Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most frequently occurring brain-based disorders. It most often manifests itself in childhood and continues to pose challenges throughout adolescence and into adulthood. Its symptoms most often include difficulty getting and staying focused, modulating attention, controlling impulsivity and self-managing behavior. While these symptoms are directly related to the ways the brain works (think brain cells and neurotransmitters), there are specific sets of mental (thinking) skills that are coordinated with the way the brain works. These are commonly called “executive functions,” and they involve things like organizing and planning, shifting attention, regulating emotions, self-monitoring and holding information in mind for easy recall. Executive functions are essential in virtually every aspect of our lives.

ADHD and Executive Function in ActionThink about people you know who have ADHD. They’re the ones who have trouble listening to or following instructions, who begin tasks and then are easily sidetracked, or who struggle to wait their turn. They sometimes blurt things out when they know better, touch things when asked not to, or don’t delay reacting to something long enough to recall that they’ve been in similar situations before and are about to make a silly statement and embarrass themselves or others. What’s going on inside their brains when these things happen? Answer: a breakdown in executive functioning.

Executive function deficits are not only seen individuals with ADHD. People who have learning disabilities, communication disorders or mental health disorders (such as those characterized by anxiety or depression) are also prone to struggle with executive functioning challenges. This is also the case with people who have sustained brain injuries or have medical conditions (such as epilepsy) that result in compromised brain functioning.

To be sure there’s no confusion about how executive functions work, it’s important to keep in mind that these are skills and behaviors that everyone uses all the time! Let’s consider one component of executive functioning called “working memory.” Consider what happens when you need to hold information in your mind while simultaneously doing something else. If you manage to keep the first piece of information from slipping away, working memory is doing its job. Trying to remember an address while scanning a map, a new person’s name immediately after being told their phone number, the number of calories or amount of fiber in a serving of one type of cereal after reading two or three different boxes—these are everyday examples of how working memory (and therefore, executive functioning) works.

Additional Resources

• National Institutes of Mental Health
• Centers for Disease Control and Prevention
• WebMD

Dr. Horowitz is the director of LD Resources at the National Center for Learning Disabilities. For more than 40 years, he has been helping children with learning and attention issues and their families in school, hospital and private clinical settings. He’s now a featured expert on the LD.orgwebsite.