第1課:ADHD執行功能解構
核心概念速記
大腦指揮中心
前額葉皮質主導,協調計劃/記憶/情緒
影響:學習表現、人際關係、壓力應對
發展期:幼兒期→成年逐步成熟
四大核心技能
▸ 視覺工作記憶:腦內畫板(例:跟地圖轉彎)
▸ 語言工作記憶:內心筆記本(例:默背購物清單)
▸ 抑制控制:情緒煞車掣(例:忍住唔插嘴)
▸ 任務轉換:頻道轉換器(例:數學課轉中文課)
功能失調真實寫照
🛑 視覺記憶弱 → 煮餸漏步驟,明明睇過食譜都搞亂落調味次序
🛑 語言記憶差 → 老師講完「做練習冊12頁+背唐詩」,放學即刻失憶
🛑 抑制失靈 → 超市排隊忍唔住轉隊,搞到被人眼超超
🛑 轉換卡頻 → 打完機想溫書,對住本書發呆半粒鐘
ADHD特別關聯 🔄
前額葉異常:工作記憶+抑制控制雙重受損
典型困擾:
任務轉換「黏住」狀態(例:做完數學轉唔到mode背詩)
衝動插嘴/情緒爆煲
日常指令記憶斷片
實戰訓練方案 🛠️
STEP 1:心理定位
▸ 明白「唔係懶/蠢,係大腦接線特別」
▸ 例:ADHD=煞車系統失靈,唔係故意衝紅燈
STEP 2:自我監察
→ 記錄「分心/爆煲」時間+觸發點(例:食糖後專注力↓)
STEP 3:目標拆解
▸ 將「溫書」變「①抄筆記15分鐘 ②做5條題」
▸ 用可視化進度條(例:每完成一步貼星星)
STEP 4:時間管理
→ 番茄鐘工作法:25分鐘衝刺+5分鐘抖氣
→ 倒數計時器:設定「轉task緩衝期」(例:遊戲→溫書預留10分鐘過渡)
STEP 5:環境改造
▸ 固定物品位:書包分「功課格」「文具格」
▸ 視覺提示:貼大字報「Check清單!」喺當眼位
STEP 6:解決問題:
識別問題,產生解決方案
最後作出決定
STEP 7:靜觀練習
→ 情緒上頭時:停低數5吓深呼吸
→ 每日3分鐘「腦部掃描」:由腳趾到頭頂逐部分放鬆
輔導員貼士 💡
比喻教學法:
將抑制控制=「腦內警察」
任務轉換=「轉電視頻道要撳實體掣」
成功案例:
→ 用「變形金剛分段法」教計劃:將大任務變形做細機械人逐件砌
家長溝通重點:
▸ 避免標籤:「你點解成日唔專心」→「我哋一齊諗計幫個腦警察」
▸ 具體讚賞:「今日鎖匙掛返原位好叻!」
記住:執行功能可以練!由細習慣開始,等大腦慢慢上返軌道🚂
References
American Psychological Association. (2025). Publication manual of the American Psychological Association (7th ed.).
Barkley, R. A. (2020). Executive functions: What they are, how they work, and why they evolved. Guilford Press.
Center on the Developing Child at Harvard University. (n.d.). A guide to executive function. Retrieved March 13, 2025, from https://developingchild.harvard.edu/resource-guides/guide-executive-function/
Cogmed. (n.d.). Cogmed working memory training program. Retrieved March 13, 2025, from https://www.cogmed.com/
Dawson, P., & Guare, R. (2018). Executive skills in children and adolescents: A practical guide to assessment and intervention (3rd ed.). Guilford Press.
National Institute of Mental Health. (n.d.). Attention-deficit/hyperactivity disorder (ADHD). Retrieved March 13, 2025, from https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd
Posit Science. (n.d.). BrainHQ cognitive training platform. Retrieved March 13, 2025, from https://www.brainhq.com/
Solanto, M. V. (2011). Cognitive-behavioral therapy for adult ADHD: Targeting executive dysfunction. Guilford Press.
Webster, J. (2023, August 15). How to improve executive function skills in ADHD. ADDitude Magazine. Retrieved March 13, 2025, from https://www.additudemag.com/how-to-improve-executive-function-adhd/