What is the Browns Executive Function test in ADHD diagnosis?

As ADHD is becoming more talked about throughout society, it is prompting many of those who may not have thought about their difficulties as ADHD to gain an ADHD assessment and possible diagnoses. Once thought of as just a childhood condition that disappears with adolescence, it is now understood that in many cases, ADHD is a condition many must deal with across their lifespan. One of the difficult areas when it comes to assessing and diagnosing patients is how their age and gender affect their ADHD symptoms, a tool created to help in evaluating the executive function of the brain is the Browns Executive Function Test.

In this guide, we will look at what this test is, how it is used, and why we here at Manchester’s expert ADHD clinic use it to assess and treat our patients.  

What are Executive Functions?

These cognitive processes, situated in the prefrontal cortex of the brain, include skills such as working memory, cognitive flexibility, and inhibitory control, essentially allowing you to manage your thinking and behaviours. Individuals with ADHD often struggle with these functions, leading to difficulties in tasks that require planning, organisation, and sustained attention. Consistently experiencing these difficulties is usually where an ADHD diagnosis comes in. 

Who is Dr Thomas E Brown? 

 Dr Thomas E Brown is a clinical psychologist specialising in ADHD and has conducted more than 25 years of clinical interviews and research with children, adolescents, and adults who have been diagnosed with ADHD. Dr Brown developed a model to describe the complex cognitive functions of the brain that are impaired in those with ADHD. 

A Closer Look at the Browns Executive Function Test

Browns model of executive function impairments in ADHD is split into 6 clusters, activation, focus, effort, emotion, memory, and action. The test provides a comprehensive assessment of all 6 of these executive functions and allows detailed insights to be derived from an individual’s cognitive processes. Below is a closer look into some examples of each of the executive function cluster types-

  Activation.

This involves the process of getting started and struggling with excessive procrastination. Patients with ADHD often describe difficulty with organising and prioritising tasks, estimating time, and getting started on work tasks. It is often only when a task becomes extremely last minute, or an acute emergency that they are able to get started on it.

  Focus.

Becoming easily distracted, not being able to focus and sustain focus, and shifting focus to tasks pose real difficulties for those with ADHD. Things going on around them and thoughts in their heads are a continuous pull from focus, including difficulty reading. Words sometimes need to be read repeatedly for the meaning to be fully grasped and remembered.

Effort.

Short-term projects tend to be successful for those with ADHD but have much more difficulty sustaining effort over a longer period. Regulating their alertness, processing speed, and completing tasks on time are also difficult for those with ADHD and this can come from a difficulty in regulating sleep. They often stay up late with racing thoughts and ideas, yet when they eventually do fall asleep, the sleep is deep and difficult to wake from, hence those with ADHD find it difficult to get up in the morning.

  Emotion.

The DSM-5 does not recognise any symptoms related to the management of emotion as an aspect of ADHD, however many people with the disorder describe extreme difficulties with managing frustration, anger, worry, disappointment, desire, and other emotions. They find it difficult to stop emotion from taking over their thinking and to get it into perspective to get on with what they need to do.

  Memory.

Difficulty utilising their working memory or accessing recall is a common symptom among those with ADHD. Very often, individuals with ADHD will be able to recall what happened a very long time ago but not be able to remember what was just said to them, where they put something, or what they were about to say.

  Action.

Even those without the symptoms of hyperactivity report difficulties in regulating and monitoring their actions. Individuals with ADHD often report feeling too impulsive with their decisions or actions, failing to understand when others are puzzled or hurt by what they say and do, and therefore being unable to modify their behaviour in different social settings. The pacing of their actions is also difficult, not being able to slow themselves or speed up if needed.

  Dr Brown’s scale was first released in 1996 and focused on adolescents and adults but went through a revision in 2001 to assess children. Again in 2018, the scale went through another revision to better assess the complex impairments impacting academic, social, emotional, and behavioural development for children and adults. It is now known as the Brown Executive Function/ Attention Scale (Brown EF/ A Scales).

The scale is divided into age groups, including:

• Young Children ages 3 to 7.

• Middle Childhood ages 8 to 12.

• Adolescents/ Teens ages 13 to 18.

• Adults age 19+

Why We Use the Browns Executive Function Test at our Private ADHD Clinic in Manchester

Here at Beyond, we are committed to providing premium ADHD assessments focused entirely on you, which is why we use the Brown Executive Function test in our simple, step-by-step process. The Browns Executive Function and Scale test comes in at stage 2, after the initial information gathering to understand your experiences. The test provides us with further quantifiable data which will aid our understanding of your ADHD symptoms and their severity. The test is also repeated to ascertain what progress you’ve made if you commence a medication care plan with us.

How Could the Browns Executive Function Test Help You?

There are other executive function tests out there, but here at our private ADHD clinic in Manchester, there are several ways we think the Brown EF/ A Scale is different and significantly helps and impacts you.

A Focus on Severity Instead of Frequency.

The Browns EF/ A Scale focuses on the severity of specific behaviours as opposed to their frequency, allowing examinees to report symptoms directly and more accurately that they perceive to be problems.

Addressing Situational Variability.

Various observers will likely perceive ADHD symptoms differently, which is why the Browns EF/ A Scales provide a comprehensive evaluation of an individual’s ADHD symptoms by analysing their behaviour using multiple perspectives: the examinee’s self-perspective, teachers’ perspective, and parent’s perspective.

A Focus on Specificities and Context.

Activities which hold strong focus for those with ADHD tend to be those that are highly interesting to them, therefore patients can experience situational variability. The Browns EF/ A Scales provide assigned tasks, specifically not self-selected, to observe difficulties in a specific context.

Utilises Dr Brown’s Model of Executive Functions.

For more than a decade, Dr Browns six-cluster model of executive functions has been explained in books and articles and is well-recognised around the globe.

Includes a Focus on the DSM-5 ADHD Symptoms.

These scales also assess other important aspects of executive function impairment that are not yet recognised in the DSM-5 diagnostic criteria for ADHD.

Our Process from ADHD Assessment, Diagnosis, and Treatment at Beyond

Beyond offers the most comprehensive ADHD assessment process available today. We employ the three fundamental testing tools required to give the most accurate diagnosis. The results of each test work together to form a clear picture of each case. Our unique assessment process ensures that our assessments are highly robust, and we provide a full suite of information for the transfer of care.

Our team at Beyond Clinics is a dedicated group of specialist psychiatrists and practitioners with a shared passion for helping individuals who suspect they may have a neurodevelopmental condition. Our process will support you through ADHD assessment, and treatment if appropriate and we put you at the heart of your health journey.

In addition to our clinical team, our patient coordinators and admin support also provide you with continued support and guidance. They enable seamless communication and co-ordinate your care working closely with you every step of the way.

Contact our private ADHD clinic in Manchester today and see how we can help make a positive change in your life.