When a young person has chronic difficulties attending to and then sustaining focused effort on a task, or following a set of instructions, this can lead to many academic, social and emotional problems.
Chronic difficulties with attention and concentration occur within 1-20% of the population. Severe difficulties may lead to a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) which carries the following features:
Cognition
- Short attention span
- Distractibility
- Unable to foresee the consequence of behaviour
- Poor time estimation
- Poor planning skills
- Language delay, delayed internalisation of speech and language impairment
- Learning difficulties, memory deficits and poor school performance
- Lack of conscious
Affect
- Poor self-regulation and lack of impulse control
- Excitability
- Low frustration tolerance and anger
- Low mood
Behaviour
- High rate of activity
- Delay motor development and poor coordination
- High level of risk taking behaviour
Interpersonal adjustment
- Problematic behaviour with peers, parents and teachers
Assessment
Assessment and management of children with attention and concentration difficulties involves a multi-system, multi-modal approach. Assessment includes clinical interview to gain an understanding of current and historical functioning, family history and developmental history of the young person and family members. Specific questionnaires are sent to both caregivers and teachers and cognitive and scholastic functioning tests are administered to determine strengths and weaknesses.
Treatment
Treatment typically takes the form of intensive periods when the young person needs initial or more intensive support and is superseded with periods of less intensive monitoring and support. Typical treatments involve the following elements:
- Psychoeducation
- Medication
- Family intervention to provide caregivers an understanding of how best to support their young person
- School intervention focusing on the management of school-based learning difficulties and any behavioural issues
- Teaching the young person self-regulation skills to identify difficulties as they arise and provide strategies to mange these difficulties effectively