Many ADHD symptoms point to difficulties with executive functioning and may indicate that ADHD is a partial executive functioning disorder. Working memory, cognitive flexibility, and inhibitory control are the three aspects of executive functioning.
Working memory is the conscious awareness location where information is manipulated or transformed. Working memory is used when you recall a mental grocery list and go around the store picking up items and then visualizing crossing them off. Working memory is also involved if your child is asked to complete three tasks: they must plan and prioritize the tasks, execute actions to complete the task, and mentally cross those tasks off the list.
Cognitive flexibility is the ability to apply what has been learned differently depending on the situation, as opposed to rigidly adhering to rules or previous ways of doing things. An adult example would be being forced to deviate from a previously established driving route home. A child might adapt to changing afternoon plans if a sibling becomes ill and needs to be taken to the doctor’s office.
Finally, inhibitory control is the ability to resist impulses to act without thinking. For adults, this could mean ignoring a text message while driving. For children, this can mean using words rather than aggression (biting, hitting, kicking) when disagreeing with peers, or raising one’s hand rather than shouting to answer a teacher’s question in class.
These three critical areas serve as a bridge between self-regulation and attention. However, rather than referring to them as innate abilities (i.e., immutable, unchangeable characteristics of a child), executive functioning may be more usefully viewed as a set of skills.
According to Dr. Adel C. Najdowski, behavior-based executive functioning treatment targets the following areas:
On the surface, some of these areas appear to be abstract concepts. They can, however, be reframed as a sometimes discrete and sometimes coordinated set of overlapping skills used to successfully navigate one’s environment (i.e., school, social situations, work, community, etc.). When learning new skills, both children and adults require assistance in applying them in a variety of situations.
The idea of teaching once and having it applied across multiple environments does not hold water. As a result, a child who learned how to plan afternoon activities for one day cannot be expected to be able to do so for morning activities, the next day, or the entire week. To “stick,” the skills must be practiced frequently, at various times, and in a variety of situations. This is known as “multiple exemplar training,” or “training to a variety of examples.”