Research recap with Skye: Executive Dysfunction and Early ADHD in Preschoolers

Summary

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Hacking Your ADHD – Research Recap with Skye: Executive Dysfunction and Early ADHD in Preschoolers

Host: William Curb
Guest: Sky Waterson
Release Date: September 19, 2025

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Episode Overview

In this episode of the Hacking Your ADHD Research Recap series, host William Curb and guest Sky Waterson delve into a study exploring whether executive dysfunction, delay aversion, and time perception deficits predict ADHD symptoms and early academic performance in preschoolers. Together, they break down the paper’s methodology, the complexities of diagnosing ADHD at a young age, and discuss what the research means for early intervention and practical strategies.

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Main Discussion Points & Insights

1. Understanding the Study’s Purpose

• The paper examined how three neuropsychological constructs — executive dysfunction, delay aversion, and time perception — correlate with ADHD symptoms and academic performance in preschool children, specifically 4-5 year olds in Hong Kong. ([02:11])
• The unique contribution: linking time perception specifically, in addition to working memory and delay aversion, to early academic challenges.

Quote (Sky Waterson, 02:11):
"So the paper we're looking at today is about Time perception and long-term academic performance. But really importantly, and we'll talk about this more, it's about that in preschoolers."

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2. Challenges in Assessing ADHD at Preschool Age

• Diagnosing ADHD is complex in preschoolers, as typical behaviors (like restlessness) may not clearly delineate between those with and without ADHD. Assessments are usually based on teacher and parent questionnaires—not full diagnoses at such an early stage. ([03:31], [04:11])

Quote (William Curb, 04:16):
"What's the difference between a four year old with ADHD who can't sit still and a four year old without ADHD who can't sit still? That can be a little bit harder to find because you don't have a lot of the inhibition control and all that things developed yet."

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3. Methodology: How Were the Constructs Measured?

• Executive function: Assessed via working memory tasks.
• Delay aversion: Used a computer game akin to the marshmallow test, requiring kids to choose between immediate or delayed rewards. ([05:39])
• Delay frustration: Children were unexpectedly forced to wait during a repetitive task, mimicking a slow computer. ([06:10])
• Time perception: Tested via time reproduction and discrimination tasks — for example, having children judge how long a light bulb was lit and then attempt to reproduce that duration. ([07:28], [08:04])

Notable Moment (William Curb, 07:28):
"I would love to see control versus ADHD on this one because I feel like this is just a very hard..."

Quote (Sky Waterson, 06:49):
"They were basically given a test of an old computer that doesn't work properly, which... that would create delay frustration in any age group, I think."

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4. Key Findings of the Study

• All three constructs—executive function, delay aversion, and time perception—were predictive, to varying degrees, of academic performance as measured by early literacy and numeracy tests.
• Working memory (executive function) was the strongest predictor.
• Time perception and delay aversion were also related, but their influence was weaker.
• Even after controlling for socioeconomic status and general ability, both time perception and working memory impacted early academic performance, notably in Chinese word reading—a task with a high memory load. ([10:44]–[12:19])
• Links found between time perception deficits and difficulties in math (dyscalculia) and reading, connecting "time blindness" to broader learning challenges.

Quote (Sky Waterson, 11:10):
"They found that when [socioeconomic status and general ability] were controlled for, time perception of working memory contributed to children's academic performance at time one and time two, specifically Chinese word reading..."

Quote (William Curb, 12:19):
"It's less a direct thing, but more of our perception of things. And I feel like that means that using certain strategies could really mitigate those factors in the long run."

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5. Practical Implications & Strategies

• The research underscores the importance of externalizing time for children (and adults) with ADHD, such as:
  • Visual timers (e.g., timers that show time passing with a shrinking red disc)
  • Accessible clocks in the learning environment
  • Practice with estimating task durations
• Traditional alarms may not be as helpful—visual and tangible cues are more effective due to inherent time perception difficulties. ([14:39]–[16:06])

Quote (Sky Waterson, 14:39):
"Externalizing time is a massive one... that visual timer where you see time passing, things like that can be really helpful."

