Executive Functioning Issues
ADHD
What is it? A brain-based condition that makes it hard for
kids to concentrate, use working memory,
organize and manage themselves. They may also
be impulsive or hyperactive. These are all issues
with executive function.
Signs you may  Has a hard time paying attention
notice
 Has difficulty with self-control
 Has trouble managing emotions
 Has difficulty holding information in working
memory
 Has trouble switching easily from one
activity to another
 Has trouble getting started on tasks
 Has problems organizing his time or
materials
 Has difficulty keeping track of what he’s
doing
 Has difficulty completing long-term projects
 Has trouble with thinking before acting
 Is easily distracted and often forgetful
 Doesn’t seem to listen when spoken to
 Has trouble waiting his turn
 Fidgets excessively
 Acts as if he’s “driven by a motor”
 Interrupts others and talks excessively
See more ADHD symptoms.
Possible social Impulsivity and trouble managing emotions may
and emotional cause difficulty making and keeping friends.
impact Frequent negative feedback for acting out or not
paying attention can impact self-esteem and
motivation. It can result in kids feeling “bad” or
“no good.”
Professionals  Pediatricians, neurologists, developmental-
who can help behavioral pediatricians, nurse
practitioners, psychiatrists: Diagnose ADHD
and prescribe medication. Can also look for
other issues, like anxiety. Pediatricians may
Weaknesses in key mental skills that are responsible
for attention, memory, organization and time
management, and flexible thinking. Kids with ADHD
struggle with these skills. But so do some kids with
learning issues who don’t have ADHD.
 Has a hard time paying attention
 Has difficulty with self-control
 Has trouble managing emotions
 Has difficulty holding information in working memory
 Has trouble switching easily from one activity to another
 Has trouble getting started on tasks
 Has problems organizing his time and materials
 Has difficulty keeping track of what he’s doing
 Has difficulty completing long-term projects
 Has trouble with thinking before acting
 Is easily distracted and often forgetful
 Has trouble waiting his turn
 Has problems remembering what he’s been asked to do
See more signs of executive functioning issues.
Trouble remembering what he’s been asked to do
can cause problems in social relationships. Not
thinking flexibly can make it hard to be flexible
with others. Poor self-control and self-monitoring
can cause problems with friends.
 Pediatricians, neurologists, developmental-
behavioral pediatricians, nurse practitioners,
psychiatrists: Refer patients to specialists who can
evaluate for executive functioning issues, along with
other learning issues. Can diagnose ADHD and
 refer patients to psychologists (or pediatric
neuropsychologists) for more complete
evaluations.
 Clinical child psychologists: Diagnose ADHD
and mental health issues that may co-occur,
like anxiety. May also evaluate for learning
issues, including issues with executive
function. Provide behavior therapy to teach
kids to manage their actions and
interactions. Provide cognitive behavioral
therapy to help with emotional issues
related to their ADHD.
 Pediatric neuropsychologists: Evaluate for
learning issues. That includes tests that look
at executive function. May also evaluate for
ADHD and common mental health issues
that might co-occur.
 Educational therapists and organizational
coaches: Work on organization and time
management skills.
What the school Accommodations under a 504 plan or an IEP. Child
may provide might be eligible for an IEP under the category of
“other health impairment.”
Examples might include:
 Tutoring or coaching that teaches executive
functioning skills
 Help with organization skills
 Extra time on tests
 Preferential seating
 Opportunities for the student to repeat and
rephrase important information
 Additional structure to the day with routines
and predictable transitions
 Tasks that have been broken down into their
smaller components
 Multisensory teaching techniques
 Increased structure and expectations for
learning activities
See more accommodations for ADHD.
prescribe medication for it (there are no
medications just for executive functioning issues).
Can also look for other related issues, like anxiety.
 Clinical child psychologists: May evaluate
for executive functioning issues as part of a
full evaluation for learning issues. Provide
behavior therapy to teach kids to manage
their actions and interactions. Provide
cognitive behavioral therapy to help with
emotional issues. May also diagnose for
ADHD and mental health issues that may
co-occur, like anxiety.
 Pediatric neuropsychologists: Evaluate for executive
functioning issues as part of a full evaluation for
learning issues. May also evaluate for ADHD and
common mental health issues that might co-occur.
 Educational therapists and organizational
coaches: Work on organization and time
management skills.
Accommodations under a 504 plan or an IEP. Child might be
eligible for an IEP if he has a learning disability or ADHD.
Examples might include:
 Tutoring or coaching that teaches executive
functioning skills
 Help with organization skills
 Extra time on tests for kids whose problems with
executive function cause them to have
slower processing speed
 Preferential seating
 Specific academic skill strategies; these might
include reading comprehension strategies, asking
questions, predicting, summarizing and organizing
thoughts for writing
 Positive reinforcement and encouragement to
increase confidence
 Structured teaching of complex academic skills;
multiple opportunities for practice and
reinforcement
 A “road map” to solve various problems with
examples that explicitly detail each step
 See more accommodations for executive functioning issues.

What you can do  Create daily routines and rituals to provide  Create daily routines and rituals to provide structure.
at home structure.
 Practice self-regulation skills.
 Practice self-regulation skills.
 Model appropriate social behavior.
 Model appropriate social behavior.
 Teach time management skills.
 Set rules and stick to them.
 Give advance warning of upcoming transitions.
 Break tasks into smaller chunks.
 Have him talk through difficult tasks. Model thinking
 Allow for frequent breaks. aloud during planning and problem-solving situations.

 Have clear expectations for behavior and  Improve monitoring skills by asking him to evaluate
prepare him in advance for new experiences. his performance. Review the accuracy of his
evaluation with him.
 Give frequent feedback.
Explore specific strategies to help your child with executive func
 Provide positive reinforcement for positive
issues at home.
behavior.

Explore specific strategies to help your child with

ADHD at home.

ADHD AND EXECUTIVE FUNCTIONING