Executive Functions by Barkley

 Russell A. Barkley, a well known expert on ADHD, wrote Executive Functions: What They Are, How They Work, and Why They Evolved, to answer four questions:

What is the definition of Executive Function (EF)?

Barkley examines EF as an evolutionary set of processes that assist humans with survival. Because there are so many humans with a large variety of settings, different skills are preferred throughout the populace. Through a examination he describes EF as a series of levels  of skills. Overall he defines the skills set as  "the use of self-directed actions so as to choose goals and to select, enact, and sustain actions across time toward those goals usually in the context of others often relying on social and cultural means for the maximization of one's longer-tern=m welfare as the person defines it to be."(p. 176)

How are existing theories of EF inadequate?

Current theories often lump EF or as he goes on to describe it self-reliance (SR) into one pool of skills. In practice it appears they develop and are seen in a series of steps of skills.

Pre-executive	Attention, memory, spatial and motor functions, primary emotions and motivations
Instrumental self-directed	Self-directed attention (self-awareness), restraint, sensory-motor action, private speech, appraisal (emotion-motivation), play (innovation and problem solving)
Methodical-self-reliant	Use of methods to achieve goals, self-management across time, self-organization and problem solving, self restraint, self-motivation, regulation of emotions, social independence and predation , and social self-defense
Tactical-reciprocal	Use of tactics- nested sets of methods- to attain goals Daily social exchanges Group living, beginning of economics Social interdependence
Strategic-cooperation	Use of strategies- nested sets of tactics to achieve long term goals Arrangement of social cooperatives with division of labor Acting in unison to achieve a common goal Origin of larger settlements
Extended-utilitarian	Use of principles Pursuit of long-term self-interests with the ability to put others needs/interests first Preference for delayed long term consequences Origin of cities, states, countries

 Barkley 2012, p 63

As people develop a sense of time, something people with ADHD tend to have difficulty with, they are able to attain higher levels of complexity along the spectrum of EF/SR skills. As such it is irrational to expect people to be able to develop higher order skills like using strategies when they do not have robust foundations of lower level skills like attention. To combat this, Barkley feels the only rational treatment is medication.

What are the purposes of EF?

Barkley sees the major function of EF as solving the problems of group living with unrelated people.

How to assess EF?

Barkley acknowledges that current tools used to measure EF are inadequate since often the problem is not one of knowing how to, but one of implementing the how to in the context of everyday life. Far too often tools used to measure EF do not really measure EF, or they measure it completely out of context. As Barkley notes, "Just knowing about self-regulation will not automatically translate into actual self-regulation." (p. 200)

People need to assess the skills in the context in which they need to be utilized. 

Barkley indicates that this is not a book for interventions but does offer some guidance. First, in order to intervene, medication needs to be utilized. This remedies innate neurological issues that cause problems. The he suggests that people look at recognizing the temporal unawareness of people with EF weaknesses and provide short, small and immediate reinforcers for motivation. Further, skills need to be taught at the point of performance. Teaching a discrete skill in a therapy room is all well and good, but without environmental modifications and practice in the relevant environment, training will have little benefit.

This book is not an easy read. It is written for practitioners, coming in between grade 13 and 16 for readability. It demands an understand of a basic level of neurophysiology. That said, it does create a structure for understanding EF skills that is important.