Table of ContentsView AllTable of ContentsDefinitionSigns and SymptomsExecutive Dysfunction and ADHDDiagnosisTreatmentOutlook
Table of ContentsView All
View All
Table of Contents
Definition
Signs and Symptoms
Executive Dysfunction and ADHD
Diagnosis
Treatment
Outlook
Executive dysfunctionis most commonly associated with attention deficit hyperactivity disorder (ADHD) and its traits of hyperactivity and attention problems. These traits stem from impairment of a person’s executive functioning skills. It’s linked todysfunction in the brainand the neurological or nervous system.
Executive function is not impaired in each person diagnosed with ADHD. It does, however, contribute to memory, problem-solving, and planning challenges in some people.It also is associated withobsessive-compulsive disorder(OCD) and other mental health conditions, including some that co-occur in people diagnosed with ADHD.
This article will discuss executive function and dysfunction and what it looks like. It also covers ways it’s evaluated and how it’s related to ADHD.
What Is Executive Function?
Executive functioning is what’s responsible for controlling thoughts, behaviors, and emotions. Executive functioning skills help a person with planning and organizing their time and regulating their emotions and actions.
These skills are necessary for:
Executive functioning also helps a person understand how the things they say and do now have future consequences for better or worse.
Executive Functioning in Autism
Signs and Symptoms of Executive Dysfunction
Signs and symptoms of executive dysfunction will vary among people. Traits also can change over time, such as when a child with ADHD grows into adulthood. In children and adults, executive dysfunction looks like:
This can result in poor academic or work performance, challenges working in team settings, and interpersonal problems with peers, family, and others. Meeting goals, learning new things, adapting to life changes, and maintaining responsibilities and relationships can be difficult.
Chronic feelings of frustration, guilt, and blame are common in people with ADHD and executive dysfunction.
ADHD Criteria for Diagnosis
Executive dysfunction isn’t a diagnosis on its own. It’s also not the same thing as ADHD (which is an official diagnosis). While people with ADHD experience executive dysfunctions, people can also experience them without ADHD.
Conversely, people diagnosed with ADHD may not demonstrate traits of executive dysfunction. Studies in children with ADHD find that less than 50% perform poorly on tasks meant to test their executive dysfunction.
Overlaps in ADHD symptoms and executive dysfunction include difficulties with:
For people with executive dysfunction challenges, it also can be difficult to consider the future impacts of their choices.
Diagnosing Executive Dysfunction and ADHD
Executive functioning skills exist on a spectrum. Evaluation is a multistep process that helpspsychiatristsand other healthcare providers assess what the underlying cause or causes may be and how greatly executive dysfunction is impairing everyday life.
The evaluation may include tests and questions aimed at revealing the level of overall functioning in specific areas like planning or organizing, multitasking, decision-making, attention-keeping and focusing, problem-solving, adapting to change, memory, and impulsivity.
The ADHD assessment includes the same full medical history, relevant symptoms, and a neurological examination. AnADHD diagnosisis made based onDiagnostic and Statistical Manual of Mental Disorders(DSM-5) guidelines for evaluating hyperactivity, attention problems, and impulsiveness.
Parents and other caregivers typically answer questions about a child’s traits. Other tests that may be part of an ADHD assessment include evaluations for other mental health conditions,blood teststo detect an underlying physical cause, orimaging studieslike magnetic resonance imaging (MRI).
Executive Functioning Tests
Several tests are available to help in the diagnosis of executive function:
The DSM-5 and ADHD Criteria for Diagnosis
Managing ADHD and Executive Dysfunction
The goal of managing executive function issues is to strengthen the executive function skills that are perceived as deficient, whether the cause is related to ADHD or another condition liketraumatic brain injury. Working out the problems is the primary focus of a highly individual process.
The National Center for Learning Disabilities (NCLD) offers the following general suggestions that can help strengthen executive function issues:
If executive dysfunction is a symptom of ADHD, consider speaking with your medical provider about how ADHD medication can help.ADHD medicationsinclude stimulants and non-stimulants that target symptoms like inattention and impulsivity.
Behavioral therapies, includingcognitive behavioral therapy(CBT) andoccupational therapy, may also be recommended to help a person learn to change their thought patterns and regulate emotions. There’s some evidence to suggest CBT success relies on tandem use of medication.
