Addressing Attention Deficits in Children

Do you ever feel like you are constantly repeating instructions or asking your child to pay attention?

For many parents, continually reminding their child to complete tasks or focus and pay attention is exhausting and frustrating. There are many reasons a child may have difficulty with attention ranging from sensory processing challenges to executive functioning issues or a combination of the two. Understanding the four different types of attention can provide parents with tools to help their children master the various types of attention that impact the child’s function and independence in the occupations of daily life.

Four different types of attention to be considered and activities to target and improve the specific type of attention:

1. Sustained attention is the ability to focus, concentrate, and hold attention over a continuous, prolonged period of time. This skill is important for listening to conversations or instructions, reading a book, or sitting through a class. On average, a typical child can concentrate for 2-5 minutes per year old. As a child grows up, the duration the child can sustain attention on a certain thing will grow longer gradually.

Activities: a) Identify a specific number of words (i.e. 10) and write out a list of words that start with a certain letter. b) Set a timer and complete a task for a certain number of minutes--gradually increase the amount of time.

2. Selective attention is the ability to select the most important input and only pay attention to the selected input. This skill is incredibly important for children in a classroom who may be surrounded by visual, auditory, interoceptive, and tactile stimuli. The ability to focus on the teacher talking about an assignment instead of the snow falling outside the window, a growling stomach, or the sticky spot on the desk is an example of selective attention.

Activities: a) Use visual cues to help a child attend to a task. b) Practice using auditory skills with games to identify specific sounds or words.

3. Shifting or Alternating attention is the ability to switch back and forth between two different activities. This skill is more advanced and requires the mastery of sustained and selective attention. One example of alternating attention is cooking a meal where you might be monitoring something baking in the oven or cooking on the stove and then chopping vegetables. You might switch back and forth between what is cooking and what you are chopping. An example for a child might be reading directions for building legos and then building the legos.

Activities: a) Cooking activities where a child must alternate between recipe and cooking task. b) Building legos by following instructions encourages alternating attention. c) Games like musical chairs or some card games that require flipping cards and then completing a task.

4. Divided attention is most commonly known as multitasking. For this skill, a child must be able to focus part of their attention on multiple items at the same time.  One example of this would be a child who is reading music and paying attention to the placement of their fingers on the keys of the piano.

Activities: a) Games like “Bop-It” or Perfection have components of timing and attention. b) Provide a child with a task like building a model or folding origami. While they complete that task, give them simple arithmetic problems.

Like any skill, developing any one or all four of these types of attention takes time, practice, and patience. If you choose to try any of these activities with your child ensure you provide lots of positive reinforcement and encouragement for their effort. Additionally, it is important to start off with easily achievable goals and gradually stretch their capacity overtime. For some children who have minor difficulties with attention, including some of these activities in their regular play may help improve their attention; however, for other children they may need more help and guidance from a professional. If you have concerns about your child’s ability with one of these four types of attention be sure to speak with your child’s primary care provider to learn about more resources and options.

References

Tao, T., Wang, L., Fan, C., Gao, W., & Shi, J. (2017). Latent Factors in Attention Emerge from 9 Years of Age among Elementary School Children. Frontiers in psychology, 8, 1725. https://doi.org/10.3389/fpsyg.2017.01725

Individual therapy is currently being offered as a hybrid model including a mix of both telehealth and in-person services based on the individual needs of the child and their family. Our occupational therapists evaluate and treat children to improve their independence and develop the skills they need to participate in their daily “occupations” such as self-care activities, playing, learning, and participating in social settings. We utilize family coaching and play-based therapy to engage children in purposeful activities to improve sensory integration, fine motor, visual motor, cognitive, self-regulation, oral, and feeding skills. The goal of pediatric occupational therapy is not only to help children adequately progress but to challenge them appropriately, helping to build self-esteem and confidence in their capabilities. Occupational therapists can address the following:

• Sensory Processing
• Play and Motor Skills
• Self-Care Skills
• Fine Motor Skills
• Social Participation
• Parent/Caregiver Education
• Fine Motor/Social/Self-Care Developmental Milestones

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About the Author

Serena Dewey is an occupational therapist, was born and raised in western Washington but has lived throughout the northwest. She completed her bachelor's degree at Walla Walla University in Speech Communication and then completed her master's degree in Occupational Therapy at Eastern Washington University. While at Eastern Washington University, Serena participated in community-based volunteer opportunities including the organization of a Halloween costume design and trick-or-treating event for children with mobility limitations. Serena also enjoyed partnering with children and their families during a constraint-induced movement therapy camp offered at Eastern Washington University. She has experience working in a variety of settings including inpatient rehabilitation, mental health, pediatrics, early intervention pediatrics, and telehealth.