In our previous blog post, we discussed the basics of executive functioning skills, in addition to the two strategies that can be used for intervention when these skills have not yet been developed: modifying the environment and intervening at the level of the child.
It was also mentioned how the frontal region of the brain is what controls much of human behavior, and disorders such as depression, anxiety, attention disorder and even fatigue can all impact a child’s ability to think critically, problem solve, and successfully engage in various other executive functioning skills. In this blog post, we are going to discuss the link between executive functioning skills and attention deficit disorder.
Within the prefrontal cortex are 4 prominent circuits that link the prefrontal lobe to different areas within the brain. Each circuit controls varying executive functioning skills, but all originate within the prefrontal lobe. The different circuits are described below:
- The first circuit travels from the frontal lobe to a structure within the brain known as the striatum. The striatum contains various forms of neurons related to movements, rewards, and the conjunction of both movement and reward to guide one’s behavior. Research shows that these neurons within the striatum produce activity related to preparation, initiation, and executive functioning. In summary, this structure within the brain allows a person to evaluate the reward of various actions and determine which specific action should be performed to have the best outcome.
- The second circuit originates in the frontal lobe and travels to the cerebellum. The cerebellum is responsible for balance and postural control, as well as coordinating the timing and force of muscle groups. How fluid one’s movements are is controlled by the cerebellum. A circuit that is functioning with difficulty may not be able to control actions in a timely manner (difficulty with time management skills) a common symptom of a child with ADHD.
- The third circuit begins in the frontal lobe travels to the amygdala. The amygdala’s main function is to regulate emotions and tie emotions to reward processing and decision-making. The amygdala is also the entry point to the limbic system, which is the part of the brain that controls emotional responses. This circuit highly controls a person’s actions as well. A person is presented with options, in which this circuit will consider how we feel about each action that can be taken and decide based on these feelings. A child with ADHD may have poor neural connections between the amygdala and the prefrontal cortex, creating difficulties with regulation of emotion and therefore behavioral responses.
- The last circuit travels from the frontal lobe to the back of this specific hemisphere, where self-awareness is enacted. Self-awareness is the ability to be both internally and externally aware of oneself. Being able to tune into your feelings and thoughts, as well as being able to recognize how other people see you in related to self-awareness. Having good self-awareness skills also means being able to efficiently identify strengths and weaknesses of a person. Self-awareness is also interrelated to emotional regulation and impulse control, which, again, is something commonly seen as a difficulty in children with ADHD.
Based on what has been presented about these different circuits and the origination within the frontal lobe, you may begin to see the connection more clearly between executive functioning skills and your child’s ADHD diagnosis. There are parts in the brain that tend to be smaller (i.e., amygdala) or take longer to mature for children with ADHD. This explains some of the deficits in the executive functioning skills mentioned in both this blog post and our post from last week.
It’s important to understand that your child is not purposely displaying impulse control issues or lack of emotional regulation skills, but instead, there may be parts of the brain that are taking longer to develop than other children his/her age. This lag in development is taking place within parts of the brain that control self-management and emotional control.
Although ADHD is a lifelong diagnosis, there are treatments and interventions available to help your child learn or enhance their executive functioning skills. These treatments may include, but are not limited to:
- ADHD medication
- Behavioral Therapy: using a rewards system at home
- Cognitive Behavioral Therapy: helps children talk and think about their thoughts and feelings in relation to how that act externally
- Social Skills Groups: it can be difficult for children with ADHD to engage appropriately in social setting. Social groups run by your occupational therapist is a great way to have your child interact with peers while having a professional guide them through the process.
- Occupational Therapy: in addition to running social groups, an occupational therapist can assist your child in developing the necessary tools and strategies to better regulate his/her emotions.