A small study of Chinese students found that both executive function and ADHD traits improved with cognitive training tailored to their needs.School support services or accommodations may also help a person with ADHD and executive functioning challenges.
Types of Mental Health Therapy
Outlook for Executive Dysfunction and ADHD
Most people diagnosed with ADHD can be treated, although their challenges often will extend into adulthood. This means that people with ADHD who also have executive function challenges may need treatment, including medication and therapy, across a lifetime.
Studies have demonstrated success in people who learn techniques and strategies to improve executive function, leading to a positive prognosis. They perform well at school or work, enjoy relationships, and can experience a good quality of life.
Keep in mind, however, that both ADHD and executive dysfunction traits can co-occur with other mental health issues (depression,anxiety,bipolar disorder, sleep disorders, andschizophreniaamong them), and these conditions may need to be treated, too.
An Overview of the Link Between Mental Health and Sleep Disorders
Summary
Executive dysfunction is a symptom of ADHD. Both are associated with differences in the brain regions responsible for thoughts, emotions, and behavior. This is also why they have so many overlapping characteristics.
Managing executive dysfunction depends on its cause and the ways it’s impacting everyday functioning. If associated with ADHD, medications for ADHD may help manage symptoms. Other strategies include therapy, skill-building, and receiving accommodation or support services in the school and work setting.
Determining the cause of executive dysfunction is an essential step in receiving the appropriate treatment, so speak with your healthcare provider if you have concerns.
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Isaac V, Lopez V, Escobar MJ.Arousal dysregulation and executive dysfunction in attention deficit hyperactivity disorder (ADHD).Front Psychiatry. 2024 Jan 17;14:1336040. doi:10.3389/fpsyt.2023.1336040.America’s Children and the Environment.Neurodevelopmental disorders.Romer AL, Pizzagalli DA.Associations between Brain Structural Alterations, Executive Dysfunction, and General Psychopathology in a Healthy and Cross-Diagnostic Adult Patient Sample.Biol Psychiatry Glob Open Sci. 2022 Jan;2(1):17-27. doi: 10.1016/j.bpsgos.2021.06.002.Attention Deficit Disorder Association.Executive Function Disorder & ADHD: Their Differences & How They Tie Together.CHADD.About ADHD-overview.Feldman JS, Huang-Pollock C.Slow drift rate predicts ADHD symptomology over and above executive dysfunction.Child Neuropsychol. 2021 Aug;27(6):834-855. doi:10.1080/09297049.2021.1902490.Rabinovici GD, Stephens ML, Possin KL.Executive dysfunction.Continuum (Minneap Minn). 2015 Jun;21(3):646-659. doi:10.1212/01.CON.0000466658.05156.54National Center for Learning Disabilities.Fact Sheet.Ogundele MO, Ayyash HF.ADHD in children and adolescents: Review of current practice of non-pharmacological and behavioural management.AIMS Public Health. 2023 Feb 7;10(1):35-51. doi: 10.3934/publichealth.2023004.Shuai L, Daley D, Wang YF, Zhang JS, Kong YT, Tan X,et al.Executive Function Training for Children with Attention Deficit Hyperactivity Disorder.Chin Med J (Engl). 2017 Mar 5;130(5):549-558. doi: 10.4103/0366-6999.200541.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Isaac V, Lopez V, Escobar MJ.Arousal dysregulation and executive dysfunction in attention deficit hyperactivity disorder (ADHD).Front Psychiatry. 2024 Jan 17;14:1336040. doi:10.3389/fpsyt.2023.1336040.America’s Children and the Environment.Neurodevelopmental disorders.Romer AL, Pizzagalli DA.Associations between Brain Structural Alterations, Executive Dysfunction, and General Psychopathology in a Healthy and Cross-Diagnostic Adult Patient Sample.Biol Psychiatry Glob Open Sci. 2022 Jan;2(1):17-27. doi: 10.1016/j.bpsgos.2021.06.002.Attention Deficit Disorder Association.Executive Function Disorder & ADHD: Their Differences & How They Tie Together.CHADD.About ADHD-overview.Feldman JS, Huang-Pollock C.Slow drift rate predicts ADHD symptomology over and above executive dysfunction.Child Neuropsychol. 