Attention Deficit Hyperactivity Disorder: What Do We Mean by Attention Anyway?

When we talk about attention, we are talking about two different kinds of abilities: The ability to focus on a specific task put in front of us to do, such as school work, and the ability to pay attention in a more global sense to the world around us, to be able to pay attention to the buzz of the lights overhead, and the touch of the clothes on your skin, and the children playing outside of the classroom. These are two different kinds of attention.

One definition of "paying attention" is "sustaining and selecting to the right cue." One part of this definition is that the child has to pick the right thing to pay attention to. That's the "selecting" part of the definition.

A better word might be "filtering." The brain is supposed to filter out distractions, or stimuli which compete for our attention, but might not be important at that moment. Many children with attention problems pay attention to everything in the world around them equally, such as giving equal time to the touch of the clothes on their skin, the buzz of the lights overhead, the kids outside the classroom, and the math worksheet in front of them. This, of course, is a problem if he needs to be paying attention to only a math worksheet or a similar task.

Many children with Attention Disorders have trouble concentrating on the specific task in front of them, especially if they are working on something like school work or chores that are only moderately interesting, or not interesting at all. These kids have to be very motivated, very excited, very interested in what they're doing in order to pay attention.

This Is NOT My Child?

Now, you might be thinking, "This is not my kid. I have a kid who could play Nintendo, and be so focused that the house could burn down around him, and he'd never notice."

Well, that could be. A lot of these kids could do just exactly that. Nintendo is interesting, its challenging, and its fun. Kids get immediate feedback, they could play Nintendo for hours. But just put a math worksheet in front of them and see how different it is. They have a terrible time paying attention to something that's not interesting or that's not motivating, which accounts for about 85% of school work, and about 100% of chores.

Part of the problem with Attention Deficit Hyperactivity Disorder is a lack of FLEXIBILITY with attention. A person without ADHD has the ability to shift from attention that is focused on a specific task at hand to the kind of attention that is global many times in just a few seconds. At will those without ADHD can shift from reading a book, to scanning the room to know where our kids are and what they are doing, and then very quickly returning to focus on our reading. Without ADHD we have flexibility in our ability to focus. We can shift from specific focus to global focus at will and very quickly.

Individuals with ADHD do not have this same flexibility of focus. Those with Attention Deficit Hyperactivity Disorder have a very difficult time shifting from a global focus, such as they might have at recess or lunch break, to a specific focus that would be required when they return to the classroom to study math and work on the math worksheet in front of them.

This is why kids with Attention Deficit Hyperactivity Disorder could play Nintendo, be really focused on that task, and not notice the house burning down around them. Or you telling them to talk out the trash.

Paying Attention to the Right Thing

A second type of problem with Attention Deficit Hyperactivity Disorder  is sustaining attention to the task long enough to finish the task. We may call this "attention span." Many children with Attention Deficit Hyperactivity Disorder may be able to focus attention to the correct task for a while, but then can't sustain it for very long. Their "attention span" is very short for their age. Unless kept highly motivated, these children have a very hard time staying focused long enough to finish the work that they start.

They are often seen as fidgety, easily distracted, and "day-dreamers." These are the people who may start five different projects, but fail to finish any of them. They may begin to clean their rooms, but after a short time become distracted by their toys or baseball cards and forget all about the job that they are supposed to be working on. Often children like this are not impulsive or hyperactive. They just appear to be "space-cadets," unfocused, or lazy.

Children with only the Inattentive Type of Attention Deficit Hyperactivity Disorder tend to be females (60% females to 40% males). They are the least likely Attention Deficit Disorder subgroup to receive any help for their condition, especially the boys with Inattentive ADHD. Kids who are just ADHD Inattentive Type are like space-cadets. They are in a brain fog. They are like Winnie the Pooh. They are often seen failing to pay close attention to details, or having trouble keeping their minds focused on a task, especially with school work or chores. They often don't seem to be listening. They are often disorganized.

They often will try to get out of doing their homework because it is just such a boring task. They are the kids that will spend two hours to complete a 20 minute homework assignment, and then fail to turn it in to the teacher the next day because they have lost it in their back pack or sent it to the Bermuda triangle of homework assignments.

Parents and teachers can learn more about the different types of ADHD, and specific treatment strategies for each type, by visiting the ADHD Information Library.

Douglas Cowan, Psy.D., is a family therapist who has been working with ADHD children and their families since 1986. He is the clinical director of the ADHD Information Library's family of seven web sites, including http://www.newideas.net, helping over 350,000 parents and teachers learn more about ADHD each year. Dr. Cowan also serves on the Medical Advisory Board of VAXA International of Tampa, FL., is President of the Board of Directors for KAXL 88.3 FM in central California, and is President of NewIdeas.net Incorporated.