003 Structural Brain Differences & Executive Function

In this episode, our daring duo explains the basics of how ADHD neurology impacts the development of executive function skills. The Episode references this book by Peg Dawson and Richard Guare. Here at the Parenting Balance Podcast, you'll find simple, science-based tools and tricks for parenting kids with ADHD or anxiety. Although we are both family therapists, this podcast is for informational purposes only and should not replace the guidance of a qualified professional. Join us as we debate and discuss our own experiences as parents of kids diagnosed with ADHD and anxiety and breakdown the latest research into easily digestible portions. We created this podcast to educate, inspire hope, explore new ideas and discover together what we know to be true: you are not alone, and finding a community of support can make all the difference. Please join our Parenting Balance Podcast Community here and sign up here to be the first in line for our new Modern Guide to Understanding Kids With ADHD mini-course.

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Transcript

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Hi everyone welcome to the parenting balance podcast. My name is Kelly Williams. I'm a licensed clinical social worker and an ADHD parenting expert by experience. I'm here with my partner Hi I'm teresa Van Pelt on the licensed mental health counselor and anxiety parenting expert by experience. And for the past 10 years, Kelly and I have had a family practice in Florida. This podcast is for parents who want to really understand what's going on with ADHD and anxiety so you can ditch the chaos and feel confident and happy again.  welcomes to episode three Today, Kelly. I will talk about another factor that may contribute to what looks like a lack of motivation. This has to do with the structural brain differences.  for ADHD. There are parts of the brain that develop at different rates. For today's episode, we're going to focus on the delay and the development of the frontal lobe. So the frontal lobe is the part of the brain where the executive functions live and executive functions are linked to the thinking skills that allow us to direct our thoughts, feelings and actions in order to achieve a goal. Right, that's it executive functions are the thinking skills that connect the dots between knowing what to do and actually doing what you know. They're really pretty complicated, and they rarely operate in isolation. Right? So we are always using multiple executive functions at the same time. So you're saying so to achieve one goal, which may be to cook dinner? Yeah. There are several executive functions that are involved in that. The process of just making dinner. Sure, sure. Well, right. So let's think about it. You need to know what you're going to make, and then you have to organize the time to kind of put everything together. In order to make it, you have to sustain your attention long enough to get the job done, and you have to avoid distractions, right? So I always I'm famous for, like, saying I can't do that right now. I'm at a critical moment in my meal, right? You know, you're, like, simmering something in the pan or whatever. And so because of a burning question, you're the one that talks on them. Just like whatever has I love to cook, but, um, yeah, you know, So it's like it's the, um I think in a previous episode, you know, I mentioned that our executive function skills are what lets us sort of realize our smartness, you know, like it's connects all the dots together. And for kids with a non-neurotypical brain, certain executive functions can be weak. Okay, Now, I personally use a model, um, that was created by Peg Dawson. She wrote a really super book, the name of which I can't recall right now, But we'll put it in the notes, uh, for this episode. But, um, her model of executive functioning has 12 areas, and, um, kind of currently the researchers, Actually, there isn't consensus yet on ah, one model of what exactly all the executive functions are. But I'd like the Peg Dawson model because her 12 different areas break it out enough that, um, things don't overlap. So, for example, um, time management task initiation and planning planning. Right. But then sustained attention. So that would be like feeling time, like having a concept of time. A lot of our kids, I don't think, have a good concept of time, right? You know, they say that 90% of people with non neuro typical brains uh, that their perception of time is skewed. And to the degree that it it's an impairment. Right? Right. So 90% of people cannot. It doesn't. It doesn't mean being able to tell time that plan time. It means feeling time, feeling time passing, and in here is kind of What goes on is when you're doing something you love, it feels like time goes faster than what it really does. And when you're doing something you hate, it feels like time is like going slower on the actual feeling of this, Like the perception of this Israel. Okay, so, you know, like, how many times have you gone to your kid and been like, Okay, time's up. You know, you've been watching this movie for 30 minutes and they look at your like What do you mean? It just started five minutes ago. Our You've been on the video games for eight hours today? No, not that that really happens, you know, But my and