Answers to Consumer Questions
What does adult ADD mean?
ADD Adults and
Executive Function In Everyday Life:
Symptoms, Diagnosis and Treatment
Research on Adult ADD [Adult Attention Deficit Disorder] is increasingly stressing
"impairment of executive function" as a hallmark of Adult
ADD. Executive Functions are a set of cognitive abilities that control other abilities and behaviors including the ability to
start and stop actions, to monitor and change behavior and to plan and carry through future plans--all
necessary for a successful adult life and more difficult for ADD adults.
Adults with Attention Deficit Disorder often spend all day
working and, at the end of the day, realize that they didn’t accomplish any of their goals for the day. They have difficulty
prioritizing tasks, organizing time and materials all because they lack
the necessary degree of executive functioning.
In plain terms, executive functions are necessary for getting through every day life
and accomplishing what needs to be done for their life to run smoothly. Any time we make a plan to do anything we are using
executive function. The simplest tasks require us to make a plan to do an action, initiate the action, see the action through to
completion, put the materials back in an orderly fashion, be aware that we have completed it and deal with interruptions.
Brushing your teeth in the morning is a simple example. You walk in the bathroom, make a plan to brush your teeth, initiate the
task by picking up your toothbrush and putting the toothpaste on, carry through with brushing your teeth, put the toothpaste cap back
on if you didn’t already, put tooth brush and tooth paste back and remember later that you actually did already brush your teeth.
Now imagine you are just starting that task and you are distracted by the telephone.
You have to prioritize. Should you finish brushing your teeth and let the answering machine get the phone call or put down the
toothbrush and answer the call? Oh right, your boss was going to call this morning. You put down the toothbrush and answer
the phone. Your boss told you about changes at work that could be challenging to deal with. What were you doing before that?
Oh yes, brushing your teeth…
You look around your house. What a mess. Piles of mail that you were going to sort, clothes that need to be put away, and then some day you will get to
the dusting under all of that… A person with good executive function skills can then do the following:
decide cleaning
this up is a high priority, figure out how much time that task is going to take, find the time in their calendar, make a plan to clean
the house, initiate the plan at the given time, sort through and organize the clothes and the mail, complete the cleaning including
the dusting and make sure that a structure is left in place so that the room will stay clean.
Adults with ADD also struggle with executive function deficits at work. Prioritizing tasks, initiating and finishing tasks, organizing work,
and materials all present challenges. Then there is difficulty with reading others nonverbal cues, inhibiting inappropriate comments,
and regulating their own emotions.
All of these challenges make everyday life for ADD adults challenging at work and at home.
The good news is that executive function skills can be learned and ADD adults can learn to understand and manage their
gifts as well. ADD adults tend to be people who can think creatively and see problems and solutions in a way their
co–workers can’t. However for those brilliant ideas to be realized, they have to learn how to use executive function.
The key is learning to build structures and supports around every day tasks. Understanding natural rhythms--when are the most
productive times--is critical. How are those times structured so that the maximum work is produced and distractions are reduced?
Sometimes simply deciding to work for 30 minutes and then taking a “green break” where you look at something green like a tree, is
effective. Other times, setting a meeting date to increase a sense of urgency gets tasks initiated.
It also helps to begin the task by visualizing what the end of the
task will look like when it is completely done, as opposed to part
way finished. How can the
workspace be organized so things can be found easily and put away easily?
Sometimes having a “clutter companion” work with an ADD adult can help them sort out what to
keep, and what to give away to reduce clutter and streamline organizing. Judith Kohlberg and Kathleen Nadeau in their wonderful
book, "ADD Friendly Ways To Organize Your Life," discuss dividing tasks into bites, gobblers and munchers and how to
use “clutter companions”.
“Bites” are tasks that can be done quickly, like putting the breakfast dishes in the
dish washer. “Gobblers” are tasks that require more of a time commitment, such as cleaning out a closet. “Munchers”
are tasks that require a weekly time commitment over a month for example or several weeks like cleaning out your basement or garage.
The reality for ADD adults is that they frequently use what Judith Kohlberg and Jean Nadeau refer to as the “EAST Strategy”,
Everything At The Same Time.” An ADD adult will be looking for that jacket they love, get upset at
how messy the closet is, and decide on the spot to take everything out of the closet. Problem is now they are late for work, still
haven’t found the jacket and now have a huge mess in their bedroom. Plus since they are overcommitted they are not going to be home in
the evening because they are committed to doing something they really don’t have time to do anyway so the mess will stay there for
awhile making life crazier than it already is.
Counseling for
ADD adults can help them achieve the life they want instead of feeling
trapped in this cycle of unfinished work, not enough time for their
priorities, clutter, impulsive spending and always feeling
overwhelmed. Working with a professional counselor, ADD adults
define the scope of the problem, take stock of their strengths, build on
previously successful patterns and learn new strategies to take
control of their lives. Through counseling, ADD adults can create the
life they want by learning to understand and utilize executive
function strategies.
An ADD adult who has learned good executive function
will realize they do not have time to find the jacket, choose something else and make a mental note that the closet really needs
to be cleaned out. They will schedule time on Saturday when they know they have 2-3 hours for a “Gobbler” task, find a “clutter
companion” to help them sort out the clothes and then tackle it on Saturday. They will sort clothes into “keep”, “give away” and “throw
away” with help from their “clutter companion”, organize the closet and dispose of everything that does not belong in the closet.
The task is completed, clothes will be easier to find, and the ADD adult feels a tremendous sense of accomplishment which will make
tackling the next task easier.
At work, the ADD Adult who has learned how to use executive function will learn how to apply the same time management strategy
to work site tasks and build their work day around “bites”, “gobblers” and “munchers,” beginning with the end objective in mind
and be able to find time to utilize all of their creative ideas. Because ADD adults crave stimulation they frequently gallop off on
new ideas without thinking through how they are going to be able to execute them. Judith Kohlberg and Kathleen Nadeau recommend
using a mental “cooler” to place these ideas into. Keep a file, then make time in your schedule to take these ideas out and
sort them through with colleagues or just flesh them out a bit more and build a solid plan for execution of the ideas. That way required
tasks are addressed at work and there is still room for developing and executing those creative ideas.
The better ADD adults
learn to utilize their executive function skills to organize their time,
home, and work tasks, the more successful they will be at creating the
kind of life they truly want. Adults with ADD have a lot to offer the world and
learning how to use executive function enables them to do it more
effectively.
See also:
Adult Attention Deficit Disorder (ADD) symptoms listed in the Diagnostic and Statistical Digest of the American Psychological Association
Test for Attention Deficit Disorder (ADD)
This article on Adult
Attention Deficit Disorder (ADD) was submitted by
Seattle counselor,
Paige Tangney.
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