DISORDER OF ATTENTION

The only disorder of attention is attention deficit. Before discussing this disorder we have to get an idea of what is span of attention. Attention span is the amount of time that a person can concentrate on a task without becoming distracted. Most educators and psychologists agree that the ability to focus one’s attention on a task is crucial for the achievement of one’s goals.

Focused attention

It is a short-term response to information that attracts attention. The attention span for this level is very brief with a maximum span that may be as short as 8 seconds. An example for this level of attention is attention given to a ringing telephone, or other unexpected occurrence. After a few seconds it is likely that the person will look away, return to a previous task, or engage in something else.

Sustained attention

It is the level of attention that produces the consistent results on a task over time. If the task is handling fragile objects, such as washing delicate crystal glasses and dishes by hand, then the person showing sustained attention will stay on task and will not break any dishes, but a person who loses focus of attention may break glass or may stop washing the dishes to do something else.

Most healthy teenagers and adults are unable to sustain attention on one thing for more than about 20 minutes at a time, although they can choose repeatedly to re-focus on the same thing. This ability to renew attention permits people to pay attention to things that last for more than 20 minutes, such as viewing long movies or reading books.

Attention span

Attention span is the measure of sustained attention or the time spent continuously on a task. It varies with age. Older children are capable of longer periods of attention than younger ones. The type of activity affects the span of attention measured as time-on-task. People are generally capable of a longer attention when they are doing something that they find enjoyable or intrinsically motivating. Attention is also increased if the person is able to perform the task fluently, compare to a person who has difficulty performing the task. If the person is interested in learning a task the attention span will be longer. Fatigue, hunger, noise and emotional stress reduce attention span measured as time-on-task.  Common estimates for sustained attention to a freely chosen task range from about 5 minutes for a two-year-old child, to a maximum of around 20 minutes in older children and adults.

A take-home point: Persons suffering from generalized anxiety disorder [GAD] often complain that they cannot concentrate for long in a task. This is not a disorder of attention but inability to sustain attention due to the stress of the anxiety disorder.

A test of attention span everybody can administer

Many different tests for attention span have been used in different populations and in different times. Some tests measure short-term, focused attention abilities. Others provide information about how easily distracted the test-taker is. These tests are administered by the professionals. Variability in test scores can be produced by small changes in the testing environment. For example, test-takers will usually remain on task for longer periods of time if the examiner is visibly present in the room than if the examiner is absent.

A test everybody can administer is asking the person to count down from 100 by subtracting 2, 3, 4, 5 or 7 depending on the age of the test-taker. If the he/she can reach the lowest level of the count without mistakes without any distraction one can assume that his span of attention is within normal limit.

Attention span in modern society

Famous educator Neil Postman wrote in his book, Amusing Ourselves to Death, that the attention span of humans is decreasing as modern technology, especially television, increases. Internet browsing may have a similar effect because it enables users to easily move from one page to another. Most internet users spend less than one minute on the average website.

Attention deficit disorder (ADD or ADHD)

ADD is a developmental disorder. It is characterized primarily by attentional problems and most commonly associated with hyperactivity. So it is often called attention deficit hyperactivity disorder or ADHD.

ADHD is the most commonly studied and diagnosed psychiatric disorder in children, affecting about 3 to 5 percent of children globally and diagnosed in about 2 to 16 percent of school aged children. It is a long standing or chronic disorder with 30 to 50 percent of those individuals diagnosed in childhood continuing to have symptoms into adulthood. Adolescents and adults with ADHD tend to develop coping mechanisms to compensate for some or all of their impairments. ADHD is diagnosed two to four times more frequently in boys than in girls, though studies suggest this discrepancy may be partially due to subjective bias of referring teachers.

ADHD and its diagnosis and treatment have been considered controversial since the 1970s. The controversies have involved clinicians, teachers, policymakers, parents and the media. Topics of controversy include ADHD's causes, and the use of stimulant medications in its treatment. Most healthcare providers accept that ADHD is a genuine disorder. 

Different types of ADHD

 It is a developmental disorder in which certain traits such as impulse control lag in development. Using magnetic resonance imaging [MRI] of the prefrontal cortex of brain, this developmental lag has been estimated to range from 3 to 5 years.

A combination in varying degrees of inattention, hyperactivity, and impulsivity is the key behavior pattern of ADHD. The symptoms of ADHD are especially difficult to define because it is hard to draw the line at where normal levels of inattention, hyperactivity, and impulsivity end and clinically significant levels requiring intervention begin. In a psychiatric conference the famous cartoon character Denis the Menace was typed as a case of ADHD by a psychiatrist. But I differed. In my opinion Denis is only a smart child not a case of ADHD.

Signs and symptoms of ADHD

To be diagnosed with ADHD, symptoms must be observed in two different settings such as home and school for six months or more and to a degree that is greater than other children of the same age.

ADHD has three subtypes:

1.    Predominantly hyperactive-impulsive

2.    Predominantly inattentive

3.    Combined hyperactive-impulsive and inattentive. Most children with ADHD have the combined type.

Predominantly hyperactive-impulsive type symptoms may include:

1.     Fidget and squirm in their seats
2.     Talk nonstop
3.     Dash around, touching or playing with anything and everything in sight
4.     Have trouble sitting still during dinner, school, and lesson time
5.     Constantly in motion
6.     Have difficulty doing quiet tasks or activities.

Manifestations primarily of impulsivity:

1.     Be very impatient
2.     Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences
3.     Have difficulty waiting for things they want or waiting their turns in games

Predominantly inattentive type symptoms may include:

1.     Be easily distracted, miss details, forget things, and frequently switch from one activity to another
2.     Have difficulty maintaining focus on one task
3.     Become bored with a task after only a few minutes, unless doing something enjoyable
4.     Have difficulty focusing attention on organizing and completing a task or learning something new or trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities
5.     Not seem to listen when spoken to
6.     Daydream, become easily confused, and move slowly
7.     Have difficulty processing information as quickly and accurately as others
8.     Struggle to follow instructions.

Most people exhibit some of these behaviors, but not to the degree where such behaviors significantly interfere with a person's work, relationships, or studies—and in the absence of significant interference or impairment, a diagnosis of ADHD is normally not appropriate. The core impairments are consistent even in different cultural contexts.

Symptoms may persist into adulthood for up to half of children diagnosed with ADHD. This rate is difficult to estimate, as there are no official diagnostic criteria for ADHD in adults.  The signs and symptoms of ADHD in adults may differ from those during childhood and adolescence due to the adaptive processes and avoidance mechanisms learned during the process of socialization.

Management

ADHD management usually involves some combination of administration of medicines, behavior modifications, lifestyle changes, and counseling.

Associated problems

Inattention and "hyperactive" behavior are not the only problems in children with ADHD. Anxiety and depression are some of the disorders that can accompany ADHD. Academic studies and research in private practice suggest that depression in ADHD appears to be increasingly prevalent in children as they get older. The rate of increase is higher in girls than in boys. Where an emotional disorder complicates ADHD, it would be prudent to treat the mood disorder first, but parents of children with ADHD often wish to have the ADHD treated first, because the response to treatment is quicker.