How does focusing on executive functions help treatment for ADHD?

The concept of executive function is really a way to understand how the brain works to solve problems and plan for the future. As Dr. Barkley says, executive functions are a set of neuropsychological processes used to sustain problem solving toward a goal. The complex set of symptoms we see in children with ADHD — deficits in a child’s ability to concentrate, stay on task, and self-regulate — can be broken down into these distinct functions, each of which should be developing through a child’s middle and high school years and even into young adulthood.

Applying the concept of executive functioning to ADHD can improve treatment by making the targets of intervention more specific, and providing a better understanding of an individual child’s strengths and weaknesses. No two children are alike. Professionals have developed scales to measure how well a child can perform the various functions — whether there are four, five, six, or more — which allow experts to identify where a child needs the most help, and how a child’s more robust skills can be tapped to compensate for problem areas.

At home and at school, day-to-day tasks can indicate the development of executive function — or that a child needs help nurturing them. In 2nd or 3rd grade, kids should reliably bring home necessary homework materials and be able to form a coherent paragraph. In 4th or 5th grade, more complex projects involving research, detailed planning and drafts should be achievable. In middle school, a nuanced understanding of priorities and time budgeting should emerge.

For parents and teachers, an understanding of the developmental track of executive functioning can provide a sort of map or set of bars to aim for as we help our kids grow. It’s important to think about the development of specific executive skills, and when and how we teach these skills to our children — especially children with ADHD, who will need extra help to master them.