Presented by: Hillary Murphy, Ph.D.
View the webinar’s corresponding slides here
While Attention-Deficit/Hyperactivity Disorder (ADHD) is commonly associated with childhood, research indicates that deficits in attention and executive functioning can persist well into adolescence and adulthood. For those individuals whose symptoms are misunderstood or misdiagnosed, these unaddressed deficits are associated with academic underachievement, underemployment, and psychosocial difficulties. The current presentation seeks to explore the literature regarding the long-term impact of unmanaged or undiagnosed attentional deficits and executive dysfunction and how these symptoms can interfere with all areas of functioning.
Hilary Murphy Ph.D. is a licensed clinical psychologist and formally trained pediatric neuropsychologist with a specialization in the neuropsychological assessment of neurodevelopmental and neuro-medical disorders. Dr. Murphy has extensive experience evaluating children, adolescents, and young adults. As part of her training, she participated in interdisciplinary treatment teams, on an inpatient and outpatient context, to treat clients presenting with a variety of neurological, neurodevelopmental, and psychological needs. Her training in school psychology provides her with expertise in collaborating and consulting with educators and other professionals to develop comprehensive, individualized educational and treatment plans. She adopts a multi-faceted approach to neuropsychological assessment, which takes an individual’s culture, social-emotional functioning, cognitive profile, and academic performance, into account to develop a holistic understanding of each patient’s unique presentation. Her areas of expertise include Attention-Deficit-Hyperactivity Disorder (ADHD), dyslexia and other specific learning disabilities, Traumatic Brain Injury (TBI), concussion, epilepsy, neuro-oncology and late effects of chemotherapy, stroke, and developmental disabilities.
Comments(16)
KellieS says:
January 24, 2019 at 10:50 amI am a school nurse and administer adhd meds to students at the beginning of each school day. Is there anything you could recommend I can say to them to motivate them? So many of my kids like you said are incredibly capable students however they struggle so much to get through the day and therefore really dislike school. I often give them their meds and say something like “ok try to make good (or better) choices today.” I have one student in particular who is severe adhd with no diagnosed comorbid condition(s). He is constantly in trouble and lacks the ability to control impulses. No concept of personal space or social cues etc…I’d love to be able to reach him. I’m usually one of the only people in their daily school lives that isn’t angry with them or discipling them.
Dr. Murphy says:
February 4, 2019 at 2:29 pmThis is such a great question and I want to commend you for going above and beyond to reach the students in your care! You bring up a great point about being a source of positive feedback and I think my first answer is to keep that up. I often will recommend that parents and teachers rely on specific labeled praise. Essentially, I recommend that we identify the specific behavior we are praising the child for. For example, rather than saying “Good job” when a child successfully waits his turn in line, we could say “Hey, great job being patient, I know you were excited but you kept yourself calm! This allows not only an opportunity for a positive interaction but also clearly identifies the behavior we are trying to encourage. Outside of therapy, showing a genuine interest in a child is often one of the best methods for reaching out, especially to a child who may otherwise have shut down on those around him.
Alina G says:
January 24, 2019 at 10:52 amFor children with ADHD, what is your response to a child who says they need music in the background to be able to study because they say it helps them focus
Dr. Murphy says:
February 4, 2019 at 2:31 pmOftentimes, I will take time to review the child’s grades, in earlier grades, many bright students can successfully study with instrumental music playing in the background. However, difficulties can arise when the curriculum becomes more complex or when the music becomes more distraction than ambiance (e.g., focusing on switching stations rather than the material). If music is absolutely necessary, I recommend instrumental or nature sounds tuned at a low level in an otherwise quiet and distraction free setting.
Nicole Z says:
January 24, 2019 at 10:55 amWhat if an individual is able to complete goals, but this is quite difficult because of time management, organization, planning, and working memory. Would it still be considered an executive functioning issue?
Dr. Murphy says:
February 4, 2019 at 2:33 pmDefinitely. We often will see individuals who are bright or extremely hardworking who can just barely meet their goals. However, it can be easy to miss out on the intensive work and stress required to do so. Unfortunately, this often comes to light when an individual reaches an academic or occupational level where the demands far outmatch an individual’s strategies. Generally, this is when we recommend working with a professional to discuss what changes can be made to better adapt to changes in environmental demands.
Manny G says:
January 24, 2019 at 10:58 amIs executive dysfunction the same thing as ADHD?
Dr. Murphy says:
February 4, 2019 at 2:34 pmWhile executive dysfunction is often seen in individuals who are diagnosed with ADHD, these two domains are not one in the same. Essentially, if a clinician knows an individual has ADHD, it is not surprising to also see that the individual will demonstrate deficits in aspects of executive functioning. However, disruptions in aspects of executive functioning can be caused by several factors and can co-occur with many kinds of disorders.
Francesca N says:
January 24, 2019 at 10:58 amCan Cognitive Behavioral Therapy (CBT) be used to treat executive deficits?
Dr. Murphy says:
February 4, 2019 at 2:36 pmSince we know that underlying emotional distress can contribute to weaknesses in many executive processes, it’s not unusual to see a secondary benefit from CBT. Essentially, executive processes can be improved indirectly by managing mood concerns. In addition, establishing healthier and more adaptive habits (e.g., addressing tasks which cause anxiety as opposed to procrastinating) can also produce improvements in these domains. However, individuals struggling with executive dysfunction which is not secondary to an emotional concern would likely benefit from more targeted treatment. Some psychologist or therapists who practice CBT also specialize in executive coaching or organizational skills training which specifically targets these domains.
John B says:
January 24, 2019 at 10:59 amDoes adult ADHD mean you develop the disorder as an adult?
Dr. Murphy says:
February 4, 2019 at 2:42 pmNo, this is a common misconception. ADHD is a developmental disorder, meaning that symptoms must be present in childhood to warrant a diagnosis. Adult ADHD simply refers to individuals whose symptoms persist into adulthood and continue to represent a functional impairment in their daily lives.
Sara C says:
January 24, 2019 at 11:00 amIs there medication that can cure ADHD and executive dysfunction?
Dr. Murphy says:
February 4, 2019 at 2:43 pmNo, there is currently no “cure” for ADHD or executive dysfunction. Research suggests that medication can be an effective tool in managing the core symptoms of ADHD (i.e., distractibility, hyperactivity, and impulsivity). However, executive functions often also benefit from behavioral techniques including establishing consistent routines, keeping track of upcoming deadlines, and using reminders to stay on top of demands.
Noelle G says:
January 24, 2019 at 11:01 amCan adults with ADHD be successful in college?
Dr. Murphy says:
February 4, 2019 at 2:44 pmAbsolutely! Every individual has a unique pattern of strengths and weaknesses and success in any domain involves an honest understanding of an individual’s work style and the establishment of realistic goals. Given that the executive demands of this domain increase dramatically, it is often beneficial for parents or school administrators to help students slowly take a more active role in their education and in managing social obligations. This allows time for an individual to slowly develop these skills while having access to the support of adults aware of potential areas of deficit. It can also be helpful to have open and frank discussions of potential areas of concern and brainstorming strategies for managing these issues before they arise.