Is It Executive Function Disorder (EFD) or ADD/ADHD?

Children and adults with executive function disorder (EFD) have problems with organizing and schedules. They may also have attention deficit hyperactivity disorder (ADD/ADHD) and/or learning disabilities, but not always. ADHD is a common misdiagnosis for those who are actually living with EFD.

Not Your Father’s ADHD © istockphoto/iofoto

A child or an adult with attention deficit hyperactivity disorder (ADD/ADHD) might be hyperactive, inattentive, and/or impulsive. Clinicians have always understood hyperactivity and impulsivity. The understanding of inattention, though, has shifted from primarily “the inability to stay on task” to a broader concept called executive function disorder (EFD), which involves a pattern of chronic difficulties in executing daily tasks.

What is executive function?

The steps of executive function:

Around the time of puberty, the frontal part of the cortex of the brain matures, allowing individuals to perform higher-level tasks like those required in executive function. Think of executive function as what the chief executive officer of a company must do -- analyze, organize, decide, and execute. Very similarly, the six steps of executive function are:

1. Analyze a task

2. Plan how to address the task

3. Organize the steps needed to carry out the task

4. Develop timelines for completing the task

5. Adjust or shift the steps, if needed, to complete the task

6. Complete the task in a timely way

When executive function fails

What is executive function disorder (EFD)? It follows naturally that someone with issues with executive functioning may have problems with analyzing, planning, organizing, scheduling, and completing tasks at all -- or on deadline.

A child without problems with executive function may appear like this: A middle-schooler's teacher assigns the class a book to read, and writes the due date for the book report on the board. A student must be able to determine where to get the book and how long he thinks it will take to finish reading it. If the teacher has a specific book-report format, the student will have to keep it in mind as he reads the book and takes notes. He needs enough time to write a rough draft, get help from teachers or parents, if needed, and write a final draft by the due date. If the student has good executive function skills, the work will get done on time. If he has EFD, it won’t.

Recognize the signs and symptoms of executive function disorder (EFD). Children and adults with EFD have problems organizing materials and setting schedules. They misplace papers, reports, and other school materials. They might have similar problems keeping track of their personal items or keeping their bedroom organized. No matter how hard they try, they fall short.

Next: The Differences Between ADHD, EFD, and LD

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This article appears in the Spring issue of ADDitude.
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