2021 Aug;27(6):834-855. doi:10.1080/09297049.2021.1902490.Rabinovici GD, Stephens ML, Possin KL.Executive dysfunction.Continuum (Minneap Minn). 2015 Jun;21(3):646-659. doi:10.1212/01.CON.0000466658.05156.54National Center for Learning Disabilities.Fact Sheet.Ogundele MO, Ayyash HF.ADHD in children and adolescents: Review of current practice of non-pharmacological and behavioural management.AIMS Public Health. 2023 Feb 7;10(1):35-51. doi: 10.3934/publichealth.2023004.Shuai L, Daley D, Wang YF, Zhang JS, Kong YT, Tan X,et al.Executive Function Training for Children with Attention Deficit Hyperactivity Disorder.Chin Med J (Engl). 2017 Mar 5;130(5):549-558. doi: 10.4103/0366-6999.200541.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Isaac V, Lopez V, Escobar MJ.Arousal dysregulation and executive dysfunction in attention deficit hyperactivity disorder (ADHD).Front Psychiatry. 2024 Jan 17;14:1336040. doi:10.3389/fpsyt.2023.1336040.America’s Children and the Environment.Neurodevelopmental disorders.Romer AL, Pizzagalli DA.Associations between Brain Structural Alterations, Executive Dysfunction, and General Psychopathology in a Healthy and Cross-Diagnostic Adult Patient Sample.Biol Psychiatry Glob Open Sci. 2022 Jan;2(1):17-27. doi: 10.1016/j.bpsgos.2021.06.002.Attention Deficit Disorder Association.Executive Function Disorder & ADHD: Their Differences & How They Tie Together.CHADD.About ADHD-overview.Feldman JS, Huang-Pollock C.Slow drift rate predicts ADHD symptomology over and above executive dysfunction.Child Neuropsychol. 2021 Aug;27(6):834-855. doi:10.1080/09297049.2021.1902490.Rabinovici GD, Stephens ML, Possin KL.Executive dysfunction.Continuum (Minneap Minn). 2015 Jun;21(3):646-659. doi:10.1212/01.CON.0000466658.05156.54National Center for Learning Disabilities.Fact Sheet.Ogundele MO, Ayyash HF.ADHD in children and adolescents: Review of current practice of non-pharmacological and behavioural management.AIMS Public Health. 2023 Feb 7;10(1):35-51. doi: 10.3934/publichealth.2023004.Shuai L, Daley D, Wang YF, Zhang JS, Kong YT, Tan X,et al.Executive Function Training for Children with Attention Deficit Hyperactivity Disorder.Chin Med J (Engl). 2017 Mar 5;130(5):549-558. doi: 10.4103/0366-6999.200541.
Isaac V, Lopez V, Escobar MJ.Arousal dysregulation and executive dysfunction in attention deficit hyperactivity disorder (ADHD).Front Psychiatry. 2024 Jan 17;14:1336040. doi:10.3389/fpsyt.2023.1336040.
America’s Children and the Environment.Neurodevelopmental disorders.
Romer AL, Pizzagalli DA.Associations between Brain Structural Alterations, Executive Dysfunction, and General Psychopathology in a Healthy and Cross-Diagnostic Adult Patient Sample.Biol Psychiatry Glob Open Sci. 2022 Jan;2(1):17-27. doi: 10.1016/j.bpsgos.2021.06.002.
Attention Deficit Disorder Association.Executive Function Disorder & ADHD: Their Differences & How They Tie Together.
CHADD.About ADHD-overview.
Feldman JS, Huang-Pollock C.Slow drift rate predicts ADHD symptomology over and above executive dysfunction.Child Neuropsychol. 2021 Aug;27(6):834-855. doi:10.1080/09297049.2021.1902490.
Rabinovici GD, Stephens ML, Possin KL.Executive dysfunction.Continuum (Minneap Minn). 2015 Jun;21(3):646-659. doi:10.1212/01.CON.0000466658.05156.54
National Center for Learning Disabilities.Fact Sheet.
Ogundele MO, Ayyash HF.ADHD in children and adolescents: Review of current practice of non-pharmacological and behavioural management.AIMS Public Health. 2023 Feb 7;10(1):35-51. doi: 10.3934/publichealth.2023004.
Shuai L, Daley D, Wang YF, Zhang JS, Kong YT, Tan X,et al.Executive Function Training for Children with Attention Deficit Hyperactivity Disorder.Chin Med J (Engl). 2017 Mar 5;130(5):549-558. doi: 10.4103/0366-6999.200541.
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