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GETTING AND MAINTAINING ATTENTION IN YOUNG
CHILDREN WITH SHORT ATTENTION SPAN. |
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By Nwokolo Okey-Martins
( Mphil/ Ph.D Student, Dept. of
Psychology,University of Lagos). |
ABSTRACT
This article examines the meaning of short attention
span as well as the difficulties that parents,
therapists and teachers encounter in their effort to
help young children with such conditions learn.
The author shares insights from practical experience
and modern research on short attention span and
Attention Deficit Hyperactive Disorder (ADHD).These
insights demonstrate the need to understand the
impact of the various types of learner environments
(including the physical, sensory, dietary, and
emotional environments) on the child’s ability to
attend for a length of time sufficient to complete a
given task. An understanding of how these
environments influence attention span as well as the
different methods of manipulating them will enable
those working with such children to develop
effective intervention techniques. Since each child
is different, and what works for a given child may
not be effective with another child, the author
concludes with a general guideline for improving
attention span.
ATTENTION SPAN:
The term attention span refers to the amount of time
a person can concentrate on a single activity. If
you are unable to complete a thought, or are easily
disturbed by other stimuli, you may have a short or
abnormal attention span. A short attention span
interferes with a person’s ability to focus and
attend, thereby making a learning difficult.
Because, most learning requires the active,
conscious and directed effort of the learner, the
ability to attend and focus is considered to be of
prime importance.
Many children with special needs, particularly those
with developmental disabilities and specifically
Autistic Spectrum Disorders (ASD) often present with
short attention span. Some are easily distracted,
have fleeting eye contact, spinning objects, hand
flapping, rocking, insistence on sameness, act
aloof, restlessness, running from one end of the
room to the other repeatedly, hand biting, head
banging, temper tantrums, starring and several other
challenging behaviors that disrupt attention.
Bayo, a two and half year old boy, avoids eye
contact with his parents and siblings and turned
away if they tried to engage him in a play. He
wandered aimlessly around a room, touching
everything, holding on to one object until he finds
another he likes better, then dropping that for
another. He couldn’t sit still, and he resisted any
attempt to engage him by screaming and throwing
tantrums. Parents reported that they were
devastated, exhausted, confused and frustrated. They
kept wondering how on earth they could get Bayo to
look at their face, play with them or even listen to
their songs for a few seconds.
Recently, I interviewed twenty-eight (28) therapists
and parents asking what they felt their greatest
problems working with special needs children was;
85% of them gave answers indicating problems that
arose from difficulties in getting the children’s
attention and keeping it long enough to complete a
given task. They complained that if only the
children could concentrate, focus and pay attention,
they can learn much more.
Getting a child to attend by making eye contact,
focus/reference, sit properly, self-regulate and be
in a calm-alert state is an initial goal in the
Acceleration therapy programme.
SOME CAUSES OF INATTENTIVENESS AND SHORT
ATTENTION SPAN IN CHILDREN WITH ASD
There are strong differences in professional opinion
about the exact causes of inattentiveness and short
attention span. However, evidences abound for
neurological, genetic, behavioral, sensory and
nutritional causative factors. In spite of the
disagreement over the exact cause(s) of attention
span problems, it is important to recognise that
whatever is responsible for the sensory, behaviour,
social and communication deficits in autism does in
fact, directly or indirectly interfere with the
concentration and attention abilities of those
living with it. When these deficits or needs are
compensated for or met, the children focus,
concentrate and their attention span increase.
ATTENTION DEFICIT HYPERACTIVE DISORDER (ADHD)
Meaning: ADHD has to do with inattentiveness,
impulsivity, over-activity, or a combination. These
problems must be out of the normal range for the
child’s age and development before they can be
labeled ADHD. Attention deficit disorder is the
commonly diagnosed behavioral disorder of childhood
(Smith & Iwata, 2002). It is more common in boys
than girls and affects about 3 – 5 % of school aged
children.
ADHD interferes with a person’s ability to pay
attention, focus and learn. It affects a child’s
performance at school, relationship with peers and
leaves parents/teachers exhausted and sometimes
frustrated.
CAUSES OF ADHD
Research suggests that the brains of children with
ADHD are different from those of other children.
These children handle neurotransmitters i.e. brain
chemicals (including dopamine, serotonin and
adrenalin) differently from their peers. ADHD is
genetic and may run in families.
