Editor's note: This week, we feature guest blogger Dr. Elizabeth Hayward. Please read her full bio below.
Parents of a child who has been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) often learn that their child also struggles with executive functioning. Executive function skills are those self-management skills that help us to set and achieve goals, including prioritizing, planning, organizing, initiating, self-monitoring, and adapting. These skills allow a child to engage independently and successfully in goal-oriented behavior, whether it’s completing homework or cleaning her room. It can be confusing to parents how executive functioning is actually related to ADHD. Parents may wonder, do all children with ADHD struggle with executive functioning? Does trouble with executive functioning automatically indicate ADHD in children?
Children with ADHD often have difficulty with many aspects of executive functioning, as both inattention and impulsivity are closely related to executive functioning deficits. Students who regularly fail to follow through on instructions may be having difficulty holding information in in their memory as they work. When a student makes careless errors in her work, or appears inattentive to details, it may well be because she struggles with self-monitoring. If she seems distractible, it is entirely plausible that she struggles more than others her age in terms of inhibition, or stopping impulsive responses.
Despite the considerable overlap between ADHD symptoms and executive function skills, having difficulties with self-management is not unique to ADHD. Rather, difficulties with executive function skills can be symptomatic of many different disorders in childhood. In that way, struggling with executive functioning is not unlike a fever- having a fever is symptomatic of many different types of illnesses, and not specific to any one particular illness. For example, children who struggle with depression or anxiety often have trouble with executive function skills, like getting started on a task or working efficiently. Thus, many more children struggle with executive function than the subset who also are eligible for an ADHD diagnosis.
This is all to say that yes, typically, children with ADHD struggle with executive functioning skills, but many children who do not meet criteria for ADHD also have difficulty in such tasks. A comprehensive neuropsychological evaluation will typically clarify whether or not a student who has trouble with these types of tasks also meets the criteria for an ADHD diagnosis. If parents of children with ADHD know specifically what areas of self-management are most troublesome, they will be better able to provide support with well-targeted interventions to ensure success both at school and at home.
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Dr. Elizabeth Hayward is a neuropsychologist in private practice in New York City, providing evaluations for children, adolescents, and young adults. Dr. Hayward is also a school psychologist at the Berkeley Carroll School. She maintains a position as a Research Scientist at the CREATE Lab at New York University. She is currently an adjunct faculty mentor in Educational Psychology at the CUNY Graduate Center, and formerly adjunct faculty in the Applied Psychology department at New York University. Dr. Hayward consults with school psychologists, learning specialists, and school directors in interpreting neuropsychological and psychoeducational evaluations. She works closely with educational advocates towards securing the appropriate placement for children she has evaluated. Dr. Hayward regularly presents to parents and educators on a wide range of topics related to learning, mental health, and development during childhood and adolescence. Reach her at firstname.lastname@example.org.