Quote (William Curb, 16:06):
"I also love when I'm trying to, like, do a task I really don't want to do, but I'm like, okay, this is going to take this amount of time. I look up and like, it's been 10 seconds."

• The impact of time blindness can last beyond school, affecting work performance, stress levels, and self-esteem.

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6. Reflections and Listener Connection

• Sky and Will invite listeners to consider whether struggles with time perception affected their academic experiences or daily functioning, and shared that lived experiences (e.g., rushing through tests, missing exam pages) reflect these research findings. ([16:16])
• Call for feedback and experiences from listeners: How does time perception affect you? What strategies work for you? ([13:46])

Quote (Sky Waterson, 16:16):
"If that's you, if you've been in that experience, this might be an ADHD that you have experienced and there might be reasons for that."

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Notable Quotes & Time Stamps

• Sky Waterson (02:11):
  "They wanted to look at how three neuropsychological constructs... were associated with ADHD symptoms and academic performance in preschoolers..."

• William Curb (04:16):
  "What's the difference between a four year old with ADHD who can't sit still and a four year old without ADHD who can't sit still?"

• Sky Waterson (11:10):
  "Time perception of working memory contributed to children's academic performance..."

• William Curb (12:19):
  "I feel like that means that using certain strategies could really mitigate those factors in the long run."

• Sky Waterson (14:39):
  "Externalizing time is a massive one... that visual timer where you see time passing, things like that can be really helpful."

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Memorable Moments

• Will openly admitting the difficulty of time reproduction tasks for anyone, not just kids with ADHD. ([07:28])
• Sky sharing personal experience with dyscalculia and relating it to the study ([02:11], [12:49])
• The hosts’ frank discussion on how academic research rarely includes solutions and actionable experimentation. ([14:39])
• Reflection on personal exam experiences and time management mishaps resonating with listener struggles ([16:16]).

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Summary of Takeaways

• Working memory is the strongest predictor of academic success among ADHD-related traits in preschoolers; time perception also plays a measurable role.
• Children with ADHD symptoms may need explicit aids to manage time and support memory, which can help long-term academic and functional outcomes.
• Research emphasizes the value of practical, visual tools to externalize time, not just alarms.
• There’s a need for longitudinal and intervention-focused research to translate these findings into concrete supports.
• Listeners are encouraged to try supportive strategies and share their own experiences, amplifying community wisdom beyond the clinical research.

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For further engagement and resources:

• Reach William Curb at hackingyouradhd.com/contact
• DM Sky Waterson at Unconventional Organization on Instagram for an annotated copy of the paper and support.

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This summary omits sponsor messages and non-content segments, focusing on actionable information and insights for those interested in ADHD research and practical strategies.

Transcript

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[Sky Waterson]

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[William Curb]

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[Sky Waterson]

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[Sky Waterson]

Okay. Rock, paper scissors for it. Rock, paper, scissors, shoot.

[William Curb]

No the Wells Fargo Active Cash credit card. Visit Wells Fargo.com ActiveCash Terms apply Foreign welcome to hacking your ADHD. I'm your host, William Curb, and I have ADHD. On this podcast, I dig into the tools, tactics and best practices to help you work with your ADHD brain. Today I'm joined by Sky Waterson for our Research Recap series. In this series, we take a look at a single research paper, dive into what the paper says, how it was conducted, and try to find any key practical takeaways, stuff that you can actually use. And in this episode, we're going to be discussing a paper called Do Executive Dysfunction Delay Aversion and Time Perception Deficits Predict ADHD Symptoms and Early Academic Performance in Preschoolers? And yeah, there's a lot in there, but don't worry, we'll be getting into all of it. Now, before we get started, I want to mention that this is still a new series, so we're going to be figuring out what works and what doesn't, and I'd love to hear what you all think of it. So if you have thoughts, head on over to hackingyouradhd.com contact and let me know. I appreciate all the feedback I've already gotten, and we're definitely going to be working on trying to do a few things with the show and shaking things up. So try and get the episodes a little bit more organized and help you get the most out of everyone. New episodes of Research Recap will be coming out every other Friday, and with that, let's get into it.

