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FocusingFocused Attention

Focused Attention Skills in Childhood

Girl sitting at table looking up with her chin resting on hands.
Marcy Willard
Marcy Willard
Ph.D., NCSP
Last modified 28 Sep 2022
Published 02 Jul 2022

What Is Focused Attention in Childhood?

Focused attention in childhood is when a child can stay focused on a task or activity despite other distractions in the environment. 

If focused attention is a concern, you may notice your child bounces from one activity to another, being easily drawn in by the noise of a car going by or a bird chirping overhead. 

For school-aged children, focus is important in the classroom. A child needs to be able to screen out distractions like a peer tapping a pencil, noises in the hallway, and squirrels on the tree out the window. 

In order to focus, a child needs to be able to listen to the teacher and complete tasks, despite these other things going on in the environment. Teachers generally reach out to parents if a child is struggling to stay focused for very long. To learn how to help your child with focused attention in just 2 minutes a day, sign up for this course by Dr. Anna Kroncke, clinical psychologist. 

Symptoms of Lack of Focused Attention in Childhood

  • Off task: your child plays with their pencil or a toy instead of completing their homework
  • Easily distracted: your child will hear someone walking by the classroom, or hear the rumble of an old car and become distracted
  • Internally focused: your child may get lost in their own thoughts
  • Bouncing between activities: your child will begin their homework, think of something funny, which makes them think of laughing at lunch today, which will make them think of grabbing a snack, which makes them wander aimlessly into the kitchen
  • Drifting off: your child may be quickly drawn away from the focus of the activity. In reference to your child you may hear family members say, “Look, squirrel!” jesting that your child is easily distracted by the smallest thing
  • Having trouble finishing homework: your child might avoid their homework or have issues finishing any tasks that they start
  • Missing cues: your child may be so busy with a task of interest like a book or video game that they do not even register your voice when you call them to come for dinner
  • Working slowly: your child may work slowly on tasks because they are constantly fighting off distractions. Some children say they have to read a passage in their school book six times before they find that they can describe what the book is about. 

What about the ‘unfocused child’ who can play Legos for hours?

Challenges with focus generally happen with tasks that are neutral or not preferred, such as doing a worksheet, reading a textbook, getting dressed, eating breakfast, and brushing teeth. 

Children may struggle with focus but sit still for hours with a favorite activity, such as a movie or video game. When the activity is a favorite, the brain activates in a different way thus other distractors do not make it hard to focus. 

In fact, you may find that your child can focus on Legos for hours, no matter what else is going on. They may not hear a word you say, even when you sit right beside them. You may say, “A tornado could come through here, and this child wouldn’t even look up from their video game.” In this case, focused attention is still a concern because it will be important for a child to be able to pay attention, even to tasks that are not particularly interesting or exciting.

Causes of Lack of Focused Attention in Childhood 

Attention Deficit Hyperactivity Disorder (ADHD)

ADHD is marked by pervasive inattention, hyperactivity, and impulsivity that often result in significant impairments in both school and social settings. 

Common symptoms in school-aged children include distractibility, inattention, inability to complete tasks and assignments, chronic fidgeting and more. ADHD is neurodevelopmental meaning it impacts the brain and first occurs in childhood.

The current Diagnostic and Statistical Manual (DSM-5) reports a 5% population prevalence rate for children and identifies the following three subtypes of ADHD: 

ADHD predominantly inattentive type

The old term ‘ADD’ has been replaced with the new diagnosis of ADHD, predominantly inattentive type. Children with this type are not hyperactive and may not be impulsive either. They tend to be highly distractible and they may have the propensity to daydream or ‘drift’ during conversations. They tend to have learning difficulties or learning disabilities.

ADHD predominantly hyperactive/impulsive type

Individuals with this type of ADHD tend to act as if driven by a motor. They may move around constantly, fidget, or bump into things. A child with this profile may accidently break toys or other objects. They may act impulsively, making decisions that they soon regret. People with this type of ADHD may have good intentions and yet get in trouble at school for failing to stop and think before taking action.

