ADHD Questions
What does impaired executive function feel like with ADHD?
Charles Li, MD
May 19, 2023
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Many with ADHD struggle with executive function, which manages our thought processes and cognition.
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This can feel like an inability to control what we pay attention to and inhibit our impulses. It can also come in the form of slower processing speeds and less working memory.
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Impaired executive function can lead to challenges at work and school.
Researchers have increasingly linked ADHD with difficulties in executive function.
Generally speaking, executive function refers to the higher-level thought processes in your brain.
What is executive function?
These include processes such as attention, reasoning, and planning.
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(Executive Function) has been defined as “the ability to maintain an appropriate problem set for attainment of future goals and includes such abilities as components of attention, reasoning, planning, inhibition, set-shifting, interference control, and working memory.
Welsh & Pennington, 1989, p. 201
These are all areas where those with ADHD can struggle. These deficits often become apparent at school or work, where we face challenging tasks requiring focus and attention.
Some of these challenges are driven by self-control and your brain’s ability to manage itself, which are all part of your executive function.
For those with ADHD, difficulties with executive function can feel like we can't control when we focus and when we can’t.
It can feel impossible to focus on some tasks, but easy to focus on others:
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Patients with
ADHD typically report that they can focus their attention
very well for a few specific tasks in which they have strong
personal interest or when they feel immediate pressure
to complete a specific task. Thus, they may be relatively
unimpaired by their chronic ADHD symptoms while they
play a favorite sport, complete an enjoyable mechanical
task, or communicate with others on the Internet. Their
chronic procrastination may suddenly disappear the night
before they are required to hand in an important report or
when a colleague is working beside them.
Other manifestations of executive function challenges in ADHD
Executive function extends beyond just focus and self control.
A study on executive function deficits among very intelligent children showed that executive function deficits often manifest as working memory and processing speed challenges.
Executive function impairments in high IQ children and adolescents with ADHD
This means that for those with ADHD, taking longer to finish a test or having trouble remembering details may not be a sign of lowintelligence. These can be signs of difficulty with executive function that even very intelligent individuals with ADHD can struggle with.
The effects of executive function challenges in ADHD
As a result of these challenges, those with executive function deficits can have trouble pursuing education and career opportunities.
Difficulties with executive function also can lead to challenges with holding jobs and performing well at work.
Impairment in occupational functioning and adult ADHD: the predictive utility of executive function (EF) ratings versus EF tests