There is a lot of confusion around executive function (EF)—and how it relates to Attention Deficit (Hyperactivity) Disorder (ADHD). Is ADHD an executive function disorder? Is every EF disorder also ADHD? What even are EF and ADHD? The answers depend on what we mean by “executive function” and how it presents in a learner’s life. Let’s examine the key relationships and differences between ADHD and executive dysfunction.
Does EF Always Overlap with ADHD?
The term “executive functioning” was coined in the 1970s by Karl Pribram, whose research indicated that executive functioning is managed by the prefrontal cortex. This is the part of our brain that controls planning of complex cognitive behavior, personality expression, decision making, and social behavior. Those who struggle with executive functions on a clinical level aren’t diagnosed with an executive dysfunction disorder—you won’t find executive function in the DSM-5. But a clinician can still detect EF weaknesses—especially those that create excessive, persistent, and severe symptoms that lead to harm or impairment.
Many people without an ADHD diagnosis struggle with their executive functioning, though not all who struggle with executive functioning qualify for an ADHD diagnosis. While executive dysfunction is often a symptom of ADHD, the opposite is not always the case.
Key Ways EF and ADHD are Related
There are so many connections between ADHD and executive dysfunction. Learners who struggle with both may have difficulty:
- paying attention
- maintaining self-control
- managing emotions
- avoiding distraction
- holding information in working memory
- switching easily from one activity to another
- getting started on tasks
- organizing time and materials
- remembering things
- keeping track of what’s going on
- completing long-term projects
- thinking before acting
- taking turns
- remembering assigned tasks.
One Key Difference Between ADHD & EF
ADHD can receive an official diagnosis while an executive function challenge cannot. However, trouble with executive function is not limited to symptoms in ADHD learners. EF refers to weaknesses in the brain’s self-management system. People can have trouble with executive function for many reasons—not just ADHD. In fact, the majority of kids with learning differences struggle with one or more of the eleven executive function skills. This means EF challenges are actually much more widespread than ADHD, even though we’re just starting to understand how prevalent these challenges really are.
Taking Action to Support Our Learners
Now that we have uncovered how the two conditions connect with one another, it is important for all of us to have access to evidence-based strategies to treat learners with executive functioning and ADHD difficulties. Awareness of ADHD and EF can help caregivers advocate for proper accommodations and treatment. Learners with ADHD or executive dysfunction can learn to use their interests, strengths and knowledge to improve their skills and advocate for their own learning needs.
- Executive Function Resources at Learnfully
- How I explain the relationship between ADHD and executive function challenges from Understood.org
- From the Ologies Podcast: AHDH Interview with Russell Barkely