ADHD combined type 

People with the combined type are inattentive, hyperactive, and impulsive. Children with this profile may have a very hard time sitting still and following instructions in school. They may seem as if they always need to scratch an itch, having a hard time feeling grounded and comfortable. Children with combined type has the most difficulty in school and more significant behavioral problems.

ADHD is more often diagnosed in males than in females; the ratio is approximately 2:1 in children. Although ADHD begins in childhood, challenges continue into adulthood for most people with the disorder.

Cognitive profiles of ADHD

Individuals with ADHD may be extremely bright or gifted (meaning that they have IQ scores which fall in the top 5% of individuals). 

Some people with ADHD may have exceptional fluid reasoning, which refers to the ability to solve novel problems and puzzles they have never seen before. They may have exceptional visual-spatial skills, which is the ability to see how objects fit together. They may have exceptional verbal knowledge, which means that they have conceptual understanding, a large vocabulary, and the ability to express themselves eloquently.

Depression or anxiety 

Children who are experiencing depression or anxiety because of traumatic events in their lives or because of brain chemistry may often have trouble focusing when they are experiencing emotional symptoms. In this case it should not be hard to focus when a child is not in a depressive episode or experiencing anxiety. With ADHD this would be a more consistent problem. If a child suddenly has trouble with focus and changes in behavior emotional symptoms will be important to look for.

Traumatic brain injury

Children who have hit their heads and suffered an injury may have unexpected memory loss as well as emotional changes, headaches, and challenges with attention. Traumatic brain injury causes changes to the brain and attention and executive functioning challenges can result. 

Other disinhibition challenges

Children who are not able to focus on uninteresting tasks and inhibit unimportant stimuli have trouble with inhibition. To be focused and concentrate on uninteresting tasks, a child has to inhibit the urge to do something else. Often, disinhibited children display extreme emotional upsets. They may seem to go from 0-60 in a matter of seconds. Recent research shows that disinhibition in ADHD may be the reason for the meltdowns and emotional ups and downs that are often seen in this disorder.

What to Do When Your Child Can’t Focus in Childhood 

DO: talk to the school about accommodations

The ability to pay attention is extremely important to your child’s development. One of the most common strategies to support a child with attention issues is accommodations. The term accommodations means that the adults in the child’s environment will provide certain support to level the playing field with the other kids in the classroom. For example, a child who has trouble reading off the board might be offered a seat at the front of the room as an accommodation. 

504 Plans

Many children with attention issues who need accommodations qualify for a Section 504 Accommodation Plan. This plan allows for the accommodations to be put into writing and formalized into a document that is to be shared with teachers and parents. The law does not actually require the 504 document, but rather, requires that the school have a plan for accommodating children with impairments that substantially limit their participation in the general education curriculum or classroom environment. Once that 504 plan is in place and communicated to the staff and parents, the child’s team can get on the same page about what the child needs and how to provide it in the classroom. 

A word of caution on 504 Plans. Once the plan is in place, yes, the teachers and staff are required to follow it. Keep in mind, though, that the plan is only as good as the skills and knowledge of the people implementing it. There are two ways to support your child’s school in implementing a 504 Accommodation plan for your child: 

  • Avoid making the plan too long. In this author’s experience, it is best to go with the rule of 3. Have the team identify 3 areas of difficulty at a maximum and then 3 accommodations for each. That is 9 total accommodations. 

“A list of 9 accommodations is plenty and it could be argued that the shorter these plans are, the more likely the accommodations will actually happen, and more importantly, actually work.”

  • The other way to support your school in providing accommodations is to communicate with the teachers frequently. One great approach is to request to have your 504 Plan Review meeting right at the beginning of the school year. Bring the plan with you and sit down with the teachers to explain your child’s needs and how these accommodations have helped in the past. The more your child’s teacher(s) know about their needs, the better the odds of success with these accommodations.

Wait! Is a 504 Plan in Special Education?

