When patients and I talk about ADHD as a “hidden disability,” we are not just talking about simple difficulties with attention or so-called “hyperactivity.” For nearly a decade, professionals in the field recognize that the real disabling features of ADHD are in the broad arena of EXECUTIVE FUNCTION. Several areas are commonly described. Thomas Brown, PhD, in his 2005 book, Attention Deficit Disorder: The Unfocused Mind in Children and Adults writes of six clusters, which may interact in various combinations:
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 our office teens and adults are given a self-administered test designed by Dr. Brown to assess these six clusters of executive function.
