Executive Functioning and Structure: Understanding Neurodiversity

Executive Functioning and Structure: Understanding Neurodiversity

As we begin to unpack the important relationship between Executive Functioning and Structure, we need to understand neurodiversity.  In 2025, the term “neurodivergent” is part of our vernacular, but many folks have a lot of questions.  Maybe you’re embarrassed to ask what the heck it means to be neurodivergent.  Maybe you’re well educated on this topic, but you’re curious about how it relates to substance use disorder and mental illness.  Maybe you’re just bored and looking for something to read.  Regardless, let’s take a peek at how Surfside’s model is built to support neurodiversity… and why.

What is Neurodiversity

The term “neurodiversity” acknowledges and respects that the human brain functions differently for different people.  Despite what we’ve been taught, there isn’t a “right” or “normal” way to think. Neurological differences are natural, regular occurrences.

A person who is considered neurodivergent may have differences in sensory processing, learning, attention, or executive functioning (read our post on Executive Functioning 101 first if you missed that one!).  Often, the term “neurodivergent” leads people to exclusively think of Autism Spectrum Disorders.  Autism can be marked by differences in sensory processing, information processing, social communication, behavioral patterns, and more. But neurodiversity includes many other conditions: ADHD, Dyslexia, Post-Traumatic Stress Disorder, Tourette’s, and more.  Some mental health professionals consider OCD and Traumatic Brain Injuries (TBIs) to fall under the neurodivergent umbrella.

ADHD, Autism, Traumatic Brain Injuries & More.

Here’s the value of acknowledging neurodiversity: we stop sending the message that people are dumb because they process information differently.  Many people carry shame because they didn’t learn, think or behave like other kids.  They adopt negative thinking patterns, particularly about themselves and how they relate to the world.  People feel alone, isolated, and ruminate on thoughts of being “not good enough” or”stupid.” 

And what does this have to do with Substance Use or Mental Illness? A ton! Here are a few insights:

• When we feel different, we try to find ways to relate to others.  Drinking and using drugs can often feel like a way to connect, belong, and reduce social anxiety. 
• Being the “clown” or the “troublemaker” allows people to invent an identity, rather than being labeled as “different” or “other.” For some people, it feels like they can control the narrative about themselves.
• It may feel like substances regulate distressing experiences.  Drugs might calm feelings of overstimulation or inability to focus. Alcohol might induce sleep for someone who’s restless or temporarily calm their anxiety.
• Putting someone in a treatment environment that doesn’t acknowledge neurodiversity and utilize different approaches is problematic.  A clinical setting that feels like school (AKA sitting around being taught information) sets a person up for frustration, feelings of inadequacy, and failure. 

Neurodiversity and the Surfside Process

Why are we reading and writing about neurodiversity on the Surfside website? In the Spring of 2025, 82% of Surfside residents had an ADHD diagnosis. At any given time, we treat a handful of people on the Autism Spectrum, and we frequently see men with a history of Traumatic Brain Injuries and Post-Traumatic Stress Disorder. 

We know for a fact that structure and routine are profoundly helpful for neurodivergent folks.  Structure is at the heart of what we do. Our days are predictable, with set routines, tasks and timelines.  Predictability reduces cognitive load, making it less challenging/exhausting for a person to move through their day. Reinforcing a routine builds healthy habits, and those habits support executive functioning.  The scaffolding around our day-to-day supports attention and memory, helping residents avoid losing track of time or important tasks. 

“But my Son is Unhappy! He’s Tired!”

Developing a new way of thinking, living, and behaving is tough. Consider all the times you may have committed to a new diet or exercise routine, but stopped because it was just… hard to sustain. That’s what we’re doing at Surfside, multiplied by a thousand. 

We’re asking your loved one to not only begin an addiction recovery journey, but to implement structure that he probably hasn’t had since high school. People often resist structure, but flourish once they develop a routine.  Things tend to feel really difficult because they’re different.  We’re asking you and the person you love to give the idea of doing something different a shot. All that’s required is to put one foot in front of the other, even when it feels scary and new. 

Complaining is natural.  When a person’s brain has been swamped with substances, social media, and a lack of routine, this change feels drastic. But we know that even for folks with PTSD, Generalized Anxiety, or a concussion history, our approach has mental health benefits. The great news? When we give someone time, they typically begin to adjust and experience the benefits.

When tough conversations happen, lean on your support system.  If you don’t have one, now is the time to build one – see some of our previous articles that talk about how to find a therapist for YOU, family support groups, and other helpful resources.

Read the next part in our series here: ADHD and Executive Functioning