Executive Functions and Attention Deficit Hyperactivity Disorder: Implications of two conflicting views

While increasing numbers of articles and books refer to Attention Deficit Hyperactivity Disorder (ADHD) as a disorder of “executive function” of the mind, two conflicting views have emerged about how ADHD and executive function are related. In one view it is argued that some, but not all, who meet the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders diagnostic criteria for ADHD suffer from significant impairments of executive function. The alternative view holds that all individuals with ADHD suffer from significant impairment of executive function, and that ADHD essentially is a developmental impairment of executive function. These conflicting viewpoints rest upon divergent understandings of the nature of executive functions and how these functions should be assessed. Each leads to a very different conclusion about the essential nature of ADHD and its relationship to other learning and psychiatric disorders. This article describes and evaluates those two views and their implications.