[Sky Waterson]

So the paper we're looking at today is about Time perception and long term academic performance. But really importantly, and we'll talk about this more, it's about that in preschoolers. So we want to keep in mind these are four to five year olds. So what we're looking at here, if you want to just give a little baseline introduction before Will goes into the methodology and how they did this is that they found that children with ADHD are commonly observed to have learning disorders difficulties. They talk about things like dyscalculia, which I have, so I definitely related to that. And they wanted to look at how three neuropsychological constructs, so that's executive dysfunction, delay aversion and time perception. And we'll talk a little bit about what those are were associated with ADHD symptoms and demic performance in preschoolers, risk of adhd. So in terms of how this was done, this was done in Hong Kong and they measured it at different time periods. And what they found was interesting in terms of the relationship between our working memory, our time blindness and potentially our academic performance. So yeah. Will, do you want to go into how they did this?

[William Curb]

Yeah, well, I mean, and it is very interesting, like I think like as we were just to like emphasize what you're saying again. Yeah, these are four to five year olds and we're talking about having lived through having children that were four to five and knowing their friends doing that ADHD assessment is very difficult at that age. And so that's like the first thing we should really discuss here is this idea of how they are measuring adhd, which for this case was just a teacher parent questionnaire that you know, goes often would be the first step in a diagnosis for a lot of people. But then that's just the standard. That's where they stop with looking for the diagnosis.

[Sky Waterson]

It's symptoms. They found symptoms, not diagnostic ADHD at this point.

[William Curb]

Yeah, because it's like what's the difference between a four year old with ADHD who can't sit still and a four year old without ADHD who can't sit still. There's. That can be a little bit harder to find because you don't have a lot of the like inhibition control and all that things developed yet. So typically we don't see that many children at that age being formally diagnosed. But it is something where you do want to start. Like with my own children, that's when we were starting to look because we did see noticeable differences in how they were performing, not academically but like socially and all that kind of stuff. And of course it's Every kid's going to be different. And that's why it's important to go beyond just that initial to questionnaire being like, hey, do you have these symptoms?

[Sky Waterson]

Exactly.

[William Curb]

They were also then looking. They were doing. The academic performance was based on these like standardized early literacy and number tests. Obviously Chinese literacy, because this was in Hong Kong. So they were using working memory for the. This executive function side of things. For the delay version, they were using a computer game that would. They could choose to. It's like a. Choose to destroy enemy spaceship at one point in time for a score or wait and have the delay and get two points for doing.

[Sky Waterson]

Version actually is basically.

[William Curb]

It's kind of like this marshmallow test idea that we. Most people know about where it's like this delayed gratification where you're trying to get the immediate reward versus delayed reward, which is often something that is a huge issue for people with adhd where they're just like, yeah, I need. I need that thing right now as I need the dopamine. If I don't have it, I'm not gonna do anything.

[Sky Waterson]

Which is what they were testing. They also had Delay frustration, which was a different task, which I love the title of.

[William Curb]

Yeah, Delay Frustration. So much fun.

[Sky Waterson]

Basically, they introduced a game. The children were asked to answer 45 questions compared to the size of two animals. Choose a smaller one by pressing a button to indicate their choices. For most of the trials, the next question would appear as soon as the participant responded with a button press. However, in some cases, the presentation of the next question was delayed by some seconds. People weren't informed of the delay, but they were just told the computer was slow. So they were basically given a test of an old computer that doesn't work properly, which. Yeah, that would create delay frustration in any age group, I think.

[William Curb]

Yeah, I like just listening to the description of that task. I'm just like, I would.

[Sky Waterson]

A lot of these tasks feel like that. I mean, they are. They are testing things that we don't like and then we get to the timepiece. Because they also did a time reproduction task and a time discrimination task. And this was really interesting because what they argued was that the time, the introduction of a measure of time was new. This was the newest thing that they were doing. They, you know, people had done working memory, people had done delay aversion, but they hadn't really separated and looked at time in the same way. And that's what they hear.

