ATTENTION-DEFICIT HYPERACTIVITY DISORDER, SELF-REGULATION, AND TIME -TOWARD A MORE COMPREHENSIVE THEORY/

This article describes the current clinical view of attention-deficit/ hyperactivity disorder (ADHD) and suggests a model of prefrontal lobe executive functions that explains better than current theories the cog nitive and behavioral deficits associated with ADHD. The model shows h ow behavioral inhibition is related to and necessary for the proficien t performance of four executive functions that subserve self-regulatio n: nonverbal working memory; the internalization of speech; the self-r egulation of affect, motivation, and arousal; and reconstitution. Thes e functions permit the construction, execution, and control of behavio r by internally represented information, which removes behavior from c ontrol by the immediate context and brings it under the control of tim e. ADHD disrupts this process and returns control of behavior to the t emporal now. A blindness to past, future, and time more generally, as well as an inability to direct behavior toward the future and to susta in it are among many of the deficits predicted by this model for perso ns with ADHD.