~Class 17 - Executive Functions and ADHD

Question 1

What are Executive Functions?

Answer 1

Executive Functions are a set of cognitive processes that allow us to engage in goal-directed behaviour and exercise control.

Question 2

Executive Functions include the ability to ___, ___, and ___ relevant information for a task.

Answer 2

organize // prioritize // activate

Question 3

What function is referred to as “The air traffic controller of the mind”?

Answer 3

Executive Functions

Question 4

Executive Functioning also deals with ___ and ___, like keeping a big-picture end-goal, and monitoring your progress towards it.

Answer 4

higher-level cognitive tasks // abilities

Question 5

What are the 3 main aspects of Executive Functioning?

Answer 5

Working Memory, Inhibition, Cognitive Flexibility

Question 6

What is Working Memory?

Answer 6

The raw capacity to keep information in mind. Involves controlling the information in working memory

Question 7

What is Inhibition?

Answer 7

The ability to control and suppress distracting stimuli (both internal and external); suppress behaviours.

Question 8

What is Cognitive Flexibility?

Answer 8

The ability to change course when the task demands change, or when you’ve evaluated that the thing you’re currently doing isn’t working out as effectively as you’d hoped. Involves shifting between mental states, rules, or tasks

Question 9

What part of the brain is most heavily implicated in executive functioning skills, including the ability to inhibit behaviours and thoughts?

Answer 9

The Prefrontal Cortex

Question 10

Inhibition facilitates ___; frees working memory capacity → aids problem-solving & ___

Answer 10

selective attention // reasoning

Question 11

Inhibition improves gradually from ___ onward.

Answer 11

infancy

Question 12

What task is good for testing children’s Inhibition skills?

Answer 12

The Day/Night Stroop Task

Question 13

How well can 3-4y/o perform the Day/Night Stroop Task?

Answer 13

3-4y/o can do it some of the time, but make a lot of errors, 65-70% accurate

Question 14

How do children aged 6-7 perform on executive function and inhibition tasks?

Answer 14

Children aged 6-7 Succeed at complex executive functioning tasks that require inhibiting distracting stimuli

Question 15

Do adults or teens have better executive function and inhibition skills?

Answer 15

Adolescents have pretty good executive functioning and inhibition skills, even fairly early on, this is especially true if you are testing their ability under ideal circumstances, like a lab circumstance, by 16y/o.

Question 16

Preschoolers can improve in their inhibition skills if they are provided with ___ and the right support:

Answer 16

scaffolding

Question 17

How can you help preschoolers improve their inhibition skills?

Answer 17

External aids; games requiring inhibition & rule-switching; pretend play

Question 18

How does a 3y/o perform on the card-sort task?

Answer 18

3y/o can sort the cards, but struggles to shift their approach when the instructions change.

Question 19

Before age 5, children tend to ___ rather than shifting to a new strategy/approach

Answer 19

perseverate

Question 20

Why will children sometimes default to the less effective strategy even after discovering a great strategy?

Answer 20

Because the strain of applying the new strategy is taxing their limited cognitive resources, so when they get this new problem and when they try to deploy their new and more efficient strategy, sometimes it overwhelms their mental capacity to the point where they don’t have enough cognitive resources left to do the counting and addition to solve the problem.

In those situations where they are discovering a new and more effective strategy, but trying to apply it to a new problem, they will frequently default to an older less efficient and less effective strategy, because it got the job done, and wasn’t as taxing.

Question 21

How do 5-6y/o perform on the card-sort task?

Answer 21

They get much better at the cognitive flexibility to switch from one strategy to the next, and they could do the card-sort task with more ease.

Question 22

What is the problem with lab-based tasks to measure the pure capacity to inhibit behaviours or to switch tasks?

Answer 22

When kids are making decisions about how to accomplish a task or avoid a certain behaviour, in their everyday lives, executive functions are only one piece of the larger picture that governs how they’re going to behave.

Question 23

What are the 4 things that are a lot easier to intervene on when we’re trying to help children resist the urge to engage in inappropriate behaviour for a particular situation?

Answer 23

1. Knowledge
2. Beliefs/Values
3. Social Skills
4. Strategies

Question 24

What does it mean when people say that ADHD is heterogenous?