[William Curb]

Yeah. Because it was a lot about just how they were able to like figure out how Long something took, you know, be like, you know, the gets. The description is the. The task was presented in game light format where the child was asked to look at a light bulb appearing on the screen and try to determine how long the light bulb was lit up. Immediately afterwards, the child was asked to reproduce the same duration by turning off and on another light bulb, pushing a button on the keyboard. I would love to see control versus ADHD on this one because I feel like this is just a very hard.

[Sky Waterson]

Well, they have done tests of this before and they have found there is a difference between control versus ADHD in other papers. But I think the difference can sometimes be very small. So you're really talking about small amounts. And in the time discrimination task they had a similar thing. You've got, they have people hear, you know, three tones. Two of them are, you know, 1200 milliseconds long and then some of them are different. And people had to identify, you know, the odd. They said the oddball. The odd time. In each trial. Some of them were easy, some of them were harder. But again, it's this perception of time. How long are things going to take to you and how well do you do this? So there is research to indicate that this is the case. But what they were looking at specifically that made their paper different was they were connecting it to performance, which. Which was very interesting.

[William Curb]

Yeah. And I would love to see that outside of four year olds.

[Sky Waterson]

That would be really good.

[William Curb]

It's. I feel like there could be some connection with how long you think something's taking. Like, I know taking tests can be very stressful with ADHD because you have this, you know, that's time blindness aspect where you're like, I don't know how long it took me to do this problem. I need to rush through the rest of this test to try and get through everything because I'm like, if I don't have can't see a clock, then I don't know how long things are taking. And it feels like I just need to go as fast as I can. And that is going to produce suboptimal results on.

[Sky Waterson]

Exactly, exactly. And if you want to see, before we go into the results, if you guys want to see an annotated copy of this entire paper, you can just DM me time at Unconventional organization on Instagram. Also just ask questions there as well if you have any follow up questions. And we can kind of take you through this a little bit more. But essentially where we're at right now is. Yeah, so preschoolers in Hong Kong. They were not tested, you know, not diagnosed with adhd, but seem to have ADHD symptoms. And they're tested on their, you know, working memory, their marshmallow test, essentially, and their time perception. And then they were also tested on their academic performance in both numbers and in Chinese word reading in a later date to see what the effect was. So what were the results? What did they find?

[William Curb]

I mean, they found that these things all had a predictor on this academic success, but it was the having that executive function piece, that working memory piece was the strongest indicator of how having a link to academic performance, while the. There was delay aversion and time perception that had a link, but it was not. Not nearly as significant as the executive.

[Sky Waterson]

So they found really interesting. You know, they. They started controlling for families, socioeconomic status, general ability, et cetera, which makes a lot of sense. And then they found that when those were controlled for, time perception of working memory contributed to children's academic performance at time one and time two, specifically Chinese word reading, which they argued was actually harder in terms of a working memory than English word reading. They'd done tests on that before, which I thought was really interesting because again, these tests can be different in different countries. But they were arguing that if you struggle to remember things, if you struggle with time, you're going to have hard, a harder time. Based on this paper, with academic performance long term, which is interesting. I think it's. It's sort of obvious, but also interesting to see it here because we don't always think of time perception specifically as a factor in your ability to do things thematically. Working memory. Yes, time.

[William Curb]

So, I mean, I actually, you know, sitting and thinking about, like, oh, yeah, you could be like, I'm bored from reading because I've been doing this forever. I. Or that, you know, I don't have time to do this. I don't have time to study for these things because I have to go do this other thing. And it's less a direct thing, but more of our perception of things. And I feel like that means that using certain strategies could really mitigate those factors in the long run.

