The Brown Model of ADHD

persistence. Barkley (2007) argues that learners with ADHD have great difficulty making a sustained effort to achieve long-term goals.

Conceptualising ADHD as a disorder of self-regulation, and not a disorder of attention, has significant implications for understanding the difficulties experienced by learners diagnosed with ADHD as well as teachers who have to manage them in their classrooms. It can assist them in coping with and managing ADHD more effectively. Barkley (2003) argues that ADHD learners may not lack the skills and knowledge to be successful, but rather their prob- lems with self-regulation often prevent them from applying their knowledge and skills when required. As Barkley (2003:79) aptly puts it: “ADHD is more a problem of doing what one knows rather than knowing what to do.” For example, even though ADHD learners may know the steps to follow in order to complete a school project properly, they may not act on this knowledge because of problems with managing time and using a long-term goal to guide behaviour.

As far as following classroom rules and completion of work are concerned, Barkley (2007) also emphasises the need to provide external prompts. Writing rules down on signs around the classroom is one way of doing it. The teacher may post class rules on an index card taped to the learner’s desk. During activities, one possibility is to have learners wear head- phones and listen to a recording that provides frequent reminders to stay on task, to write neatly, and to check their work. In all of these examples, the principle is to compensate for the learners’ inability to control their behaviour through internal means by providing as many external prompts, reminders and motivation as possible.

This model describes executive functions, as Brown (2007) considers them to be the cognitive management system of the human brain. Although the model shows six separate executive function clusters, these functions continually work together, usually rapidly and unconsciously, to help each individual manage many tasks of daily life. The executive functions work together in various combinations. They appear in basic form in young children diagnosed with ADHD and gradually become more complex as the brain matures throughout childhood, adolescence and early adulthood. Executive functions are not fully developed until the learner reaches her early twenties. All individuals have occasional impairments in their executive functions, but learners with ADHD experience much more difficulty in the development and use of these functions than most others of the same age and developmental level. However, Brown (2005) points out that even those with severe ADHD usually have some activities where their executive functions work very well. ADHD learners may have difficulty with ADHD symptoms in most areas of their lives, but when it comes to a few special interests such as playing sports or station games, their ADHD symptoms are absent. This phenomenon causes ADHD to appear as a simple problem of lacking willpower, but Brown (2005) contends that it is not the case. These impairments of executive functions are usually due to inherited problems in the chemistry of the brain's management system.

By utilising clinical interview methods, Brown (2002) studied children, adolescents and adults diagnosed with ADHD according to the DSM-IV-TR criteria. Comparisons were made with reference to their descriptions of their problems with those of matched normal controls (Brown, 2002). Comparisons between the ADHD-diagnosed samples and the non- clinical samples in each age group yielded reports of impairments that can be recognised in the six clusters of this model of executive functions:

Figure 2.5 Brown’s model of ADHD (Brown, 2001)

Accordingly, Brown (2005) clusters the executive functions in the following groups:

2.10.3.1 Activation

Activation refers to the individual’s ability to organise tasks and materials, estimate time, prioritise tasks, and get started on assignments. ADHD individuals report chronic difficulty with excessive procrastination as they often postpone getting started on a task until the very last minute, even on a task they realise to be very important to them.

It seems that ADHD individuals are unable to commence with a task until it is perceived as an emergency.

2.10.3.2 Focus

The ability to focus refers to focusing, sustaining focus and shifting focus to assignments or tasks. Brown (2005) found that some ADHD sufferers reported to be easily distracted, not only by things that are going on around them, but also by thoughts in their own minds. In addition, focussing on reading assignments poses difficulties to

many of them. When doing reading assignments, ADHD learners may understand the words they read, but they often have to read the words repeatedly in order to fully grasp the meaning and remember it.

2.10.3.3 Effort

This cluster of executive functions refers to regulating alertness, sustaining effort and processing speed. According to Brown, many ADHD learners can perform short-term projects well, but they have greater difficulty with sustained effort over longer periods of time. These learners also find it difficult to complete tasks on time, especially when required to do expository (a detailed description of a theory or problem) and creative writing. Some may even experience difficulty regulating sleep and alertness. Parents will find that they often stay up too late because they are unable to shut their brains down, and once asleep they often sleep in the delta (deep) sleep phase and have difficulty rising in the morning (Brown, 2007).

2.10.3.4 Emotion

Emotion as an executive function refers to both managing frustration and modulating emotions. Although DSM-IV-TR does not recognise any symptoms related to the management of emotion as an aspect of ADHD, Brown’s study found that many individuals with this disorder experience difficulties managing frustration, anger, worry, disappointment, desire, and other emotions on a continuous basis. They find it difficult to get an emotion into perspective, to put it to the back of their mind, and to get on with what they need to do (Brown, 2002).

2.10.3.5 Memory

This refers to utilising the individual’s working memory and recalling information.

ADHD learners may often have adequate or exceptional memory of things that happened long ago, but they have great difficulty remembering where they just put something, what someone just said to them, or what they were about to say. This can

have a great influence on the ADHD learner’s academic achievement. These learners often complain that they cannot recall information from their short term memory when they need it (Brown, 2007).

2.10.3.6 Action

This cluster refers to the ability to monitor and regulate one’s actions. Many ADHD learners, even those without problems of hyperactive behaviour, experience ongoing difficulties in regulating their actions. According to Brown they are often too impulsive in what they say or do and in the way they think, causing them to jump too quickly to inaccurate conclusions even before the teacher has fully explained a concept. These learners may also experience problems in monitoring the context in which they are interacting. They do not notice when other people are confused, hurt or annoyed by their words or actions, and they hence fail to modify their behaviour in response to specific circumstances (Brown, 2007).

These clusters function in an integrated and dynamic way to accomplish a wide variety of tasks. Brown (2007) asserts that these executive functions do not continually function at peak efficiency for any learner and that all learners have difficulty with some of the functions from time to time. However, ADHD learners are substantially more impaired in their ability to apply these functions than other learners at the same age and developmental level. Impairments of these executive functions can be assessed with The Brown Attention Deficit Disorder Scales, normed rating scales for children, adolescents and adults.