Answer 24

This means that people with the same diagnosis can have dramatically different clinical presentations, the challenges they face, and the symptoms they experience.

Question 25

To get diagnosed with ADHD you must experience at least ___ possible symptoms in at least ___ possible clusters.

Answer 25

6/9 // 1/2

Question 26

There are ___ different ways of having at least 6 of the symptoms in a cluster

Answer 26

130

Question 27

Overall, there are ___ different symptom combinations that could result in an ADHD diagnosis

Answer 27

115,960

Question 28

What is Inattention?

Answer 28

Inattention: Refers to an inability to sustain attention & stick to tasks, to remember and follow through on instructions, and to resist distractions. (A better term might be “attention dysregulation”)

Question 29

Why is Inattention is a misnomer?

Answer 29

It suggests that they don’t have the raw attentional capacity to focus on the things they need to pay attention to.

We’re increasingly recognizing that the inattention in adhd, might be better described as difficulty regulating your attention.

ADHD almost involves an abundance of attention, in a sense that, in some contexts, you want to focus on everything, everything is interesting to you, you are casting a wide net. Distractibility can become a problem because your attention is spread over so many different parts of your environment.

Question 30

What is Hyperfocus?

Answer 30

In some situations, people with ADHD who struggle with Inattention will get so laser-focused on one thing that it’s like they are zoomed in on that, and are excluding everything else.

Question 31

What skills do people with Inattentive ADHD struggle with?

Answer 31

Selective Attention, Sustained Attention, and Alerting

Question 32

What is Altering?

Answer 32

Involves initial reaction to stimulus and ability to prepare. Deficit may contribute to difficulties with sustained attention.

Question 33

Do kids with ADHD and kids without ADHD have the same Attentional Capacity?

Answer 33

Yes, kids with ADHD can attend to & remember the same amount of information as kids without.

Question 34

Hyperactivity and Impulsivity are ___, but ___ in practice

Answer 34

conceptually distinct // highly related

Question 35

Can you Hyperactive and not Impulsive, and vice versa?

Answer 35

Yes, but they do tend to go hand-in-hand with one another, and are treated as a single category.

Question 36

Is Inattention or H-I more predominant among children?

Answer 36

Inattention

Question 37

We typically see that children who are high in this Hyperactivity-Impulsivity dimension show activity that is really energetic and intense, but doesn’t tend to be ___.

Answer 37

goal-directed

Question 38

In children with ADHD in the H-I dimension, amount of activity linked with ___.

Answer 38

environmental demands

Question 39

Although the broad clusters of symptoms in ADHD are Inattention and H-I, most of the symptoms that are actually used to diagnose ADHD have at least some degree of connection to an underlying ___ difficulty that tends to be at the core of peoples experience with ADHD.

Answer 39

Executive functioning

Question 40

People with ADHD will often report feeling excessive levels of ___ during the day.

Answer 40

drowsiness

Question 41

You sometimes see ___ of taking in and integrating information in people with ADHD, and when you couple those things with some of the other challenges, in day to day life it can result in a difficulty in completing tasks on time and when you had intended to.

Answer 41

slow processing speed

Question 42

At what age can you reliably diagnose ADHD?

Answer 42

Age 3

Question 43

What does it mean when they say ADHD is a developmental diagnosis?

Answer 43

It exists from birth to early in childhood. Given that, there is a very good chance that there are some early signs of ADHD, but our ability to detect those things reliably and use that to predict an individual child’s trajectory is still pretty limited.

Question 44

What are the symptoms of ADHD in infants?

Answer 44

• Difficult temperament
• Extremely active
• Erratic sleep patterns

Question 45

ADHD diagnoses are based on ___ reports.

Answer 45

retrospective

Question 46

What are the symptoms of ADHD during preschool?

Answer 46

• Symptoms become increasingly visible as hyperactivity increases
• More mobile/independent! Act without thinking
• Oppositional behaviours and difficulty resisting temptation predict ongoing ADHD-related difficulties

Question 47

At what age does salience of Hyperactivity drop off?

Answer 47

Elementary school