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Struggling to Learn

 
Home » Understanding and Recognizing »

Attention Disabilities


 

Why Attention Matters

"Paying attention is a task many of us take for granted, except perhaps when we're daydreaming or otherwise distracted."

Paying attention refers to the brain's ability to take in, categorize, and prioritize sensory information and to focus on those things deemed most important. Contrary to a common misconception, attention problems do not result from an inability to take in sensory information but instead from an inability to distinguish among and respond appropriately to different types of information — some important, some insignificant.

The school environment presents an extreme challenge to anyone who struggles with attention. Students must focus intently on a teacher's words while filtering out the dynamics among 20 or more classmates — private conversations, dropped pencils, fidgeting, note-passing, and countless other distractions within and outside the classroom. They must then sort through the information they hear, organize and prioritize their thoughts, plan their responses, and perform the work assigned to them. Those with chronic attention problems describe their world as a cacophony of distractions, with no sound, image, or idea necessarily more important than any other.

Descriptions like these illustrate yet only hint at the negative impact an attention problem and its resultant organizational difficulties can have on a child's ability to make it through the daily life of school and his or her life-long potential for success. According to many experts, these types of disorders, which often begin in early childhood, typically persist well into adolescence and adulthood, turning a child's daily struggles into a lifetime of feeling left behind.

Several studies have suggested that children with attention problems run a greater risk of developing many other behavioral and social problems. One such study found that adolescents with Attention Deficit and Hyperactivity Disorder (ADHD), one of the most common attention disorders, "completed less formal schooling, achieved lower grades, failed more courses and were more often expelled" than those without the disorder. Other long-term studies connect ADHD with an increased risk of substance abuse and criminal behavior when the disorder is left untreated with either behavioral or medication therapy or both.

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Easier Said Than Done

Paying attention is a task many of us take for granted, except perhaps when we're daydreaming or otherwise distracted. Rarely do we stop to consider the elaborate neurocognitive processes involved in paying attention. Just for a moment, think about all the things that are stimulating your senses as you read this sentence — background noises, the aroma of food, distractions in your peripheral vision, thoughts of other things you need to do.

To efficiently process the huge amount of information it takes in, the brain must impose several control measures. It must first prioritize different types of stimuli, a process that controls not only what information gets ignored or recognized but also how much concentration is given to any one piece of information. When possible, the brain also connects new pieces of information to prior knowledge, thereby aiding in the understanding of new information as well as broader concepts. Finally, no matter how quickly it processes information, the brain must also help us focus our attention on important information for an appropriate amount of time. This becomes more difficult when we are faced with subjects that aren't inherently interesting to us.

In addition to processing relevant information, we must also be able to respond to the information in a productive and organized way. A student must be able to respond in an appropriate manner to a teacher's instruction. Often, an appropriate response involves considering the possible consequences of a number of different actions — perhaps requiring that the student not respond immediately and instead appropriately organize, plan, and pace his or her work. Effective production also requires that students monitor their own work while performing or completing a task, thereby allowing them to revise their level of attention as necessary.

Given the processes and mental effort involved in paying attention, it's not surprising that, at times, we all find ourselves unable either to prioritize the sensory information coming at us from all directions or to respond to it appropriately. This does not necessarily mean, however, that we suffer from an attention disorder — or that such disorders don't exist.

The question of whether disorders like Attention Deficit and Hyperactivity Disorder (ADHD) exist is a controversial one. Until recently, there was no consensus about the validity of the diagnosis in large part because researchers had not found evidence of a biological cause. The issue is further complicated by the fact that the criteria used by doctors to diagnose the disorder are not uncommon to any of us; they include failing to pay attention to details, struggling to organize thoughts and tasks, and having difficulty waiting patiently in line.

One viewpoint, held by a minority of medical and psychiatric professionals, notes that there is no fundamental difference between people who struggle regularly with attention problems and those who are easily able to focus when needed. These experts argue that scientific research has failed to uncover a legitimate biological cause for the behaviors that, according to the American Psychiatric Association, constitute ADHD.