No. Although children in special education may also have accommodations in school, the term is most often used within the context of the general education classroom. This might mean that the teacher or other staff members provide extra help for a particular student within the classroom, cafeteria, or playground. These accommodations are offered such that a child can receive the school’s services as adequately as non-disabled peers. Typically, 504 plans do not include service providers. That is, special education staff like speech therapists and school psychologists are typically not available through the 504 Plan. If a child needs ‘direct service’ or ‘specialized instruction’ those services are generally provided through an Individualized Education Program, rather than a 504 Plan.  

Accommodations on a 504 may include 

  • Extra time on assignments and tests
  • A quiet space to do ‘seat work’ or in class assignments
  • The opportunity to take breaks – or use of a break pass
  • The ability to have fidget toys
  • The chunking of assignments with intermediate due dates
  • The option to stand up during work time

DO: Consider accommodations at home

Home accommodations for attention might include

  • Having a quiet designated space for work
  • Using a timer to keep homework sessions manageable
  • Offering rewards like game time for completing assignments
  • A sticker chart and a visible schedule for the daily routine
  • Take up swimming, research shows that swimming can be extremely helpful to modulate attention and help with emotional regulation.

Home accommodations for impulsivity might include

  • Provide many outlets for your child’s energy. Activities like swimming, horseback riding, and gymnastics can be therapeutic for a very active child.  
  • Practice mindfulness and relaxation in everyday life. You may find that taking time to relax and recognize feelings in their body can help your child be more aware and less impulsive. This may be best to practice right before bed as a way of calming down and getting to sleep.
  • Think carefully about the demands of the social environment. Think twice before taking your child to a tea party, movie theater, library, story time at the bookstore, or adult birthday party. Your child may not be able to maintain their composure in quiet places, so set them up for success with activities where they can excel. Climbing gyms are fun, bounce places, the zoo or an engaging and interactive museum.
  • Read books with your child about attention issues. Resources like Personal Space Camp [5] and Ms. Gorski, I Think I Have The Wiggle Fidgets [6], are provided below. Reading these books with your child can help ‘put a name on’ their challenges. They can learn that many children have the same struggles [5,6,7,8,9].

DO: pursue an accurate diagnosis

It is important for parents to be aware that attention and related problems can have a significant impact on a child’s functioning and that an accurate diagnosis by a doctor who has experience with mental health diagnosis in childhood is important. 

Some pediatricians feel uncomfortable making these diagnoses, ask your child’s pediatrician if they have training in diagnosing attention issues. If not, ask for a referral.  

An assessment of these difficulties should shed light on the severity of the challenges and determine if they are related to ADHD. It is important to note that children with ADHD often have significant problems in school, socially, and in the community.

DO: make sure

There is a lot of misinformation that has been circulating about ADHD for decades. The prevailing story is something like, “I don’t think ADHD is a real thing. Those parents just want to put the kid on medication.” Unfortunately, this is an urban legend with no basis in research. ADHD is a structural brain difference that causes children to function differently. It is absolutely real. 

The way to avoid significant problems later is for parents to be sure. If you are concerned about ADHD in your child, get a comprehensive psychological evaluation. Do not rely on checklists, school reports, or internet searches. The only way to know for sure is to have a full assessment. Most of these assessments include: IQ testing, executive functioning testing, memory, and tests of continuous performance. These authors do see positive results from a full assessment that may lead to a prescription for ADHD medications. HOWEVER, it is absolutely essential that parents make sure that the child indeed has this diagnosis before pursuing medications. 

DO: be aware

Combined behavioral and pharmaceutical intervention is generally best, given that success is contingent on an accurate diagnosis. Most psychologists and medical doctors agree that behavioral therapies are best when combined with medications in the treatment of ADHD.

Although there are many treatments that can help with ADHD, medication has the most research to support its efficacy. In some cases, these medications can bring about life-changing differences in your child’s ability to function and succeed at school. 

DO: remember you are in control if your child is put on medication or not

Too often, parents are hesitant to get a diagnosis because they think, “I don’t want to put my kid on medication.”

If ADHD is indeed diagnosed, your family will still be in control of any decisions made regarding your child’s medical interventions and supports. Medication options should be discussed with a psychiatrist or primary care physician and not with school staff or other therapists.