SYMPTOMS OF ADHD
According to the Diagnostic and statistical manual
(DSM – IV), the symptoms of ADHD can be divided into
two – namely:
(a) Those of inattentiveness
(b) Those of Hyperactivity / impulsivity
(A) Inattentiveness Symptoms:
1. Difficulty sustaining attention in tasks or play
2. Fails to give close attention to details
3. Does not seem to listen when spoken to directly
4. Does not follow through on instructions and fails
to finish drills, exercises or home work
5. Difficulty organizing tasks and activities
6. Avoids or dislikes tasks that require sustained
mental effort
7. Often loses toys, pencils or items needed for
tasks
8. Easily distracted and inability to sit at a
place.
9. Fidgets with hands or feet or squirms in a seat
10. Leaves sit when remaining seated is required
11. Often forgetful in daily activities
12. Difficulty playing quietly
13. Often in motion or “on-the-go”, acts as if
driven by a motor
(B) Impulsivity Symptoms:
1. Difficulty awaiting turn.
2. Interrupts or intrudes on others games or
conversation.
3. Blurts out answers before question have been
completed.
Not everyone with short attention span has Attention
Deficit Hyperactive Disorder, but many do manifest
the inattentiveness symptoms. For a person to be
diagnosed ADHD, such a person should have at least 6
attention symptoms or 6 activity/impulsivity
symptoms to a degree beyond what would be expected
for children their age.
The symptoms must be present for at least 6 months,
observable in two or more settings, and not caused
by another problem.
TECHNIQUES FOR GETTING AND MAINTAINING YOUR
CHILD’S ATTENTION
1. Getting attention through behaviour modification
techniques – the Ivar Lovaas technique
2. Getting attention through your child’s senses;
obtaining calm-alert state.
3. Getting attention through diet and medication.
4. Getting attention by improving the learning /
teaching environment.
5. General guidelines.
1. GETTING ATTENTION THROUGH THE LOVAAS
TECHNIQUE:
Lovaas, (1982) described a behaviour technique for
getting and maintaining attention in developmentally
disabled children. He developed a preparation
program called “Getting ready to learn”. The first
steps when you begin to implement this program
include to teach: proper sitting, directed attention
and elimination of disruptive behaviour.
DIRECTED ATTENTION:
Teaching directed attention using Lovaas technique
involves two procedures. The first is teaching the
child to visually attend to your face (establishing
eye contact). The second is a general procedure for
teaching the child basic behaviors such as visually
attending to objects in the environment to which you
wish to direct his attention.
To establish eye contact, you have to use the
command “Look at me” There are 7 steps and they
include:
Step 1: Have the child sit in a chair facing you
Step 2: Give the command “Look at me” every 5-10
seconds
Step 3: Reward the child with praise and food for
correctly looking at your face. In the beginning, a
correct response occurs when the child looks in your
eyes for at least 1 second and looks within 2
seconds after the command is given. Say “good
looking” and simultaneously feed him.
Step 4: If the child does not visually attend to
your face within the 2-seconds interval, look away
for 5 seconds and then give the command again.
Step 5: Some children will not look at you when you
say “look at me”. Therefore, you have to prompt the
response. You can prompt eye contact by holding a
piece of food (or something else the child will look
at) directly in the line of vision between your eyes
and the child’s eyes at the same time you give the
command. Therefore, repeat the command (“look at
me”) and simultaneously present the prompt (move the
piece of food into his line of vision and level with
your eyes.
Step 6: When eye contact occurs within the 2 –second
interval on 10 consecutive commands, gradually and
systematically fade the prompt, by increasingly
hiding the food in your hand and minimizing the
movement of your hand and over successive commands.
Step 7: To increase the duration of the child’s eye
contact, gradually delay giving the food while
maintaining eye contact with praise, that is,
increase the length of time that the child must look
before he is given food.
You must have a clear idea of what is the correct
response, and you have a clear idea of what is an
incorrect response. It is best to start teaching eye
contact while the child is sitting in the chair,
because of less distraction. However, generalize to
other chairs, have him look at you while standing,
walking, when in other rooms as well. When the child
has mastered how to sit properly, stand, sit up
straight, hands quiet, look at me, it becomes easy
to get attention and the child is ready to learn.
Maintaining the attention would require the
therapist/teacher to be firm, consistent in
insisting that the child does not lose what he has
already learned. Also, reinforcements must be made
effective at all times. Don’t use food reward after
meal!
GETTING AND MAINTAINING ATTENTION THROUGH YOUR
CHILD’S SENSES:
When you try to capture your child’s attention, it
is important to remember his strengths and
difficulties in processing sensory information. It
is equally necessary to notice whether the child is
under-aroused or over-aroused. If the child is
irritable or overexcited, sleepy or withdrawn, it
may be very difficult to engage him or get him to
attend.
