Attention
What It Is
To adequately pay attention to a task, certain abilities are required:
- Calming down and settling quietly
- Ignoring distracting external stimuli
- Isolating stimuli of interest
- Postponing other sources of gratification
- Organizing the environment to facilitate focus
- Noticing lapses in attention to redirect it back to the task
These abilities are summarized in the three fundamental components of attention:
- Selective attention: the ability to respond only to relevant aspects of a task or situation, ignoring non-essential ones.
- Attentive capacity: the ability to pay attention to multiple stimuli simultaneously.
- Sustained attention: the ability to follow task demands without distraction for a sufficient period of time.
From birth to age 5, attention development occurs in two phases: up to 1 year of age, the “orientation/investigation” system prevails, driven by the novelty of stimuli; after the first year, a “controlled” system emerges, guided and oriented towards achieving goals.
Attention and self-regulation develop mainly between ages 3 and 10, when the child’s prefrontal cortex matures.
Selective and focused attention is developed like adults by age 7, while sustained attention continues to develop until age 11.
Motivational aspects are fundamentally important in maintaining long-term attention. In fact, many hyperactive and inattentive children can maintain good attention for a prolonged period, but only on activities of great interest to them.
To maintain attention on a task, other cognitive components come into play, in addition to those of attention: cognitive events, i.e., the “internal dialogue” made of almost automatic thoughts that accompany and influence behavior; cognitive and metacognitive processes, i.e., the ways in which the subject processes information and knowledge and the ability to regulate these ways; cognitive structures, i.e., automatic assumptions, beliefs, and meanings that influence the perception of oneself, others, and the world.
ADHD – Attention Deficit Hyperactivity Disorder
What It Is
Symptoms of inattention and hyperactivity are often difficult to identify because:
- It is normal for children to be active and lively
- It is normal for children’s concentration ability to be limited
- It is normal for children not to finish what they start
- It is normal for children to have their heads in the clouds
However, if this state is more persistent, frequent, and severe than observed in other children and if it compromises the child’s relationships and/or learning abilities, it could be Attention Deficit Hyperactivity Disorder (ADHD). This is evident in children who, compared to their peers, have marked difficulties in staying attentive or working on a task for a prolonged period.
Inattention, hyperactivity, and impulsivity are considered symptoms of ADHD when:
- they appear before age 7
- they manifest in multiple contexts
- they persist for at least 6 months
- the frequency and severity of symptoms are such that they interfere with social
and school activities - other mental disorders with similar symptoms are excluded
Despite these clarifications, these characteristics are common in children up to age 6, so it is important for a specialist to assess their intensity, frequency, and persistence.
Typical symptoms can be distinguished in the three different affected areas.
Inattention
Fails to pay attention to details or makes careless mistakes; often seems not to listen when spoken to directly; often does not follow instructions and fails to complete tasks; often shows difficulty organizing; often avoids engaging in tasks that require prolonged mental effort; often loses items needed for tasks and daily activities; often easily distracted by external stimuli; often forgetful in daily activities.
Hyperactivity
Fidgets with hands or feet or squirms in seat; often leaves seat in situations where remaining seated is expected; often runs and jumps excessively and in inappropriate situations; often has difficulty playing or engaging in leisure activities quietly; often “on the go” or acts as if “driven by a motor”; talks excessively.
Impulsivity
Often blurts out answers before questions have been completed; has difficulty waiting for their turn; often interrupts others or is intrusive towards them.
How they manifest
In different contexts, certain characteristic behaviors of the disorder can be identified.
At home and common behaviors
Attraction to every source of distraction; disorganization and disorder; tendency to avoid activities requiring attention to detail or organization; tendency to forget important activities; excessive motor activity, seem “driven by a motor”, do not respect time and space, do not stay seated; conflicts with family members.
At school
Show interest only if strongly motivated; difficulty completing tasks and haste in execution; inaccuracy and carelessness; tendency to respond poorly; tendency to lose school materials; often get up from desk or move continuously while seated; disrupt lessons or classmates.
In play
Frequent loss or forgetting of objects; failure to respect rules and difficulty observing turns; quick transition from one game to another; prefer movement games or video games; intolerance for structured games; difficulty in games requiring attention effort; difficulty in team games.
