Everyone has a hard time paying attention once in a while. It can happen for many different reasons: being bored or tired, not understanding what is going on, feeling afraid, hiding a problem you are dealing with, or not liking yourself very much. When people  have a much harder time paying attention than their classmates a lot of the time even when they want to, though, and this causes problems at school and other places, it is given a name: Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type, or ADHD-PI. At least that’s what it’s called nowadays – in the past it has been called Attention Deficit Disorder (ADD), and even Minimal Brain Dysfunction (MBD)! Both of these terms are now obsolete though.

Whatever you call it, it can be a real pain:

  • You might be told that you ‘aren’t listening’, which is true, but people seem to think you are doing that on purpose
  • They also might say you make “careless” mistakes…but that doesn’t seem right, because you do care
  • You mean to finish something, but then before you know it something else side-tracked you and you forgot all about the first thing
  • You lose things because you are paying attention to something else when you put them down, and so you ‘forget’ where they are

Aargh! Why is this happening?

This is why! Most people have brakes to help control where they focus their concentration and what they ignore (called “selective attention” or “focused attention”). They also have brakes to help them switch between things they want to centre their concentration on (called “attentional control”), and brakes to help them maintain their concentration on something even if it is really boring (called “sustained attention”). If these brakes are leaky, different problems can result. For one, your attention may be in too many places at once, which means that you’ve got little bits of focus all around the room and every time someone moves or talks it grabs a little bit more of your focus. Or, your attention may  be in the wrong place. You may be focused all right…but on the wrong thing! Another thing that can happen is that you have a hard time turning your energy on when you need it, and off when you don’t – you might be falling asleep in class during the day when you need that energy, but then are up and raring to go at 3 o’clock in the morning! Finally, you may be experiencing some of all three of these problems together! No wonder everything seems so much harder for you to do!

Did you know that Albert Einstein was kicked out of school as a young boy because he couldn't pay attention though? Many people with attention problems, like Einstein, learn that they are still smart and can still learn - they just do it differently than others!

So let's give them a brake

  • It will be important for these children and youth, for those who work with them, and for those around them to understand that their ability to concentrate and stay on task will fluctuate from day to day and from task to task. Patterns may be discernible, predictable, and therefore worked around. Keeping a logbook of what time of day, what types of tasks, and in what sort or surroundings they are able to work optimally may help you to find common factors that help their performance.
  • Some people find that when they work on many things for short periods of time all at once they still accomplish many things by the end of the day even though they’ve only been concentrating on each thing for short periods! Keep a list of all the things that need to be done in the time you have, and make a deal with your attention – as long as you are always working on something on that list, it does not matter how long your attention stays on each thing!
  • You may have heard of different medications that are used for ADHD – names like Ritalin, Dexedrine, and Concerta. These medications tend to be more  helpful for the OTHER type of ADHD – that Predominantly Hyperactive-Impulsive Type (ADHD-PHI). Don’t worry though! They can still be tried if you want. Plus there are still plenty of other things that can help, listed below
  • I mentioned difficulties with regulating energy levels: those with ADHD-PI cannot always be as alert as they want to be, and they cannot always shut off their energy when they want to. Strategies intended to help keep the person stimulated such as in-class stand-and-stretch breaks may help when the ‘volume’ is turned too low; squeezing a stress ball, chewing gum, or doodling may help burn off extra arousal so the person can better pay attention when the ‘volume’ is turned too high. Here’s something you may not have known: lots of times that fidgeting child rocking in his chair or sitting in an odd posture is doing what you’ve asked him to do – paying attention! In fact, even though it sometimes makes them look as though they are not paying attention at all; these activities actually help them to do it better…

Motivation:

  • A lack of motivation isn’t the cause of the problem (the ‘leaky brake’ is),  but it can still help to minimize the problem. Picture the individual’s wandering attention as being like a magnet looking for something to stick to. If we can’t control where that “attention magnet” goes, but we still want it to stick to the right thing, then we’d better build that thing out of a magnetic metal. Increasing motivation for a task helps to make it “magnetic”!
  • It is important to give the individual choices when working, so that (s)he has some control over the session (making up for the lack of control over his/her focus). Whenever possible, incorporate a topic or item that the student already very much enjoys and/or is successful at into the assignment. This results in more personal investment in the task, and therefore increased intrinsic motivation to complete it.
  • To maximize the individual’s interest, teach in short sessions and reward his/her effort on a task, as well as the outcome. It may also be necessary to use immediate and concrete rewards (e.g., small candies, stickers, etc.) as well as social praise to increase his/her on-task time.
  • Garber, Garber & Freedman-Spizman (1995) suggest that you together create a distraction zapper to externalize the difficulty in ignoring things the person shouldn’t be paying attention to. This “zapper” may take various forms (everything from a phaser or a magic wand to the evil eye or a wizard’s blink – whatever motivates the person). Each time the person “zaps” an evil distracter trying to pull him/her off course, a point is earned (points can later be cashed in for special treats).  Practice first with enjoyed activities and don’t worry if the person initially gets carried-away with “zapping” – remember how important motivation is! Over time (and depending upon the age of the person) “zapping” will become more refined and less obvious.
  • Clear, concise directions that include only one or two steps at a time will help to make sure that all the directions are heard before that attention wanders off again! And to prevent forgetting, write each step down or use a picture as a reminder. It might be helpful to place a "white board" in a strategic place in the house or classroom, where instructions can be written and/or diagrammed to aid in remembering which tasks (s)he has done, and still needs to accomplish. A written instruction sheet with places to check off tasks might also be helpful. As each set task is completed, (s)he should “check in”.
  • Along the same lines, it is smart to keep a backpack or DayTimer, where a "to do" list and materials (e.g., homework assignments, appointments to keep) can be kept. (S)He can check and update this list on a regular basis, crossing off tasks when (s)he has completed them and adding new tasks as they come to mind. Structuring your day through the DayTimer takes the pressure off remembering everything yourself; the DayTimer remembers everything for you! Only one thing has to be remembered now: check the DayTimer whenever you need to remember something! (Tips on DayTimer use).
  • Because most everyone’s brain is trained to immediately pay attention when their name is said, use the individual’s name frequently when speaking to him/her in the home and classroom. You could also ask the individual to repeat, in his/her own words, what (s)he has been asked to do.

Teacher-specific:

  • Using as many visual materials (pictures, models, etc.) as possible is generally beneficial for these students.
  • A schedule that spreads out short periods of time for "boring", difficult, or taxing work, alternating with times for "interesting" or active work (e.g. role-playing, a “hands-on” activity, incorporating an existing interest or humour into the task), should help improve performance. People with ADHD-PI may need to take breaks from time to time during the school day.
  • Taxing work should be provided in small ‘chunks’. For example, a page of math problems could be administered one row at a time (perhaps by computer to reduce paper requirements) so (s)he does not become overwhelmed or distracted by the number of questions to complete.
  • Preferential seating isn’t a punishment – it is actually a smart strategy! Sitting near the front of the classroom means that there is less for you to see, and therefore less for you to get distracted by! It also means that you are closer to the teacher so that you can ask more questions about what to do next and keep on-track.

External reminders to keep on task will be of great assistance:

  • One example is the Tone-Tape, which is a cassette that randomly emits tones while a student works. Each time a student is working appropriately when the tone emits, points are given – if he is off-task, points are deducted. At the end of each day points can be cashed in for tangible rewards. The Attention Training System is based on a similar premise but is more elaborate. A small battery-operated electronic counter is placed on the student’s desk, which automatically awards the child a point every sixty seconds. If the student wanders off task, the teacher uses a remote control to deduct a point and activate a small warning light on the student’s module. The ATS delivers unobtrusive but effective feedback, functions during regular classroom activities, circumvents the problem of treatment generalization, and has been shown to be as effective as stimulant medication in increasing attentiveness. Each teacher can control four student modules.
  • Another example is The Invisible Clock, a small personal timer which can be kept in the individual’s pocket. It uses silent vibration signals or beep alerts at specified times to cue him/her for specific tasks. It can be used as a learning tool, or as a reminder to practice positive new behaviours and/or habits. The WatchMinderTM is a specially designed shock-resistant sports wristwatch with large, easy-to-read display for time, date, training and reminder functions which also provide silent reminders (vibration) similar to a common pager. It is simple to operate, pre- programmed with over 60 visual reminder messages and 20 training/self-help messages that can be activated and displayed at pre-set times during the day. Multiple messages can be selected daily. These and other such items can be found online at the ADD Warehouse.
  • “Teaching the Tiger” by Marilyn Dornbush, Ph.D. and Sheryl Pruitt, M.Ed. is an excellent resource for finding classroom strategies to assist the teacher in educating, or a parent in parenting, a child with ADHD (both the Predominantly Inattentive Type, and also the Predominantly Hyperactive-Impulsive Type).

Adults working with these children and youth sometimes indicate concerns about the seeming inability of individuals with ADHD-PI to learn from past experiences. Individuals with ADHD-PI often have difficulty linking cause and effect simply because their roving attention visits many more places in between the ‘action’ and the ‘consequence’ and so the connection between the two isn’t as obvious. By explicitly linking these two events this can help them to understand why they are being rewarded or punished, to better carry those experiences with them, and to not feel as ‘out to sea’ as they sometimes might when consequences appear seemingly out of nowhere.

Finally, parents, be sure you request that any relevant accommodations found on this hand- out are added to a formalized Individualized Education Plan (IEP). An informal IEP may not be implemented or transitioned, whereas a formal IEP is a legislated process that also includes the Identification Placement and Review Committee (I.P.R.C.) that must be adhered to. Under the Education Act, any child with identified special needs has access to this process.