SENSE OF SIGHT:
Observe carefully and identify the kind of visual
stimuli that attract your child. It is well
documented that many children with autism are
strongly visual learners (Greenspan & Wieder, 1998).
They attend to and pick up pictorial information
quicker than via other modalities.
* If bright colours attract your child, use his
interest in colours to attract his attention. When
you find him gazing at something bright, use a
brightly coloured paper or object and stand between
him and what he is looking at. If possible, use it
to reward him if he makes eye contact or gives a
desirable response.
* You can train directed gaze, focusing and
attention by making a room dark and using two flash
lights to explore the room or track the light around
objects.
SENSE OF SMELL AND TASTE:
If you find that your child loves a particular
perfume or a certain food or drink, use it to get
his attention. Wear the perfume or spray it each
time he concentrates. If it is food, eat from the
same bowl or feed him if he is still very young.
While he is eating, cue him with your actions and
voice, holding his attention as long as possible.
Coo, laugh and make funny faces at him. Introduce
concepts of “give” “take” “more” and “please”.
SENSE OF HEARING:
If the child listens well, use a variety of sounds
and words to woo him while keeping your gestures
uncomplicated. Some children with special needs
especially ASD may not respond when you call their
names or be comforted by a soothing voice. They
sometimes act as though they are deaf. Such children
may be having problems with receiving aid processing
auditory stimuli. Auditory processing problems make
it difficult for the child to tune in to you,
because he may miss or misinterpret some of your
signals.
To get across to such a child, talk slowly, make
sounds that are distinct and energetic. Also, use a
lot of hand gestures and facial animations. Change
your tone quickly if he covers his ears, you can get
attention by expressing words and sounds with great
emotion and rhythm. Talk slowly to help him process
the words.
GETTING AND MAINTAINING YOUR CHILD’S ATTENTION BY
OBTAINING THE CALM – ALERT STATE.
A calm-alert state refers to a learning ready-state.
It is one in which a person’s ability to register
and orient to sensory information is optimal.
According to Murray-Slutsky and Paris, (2000), a
calm-alert state is a window in which our ability to
function is maximized. When in this state, the
nervous system is sufficiently aroused for peak
attention and task performance. It makes the child
to be alert, attentive and open to learning.
The therapist or teacher who wants to get and
maintain a child’s attention must therefore help the
child function in the calm-alert state. A child who
is under-aroused or over-aroused is not in this
learning ready state, therefore, aim to achieve a
balance.
GETTING AN UNDER-AROUSED CHILD INTO A CALM ALERT
STATE:
An under-aroused child may have difficulty
registering or processing sensory information within
his environment and may appear bored, tired,
sluggish, uninterested. He may not want to
participate in activities, and may react or
over-react if he is not feeling well. He may prefer
to watch TV.
To bring such a child into a clam-alert state, the
therapist or teacher should engage him in
sensory-based activities that increase the child’s
arousal. Some of such activities are repetitive,
regular and fast in nature. Also linear vestibular,
deep-touch or proprioceptive input helps to arouse
and organize the nervous system. Examples include:
· jogging
· Bicycle riding
· Jumping on a trampoline
· Bouncing while sitting on a ball
To help an under-aroused child into the calm alert
state, the therapist can also do the following: -
· Work with high level of enthusiasm and energy
· Use voice with changing inflections
· Brighten or illuminate the room
· Sing faster rhythms and songs
· Exaggerate gestures and animations.
GETTING AN OVER-AROUSED CHILD INTO A CALM-ALERT
STATE:
A child will not register and process sensory
information very well if he is over-stimulated or
over-aroused. Such a child may have difficulty
sitting still to complete a drill, “always
on-the-go”. He may not be able to tolerate
frustration or control his impulses.
To get an over-aroused child into the calm-alert
state, the therapist should introduce activities
that reduce anxiety, and lower arousal levels. They
include calming techniques such as:
· Deep pressure (touch) firm deep strokes
· Proprioceptive inputs
1. Animal walks such as crab or bear
2. Wheel barrow walks
3. Chair push ups in which the child lifts up his
body weight while sitting in his chair.
4. Quiet enclosed rooms
5. Slow rhythms and songs
6. Low voices, slow calm speech
7. Avoid animations and exaggerated actions
GETTING AND IMPROVING YOUR CHILD’S ATTENTION
THROUGH DIET AND MEDICATION:
DIET:
My experience working with children in the spectrum
has shown that quite a number of them lose
concentration and focus after taking foods and drink
that contain sugar and in some cases milk and dairy
related foods.
