How is Teen ADHD Different?
ADHD Hong Kong
As children enter the teenage years, ADHD becomes less about “being fidgety” and “inattentive” in class, and more about the executive functions required to keep up with the rigorous demands of junior and senior high school.
Executive Functioning
There is no widely accepted definition for EF (executive function), however broadly speaking the term refers to the brain-based skills required to execute tasks or achieve a goal.
In terms of schooling, literally every task or challenge given to students requires some level of executive functioning.
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For instance, a teen with a weakness in organization skill may have a hard time keeping track of his homework assignments, or keeping his locker in order. Another teen with a weakness in working memory may forget to complete her homework. Still another teen who struggles with behaviour inhibition may blurt things out in the middle of class, or do things he immediately regrets.
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As children progress through school, the demands on executive skills increase.
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ADHD vs Executive Functions
Executive function encompasses a wide range of skills, including the classic symptoms most often associated with ADHD (hyperactivity, inattention and impulsivity), but go beyond these. The executive functions most related to schooling include -
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Response inhibition
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Time management
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Emotional control
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Flexibility
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Sustained attention
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Task initiation
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Planning/prioritization
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Organization
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Working memory
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Metacognition
Students with vulnerable executive skills may function adequately in the lower grades, but as they are expected to complete homework independently, collaborate on project-based assignments, self-monitor progress, and manage more complex tasks (for instance, studying for mid-terms) they often struggle to keep up.
For many students, middle school is the tipping point.
The good news is... research shows executive skills are developmental and due to neuroplasticity (the brain’s capacity to rewire and grow) EF skills can be learned and enhanced at any age.
More good news... there are proven, effective strategies for doing this. The goal of ADHD coaching is to condition these critical skills and behaviours so they become “automatized’ (i.e. executed without conscious thought – similar to brushing your teeth or walking down a flight of stairs).
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a New Model of ADHD –
not so much a "disorder" or "deficit"
but rather a "difference" ... a delay in development
** There is a growing body of research indicating ADHD and weak Executive Functions are due to a delay in development (specifically, cortical maturation), and not as some believed a "chemical imbalance" in the brain. See further below. **
What to Look For -
A Maturing Brain
Neuroscientists have long thought a child's brain was mostly developed during early childhood. However recent research using MRI scans year after year, has revealed that the brain continues to undergo radical changes throughout adolescence and the teenage years, reaching full maturation around the age of 25.
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Studies show the cortical development in children diagnosed with ADHD
lags behind those of typically developing children by several years.
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Specifically, the delay in development is most significant in the lateral prefrontal cortex -
the area of the brain responsible for cognition and executive functions.
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Source: "ADHD is characterized by a delay in cortical maturation," Shaw, et al., Proceedings of the National Academy of Sciences, (December, 2007)
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"The brain of the child identified with ADHD is not a flawed brain, a broken brain, or a disordered brain; it is a developmentally delayed brain."
Thomas Armstrong, PhD
“With ADHD, many parts of the brain are working beautifully, but a slower-to-
mature part of the brain isn’t working as well.”
Martha Denckla – neurologist, Kennedy Krieger Institute
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“Recent scientific research has developed a new paradigm which recognizes ADHD as a developmental disorder of the cognitive management system of the brain - its executive functions. This updated model is increasingly being recognized and used by many professionals in psychology, medicine, education and related fields."
Thomas E. Brown, PhD – leading ADHD expert
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