Steve:So I'm aware that many of our subscribers may have heard how ADHD can affect or impede our executive functioning. And I thought that some subscribers might not be too familiar with what that actually means. So I'm delighted to ask back, Dr Young, consultant clinical psychologist, to tell us a bit more about that and what it means to have impaired executive functioning.Clare:Okay, hi, thanks for asking me back. So it's certainly something that probably does get said quite a lot without necessarily providing that explanation. So when we think about ADHD and all neuro-developmental differences, what we're really describing is, obviously differences in the way that the brain works. And, particularly with ADHD, what we understand to be quite a core set of features or difficulties within this executive functioning system. So think about what that means. There are different components to executive functioning. So it's along a spectrum and certainly, there will be strengths and challenges along this spectrum.So when we talk about executive functioning, what we mean is things like working memory, so the ability to hold information in your memory, with the aim to perform a task with that information, without writing it down. So it is your moment to moment memory. So day-to-day, you may be asked to remember verbal information. So things that people tell you, you may be asked to remember visual information, so things that you see. But the key thing about this particular memory store is that you don't write things down. So you do not have a reference point, it's your ability to hold that information in your memory without creating a record of it. Now, lots of people with ADHD, not exclusive to ADHD, but of course, we're thinking about executive functioning as a spectrum of difficulties.So lots of people with ADHD will describe quite significant difficulties with their working memory, that moment to moment memory. So for example, being asked to remember different sets of instructions or various commands, particularly if they are chain commands, so "I've got to go to work", "I've got to remember to send that email", and after I've sent that email, I must remember that I've got a two o'clock appointment, and then in that two o'clock appointment, I've got to perform this task". So being able to remember all of those different instructions without writing them down. So that's often reported to be a considerable difficulty. Now, there are lots of different solutions to these difficulties, these difficulties do not mean that all is doomed. And of course, that's something else that will be discussed in later audios.So as well as working memory difficulties, other executive functionings relate to planning and organization. So this is the ability to think ahead, to put ideas and processes in place in a good sequence. So I do A, then I do B, then I do C then I do D, and the ability to slow down the brain sufficiently enough to be able to make those plans in that sort of good sequence order. Now lots of people find that this is very, very difficult. Not only can they struggle to make simple plans, but it's a case of needing to plan consequences and, you know, projected outcomes to ideas that also can be difficult. So this also hinders any successful planning, when you have to be able to kind of predict or foresee how your plan could ultimately end up, so these difficulties are often also very commonly reported.Another primary executive functioning difficulty is something we call cognitive flexibility. So that's the ability to move seamlessly from one particular task through to another, without that causing overwhelm or without that causing a shutdown, and lots of people with ADHD report this is quite a significant challenge, where they can sometimes get stuck on one task or they are unable to finish one task before they complete another, which means that you have sort of a scattering of lots of half-finished things as somebody will just move through from one task to another without there being this sort of fluidity to doing that IE completing one task before you start another. So that's another area of difficulty when we think about executive functioning. There are others which we will talk about, in other audios.