Understanding ADHD Through a Speech Therapy Lens: Why Executive Function and Communication Matter

When most people hear the term ADHD, they often picture energetic children who struggle to sit still or pay attention in class. But ADHD doesn’t end in childhood—and for many adults, it presents very differently. Instead of obvious hyperactivity, adults with ADHD often face a quieter, internal struggle: difficulty with planning, organization, follow-through, and clear communication. These challenges are rooted in how the brain manages executive function—and they can impact everything from daily routines to relationships.

These challenges stem from disruptions in a set of cognitive skills known as executive function. And while ADHD is not a speech or language disorder, many adults with ADHD experience real struggles when it comes to expressing themselves, staying on topic, or following through in conversations. That’s where speech therapy can make a meaningful difference.

Understanding the neurological basis of ADHD can help make sense of these experiences—and open the door to meaningful support, including through speech therapy.

🧠 What Is Executive Function?

Executive function refers to the brain’s “management system.” It’s what allows us to set goals, make decisions, stay organized, and regulate emotions. For individuals with ADHD, this system works differently—and that can affect nearly every area of daily life.

Key executive function skills include:

• Planning & Prioritizing – Knowing what needs to be done and how to do it

• Organization – Keeping track of tasks, materials, and ideas

• Initiation & Follow-Through – Starting a task and finishing it, even when motivation is low

• Focus & Attention – Filtering distractions and staying on task

• Time Management – Estimating how long things will take and meeting deadlines

• Emotional Regulation – Navigating frustration or stress without shutting down

When these abilities are disrupted, everyday demands—like managing work emails, remembering appointments, or even explaining your thoughts—can feel overwhelming.

🔍 How Executive Dysfunction Shows Up

Adults with ADHD often describe feeling mentally scattered, stuck, or “disorganized in their head.” These aren’t personal failures—they’re symptoms of executive dysfunction, rooted in how the brain regulates thought and behavior.

Common struggles may include:

• Losing track of appointments, tasks, or conversations

• Difficulty organizing thoughts into clear communication

• Speaking impulsively or going off-topic

• Trouble breaking down big tasks into manageable steps

• Getting stuck on one detail and missing the bigger picture

• Struggling to express complex ideas under stress

These experiences can create frustration in both personal and professional settings—and they’re often misunderstood.

🧬 The Brain Science of ADHD

Neuroscience gives us a clearer picture of what’s happening in the brain. Research shows that ADHD is associated with functional differences in the prefrontal cortex—the area responsible for executive functioning.

Studies also highlight:

• Altered dopamine signaling that affects working memory, attention, and focus (Arnsten, 2009)

• Differences in how the prefrontal cortex and striatum (a region involved in motivation and control) interact (Castellanos & Proal, 2012)

• Challenges in regulating behavior, speech, and thought sequencing linked to these brain regions (Barkley, 2015; Brown, 2013)

These neurological differences don’t mean someone isn’t trying hard enough—they mean the brain is wired to work differently.

💬 Why ADHD Affects Communication

Even though ADHD isn’t a language disorder, it often impacts communication in ways that are frustrating and misunderstood.

Adults may experience:

• Disorganized or nonlinear speech

• Forgetting what they wanted to say mid-sentence

• Going off-topic or struggling to stay engaged

• Trouble expressing complex thoughts clearly

• Feeling overwhelmed during high-stakes or emotional conversations

These patterns can affect relationships, work performance, and self-esteem. But the good news? Support is available.

🌼 How Speech Therapy Can Help

At Marigold Speech, we recognize that ADHD doesn’t just affect focus—it shapes how people think, speak, and connect with others.

Our speech-language pathologists work with adults to:

• Improve verbal organization and idea sequencing

• Develop strategies for working memory and task planning

• Build routines to support follow-through and time awareness

• Support confidence in communication

Rather than offering one-size-fits-all tips, we work with you to create personalized, meaningful strategies rooted in how your brain works.

✨ Curious how speech therapy could support your executive functioning and communication?

We’d love to connect. Call us at 608-728-7774 to schedule a consultation. Let’s find the strategies that help you thrive.

📚 References

Arnsten, A. F. T. (2009). The emerging neurobiology of attention deficit hyperactivity disorder: The key role of the prefrontal association cortex. Journal of Pediatrics, 154(5), I–S43. https://doi.org/10.1016/j.jpeds.2009.01.018

Barkley, R. A. (2015). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (4th ed.). Guilford Press.

Brown, T. E. (2013). A new understanding of ADHD in children and adults: Executive function impairments. Routledge.

Castellanos, F. X., & Proal, E. (2012). Large-scale brain systems in ADHD: Beyond the prefrontal–striatal model. Trends in Cognitive Sciences, 16(1), 17–26. https://doi.org/10.1016/j.tics.2011.11.007