A Cognitive Functioning Model of AD/HD

Dr. Thomas E. Brown, Associate Director of the Yale Clinic for Attention and Related Disorders, has developed a model for AD/HD which is having a profound impact on our understanding of this disorder. In his book, “Attention Deficit Disorder: The Unfocused Mind in Children and Adults”, Brown describes a model for AD/HD based on an understanding of the cognitive management system of the human brain, a system commonly known as one’s “executive functioning.”

Two analogies masterfully illustrate the “executive functions” of the brain:

1. A CONDUCTOR — We can make an analogy between the executive functions in the brain and the conductor of an orchestra. No matter how talented each player in an orchestra may be – violin, oboe, percussion, and so forth – if the conductor is not skilled, the music will sound more like noise. “Similarly,” an article on the Teach ADHD website explains, “it is the executive functions of the brain that organize an individual’s current or ongoing actions and emotions to guide intentional [behavior] from moment to moment.”

2. A CEO — The Teach ADHD website also compares the brain’s “executive functions” to the role of a CEO in a big business. To be effective, the CEO must integrate information from various departments and individuals; prioritize, plan and organize strategies and actions; and guide progress. In the brain, our “executive functions” organize and coordinate our thoughts, actions, and emotions to assure coordinated and efficient behavior, including planning, making decisions, and responding to our environment.

Brown’s model of AD/HD describes six key executive functions in the brain, essential for smooth “management” of cognitive functioning and relates AD/HD to impairments in one or more of these key cognitive functions:

1. Activation – organizing, prioritizing, and activating to work

2. Focus – focusing, sustaining, and shifting attention to task

3. Effort – regulating alertness, sustaining effort, and processing speed

4. Emotion – managing frustration and modulating emotions

5. Memory – utilizing working memory and accessing recall

6. Action – monitoring and self-regulating action

In subsequent posts, I will explore strategies that can help bolster each of these areas of executive functioning.

To learn more about executive functions and AD/HD, see the following:

– A series of articles by Dr. Philip Zelazo, posted on AboutKidsHealth

– Dr. Thomas Brown’s website

– Video and podcast interviews with Dr. Brown

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