Delayed Executive Functioning in Children Diagnosed with ADHD

ADHD is a development delay in executive functioning.

Executive functioning is a term used to describe the processes that happen in the pre-frontal cortex of the brain — its operating system. Anybody who has ADHD has lagging executive function skills. Sometimes it can appear that they do not if they are really motivated and learn how to compensate early, but essentially ADHD is lagging executive function skills.

A child with ADHD has a two- to three-year delay in their executive function skills, which means a 7-year-old has the executive function skills of a 4- or 5-year-old. A 13-year-old’s EF age is between 10 and 11, and a 19-year-old’s EF age is about 16. Would you send a 16-year-old off to college? That is something you need to take into consideration when planning for post-high-school options, for example.

Your expectations for your son or daughter need to match their EF age. To help them improve their executive function skills, change the way you use language and implement strategies to build skills and cultivate independence. The sooner you start this, the better.

Kids cannot improve their executive function skills on their own by watching a webinar or reading a book. Parents have to create the scaffolding and change the way they use language if they want to see improvement in their child’s EF skills.

1. Difficulty with self-directed talk, or what I call a child’s ‘brain coach.’ We all have an internal dialog in our heads. When someone’s brain works with ADHD, the volume on this brain coach is turned down too low if it’s something that is not interesting to them.

2. Non-verbal working memory. Kids with ADHD have difficulty with future thinking skills, which is why it doesn’t work to say, “If you do all your chores this week, you can have extra video game time this weekend.” The time horizon is too far into the future for them, so the reward feels too abstract.

If your child has ever done their homework but forgotten to hand it in, it’s because she didn’t visualize herself handing in the work. If your son just sits there in the morning and you have to guide him through each step of getting ready, it’s because he’s not visualizing himself doing that routine.

3. Sensing the passage of time. If your child ever lacks a sense of urgency or spends more time complaining about a chore than it would actually take to do the chore, that is because he has difficulty sensing the passage of time. Typical strategies like visual timers or checklists may keep a child on track, but it will not help them build stronger executive function skills.

4. Ability to sustain attention to non-preferred tasks or subjects. ADHD is not an inability to pay attention. When someone with ADHD finds something interesting, they can fully pay attention and even notice details that others don’t see. That can really help them in life, particularly when they find a career path that works for them. If your son ever starts yelling at you and gets really upset when you tell him it’s time to get off video games, that is not a behavior issue; it is an executive function — he wasn’t prepared for the transition from a preferred task to a non-preferred task.

1. Intelligence has nothing to do with executive functioning, so please don’t say things like “You’re so smart; why do you always forget to hand in your homework?” It’s also not helpful to say things like, “Think before you act,” because you’re asking your child to do something that their brain is not capable of doing yet.

2. Lagging executive function skills often appear behavioral in nature to the untrained eye. Counseling or talk therapy is not going to address lagging EF skills.

3. It’s natural for parents of kids with ADHD to act as their executive functioning, but this creates prompt-dependence, which means kids become over-dependent on their parents to act as their executive functioning rather than developing their own. The problem with this is that it can further delay the development of EF skills. Kids learn that, if they act helpless, things will be done for them.

It’s never too late for your son or daughter to improve their EF skills and develop independent. When kids realize their abilities and that they can do tasks independently, it builds their confidence.

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Ryan Wexelblatt, LCSW is the facilitator of the ADHD Dude Facebook Group and YouTube channel.