EFD is directly related to ADD/ADHD. It is one of the symptoms. Her medication may not be at the right dosage. Speak to her doctor, ask your niece if she had noticed a change in her focus and distractability. Growth may cause a need for an increase in medication dosage. There are two works books that I highly recommend. “Train Your Brain for Success” & “The Executive Functioning Workbook for Teens”. These are for the child/student to go through and it helps them figure out where their weaknesses are and then there are activities to help them in these areas. Then another EXCELLENT book is “Late, Lost & Unprepared: A Parent’s Guide to Helping Children with Executive Functioning” This is super insightful! Lots of “Oh, that’s why XXX does XXX” moments when reading it. Lucky her to have you for her aunt and in her court!