Tips to Aid a Child with Attention Difficulties

Adapted from Driven to Distraction – by Edward M. Hallowell MD and J. Ratey MD

It is important to remember that inattention is a symptom, not a diagnosis. Many factors can contribute to inattention ranging from poor diet, learning problems, and not enough sleep to medical and NBD disorders.

1. If you have been told that the problem is ADD, make sure that it is. It is not up to the teacher to diagnose ADD. You can and should raise questions. Make sure that the child’s hearing and vision have been checked, and that other medical problems have been ruled out. It is the parent’s responsibility to make sure that an adequate evaluation has been done.
2. Does the teacher have support? This could be from a learning specialist, child psychiatrist, social worker, school psychologist, or pediatrician. Teachers cannot be expected to be experts on inattention. They need to be able to ask for help if they need it.
3. Ask the child what will help. Children with inattention are often very intuitive and they can tell you how they learn best if you ask them. It is amazing how often their opinions are ignored or not asked for.
4. These children need special help to find enjoyment in the classroom. Their program needs to be set up so the child can succeed and gain mastery instead of failure and frustration. Parents need to ask, “How can we set things up so that this child experiences success instead of failure?”
5. These children need structure. Surprised? They need their environment to structure externally what they can’t structure internally on their own.
6. They need:
   • previews
   • repetition
   • lists
   • reminders
   • directions
   • limits
7. They need rules. Write them down and post them. The children are reassured by knowing what is expected of them. Rules set limits and boundaries. They are containing and soothing for the child. Rules need to be:
   • consistent
   • predictable
   • promptly enforced
8. Avoid lawyer-like discussions of fairness. These long discussions are just a diversion.
9. They need to hear things more than once. So, repeat directions, write them down, and repeat them again.
10. Eye contact works like magic. You can “bring back” an inattentive child with eye contact. Do it often. A glance can retrieve a child from a daydream or give permission to ask a question or just give silent reassurance.
11. Seat an inattentive child near your desk or wherever you are most of the time. This helps stave off the drifting away that so bedevils these children.
12. Give the child a predictable schedule. Post it on the blackboard or the child’s desk. Refer to it often. If it will vary give the child lots of warnings and preparation. Transitions and unannounced changes are very difficult for these children. They become discombobulated by them. Take special care to prepare for transitions well in advance. Announce what is going to happen, then give repeated reminders as the time approaches.
13. Allow these children to have input into their own schedules for after school in an effort to avoid one of the hallmarks of inattention, PROCRASTINATION.
14. Eliminate timed tests. There is not great educational value to timed tests, and they definitely do not allow many children with inattention to show what they know.
15. Provide an escape-valve outlet such as leaving the room for a moment. If this can be built into the rules of the classroom, it will allow the child to leave the room rather than “lose it,” and in so doing begin to learn the important tools of self-observation and self- modulation.
16. With respect to homework, quality is more important than quantity. These children often need a reduced workload. As long as they are learning the concepts, that should be enough. They will put in the same amount of study time, just not get buried under more than they can handle.
17. By evening these children can be exhausted from their efforts at school. Some children may need a pre-planned or scheduled holiday from homework.
18. The child will benefit greatly from frequent feedback. It keeps them on track, lets them know what is expected of them and if they are meeting their goals. This can be very encouraging.
19. Help the child break large tasks into smaller ones. This is crucial. Large tasks quickly overwhelm the child, and he recoils with an emotional “I’ll never be able to do that!” In small children this can help avoid tantrums stemming from anticipatory frustration. In older children, it can help them avoid the defeatist attitude that so often gets in their way.
20. Every once in a while be silly if you can. This will help a lot. They love people who can be playful, have fun, and be unconventional, or flamboyant. They respond to this with enthusiasm.
21. However, watch out for overstimulation. Like a pot on the fire, these kids can boil over. You need to be able to reduce the heat in a hurry.
22. Set the child up for success. These kids live with so much failure, they need all the positive handling they can get. This point cannot be overemphasized: These children need a regular diet of encouragement. Without it they will shrink and wither. The secondary damage done to self-esteem by falling out from inattention is the most devastating repercussion.
23. Use outlines. Teach outlining. Teach underlining. These techniques help the child structure and shape what is being learned as it is being learned. This gives the child a sense of mastery during the learning process.
24. Announce what you are going to say before you say it. Say it. Then say what you have said.
25. Many kids are visual learners rather than auditory. So if they can have what you are going to say in writing that can be extremely helpful.
26. Be explicit. These children are not great at inference. They can also be very literal and benefit from explicit instructions.
27. Simplify instructions, choices and schedules. The simpler the wording the more likely it will be understood.
28. They like colour coding and colourful language. It helps them pay attention.
29. Help the child become self-observant. They have no idea how they come across to others. Try to ask questions like:
    • “Do you know what you just did?”
    • “How do you think you might have said that differently?”
    • “Why do you think that other girl looked sad when you said what you did?”
30. Try a point system as part of behaviour modification or a reward system for younger children.
31. These children respond well to rewards and incentives. Many are little entrepreneurs.
32. Teach test-taking skills.
33. To improve motivation, make a game out of things.
34. Activities, where the kids feel engaged and connected, will hold their attention best.
35. Communication between home and school works well with a planner; where teacher, student and parent can write things back and forth to each other. This gives the child frequent feedback and avoids crisis meetings.
36. A daily note of encouragement describing what has gone well encourages the child and the parent.
37. Timers and buzzers help some children gauge time. Others may feel pressured.
38. While older children are taking notes they can also keep track of their questions. This will help them listen more effectively.
39. If handwriting is difficult for the child let them learn keyboarding or have them dictate their story or assignment to someone who types it exactly as dictated without editing.
40. Get the child’s attention back by saying his name.
41. If possible, arrange for students to have a “study buddy” in each subject with a phone number in case there are questions.
42. To avoid stigma, try to make use of these ideas with the whole class and with siblings at home.
43. Parents and teachers should meet often. Avoid the pattern of meeting only when there are problems or crises.
44. Repeat, repeat, repeat. Understand that routines and techniques will eventually become habits or sink in. It may take years of repetition for the child to develop effective time management and good study habits.
45. Encourage physical exercise. It helps work off excess energy, focuses attention, and stimulates certain hormones and neurochemicals that are beneficial. Make sure that the child sees it as fun.
46. Try to bridge schoolwork with things that the child is keenly interested in. Get them to do an interest inventory and draw from it.

Reviewed by M. Kodsi, M.D., Child and Family Psychiatrist.