It has been documented that people with short
attention span, especially those with attention
deficit disorders have a high carbohydrate; low
protein diet that may be linked to the
neurobiological etiology of ADHD. In other words,
their diet can be causing an imbalance in the
production of neurotransmitters required for
attention and proper focusing abilities. NutraSweet
or Aspartame also has a detrimental effect on these
neurotransmitters.
Most of the time, eliminating sweets (NUTRASWEET),
reducing carbohydrates and increasing vegetables
(especially those rich in vitamin B) and protein
help tremendously.
MEDICATION:
Although differences in professional opinion do
exist over the use of drugs to improve attention
span, medication remains a popular treatment option
for ADHD, stimulant medicines like Ritalin,
Dexedrine and Adderall are still being prescribed by
medical doctors. These drugs are said to have a good
track record. There is now a newer medication called
Strattera. Strattera is not a stimulant but is used
for children who have not done well on the
stimulants. It is necessary to remind parents not to
administer any medication without an experienced
doctor’s prescription.
GETTING AND MAINTAINING ATTENTION BY IMPROVING
THE TEACHING/LEARNING ENVIRONMENT
In order to get and maintain attention and or
increase attention span, we should create an
enabling environment for optimal function. Murray –
Slutsky and Paris, (2000) suggested that challenging
behaviors and attention problems would most likely
occur in environments where: -
1. There is a high child-adult ratio
2. Sessions are conducted in a large room
3. Transitions are poorly planned
4. Tasks are unstructured
5. Tasks are adult-directed
6. Child has no space; with people physically near
7. The child is stressed and frustrated
8. The environment is noisy and cluttered
9. There is no repetition and routine. People,
activities, place change
10. The child is bored, unstimulated
11. Waiting time is excessive
The children we work with have difficulties
organizing themselves and recognizing which aspects
of the environment are important. They need
predictability, structure and organization.
* Defined boundaries help to improve attention -
Rooms with boundaries help our children to maintain
a sense of organisation and control thereby leaving
them calm. Large open rooms appear to have no
boundaries and are therefore, not good for
maintaining attention.
* Distraction – free work area – Therapists and
teachers should ensure that they work in a clutter
free environment. Do not clutter your work area or
walls with pictures, drawings, words and other
irrelevant visual information that distracts.
* Free your work table and keep materials that are
not in use out of sight until needed.
* Put away toys and equipment when you complete each
task. Progress to next activity and do not spend
time on clean-up. Simply keep items away from
child’s visual field.
* Sensory Environment – Ensure that the environment
meets each child’s sensory needs. Odours, visual
distractions, noise levels, and number/proximity of
other children contribute to the sensory
environment. If a child is hypersensitive to sound
or noise, an open classroom, or a large play field
with many children making noise, will be a bad
environment.
GENERAL GUIDELINES
* Use picture schedules and planned activities.
Attention and concentration will increase if
schedules are provided. Schedules help the child to
predict what’s next.
* Reduce waiting time – Minimize down time, i.e.
time between activities. Always keep the child
mentally involved and make activities to proceed at
rapid rate. Position all needed materials handy.
* Plan transitions – Give advance notice and prepare
your child for a change. Use visual reminders.
* Don’t forget to use effective reinforcers
* Make defined rules – specify rules clearly and
concisely and enforce them consistently. Post the
rules pictorially and even review them before each
session.
* Do not be in a hurry with instructions. Be
patient; allow the child time to process the
instruction.
* Break down tasks.
* Make drills interesting
* Foresee emotional crisis – You can decrease
inattentiveness by learning to sense when the child
is about to lose control and remove him from the
situation or circumvent the crisis. Monitor the
environment for sensory overload.
* Use Rhythmic Activities – Repetitive, regular pace
rhythmic activities and songs are organizing - use
this to maintain
attention.
* Avoid verbal overload irrespective of child’s
apparent language ability
* Use visual cues, prompts and schedules
* Monitor yourself and know when you burn out or
become less enthusiastic and bored.
* Be firm; insist on proper sitting and no
disruptive behavior when you teach.
* Pace instruction properly – Attention is enhanced
when instruction is delivered in a fast paced manner
(short inter-trial interval (Lovaas, 1982).
* Intersperse easy and difficult demands –
Presenting several easy tasks (which brings frequent
reinforcements) intersperse with difficult tasks
sustain attention (Homer, Sprague, Teusday –
Heatfield, 1991)
* Keep demands low at first.
* Limit TV viewing. TV watching is now linked to
short attention span. |
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