Executive Dysfunction

“Attention Deficit Disorder: The Unfocused Mind in Children and Adults”

A new way of understanding — and diagnosing — ADHD, by Thomas E. Brown, Ph.D.

by Thomas E. Brown, Ph.D.
Yale University Press, $27.50
Buy: Attention Deficit Disorder

Thomas Brown is a maverick. According to the American Psychiatric Association’s Diagnostic and Statistical Manual V — the bible of the mental health field — ADHD is a disorder marked by hyperactivity, distractibility, and impulsivity. But Brown, a professor of psychology at Yale University, argues in Attention Deficit Disorder that ADHD is more accurately viewed as a highly nuanced constellation of symptoms, or a syndrome. He writes, “ADHD is not like pregnancy, where one either does or does not have the characteristics, where there is no ‘almost’ or ‘a little bit.’ ADHD is more like depression, which occurs along a continuum of severity.”

Brown contends that “ADHD Syndrome” affects all of the brain’s so-called “executive functions.” These functions include:

  • Getting started
  • Getting organized
  • Being able to focus, and to shift focus
  • Making an effort
  • Being persistent
  • Managing frustration
  • Keeping things in mind and retrieving things from memory.

Brown’s view rings true to many mental-health professionals. It certainly does to me. And I’m sure it will ring true to parents who have been told that their child’s “significant symptoms of ADHD” don’t quite meet the official criteria for a diagnosis of ADHD. Many kids have been diagnosed with an ill-defined condition called “Executive Function Disorder.” To Brown, they simply have a mild version of ADHD Syndrome.

Thanks to the clinical vignettes that complement Brown’s explanations, this intelligent book does a better job of explaining ADHD than any book in recent memory. It’s a must-read for anyone with an interest in ADHD, whether of a personal or professional nature.