View Full Version : How to recognize? ADD inattentive or executive functioning deficit?

10-29-16, 11:36 PM
What distinguishes ADD inattentive subtype from an executive functioning deficit? If a person has an executive functioning deficit and as a result are consistently confused, won't that inevitably lead to attention problems?

All the traditional ADHD medications have failed to significantly help me, so I'm having 2nd thoughts about my ADD inattentive diagnosis.

10-30-16, 01:37 AM
It can be a very tricky question, as ADHD (and some other disorders) typically involve deficits in executive functioning. They're not necessarily separable, and they're definitely not mutually-exclusive.

Another tricky thing is that response to medication alone can neither confirm nor disprove a diagnosis of ADHD. Some people who meet all of the criteria for ADHD respond poorly to medications or can't take them for other reasons.

A third tricky thing is that there is some overlap in terms of deficits (and appearances) in ADHD and certain specific processing or memory problems or learning disabilities.

If you have not previously been tested for specific processing or memory problems, this type of testing might help you sort out whether there is a specific deficit in one or more of these processes that might be in play (in addition to, or as an alternative to) ADHD. A neuropsychologist or educational psychologist might be able to give you some targeted tips for addressing or (more likely) working around such problems, if they are present. (Several big caveats, though: this type of testing is often quite expensive and not often covered by insurance, it can't definitively tell you if you have or don't have ADHD, and it may not tell you much that you don't already know from experience in terms of how you process things. But it might give you some insights into which specific processes work well for you, and which work less well.)

Meanwhile, you might be interested in some of the discussion of "sluggish cognitive tempo" and "slow processing speed" -- neither of which is universally recognized as a formal diagnosis, but both of which are sometimes discussed by researchers and/or clinicians (as companions to, or alternatives to, ADHD).

Finally, I don't know your experience with ADHD medications, other than what you've tried hasn't worked. Is your doctor well-versed in using stimulants and other medications? Some doctors have less experience with ADHD meds, which can sometimes lead to inadequate trials of medication (starting with too high a dose, not trying a high enough dose, changing things too often to get a good idea of how something affects a person, etc.). Even if you're pretty sure you've exhausted all of the possibilities, it might be worth seeking a second opinion from someone with expertise in ADHD who can review your records in detail (both the diagnosis and the treatment history). Again, this is likely to cost money, and may not lead to brilliant treatment ideas, but it may be worth looking into if you are out of other ideas.

It's frustrating to feel stuck and out of options, but it's not necessarily the way things will always be. I hope you're able to get un-stuck and to find some approaches that work for you. Best wishes!