Disorders of Attention (page 2)

Attention is a critical skill in learning. Conte (1991) suggests that to be effective learners, children must be able to initiate attention, direct their attention appropriately, sustain their attention according to the task demands, and shift attention when appropriate. Deficits in these areas can have an impact on all areas of school. When children are not paying attention, they cannot respond appropriately to questions, follow directions, or take notes during a lecture. Social problems occur when the student interrupts others and does not listen to peers. Estimates of the number of students with LD that have attention problems range from 41% to 80% (Smith et al., 2004).

Attention problems for children with learning disabilities are often characterized as short attention span. A short attention span is defined as an inability to focus one's attention on a task for more than a few seconds or minutes. Parents and teachers note that many children with LD share the following characteristics.

• Cannot sustain attention for more than a short period of time
• Exhibit excessive daydreaming
• Are highly distractible

Individuals with learning disabilities often have attention problems (Kotkin, Forness, & Kavale, 2001). Their attention difficulties are often severe enough for them to be diagnosed as also having Attention-Deficit Hyperactivity Disorder (ADHD). ADHD is a diagnosis normally made by either a psychiatrist or psychologist, using the criteria as established by the American Psychiatric Association (1994). Although estimates vary, researchers have consistently found an overlap of 10 to 25% between ADHD and learning disabilities (Forness & Kavale, 2002).

Several characteristics of ADHD have long been recognized in many children with learning disabilities, and there is a significant level of comorbidity (a situation in which multiple conditions occur together) between the two conditions (some experts estimate as high as 25%).

Overview of ADHD

Attention-Deficit Hyperactivity Disorder is a condition that can make it hard for a person to sit still, control behavior, and pay attention. These difficulties usually begin before the person is 7 years old. However, these behaviors may not be noticed until the child is older. Doctors do not know just what causes ADHD. However, researchers who study the brain are coming closer to understanding what may cause it. They believe that some people with ADHD do not have enough of certain chemicals (called neurotransmitters) in their brain. These chemicals help the brain control behavior. Parents and teachers do not cause ADHD. Still, there are many things that both parents and teachers can do to help a child with ADHD. As many as 5 out of every 100 children in school may have ADHD. Boys are three times more likely than girls to have ADHD. There are three main signs, or symptoms, of ADHD. These are (1) Problems with paying attention, (2) Being very active (called hyperactivity), and (3) Acting before thinking (called impulsivity).

More information about these symptoms is listed in the Diagnostic and Statistical Manual of Mental Disorders (4th ed. rev.) (DSM IV-TR), published by the American Psychiatric Association (2000). Based on these symptoms, three types of ADHD have been defined.

• Inattentive ADHD. The person can't seem to get focused or stay focused on a task or activity
• Hyperactive-impulsive ADHD. The person is very active and often acts without thinking
• Combined ADHD. The person is inattentive, impulsive, and too active

Inattentive ADHD. Many children with ADHD have problems paying attention. Children with the inattentive type of ADHD often exhibit the following characteristics.

• Do not pay close attention to details
• Can't stay focused on play or school work
• Don't follow through on instructions or finish school work or chores
• Can't seem to organize tasks and activities
• Get distracted easily
• Lose things such as toys, school work, and books (APA, 2000, pp. 85–86)

Hyperactive-Impulsive ADHD. Being too active is probably the most visible sign of ADHD. The hyperactive child is "always on the go," although as he or she gets older, the level of activity may go down. These children also act before thinking. For example, they may run across the road without looking or climb to the top of very tall trees. They may be surprised to find themselves in a dangerous situation. They may have no idea of how to get out of the situation. Hyperactivity and impulsivity tend to go together. Children with the hyperactive-impulsive type of ADHD often may:

• Fidget and squirm
• Get out of their chairs when they're not supposed to
• Run around or climb constantly
• Have trouble playing quietly
• Talk too much
• Blurt out answers before questions have been completed
• Have trouble waiting their turn
• Interrupt others when they're talking
• Butt in on the games others are playing (APA, 2000, p. 86)

Combined ADHD. Children with the combined type of ADHD have symptoms of both of the types described above. They have problems with paying attention, with hyperactivity, and with controlling their impulses. Of course, from time to time, all children are inattentive, impulsive, and too active. With children who have ADHD, these behaviors are the rule, not the exception. Such behavior can cause a child to have real problems at home, at school, and with friends. As a result, many children with ADHD feel anxious, unsure of themselves, and depressed. These feelings are not symptoms of ADHD. They come from having problems again and again at home and in school. There is no quick treatment for ADHD. However, the symptoms of ADHD can be managed. It's important that the child's family and teachers find out more about ADHD, learn how to help the child manage his or her behavior, create an educational program that fits the child's individual needs, and provide medication, if parents and the doctor feel this would help the child.