[Sky Waterson]

And it was interesting. They also said that it related to other papers and other things that were also done with preschoolers and a few studies with older children that showed that people who had developmental dyscalculia, which is sort of like math dyslexia, I actually have, that performed more poorly than healthy controls in time processing as well. So there seems to be this connection between time blindness essentially, which is what we're Talking about here and your ability to do things like basic math or, you know, English or, you know, Chinese letter writing. And it does, I think the biggest thing I had wanted to know, and I don't feel like it was fully described. Described in this. So if you do have any ideas, please let us know. Like, message us and let us know. Why do you think this is? You know, do you feel like this is effective for you and why?

[William Curb]

Yeah, because I'd love. Again, while great as a initial study here, I feel like aging this up to other groups would be more informative for the long run of things. And again, because then we can do some of those mitigating strategies that might, you know, correct for this and you go, okay, we found this result where this time effect is something that, you know, is significant enough to measure. And then we've tried to do these mitigating factors like using a timer or having practice estimating tasks to see how long they take. And then does that have a good effect on actually making it so that you have you improve your academic performance simply from the fact that you have done these strategies that are somewhat unrelated.

[Sky Waterson]

Exactly. And I feel like ability to do these. Yeah, I think this is a great paper to get a sense of the struggles. And the next paper is experimentation to find out, fix them. I will say, though, those papers are sadly much rarer because it's not usually the point. The point is to find the struggles and then, you know, solve it with, you know, one or two things and not necessarily look for specifics. For me personally, this is usually the paper that makes me kind of go out and look for a solution. Like you said, externalizing time. Do we. If you use timers, how does that work? What are the other ways you can support time blindness? I think externalizing time is a massive one. Like having lots of clocks and lots of, you know, not necessarily timers, but having that visual timer, you know, that red timer where you see time passing, things like that can be really helpful. A lot of times people feel like they should have, like, alarms on all the time, but that can be very frustrating. And actually, when you look at this paper, it doesn't actually help as much as you think it is, because you can look at it at a clock or a timer and it can say, you've got 25 minutes and you can look at it again and it can say, you have two minutes. You're not very good at measuring. So time timers and things like that do a much better job.

[William Curb]

Yeah. I also love when I'm Trying to, like, do a task I really don't want to do, but I'm like, okay, this is going to take this amount of time. I look up and like, it's been 10 seconds.

[Sky Waterson]

Yes.

[William Curb]

I've just spent three hours.

[Sky Waterson]

Yes, exactly. Exactly. I think maybe a little bit of. A little bit of. What's the word? Like acceptance or acknowledgement that maybe the struggles that you had with time could have affected academic outcomes. I know I always felt like in exams I was rushing. I was like, oh, my God, no time. I have to go. And then I would rush through the whole thing and sometimes I would miss the last paper. I regularly got to a point where I had to double check that I hadn't missed, you know, the last page of an exam paper, because I definitely did that because I was always rushing because I felt like I didn't have enough time. I wasn't able to measure it accurately. And the clocks weren't always very good. So things like that, you know, if that's you, if you've been in that experience, this might be an ADHD that you have experienced and there might be reasons for that.

[William Curb]

Yeah, well, I think that's a great takeaway for us here that, yeah, if you are experiencing some of these things that are maybe outside of the academic area, it might still be affecting that kind of thing, be it. And beyond academics, you know, into work performance, where you're like, oh, I only have so much time before I have to do this thing, so I have to just rush in whatever I'm doing and not do as good of a job as I know I could.

[Sky Waterson]

And if you need help with any strategies, you can always, you know, DM me, I'm always happy to share. I know we'll probably be the same, but because there are strategies out there. And as much as it can be frustrating to see this stuff, even among preschoolers and be like, it's going to affect academic performance, you know, and be negative, there are strategies out there. It just doesn't often get covered in the academic literature. And that's the piece that. That's why we talk to you guys and we share this research. So we can also bring some of that. Some of that strategy. Hello. So you were just listening to a research recap. I'm Sky Waterson of Unconventional Organization. If you like that, there's lots more information, ADHD and support for [e-mail] you can go ahead and check that out. Lots of free resources, lots of strategies. And if you want to join our programs you can do that as well. And we'll see you there. Unconventional organization. What do you think makes the perfect snack?

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