How does working memory impairment relate to challenges in following verbal instructions? 

Working memory is the mental workspace that allows us to hold and manipulate information long enough to use it. For people with ADHD, this system often works less efficiently, which can make following multi-step spoken instructions especially difficult. According to NICE guidance (NG87), ADHD commonly affects attention, organisation and memory, meaning individuals may lose track of verbal information before they can act on it. 

Why working memory matters in verbal instruction 

Research shows that both verbal and visuospatial working memory are frequently impaired in ADHD. A 2024 review of executive functions found significant deficits in working memory and inhibitory control, explaining why even clear instructions can be hard to retain. A 2025 study on executive functioning identified verbal working memory and processing speed as core difficulties linked to inattentive symptoms, while brain-imaging research has shown distinct activation patterns in prefrontal and parietal networks during working-memory tasks (PubMed, 2024). 

Supporting memory and instruction-following 

NICE and UK education guidance recommend breaking instructions into smaller steps, using visual prompts and repeating key details to support understanding. Written notes, checklists and reminders can also help reduce working-memory load. Some evidence suggests that ADHD medication and targeted cognitive training may further support attention and task follow-through. 

Key takeaway 

Working-memory impairment plays a major role in the difficulty people with ADHD experience when following verbal instructions. By using structure, repetition and external supports, individuals can strengthen understanding and improve everyday communication. 

Avery Lombardi, MSc

Author

Avery Lombardi is a clinical psychologist with a Master’s in Clinical Psychology and a Bachelor’s in Psychology. She has professional experience in psychological assessment, evidence-based therapy, and research, working with both child and adult populations. Avery has provided clinical services in hospital, educational, and community settings, delivering interventions such as CBT, DBT, and tailored treatment plans for conditions including anxiety, depression, and developmental disorders. She has also contributed to research on self-stigma, self-esteem, and medication adherence in psychotic patients, and has created educational content on ADHD, treatment options, and daily coping strategies.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy. 

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.