What are executive functions and how is executive function disorder different from ADHD?
Executive function very loosely could be described as the various abilities to control thinking and therefore actions. They’re are a group of cognitive controls that allow you to manage your life. They’re often associated with the prefrontal cortex, though other parts of the brain are important to, and are among the last traits to come online in human cognitive development.
There isn’t one definitive list of executive functions, but most lists include:
Impulse control - or the ability to pause, to look before leaping to think before speaking or acting.
Inhibition or interference control - which is the ability to block distracting external noise and internal thoughts.
Working memory - the ability to hold thoughts and details in mind while engaged and recall them at the right time.
Cognitive flexibility - the ability to think creatively outside of the box, to think from different perspectives and adapt to changing circumstances.
Other executive functions planning, organization, self monitoring, and attention stability etc.
Most lists include between 10-15 traits. They are the late to develop high-level cognitive abilities for managing your life effectively.
Executive function disorder, or just executive dysfunction, is when one or several of these traits are very significantly impaired or falls well below statistical norms for a person of that age. Now you may notice if you know much about ADHD that we’re talking about a lot of the same traits. But executive dysfunction is not a diagnosed condition, ie, it’s not officially recognized in the DSM 5 (the official American psychological association doctor book) whereas ADHD is.
ADHD confirms that a person checks enough specific boxes to qualify for the diagnosis. It’s five out of nine boxes for kids six out of nine for adults. Furthermore, ADHD breaks into a few different flavors. well, two flavors plus combined.
There’s hyperactive ADHD. These are the people we most often associate with the condition. They always moving and fidgeting, they have a little ability to control Their movement are described as “driven by a motor”. They struggle with impulse control, lack of inhibition, self monitoring, attention stability, as well as time blindness.
Then there’s inattentive ADHD. Some doctors and experts still referred to these folks as just ADD though technically that term has been absorbed into ADHD in the DSM 5. These folks are pretty different than the hyperactive subset. They don’t have the hyperactive component at all. They’re often seen as spacey or in their own worlds. They also struggle with self monitoring, attention stability, working memory, time blindness, and are often disorganized.
Both sub types can and do often struggle with many of the other executive functions. The combined ADHD sub types are simply the double winners. They check enough boxes for both diagnoses.
OK so that’s the difference between executive dysfunction and ADHD if we’re talking about the same sorts of impairments. Often not much.
Put simply, People with ADHD have executive dysfunction. But not everyone with executive dysfunction is ADHD. ADHD is about significant impairments of specific executive functions and they’re impaired enough that they often need medication and therapies as well as school and sometimes even work accommodations.
Executive Dysfunction on the other hand may involve one or several of the same executive functions, but either doesn’t rise to the level of an ADHD diagnosis or doesn’t check enough of the specific ADHD boxes.
In real life, there’s often little true distinction in the kind of life disruption each experiences. And the skills and tools for shoring up the specific deficits are often the same. The truth is both conditions can be very individual in terms of the constellation of specific symptoms with tons of overlap regardless of the official diagnosis. It’s important to establish an ADHD diagnosis if your intent on pursuing meds or therapies with the hopes of having insurance cover them.
But in the end, both conditions will need some degree of physiological intervention be at meds, Neurofeedback, physical exercise, mindfulness training, etc. As well as many of the same sorts of learned behavioral skills and tools.
I hope this has been helpful and If you have any questions about any of this, please don’t hesitate to reach out to us.
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