Most experts accept that ADHD is a disorder caused by a structural and/or chemical abnormality in the brain, and they note the statistically significant differences between individuals with ADHD and individuals without ADHD. According to many ADHD researchers, the presence of a biological cause is increasingly supported by brain research. For example, neuroscientists have identified parts of the brain that they say are smaller and less active in people with ADHD than in individuals with no chronic attention problems.

Unfortunately, there is still much that remains unknown. Although researchers have identified what they say are "neural signatures" of attention disorders and have found that ADHD tends to run in families, they have not yet linked attention problems to any specific genetic mutations or environmental factors.

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Signs of Struggle

Although everyone exhibits inattention at various times, medical experts have come up with a set of criteria used to identify the patterns of behavior that constitute Attention Deficit Hyperactivity Disorder (ADHD). According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), a reference published by the American Psychiatric Association, the three patterns of behavior that indicate ADHD are inattention, hyperactivity, and impulsivity (difficulty controlling one's actions).

Signs of inattention as outlined in the DSM-IV include:

  • becoming easily distracted by irrelevant sights and sounds
  • failing to pay attention to details and making careless mistakes
  • rarely following instructions carefully and completely
  • losing or forgetting things like toys or pencils, books, and tools needed for a task

Signs of hyperactivity and impulsivity are:

  • restlessness, fidgeting with hands or feet, or squirming
  • running, climbing, or leaving a seat in situations in which sitting or quiet behavior is expected
  • blurting out answers before hearing the whole question
  • exhibiting difficulty waiting in line or for a turn

"Attention deficit" is a common explanation for learning difficulties, but it may also be one of the most common misdiagnoses. Although it is important for teachers and schools to be aware of the signs of ADHD, focusing primarily on attention deficit may cause educators to overlook other learning problems. Dr. David Urion, Director of Neurology and Learning Disabilities at Children's Hospital in Boston, suggests that parents and teachers look for behavioral inconsistencies. If any of the behaviors listed above occur inconsistently or only within the context of a particular subject area, they may indicate a more specific learning problem. When a child struggles to read, for example, it may be very difficult for him or her to concentrate and stay focused because a neurological breakdown exists that hinders their decoding ability.

In addition to the diagnostic criteria listed above, the DSM-IV also contains very specific guidelines for determining when these criteria indicate ADHD. The behaviors must appear early in life (before age 7), continue for at least six months, and be more frequent or severe than those exhibited by others of the same age. Most importantly, the behaviors must create a significant handicap in at least two settings, such as in school, at home, at work, or in social settings. A child who has some attention problems but whose schoolwork and friendships are not impaired by these behaviors, or who seems overly active at school but functions well elsewhere, would not be diagnosed with ADHD.

Many times attention problems come to light in the context of a child's schoolwork. For this reason, educational experts recommend that parents and teachers be aware of warning signs that may indicate attentional difficulties. The following is a list of those early warning signs, as outlined by Dr. Mel Levine in his book Developmental Variation and Learning Disorders.

Processing

A child struggling to appropriately process and organize information because of attention difficulties may:

  • process too little or too much information and not be able to distinguish between what is important and what isn't
  • focus too superficially or too deeply on information presented
  • have difficulty connecting new information with information already known
  • only pay attention to exciting information or during highly stimulating activities
  • focus for too brief a period
  • have problems shifting focus from one subject or activity to another

Production

A child who struggles to organize and produce schoolwork because of an attention or problem may:

  • fail to foresee the outcome of a task or activity
  • have difficulty coming up with the right strategy or technique to accomplish a task
  • not monitor the quality of his or her work or the effectiveness of strategies used
  • not use past successes and failures to guide current behavior, actions, or strategies
  • be apt to do too many things too quickly or other things too slowly
  • have a poor sense of time and how to manage it

Mental Energy

A student who is unable to maintain the mental energy required to stay focused and be productive may:

  • have difficulty concentrating and may complain of feeling tired or bored
  • not seem to be well rested and fully awake during the day
  • have inconsistent work patterns that negatively impact quality and quantity of work
  • be overactive and fidgety, especially when sitting and listening

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