Executive function involves any process or set of mental skills that allows us to achieve a goal or to get a job done. It affects our ability to prioritise, organise, plan, focus, process instructions, remember instructions and work to goal completion.

Compared to neurotypical brains, there are lower levels of the neurotransmitters dopamine, noradrenaline and serotonin in the ADHD brain, parts of the brain are less developed, smaller in size, have poorer blood supply and show lower activity. The consequences of which impair our executive functioning ability. ADHD is an impairment of neurological or mental function. An impairment requires accommodation. We wear glasses for impaired eyesight, hearing aids for impaired hearing. The impairment of our mental ability needs to be effectively treated and accommodated as it has an effect on our behaviour, just the same as having poor eyesight and hearing does.

To better understand this impairment the following, very simplified analogy of the functioning of an ADHD brain could be useful. Imagine a complex junction where traffic lights control the flow of traffic. On a green light the traffic in that direction flows, on a red light it stops, anothis line of traffic flows and so on, each line of traffic waiting its turn to move and stopping when prompted. Each vehicle represents a thought for action, the flow of that line of traffic represents that thought from inception to completion. Thoughts, through to action, flow in an orderly, structured manner. In an ADHD brain these traffic lights are permanently broken. Thoughts for action start as individual vehicles, each trying to squeeze and weave its way through the junction. Thoughts stop and start randomly, the first thought for action is rarely followed by the second sequential thought. Thoughts for a variety of actions move at the same time, each vying with the other to get through the junction. The outcome is a random flow of action thoughts, different every time, starting and stopping in indifferent places, seldom with the necessary back up needed for action.

In school going or college going teenagers and young adults the following are some of the implications, the impact of which will vary from one individual to the next. Some have little impact on the individual, others will have a profound impact. For ease of reading, ‘he’ represents ‘He’ ‘he’ or ‘They’.

Time management

He has no concept of time, he is only aware of the immediate present. This means he often spends too much time on individual tasks and tasks will always take his more time to complete than it does for others, he is not able to plan work with time frames in mind, time being fluid to his, which leaves his working to deadlines at the last minute. he is never late until he is. A class or appointment at 9am can be made on time even if he leaves home at 8.59am. When 9am arrives, he realises that he is late! he panics, followed by a flurry of activity to get there.

Processing

His processing ability is slower. It takes him more time to process what he hears, what he reads and what he is going to write. He commonly forgets the train of his thoughts, when he is writing, listening, speaking. The general speed at which he works is slower as he is multi-processing while there are always other distractions going on.

Working memory

His working memory is poor and he needs to repeat and repeat more than the average person in order to learn effectively. He can forget work he has completed, leaving books at home and in school/college. Distractions impede his ability to remember.

Focused attention

He has to work hard to focus, if he is interested in something, this hyper focus is easy for him to do. These are visual, auditory, sensory distractions vying for his attention. The effort it takes to focus makes him very tired and has a knock on effect on everything else he has to do.

Organisation

He may have OCD tendencies which help him with physical organisation, his memory and time awareness issues can then hinder his. he is not organised in his way of thinking, his work is untidy, his living space is chaotic.

Task Initiation

Task initiation is difficult for him, he will procrastinate about everything because the steps necessary to complete the task are not clear in his mind. To him, there are endless possible ways to go about doing something and deciding which way to choose takes time. He often chooses the roundabout route (due to the broken traffic lights).

Self assessment

He is not able to assess his performance in comparison to his peers or assess himself in relation to his own performance which makes improvement harder for his. he needs to be directed on how to do so.

Impulse Control

He can jump to conclusions, blurt out the first thing that comes into his head and behave aggressively. He looks for attention, can seek stimulation from drugs and alcohol, from dangerous behaviour. He may exhibit abrupt, defiant behaviour.

Emotional Regulation

He finds this very challenging as he is hyper aware, he becomes very overwhelmed but hides it well. He can act out, demanding attention by inappropriate behaviours, he can be very angry all the time.

Cognitive flexibility

It is extremely difficult for him to be flexible. He finds it hard to switch tasks if he is engaged, he will have spent a lot of energy becoming engaged in the first place. If he is not engaged then switching is too easy and often.

Planning and problem solving

If he is engaged and focussed he is an able problem solver, generally however he struggles.

Anxiety

All of the above can make him feel anxious. He hides this extremely well because he wants to do well and overcome his challenges. He may choose to avoid engaging with school or college altogether and opt out, either way he is under huge stress. The manifestations of stress or feeling anxious may come out at home or at school. It will manifest differently for each individual and vary with age. Stressful times can be, starting a new school, going back to school after holiday time, exams, assignments, starting college, coming back from a trip with school, college, scouts, going to a competition or simply having visited a friend for a sleepover.

Self Esteem

His self esteem and feelings of self worth are low, he has learned to doubt himself, he sees his limitations compared with others. he does not see the world as others do, he does not function as others do, he does not understand and process as others do. he struggles but does not know why, he is different.

Confrontation

He loves confrontation. This may be quietly, on an emotional level with himself, family or friends, it may be by overtly acting out. Confrontations boost neural activity and give temporary relief from the symptoms of having ADHD. He may have oppositional defiant disorder, ODD or because he has ADHD, behave in a manner similar to those with ODD. He is not being defiant on purpose, his ADHD brain will not allow him to follow instructions, he must do it his own way, in his own time, even if that means he has to struggle. He may be a compulsive liar.