Guide
Guide | Reference

18  Attention, Executive Function, and Neurodevelopmental Experiences

18.1 Summary

  • Differences in attention, organization, impulse control, or social communication that are often longstanding and context-dependent.

18.2 Patient-Language Phrases

  • “I can’t stay focused unless I’m really interested.”
  • “I lose track of time and tasks.”
  • “I miss social cues or feel out of sync.”
  • “Sounds, lights, or textures feel overwhelming.”

18.3 Core Features

  • Inattention, distractibility, or hyperfocus.
  • Impulsivity or difficulty with planning and follow-through.
  • Social communication differences or sensory sensitivity.

18.4 Boundary Markers

  • What it is: persistent patterns across time and settings.
  • What it is not: acute attention changes driven by mood, sleep loss, or substances.

18.5 Quick Structure

  • Variants / Spectrum
    • Inattention-dominant presentations.
    • Hyperactivity or impulsivity-dominant presentations.
    • Social communication and sensory regulation differences.
    • Learning-related challenges.
  • Severity (0-4)
    • 0: No significant impairment in attention or executive function.
    • 1: Mild, situational, manageable.
    • 2: Moderate, recurring, impacts function.
    • 3: Severe, persistent, with clear impairment.
    • 4: Extreme, disabling or unsafe.
  • Time-course
    • Lifelong or early-onset patterns.
    • Stable with situational fluctuations.
  • Functional impact
    • Work/school: missed deadlines, disorganization, inconsistent performance.
    • Relationships: miscommunication, conflict, or withdrawal.
    • Self-care: routine instability, forgetfulness.
  • Developmental expression
    • Childhood: attention, behavior, or learning challenges.
    • Adolescence: academic demands reveal deficits.
    • Adulthood: organizational strain and burnout.
  • Cultural/context notes
    • Expectations of attention and behavior vary by context.
    • Environmental mismatch can amplify impairment.