Paying Attention to Attention
By Drs. Rosemarie Scolaro Moser, Sarah Friedman & Christina Zebrowski
Back to school time, that time of year when both youth and adults must bid a temporary farewell to vacation mode and attend to the business of school and work. For some, the transition is an easy one. For others, problems with rallying our attention make the transition difficult.
We all experience occasions when our minds wander, or when we miss the details of conversations because we are preoccupied. At these times, our attention is interrupted by distractions. For some, this distractibility or loss of focus is frequent, persistent, and longstanding since childhood, disrupting normal daily activities. It can hamper our academic achievement and professional performance, place stress on relationships and jobs, and make the back to school transition agonizing both for students and parents.
Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder, or pattern of brain functioning characterized by inattention, distractibility, and, in some cases, hyperactivity. Individuals identified with ADHD typically fall into one of three categories: Inattentive, Hyperactive/ Impulsive, or Combined. Inattentive ADHD is characterized by a failure to give close attention to details, to engage in active listening, or to see a task through to completion. Individuals often have trouble organizing tasks and activities, are forgetful, and are easily distracted. Hyperactive/ Impulsive ADHD is characterized by fidgetiness, chattiness, restlessness, difficulty remaining seated, and risk-taking. Combined ADHD is characterized by symptoms of inattention as well as hyperactivity and impulsivity.
It is estimated that ADHD occurs in approximately 5 to 8 percent of the population. It is more frequently diagnosed in males than females, perhaps because males display more of the hyperactive symptoms that are easily identified. ADHD is not a modern disorder. Many believe that historical figures such as Pablo Picasso, Thomas Edison, Albert Einstein, and John F. Kennedy may have coped with ADHD, which has also been associated with creativity, spontaneity, innovation, and energetic qualities. Celebrities and contemporary figures such as Terry Bradshaw, James Carville, Justin Timberlake, Henry Winkler, Jim Carrey, Michael Phelps, and Adam Levine have also been identified with ADHD.
Attention, the first step in capturing new information, is critical to learning and memory. With a lack of attention, new information cannot be stored in memory, and cannot be retrieved as needed. In this case, the problem is not with memory (or storage) per se, but poor initial attention (or encoding). There are also different types of attention depending on which body sense is registering the new information: visual (sight), auditory (hearing/listening), tactile (touch), olfactory (smell), and gustatory (taste). Attention concerns are usually associated with problems in visual and auditory attention.
To help improve attention while studying:
Remove games, electronics, and non-homework related materials from the desk.
Be sure the desk is fully organized with all necessary work materials, before sitting down to study. Use of external organization aids such as calendars, whiteboards, bins, and colored folders may help to support organization.
Use a white noise machine, electric fan, or soft classical music in the background to drown out distracting noises, voices, and conversations that may disrupt attention and focus. Noise canceling headphones may also be helpful.
Program a timer or alarm to sound every 5 to 10 minutes to minimize daydreaming, check on wandering focus, and provide designated break times to reset focus on the task.
Attention is highly influenced by the value of the stimulus. It is far easier to attend to information that is considered to be very important or very interesting. A student who is passionate about video games may be able to focus on them for hours at a time, yet be unable to focus on his or her teacher for five minutes in the classroom when the educational material seems monotonous, repetitious, or uninteresting.
ACCURATE DIAGNOSIS AND TREATMENT ARE ESSENTIAL
ADHD can often be misdiagnosed. Proper diagnosis is imperative in order to effectively treat and manage the symptoms of ADHD. Symptoms of attention difficulties are found in a wide array of disorders and diseases other than ADHD, which may include but are not limited to: hearing loss, depression, anxiety, stress, behavior disorder, brain impairment, concussion, dementia, autism, seizures, auditory processing difficulties, emotional trauma, learning and memory disorders, chronic sleep deprivation, and even normal aging. As an example of the serious implications of misdiagnosis, a student who appears inattentive, due to an undiagnosed auditory processing disorder, may be incorrectly prescribed ADHD stimulant medications.
In order to most accurately diagnose ADHD, a clinical interview and completion of self- report checklists are not enough. It is important to conduct a comprehensive evaluation, which includes a broad range of neuropsychological tests that measure various aspects of attention, and assist in ruling out other potential causes. Based on the findings of testing, a tailored treatment plan can be developed to address the individual’s areas of functioning that are most affected by ADHD. Depending on the age and life stage of the individual, recommendations may include academic accommodations for school and for standardized testing, work accommodations, skill training, coaching, psychotherapy, behavior therapy, and mindfulness training. A medical-psychiatric consultation for possible pharmaceutical therapy may be considered and, in many cases, may be helpful. In addition, an ADHD academic or life coach can be instrumental in teaching compensatory strategies to manage distractibility, motivation, procrastination, and organizational difficulties.
Director Rosemarie Scolaro Moser, PhD, right; Sarah Friedman, PsyD, left; and Christina Zebrowski, PsyD provide neuropsychological testing, psychotherapy, and academic coaching services at the RSM Psychology Center in Princeton.