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ADHD & Executive Function

 

Executive function utilizes the following skills and abilities to


- Efficiently plan, initiate, and complete tasks
- Make decisions
- Regulate emotions and behaviors

Have you ever...

Forgotten the name of someone you just met?
- Dialed a number only to forget who you were calling?
- Stopped at a stop sign and waited for it to turn green?
- Wondered what’s for dinner while a friend pours out their heart to you?
- Been asked by someone to get them a drink and you make yourself a peanut butter sandwich instead?
- Felt like the mouse in Laura Numeroff’s book, “If You Give a Mouse a Cookie?”

If you answered yes to any of these, you might be among the 15.5 million or 6% of Americans who have ADHD (i.e., attention deficit hyperactivity disorder).

 

ADHD is a disorder in which the part of the brain responsible for executive function does not work properly. When functioning correctly, executive function is responsible for 1) efficiently planning, initiating, and completing tasks, 2) making decisions, and 3) regulating emotions and behaviors. Executive
function facilitates these essential tasks by utilizing various skills such as focus, working memory, self-control, and time management (a complete list of these executive functioning skills is illustrated in the diagram above). For those without ADHD, whose executive function operates correctly, most of these skills are intuitive and come naturally. For those who struggle with ADHD, however, many of these skills feel foreign and are challenging to incorporate into daily use.

What should you do if you have ADHD?

Medication can be beneficial; however, medication alone is often not sufficient. It is also essential to identify the areas of executive functioning that are not performing well and to adopt strategies to compensate for each of these areas. To understand how this works, let’s examine the executive functioning skill of organization.

Organization involves systematizing our belongings, tasks, and activities in our
workspace to easily locate them when needed. Clutter is the enemy of staying organized, as it leads to distraction and overstimulation. For someone with ADHD, maintaining organization and preventing clutter accumulation can be challenging.

If this is a difficult area for you, the following strategies can help reduce clutter in the workspace and assist you in becoming and remaining organized:

 

Strategy 1: Remove Non-essentials

The first strategy is to eliminate all non-essential items from your workspace. Non-essentials are anything you have not used in the past six months. These items can either be discarded or placed in storage if you are not yet ready to part with them.

Strategy 2: A Place For Everything

Strategy two emphasizes having a designated place for everything.  This idea originates from the widely credited adage by Benjamin Franklin: “A place for everything and everything in its place.”  Once your workspace contains only essential items, you assign a specific location for each item when it is not in use. Each item should have only one designated place and must remain there when not in use. To ensure your items are easy to locate, consider tactics such as grouping similar items, using a color code, or labeling where each item belongs.

Strategy 3: Everything In Its Place

Strategy three represents the second half of the adage: Everything in its place.  When you finish using an item, immediately return it to its designated spot.  The temptation may be to put the item away later.  Do not give in to this temptation. Remember that with ADHD, you cannot rely on your memory!  If you set the item down “for just a moment,” you will likely forget to return it later, which could lead to losing it.  Furthermore, this habit will quickly turn your workspace into a cluttered mess.   

 

Early in my career, I met with an ADHD client who said, “ I have a system [or strategy] for everything.”  He identified each executive function that was a struggle for him and adopted a strategy to compensate for each area.  Likewise, if you are diagnosed with ADHD and struggle with executive function, I recommend identifying the personally difficult areas.  Then, as with the example of organization, I encourage you to adopt strategies or systems to compensate.  If this seems like a formidable undertaking, I suggest finding an ADHD coach who is certified to help with this very task.  By recognizing your areas of struggle and adopting strategies to compensate, you will complete tasks more efficiently, reduce stress and overstimulation, and prevent yourself from embarrassing moments, such as searching for your glasses when they are on your head or leaving the remote control in the refrigerator. 

Author
Dan Muster, DNP, APRN Psychiatric Mental Health Nurse Practitioner

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