ADHD and executive function disorder (EFD) are tightly linked, but far from synonymous. They both make it exceedingly difficult to complete tasks and stay organized, but EFD is a broad condition that also affects attention, learning, and social, organizational and time management skills.
Executive functions refer to cognitive and mental abilities that help people engage in goal-directed action. They direct actions, control behavior, and motivate us to achieve our goals and prepare for future events.
Executive functioning is an umbrella term describing seven major types of self-regulation that control behavior:
1. Self-Awareness: self-directed attention
2. Self-Restraint: inhibiting yourself
3. Non-Verbal Working Memory: holding things in your mind to guide behavior
4. Verbal Working Memory: internal speech
5. Emotional: Using words and images along with self-awareness to alter how we feel about things
6. Self-Motivation: the ability to get ourselves to do things when there are no outside consequences
7. Planning and Problem Solving: finding new ways to do things
These abilities don’t all develop at once, but rather in a sequence — one skill building atop the next. All of the executive functions interact with each other, and impact how we regulate ourselves and our behavior to create positive future outcomes.
Executive functions begin developing by age two, and are fully developed by age 30. People with ADHD often are 30 to 40 percent delayed in development, which makes them more likely to act for the immediate future rather than for longer-term goals. The back of the brain is where we store information that is already learned. The front part of the brain is where we use the information we have learned to be socially effective and succeed in life. This prefrontal cortex mediates executive functioning and it contains four major circuits.
• The “what circuit” controls working memory, helping us execute the plans, goals, and specific steps needed to complete a project.
• The “when circuit” helps us organize the order in which we complete activities, and address timelines.
• The “why circuit” controls emotions — what we think about, and how we feel.
• The fourth circuit controls self-awareness of how we are feeling, and what is happening to us.
People with ADHD and EFD often have impairments in one or more of these circuits and, therefore, symptoms that touch memory, planning, emotional regulation, and/or social skills.