In contast to earlier views of attention disorders as a behavioral issue, ADHD is now understood in the neurocognitive context as pervasive impairment in the self-regulation of behavior, thought, and emotions due to developmental difficulties with executive function (Barkley, 1997; Reid, Trout, & Schartz, 2005). It is now also understood that ADHD symptoms generally persist into adulthood, and that individuals who may have compensated for executive function impairments in earlier years often find later challenges on these functions overhwleming and debilitating.
In his 2005 book Attention deficit disorder: the unfocused mind in children and adults, T.E. Brown identified six clusters of executive functions:
- activation (organizing and starting one’s work)
- focus (sustaining or shifting one’s attention)
- effort (regulating alertness and adjusting processing speed)
- emotions (managing frustrations and modulating intense emotions)
- memory (retrieving, holding, or working with information)
- action (monitoring and regulation of effort)
Increasing academic and organizational demands as students transition from middle school to high school and high school to college place students with ADHD at greater risk for academic difficulties and psychological distress compared to students without disabilities (Weyandt and DuPaul, 2006).
Research now supports a dual approach to interventions for assisting individuals with executive functioning impairments: medication and support services (although many individuals opt out of medication due to side effects or success with support services). Findings from the 2007 National Institute of Mental Health Conference emphasize the importance of identifying effective ways to assist students with executive functioning impairments:
“Despite the short-term effectiveness of current treatments for ADHD, particularly stimulant treatments, the limitations of these treatments for long-term otucomes are increasingly recognized. Among these limitations are failures to achieve long-terms gains in academic achievements (e.g. elevated high school dropout rates) and limited vocational opportunities and succes (e.g. frequent job changes, greater unemployment). The persistence of deficits in executive functions, motivational deficits, and impairments in self-regulation are increasingly acknowledged.”
Together, students with learning disabilities and/or ADHD appear to constitute well over half the population of postsecondary students with disabilities (Brinckerhoff et al., 2002). Understanding executive function challenges and providing effective interventions is especially important for this population, as well as the general population of college students.