They Told You Your ADHD Brain Was Broken. They Were Wrong.
New research tears apart the “executive function” story that launched a billion-dollar industry…
“Executive function” is the big buzzword these days in ADHD circles. Psychology Today defines it:
“Executive function describes a set of cognitive processes and mental skills that help an individual plan, monitor, and successfully execute their goals. The ‘executive functions,’ as they’re known, include attentional control, working memory, inhibition, and problem-solving, many of which are thought to originate in the brain’s prefrontal cortex.”
The hit on Hunters that’s been going on since the 90s when people like Russell Barkley starting claiming that the main feature of ADHD was a lack of quality executive function has been that this is the fundamental “weakness” we experience.
Out of that has grown a mini-industry of people selling everything from books and lectures to computer games and therapist-led trainings to improve executive function. It’s a billion-dollar industry nowadays.
So, of course, a group of scientists decided to see if there’s anything to this idea that it’s possible to train Farmer-quality executive function into a Hunter’s brain. What they found simply confirms what I’ve been saying for three-plus decades and Popeye said so eloquently: “I am what I am” and that’s not going to change.
A meta-analysis published this summer in the peer-reviewed journal Frontiers in Psychology examined 52 randomized controlled trials covering nearly three thousand children, testing four different types of executive function training.
They included: Computerized working memory drills with coaching; face-to-face stop-signal and rule-switching tasks; cognitive flexibility software; and a hybrid program that paired exercise with mental demands.
While they found that “three of the four produced statistically significant improvements” the statistical significance of those “improvements” were shockingly minor. They were essentially nothing.
Scientists have a mathematical threshold for what they’ll say counts as a “small effect” and it’s a standardized mean difference of 0.2. But the single largest effect in the entire analysis of all of these studies came in at 0.097, less than half of that floor.
The authors described the results as “modest,” but that’s a wild overstatement when you look at their actual findings.
On the other hand, a separate meta-analysis of school-age children who were diagnosed ADHD found medium effect sizes for inhibitory control and working memory from what they called exercise interventions.
But it wasn’t just the physical exertion that produced the benefit; regular gym-style exercise produce no measurable improvement in executive function. What did improve it, though, was the type of exercise that requires both physical activity and interaction with a team, where logic and strategy are part of the game.
Like soccer, football, baseball, and other team sports. They all produced measurable improvements — far greater than the billion-dollar executive function industry’s products — in the ability to think, reason, and remember.
Which makes perfect sense for Hunters. After all, in hunter-gatherer societies, hunting is a team activity. It’s exercise combined with continuous pattern recognition, rapid revision of strategy when faced with uncertainty or problems, and a clear reward when the team actually brings home dinner.
The Hunter’s brain, in other words, didn’t evolve to hold still and pump iron or even to run in circles on a track: it evolved to move and read the world and immediately adjust to changing circumstances.
This explains why when we build an ADHD intervention that accidentally recreates those conditions, kids improve. On the other hand, when we ask the kid to be a good Farmer for thirty minutes, the science shows little to no result.
We keep getting this backwards because we keep starting from the wrong question, that assumption that Hunters have “broken brains.”
The whole architecture of this new industry of executive function training rests on a dysfunctional premise: that a Hunter’s brain is a Farmer’s brain with certain parts underdeveloped, and that with sufficient repetition and hard work we can grow or repair the missing, damaged, or underdeveloped parts.
Just fix the child with some computer games or boring mental exercises, this industry argues, and suddenly he’ll fit into the classroom.
Researchers in Sydney this year found that this so-called ADHD “impairment” is mostly the mismatch between a Hunter’s brain and the setting in which it must work, rather than any kind of dysfunction or failure inside the brain itself.
Change the setting, they found, and much of the disorder goes away and now the Hunter is operating at peak function.
I learned this the hard way, long before the phrase Attention Deficit Hyperactive Disorder was ever invented.
I got thrown out of high school in the tenth grade for starting a little newspaper railing against the war in Vietnam and the school administration’s support of it via the draft. My dad, a Republican supporter of the war, printed it on his office’s mimeo machine, and defended me when they threw me out; he helped me transition that year straight into community college.
It wasn’t that I lacked executive function; it was that I was both bored and horrified by my school’s support of an illegal and immoral war and had the working memory, task initiation, and follow-through (aka “executive function”) to produce the newspaper.
Years later I watched my son go through his own version of my experience in school. The ADHD diagnosis nearly crushed him because the doc we visited tried to tell him that his brain was broken and he needed a drug to correct his “neurotransmitter deficiency.”
It turned out, as we discovered when we moved him to a different (Waldorf) school, that what he really needed was intellectual challenges and an educational environment that met his needs rather than forcing him into a boring Farmer regime.
So if a school is pushing executive function training on your child, ask them if they still have recess and organized sports activities. Having your kid chase a ball across a field, reading the other players, revising the plan every four seconds, is a heck of a lot more powerful and therapeutic than his clicking through a computerized “set-shifting exercise” that fifty-two studies just proved will do almost nothing for him.