In relationships
Disregard for social rules; difficulty keeping commitments; inconsistency in friendships; poor listening skills and tendency to change the subject frequently; inappropriate behavior for the situation; leadership attitude inattentive to others’ interests.
These behaviors increase in group situations, while they diminish: when the subject is guided or monitored by an adult, when participating in activities particularly interesting to them, under the promise of a pleasant reward, in one-on-one interactions.
In managing a child with ADHD, it is important to address dysfunctional behaviors while recognizing and valuing the child’s resources to promote adequate personality development and self-esteem levels. Often, in children with mild forms of ADHD,
What parents can do before a visit
It is important to provide the specialist with as much information as possible about the child for an accurate assessment. Before a doctor’s visit, it may be helpful to:
- Note all aspects concerning the child’s health and well-being, such as mood, sleep/wake rhythm, diet, habits, characteristic behaviors, other conditions, and any medication intake;
- Compile a sheet with your assessments regarding the symptoms observed in the child;
- Gather teachers’ opinions on the child’s behavior and school performance.
What Spazio FormaMentis offers
Psychoeducational interventions
The psychoeducational approach consists of a series of interventions united by the goal of modifying the child’s physical and social environment to improve behavior and social adaptation, reducing external factors that favor behavioral problems.
In psychoeducational interventions, parents have a direct and active role: for this purpose, they can be trained through specific courses called parent training.
Parent training
The parent training program aims to strengthen parents’ knowledge about the behavior of children with ADHD and to enhance their management skills through the teaching of specific techniques.
Courses consist of 8-12 weekly sessions, in groups of 5-6 couples or individually. Parents are taught a method to analyze situations and identify factors that favor the child’s instability: antecedents (events predicting the onset of negative behaviors), problem behaviors (precise analysis of what the child does), and consequences (what happens after the child exhibits problematic behavior).
In this way, parents can see the close relationship between the child’s characteristics, their own, and those of contingent situations.
Some educational techniques for managing the child’s behavior are also taught.
Integrated Cognitive Training – Benso Method
The Integrated Cognitive Training – Benso Method is defined as integrated because it trains both attentive abilities and specific learning (reading, writing, calculation) as well as the underlying functions necessary for these learnings (language, visual perception).
The focus of the training is on what is found weak during evaluation.
The model supports that all types of learning require attentive resources to be realized; therefore, an habilitative or rehabilitative intervention must also extend to attentive components.
The treatment gradually and directly exposes the subject to increasing attentional-executive “stress”. The graduality reinforces the subject, the reinforcement fuels motivation for the task, the motivation amplifies the resources available for the task.
This individual work must be tailored to the individual subject so that the cognitive system is stimulated to the maximum level.
It is necessary to administer the training with frequency, patience, and consistency to achieve progress. There must be a balance between the number of weekly hours and the ability to keep the subject motivated on the task; therefore, the work is structured with concentration in short but frequent sessions.
Parents, the support clinician, or the teacher can benefit from an “habilitative package” that must be monitored and modified during the process. This task is the responsibility of a reference clinician qualified to evaluate and supervise the proper progress of the training through ongoing assessments.
It is important to consider that the environment and the operator themselves can play a significant role in the child’s motivation, commitment, and consequently, results.
Bibliographic sources used
- “Learn to Organize Yourself! How to Teach Order, Time Management, Concentration, and Self-Control” R. Branstetter ed It. Edited by G. Daffi (2106) Edizioni Centri Studi Erickson
- “Diagnosis of Developmental Disorders. Models, Diagnostic Criteria, and Clinical Cases” Claudio Vio, Gianluca Lo Presti (2014) Edizioni Centri Studi Erickson
- “Attention and Metacognition. How to Improve Classroom Concentration” G. M. Marzocchi, A. Molin, S. Poli (2013) Edizioni Centri Studi Erickson
- “Attention and Hyperactivity Disorders. Guide for Psychologists and Teachers” E. A. Kirby, L. K. Grimley (2016) Edizioni Centri Studi Erickson
- “ADHD at School. Effective Strategies for Teachers” AA. VV. (2013) Edizioni Centri Studi Erickson
- “ADHD: My Exercise Book. Ages 6-12. Activities to Develop Self-Confidence, Social Skills, and Self-Control.” L. Shapiro (2015) Edizioni Centri Studi Erickson