they feel like No, I've just been in this one game like this. Has not been all day. No concept of rhyme, None. So, for example, so, like, one sort of, um, way that I deal with this in my house is that we used timers for everything. We keep track of time all the time. So my son, who's super into video games, has an alarm clock right there, like Big, I don't know, three inch digital clock right next to his, uh, video screen. Sure, he loves that. And he will say, right? Yeah, and he will say, I want to play my game and I'll say, Well, how long are you going to play? I'm gonna play for an hour and then I'll say, Okay, what time is it on your clock, And what time will you be done? Right. So we have that conversation before he gets started. So you're setting expectation so that when I come in and say, Hey, buddy, it's It's almost a hour And he wants to say to me, No, I just got started, right? And I say, Look at your clock. What time did you say you would be done? And he looks at his clock. And so then he's adjusting his sense of time. He's realizing what an hour feels like to him, you know, because it's sort of like, um, that analogy with the eyeglasses, right? Like I can tell you, it's been an hour. But if you don't feel like it's been an hour, you're not gonna believe me that it's been an hour, Right? So we have to have these kind of ways to help our kids feel on the inside, realize what's really going on, you know? So, um all right, but so we haven't even done the overview of way executive functioning is all right. So we said, executive functions air like the thinking skills that connect the dots between knowing what to do and doing what you know. So it involves things like time management, which we just discussed. It involves being ableto organize and prioritize information. It involves being ableto sustain your attention long enough to, you know, to do something. Um, it absolutely is related to effort, right. Being able to, like, regulate effort. And, um, I guess this sort of part of sustaining attention is like being able to push through until the job is done and memory, right. So, um, working memory is something that can, um you know, like time management. Working memory to can be a real problem for many people that have a non neuro typical brain. So when you talk about thes executive function skills, does every a person with a non you're a typical brain Have a deficit in all of them? No. OK, no top talk about that. Yeah, You know, we all And this goes for all humans, which ever kind of brain you have. We all have areas that we are stronger in an areas that were weaker in right. So, like, everybody who knows me knows that I am always late time management is weak, right? And so I have to put a lot of effort in, Like when I'm working with my family's at the practice. This is a quick little aside. When we first started working together, she came to my practice toe help with my my over full overflow. I had too many Too many people were clocked calling and I couldn't meet the need. Um, so she worked for a little bit and then she finally said, Theresa, we have to have a clock I have in the office like I can't man off on time. Yeah, it's like she was like, stuck in a vacuum chamber, and she had no idea what was happening. I couldn't. Yeah, I couldn't navigate, you know? So here I am. I'm supposed to be doing a 60 minute appointment with someone, and all of a sudden, it's like, Oh, my gosh, it's been an hour and 1/2 like, I have no clue. Yes. So, um, so clocks are a big thing for me. Um oh. In the clock I got was probably, like, six feet tall. I don't know, it was huge. Do you remember that? I dio I was huge. I dio that's funny. But anyway, it was four deck for decorative purposes. But that's you. That was right. I remember that because then we had to change it when we moved. Yeah, it is a new location. All right, So, back to back. Well, so yes, So everyone now, when it comes to prioritizing information, right? So let's, like, use each other as an example, I struggle with that. Exactly what I am super strong in knowing how to prioritize information. So Kelly really helps me prioritize. I'll come to her and say, Okay, I have this this in this. What? What do I need to focus on? First because I I have a hard time understanding what, exactly? Horton? Yes. So that's an area where you are weak and I am strong. And because we know that about each other, we can talk about it and kind of support each other, you know? So and I think this was really interesting. Like one of the most interesting things that I first discovered when I was developing this model that I teach to parents for, um, you know how to help kids with a D H d Ah was that what I started to see in the practice is that there's an intersection where the parent has a strong skill. And if the child, if they are weak in that same skill, there's kind of this X marks the spot, and that's right where the conflict always waas. It's really hard thing to understand. It's like one person said. It looks like it's so easy for May. So that's if Kelly didn't have the understanding. She would just be like wtf Theresa. Like what? Why don't you understand What? Why don't Why can't you just do this on your own? Why do you need me to tell you what to do first. Exactly. So sometimes we can be so strong in an area that we can't. You know, we can't comprehend that someone else