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Marianne Glanzman, MD: Explaining Executive Function in ADHD

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Executive function can include working memory, behavioral inhibition, and cognitive flexibility.

Attention deficit/hyperactivity disorder (ADHD) is a disease that manifests in many different ways, often impacting the executive function of the patient.

Recently, during the 2021 American Academy of Pediatrics (AAP) virtual conference, Marianne M. Glanzman, MD, Attending Physician, Department of Developmental and Behavioral Pediatrics, Children’s Hospital of Philadelphia (CHOP), presented a session about executive function in patients with ADHD.

Executive functions are basically the ability to accomplish goal-directed behavior, including working memory, behavioral inhibition, and cognitive flexibility. However, Glanzman said those are most common impairments, they are not the only impairments. In fact there are about 33 different constructs considered part of executive function.

And a lot these impairments can impact the patient’s ability to complete everyday tasks.

For example, an individual with ADHD might have poor reaction times, which will impact their ability to drive a car.

“These characteristics really contribute to the difficulties that students with ADHD generally have,” Glanzman said.

However, there are ways to measure executive functions with neuropsychological tests and rating scales, which could help clinicians and educators gauge the student’s executive function in order to craft a plan that better helps.

Glanzman said neither of these options are perfect measures, but can be utilized and leveraged with other measures to help teach and reinforce skills children need in their daily lives but do not have.

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