Understanding ADHD: A Performance Disorder

Key Concepts

ADHD and Brain Function:
- ADHD impacts the connection between knowledge and performance.
- The disorder separates 'knowing' (stored in the back part of the brain) from 'doing' (front part of the brain).
Performance Disorder:
- Individuals know what to do but struggle to execute actions.
- ADHD is not a lack of knowledge but a disorder of performance, specifically the 'when' and 'where', not the 'what' and 'how'.
Executive Functions:
- ADHD affects all seven executive functions, leading to difficulties like time blindness and a lack of future-oriented behavior.

Environmental Scaffolding:
- Interventions must occur in real-world settings.
- Creating supports in the individual's environment is essential for bridging the gap between knowing and doing.
Role of Medication:
- Medications are justified due to ADHD's neurogenetic basis.
- 80% of people with ADHD will be on medication at some point; it's considered highly effective.

Externalizing Information:
- Use physical cues, reminders, and tools to assist with memory and organization.
Physicalizing Time:
- Utilize timers, clocks, and other time-management tools to help perceive and manage time better.
Breaking Down Tasks:
- Divide larger projects into smaller, manageable steps.
Externalizing Motivation:
- Motivation must come from external sources; rewards and consequences need to be immediate.
Manual Problem Solving:
- Provide physical tools or aids for tasks that require problem-solving.
Refueling the Executive System:
- Engage in activities that recharge cognitive resources, like short breaks, physical exercise, and maintaining blood glucose levels.

Chronic Condition Management:
- ADHD is likened to diabetes, requiring daily management.
- No cure exists, but management strategies can greatly reduce the impact.
ADHD in Adulthood:
- The majority will continue to manage ADHD into adulthood.
- Viewing ADHD as a chronic condition is crucial for effective management.