can't do that. Skill. And, ah, lots of parents. When when we first start talking about executive functioning. Because, of course, these are skills that we don't teach in school. OK, so they're kind of the things academically speaking that I think, um, teachers of model these skills and they provide like, for example, like when you have to write an essay and they give you the hamburger thing where it's like the subject is the bond and the meat is for that. Whatever the introduction, I can't even say it right, but, you know, so they can give you these tools, but they don't kind of explain. They don't connect the dots for you about why it is you have to use this method. Okay, anyway. And so, um, a lot of times, the specific executive function skills are not taught in a concrete way to kids. And when we're weak in an area, the result of that is that we I kind of don't we don't learn how to do it. But then we sort of internalized that there's something wrong with us that we can't do that. So that's something that I'm thinking. I bet you're saying that is homework. So we've talked before and we have said that, um, people with 80 HD tend to have higher IQ's. Oh, yeah, Um, but their ability to show right they know isn't as high. It's like so they may understand the stuff. But when you do homework, there's a lot of executive function skills that are required. Sure, it's not just one step. There's several steps. That's right. And this is a big one. So it could be a problem of getting started, right? They can't edge initiate. That's right. Yeah, getting started is a problem. And once we see this all the time in my house, like once, you finally get started, the whole thing's over within five minutes. Okay, but it took 45 minutes just to be able to come around to this idea that I got to start doing this homework, you know, Soho. Mark takes us an hour, but the actual time spent doing the work is is 10 minutes of that hour. You know, that could be really frustrating for parents. I want to start cooking dinner. Yeah, right. You are busy. Um, were there could this be this problem of working memory, Right. So remembering what it is that you're supposed to dio or there could be this problem of organization which involves that would involve, like, bringing home the necessary supplies. You need a textbook and a worksheet and this and you have to bring all that home in order to do the project. So maybe you remember that you needed to do the project, and you're ready to get started on the project. But then you open your backpack, and it's like, Oh, crap, I don't have the materials I need to do the project. OK, so this is a good example of how like using this model of these different executive functions can really help you to pinpoint what the problem is. And sometimes when we don't understand, overall, that there are these different skills that everything involves all these different steps. Um, we can assume right, like, Oh, you just didn't bring the stuff home because you didn't wanna have to do it. You know, like sometimes it can feel like our child who is bright and smart enough to do whatever they need to do but keeps making this one little mistake. Like, um, my son will chronically underestimate how long it takes to do something, you know. And so that's a little bit related to time management, but it can also be related to procrastination. Right? So of putting off procrastination is putting off getting started on something where as, um and kind of procrastinating is different from initiating sometimes you know what I mean. So, um, so anyway, so having this, you know, this is the lens through which I am always looking at what's going on for families. I try to examine everything through an executive functioning lens because, um, and your take away for today okay, Is that because there is a structural brain difference in the neurology of 80 HD week executive functions are, um I guess I say it like this executive age is three years less than chronological age. All right. Says sometimes for non neuro typical brains, there are areas of executive functioning that are weak because this frontal lobe part of the brain is delayed in development. So we have to always adjust our expectations to match with developmental ability. And I guess if if we don't do this, we inadvertently set our kids up to fail. Yes. Yes. You know, right. Like it's like expecting someone to be doing multiplication before they can add. Yeah, you know, and that's why it's important to understand this, because without this knowledge, we would Yeah. Yeah, absolutely. Look it. This is one of the sessions that I have in my office with. You know, when I explain this parents, I mean lightbulbs, air, going off everywhere and emotionally. I think there's there some guilt sometimes, but it is what it is. Yeah, yeah, yeah. Look, we can always adjust, right? So, um yeah, so your take away for today is executive age is three years less than chronological age. And if you kind of take that into your house and you look at where you're kind of hot spots are, um, try to see is my expectation for what I want to too high too much. Is it appropriate for a child this that has this executive age? Yes. Thank you for listening to the parenting balance podcast to doing our mailing list. Go to parenting balance dot com slash podcast. 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