The ADHD Brain

Intention Deficit Disorder: Why ADHD Minds Struggle to Meet Goals with Action

Intention deficit disorder is not a medical diagnosis but a helpful way to frame a persistent ADHD challenge: the inability to further goals with timely action. Here, learn about the executive function deficits that give rise to “intention deficits,” plus ways to bridge the gap between objectives and tactics.

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What Is Intention Deficit Disorder?

Intention deficit disorder is not a real diagnosis but a term I used to describe what I believe is a central struggle of attention deficit hyperactivity disorder (ADHD): difficulty in accomplishing one’s goals.

Think of ADHD as a performance disorder. People with ADHD know what they need to do, but they struggle – greatly, at times – to transform intention into action, whether that’s preparing for a test or finalizing an important project at work. It’s an issue directly tied to the executive function difficulties inherent in ADHD. And yet, this very real challenge of ADHD is often mistaken for laziness and lack of motivation, which many breed low self-esteem and even depression.

Unpacking Intention Deficit Disorder: The ADHD Struggle to Perform

1. Executive Dysfunction Affects Behavior and Performance

The self-regulation problems inherent in ADHD stem from deficits in executive function, or the mental skills that allow us to initiate and carry out actions toward a future goal.

The executive system lives in the brain’s frontal lobe, and it is responsible for putting into action the knowledge that lives in the back of the brain. But ADHD separates these two parts of the brain like a meat cleaver.

In ADHD brains, intention and action are disconnected. This is why people with ADHD seem unlikely, unable, or unwilling to carry out behaviors that they know may be good for them. It is also why they are often unable to act effectively on what they know.

[Take This Self-Test: Executive Function Deficits]

2. Executive Dysfunction Muddles Time

Executive dysfunction also creates issues with time, timing, and timeliness of behavior. People with ADHD are often “time blind,” and they struggle to organize large, hierarchically sequenced behavior across time.

3. Intention Deficit Turns Everything Into a Crisis

As people with ADHD are nearsighted to time, they will often wait until the future is imminent to take action. That means that so long they perceive the future to be “out there,” an I-don’t-have-to-deal-with-it-yet outlook will prevail. Hence the almost universal experience of procrastination.

This far-away feeling of future events often means that people with ADHD are often only able to take action at the 11th hour, when time is all but running out. In a race to make a deadline, they may put things together in a slapdash manner. Or they may deliver high-quality work – at the cost of burnout and exhaustion.

The inability to organize and prioritize to the delayed future means that everything inevitably becomes a crisis with a too-near deadline.

[Read: 6 Secrets to Goal Setting with ADHD]

4. Intention Deficit Looks Like Laziness

Future-directed behavior is intentional behavior. When there’s often a sizable gap between intention and action, the term “intention deficit disorder” feels more accurate than “attention deficit hyperactivity disorder,” I think.

But those without ADHD often have very little patience for the short-sighted decisions of individuals with ADHD. They view these outcomes as avoidable, and attribute them to laziness, carelessness, poor time-management, lack of motivation, and moral failure instead of what it really is: executive dysfunction.

Intention Deficit Disorder: Turning Intention Into Action

Many people mistakenly believe that skill-building – in the form of time-management tips, self-motivation skills, etc. – will help people with ADHD bridge the gap between intention and action.

But in the field of neuropsychology, we know that the best way to treat a performance (i.e., executive) disorder is by targeting the point of performance, or the place and time across various settings of a person’s life where they are failing to act on what they know. Targeting the point of performance largely involves changing environments to facilitate performance. The following are key point-of-performance enhancements that work for people with ADHD:

1. Externalize time

Executive dysfunction renders internal cues unreliable, hence “time blindness” among people with ADHD. External representations of time — like calendars, white boards, visual timers (like the Time Timer), and other tools — may help guide behavior more reliably and effectively.

2. Bring the future to the present

If people with ADHD tend to wait until the future is imminent to act, then pushing the future back a few notches can help spur action. Dividing long-term goals into smaller, contiguous steps is one way to ensure constant action on an overall goal.

3. Ensure motivation along the way

Along with breaking up tasks into manageable chunks, people with ADHD will benefit from what I call motivational prostheses to sustain action toward a goal. The following are a few ideas:

  • short breaks in between longer bursts of work
  • body doubles, or accountability partners
  • visualizing rewards and positive outcomes

Intention Deficit Disorder and ADHD: Next Steps

The content for this article was derived with permission from Dr. Russell Barkley’s lecture, “The Neuroanatomy of ADHD” delivered during the Centre for ADHD Awareness, Canada’s (CADDAC) annual ADHD Conference (2009).

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