and express our emotions can affect how we relate to others. Those with executive dysfunction can experience a hard time controlling their emotions and behavior. This can cause behavior problems and conflicts between you and your loved ones.
Problem Solving and Multitasking
The ability to multitask and solve problems is crucial in adulthood, but executive dysfunction can make it feel impossible. Executive dysfunction can negatively impact flexible thinking, which is the ability to approach a problem from multiple perspectives. Because of this, a person may only be able to perform one task at a time and have difficulty with problem-solving.
What Are the Seven Executive Functioning Skills?
There are seven skills involved in executive functioning:
- Self-awareness: This is simply self-directed attention.
- Inhibition: This is also called self-restraint.
- Non-verbal working memory: This is visual imagery or how well you can picture things mentally.
- Verbal working memory: This is internal speech, self-speech, or what some people call their “inner monologue.”
- Emotional self-regulation: This is using the above-mentioned four executive functions to change your emotional state. Using words, images, and self-awareness to process and change how you feel about things.
- Self-motivation: This is simply how well you can motivate yourself to complete a project or task when there is no immediate consequence.
- Planning and problem-solving: This is how you use and play with information in your mind to conjure up new ways of doing things and finding solutions to your problems.
If someone has trouble with their executive functioning skills, they may find it difficult to focus, handle emotions, follow directions, and complete tasks, according to Understood.org.
What Are the Signs of Executive Functioning Issues?
If an individual has trouble with executive functioning, they may present signs that appear to be attention-deficit hyperactivity disorder (ADHD). ADDitude Magazine wrote that ADHD is an “executive function deficit disorder as it pertains to chronic difficulties in executing daily tasks.” They also say executive dysfunction is “a brain-based impairment that causes problems with analyzing, planning, organizing, scheduling, and completing tasks at all — or on deadline.” Individuals with executive function disorder will have trouble with organizing information and materials and setting a schedule to complete tasks.
Also, it is essential to know that the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does not recognize this disorder as a specific mental health condition. Executive function issues are symptomatic of mental health, behavioral disorders, and other neurological issues, per Medical News Today.
Specific symptoms for executive function disorder are:
- Difficulty with starting, organizing, planning, or completing tasks
- Difficulty in controlling impulses or emotions
- Difficulty with listening or paying attention
- Unable to multitask or balance tasks
- Trouble solving problems
- Trouble learning or processing new information
- Short-term memory issues
- Behaving in a socially inappropriate manner
- Not learning from past consequences
Causes of Executive Dysfunctioning
Good Therapy explains that executive dysfunction is not a diagnosis but rather a symptom that signals mental health or neurological conditions. Some causes for it might be:
- ADHD or other developmental disabilities
- Drug addiction
- OCD (obsessive-compulsive disorder)
- Traumatic brain injuries (TBIs)
Executive functioning can also be affected by other aspects of life, such as stress, boredom, and distraction.
Executive Functioning Skills and the ADHD Connection
It is thought that if you have trouble with one, several, or all of the seven executive function skills, you probably have symptoms of ADHD. Also, there are four main circuits in the prefrontal cortex of the brain that specifically relate to executive function and ADHD. As ADDitude explains:
The first brain circuit, nicknamed the “What Circuit,” goes from the frontal lobe, particularly the outer surface of it, to the back into an area of the brain called the basal ganglia. This is linked to working memory, and it begins to guide what you do, and more so when it pertains to plans, goals, and the future.
The second brain circuit, nicknamed the ‘When Circuit,” goes from the prefrontal area to the cerebellum, which is in the back of the brain. This is the timing circuit. It coordinates the timeliness of actions and sequence of behavior. A person with ADHD will have problems with time management that are due to this circuit not functioning properly.
The third brain circuit is nicknamed the “Why Circuit.” It runs from the frontal lobe and goes through the central part of the brain to the amygdala, which is the avenue to the limbic system. This circuit is linked to emotions and is sometimes called the “hot” circuit. It chooses among all the options of the many things we could be doing based on how we feel about them and is the final decision-maker.
The fourth brain circuit, nicknamed the “Who Circuit,” goes from the frontal lobe to the very back hemisphere of the brain. This is where self-awareness takes place. It is where we are aware of what we do, how we feel, what is happening to us.
These four circuits are essential in understanding ADHD because it helps determine symptoms. Various symptoms can be present based on which circuits are most impaired or not.
How Will You Know If It’s Executive Function Dysfunction or ADHD?
People with executive function dysfunction will exhibit signs that they are having difficulty with estimating how much time it takes to finish a task, planning projects, memorizing information, starting tasks, planning projects, shifting plans when the situation changes, staying focused on one task, relaying stories either in writing or verbally.
While EFD is not a recognized disorder, there are a few ways, which can be used to determine if an individual has EFD and/or ADHD. Physicians use interviews with parents, teachers, or other adults, personally watching the child or adult, use questionnaires that measure ADHD symptoms and psychological tests, per WebMD.
In addition, they may look for symptoms of the three ADHD types, which are inattentive type, Hyperactive-Impulsive type, and Combination type. The truth is that many people with ADHD show signs of EFD, but it is essential to determine if the individual has only EFD or both conditions. Knowing this will determine what type of treatment the person needs to function better at home, school, or work.
How Vista Pines Health Can Help with EFS
It is estimated that 11 percent of children, 2 million teens, and more than four percent of adults in the U.S. have ADHD. Between 60 percent of the younger generations will show symptoms of ADHD when they are adults. The Journal of the American Medical Association (JAMA) found that ADHD diagnoses have escalated in adults and teenagers significantly over a 20-year period. Many people have a few symptoms of executive function disorder in all stages of life.
Executive function and ADHD are linked when executive functions are impaired in different brain circuits. Professional diagnosis is required to definitely determine if the individual has ADHD or a learning disability, as executive function dysfunction is often found in both conditions. A correct diagnosis will spur the correct treatment for the person.
Often, people turn to alcohol or drugs to self-medicate and ease their symptoms or to make themselves feel more confident. The more this is done, the more likely chemical dependence occurs and substance abuse later on.
Vista Pines Health in Pembroke Pines, Florida, is a mental health treatment center with extensive experience treating ADHD. The most effective treatment for this is a combination of medication and behavioral therapies, like cognitive behavioral therapy (CBT).
CBT helps you become aware of inaccurate and negative thinking so you can change it. You will be able to view challenging situations more clearly and respond to them in a more positive and healthy way. Dialectical behavior therapy (DBT) will help you manage painful emotions and lessen conflicts in relationships.
Our facility also provides addiction education, mental health education, medical/medication management education, coping and life skills, family dynamics groups, and more. If you are an adult with ADHD and struggling with substance abuse, we are here for you.
Vista Pines Health provides detox services, relapse prevention education, and behavioral therapies to help your stay on the road to recovery while managing ADHD symptoms. Connect with us today and begin to get your life back.