DO: be careful with medications, particularly in teenagers

It is really important for parents to be aware of the interaction effects of medications. If your child is on other medications, it will be necessary to let your child’s doctor know. Further, if your child engages with non-prescribed drugs such as THC or alcohol, other prescribed medications can be very dangerous. It is generally advised that teenagers be drug tested before beginning any medication, especially in the case of a controlled substance like ADHD medication. 

In some cases, teens can become addicted to prescribed medications, illegal substances, or a combination of both. If you are concerned about addiction, see this article. Here, you can learn about ways to identify addiction issues and how to get your child into a healthy place.

If you are concerned about any aspect of your child’s medications, reach out to your child’s doctor right away. If you are in crisis, call 911 or visit your nearest emergency room.

When to Seek Help for Attention Problems in Children

If your child is struggling with attention, or hyperactivity and impulsivity, it is often necessary to seek professional help. If these challenges are clinically significant they can have a pervasive impact in many areas of your child’s life.

If some of the at-home strategies mentioned in this article or reference list do not help with the problem, your family is going to need some support. Children who are highly distracted tend to have challenges at school and home because they often miss key instructions and information.

Unfortunately, this symptom is often linked to poor behavioral inhibition, which leads to getting in trouble at home and at school.  

Taken together, it is important for parents to be aware that attention problems can have a significant impact on a child’s functioning and that the provision of accurate diagnosis, psychological or pharmaceutical intervention can bring lasting positive change.

Further Resources on Attention Problems in Children

If your child is struggling with a similar problem, not directly addressed in this section, see the list below for information about other related symptom areas.

  • School psychologist: to determine learning needs based on your child’s neuropsychological profile; perhaps an IEP, 504 plan or RTI is warranted to help your child. Perhaps tutoring is recommended and your school psychologist can help you locate resources.
  • Psychologist or neuropsychologist: to conduct a full assessment and examine symptoms in a mental health or behavioral context
  • Child psychiatrist: to help you learn more about medications that can help with hyperactivity
  • Executive functioning tutor or coach: to help your child focus and organize school work and keep up with study skills

Similar Conditions to Focused Attention 

  • Shifting attention: difficulties with focused attention may be accompanied by challenges with shifting attention
  • Executive functions: difficulties related to planning, sequencing, and organizing information can co-occur with challenges in focused attention
  • Processing speed: difficulties with fluency and other areas of cognitive processing may be impact attention

Resources on Focused Attention in Childhood

[1] Kroncke, Anna; Willard, Marcy & Huckabee, Helena (2016). Assessment of autism spectrum disorder: Critical issues in clinical forensic and school settings.

[2] ADDItude Editors (n.d.) Focus the Attention of Distracted Children 

[3] Linder Ed.D., Toni & Petersen-Smith Ph.D., Ann (2008) Administration Guide for TPBA2 & TPBI2 (Play-Based Tpba, Tpbi, Tpbc). Paul H. Brookes, Inc. 

[4] Lewis, PhD, Jeanne, Calvery, Ph.D., Margaret, & Lewis, Ph.D., Hal (2002). Brainstars. Brain Injury: Strategies for Teams and Re-education for Students. US Department of Education: Office of Special Programs.

Resources For Parents

[5] Zeigler Dendy, Chris A (2003). Teaching teens with ADD and ADHD. Woodbine house.

[6] Zeigler Dendy, Chris A. (2011). Teaching Teens With ADD, ADHD & Executive Function Deficits: A Quick Reference Guide for Teachers and Parents.

[7] Cooper-Kahn, Joyce & Dietzel, Laurie C. (2008). “Late Lost and Unprepared”: A Parent’s Guide to Helping Children with Executive Functioning.

Resources For Kids

[8] Cook, Julia (2012). Personal Space Camp. National Center for Youth Issues.

[9] Esham, Barbara (2015). Mrs. Gorski, I think I have the Wiggle Fidgets. (New edition) Adventures of Everyday Geniuses.

 

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