Parenting a Child with ADHD- Getting Their Attention
At first thought, many think of distractibility and hyperactivity as the defining characteristics of Attention Deficit Hyperactivity Disorder. While these characteristics are the common hallmark symptoms of ADHD, causing individuals to demonstrate difficulties in sustaining concentration, proness to anger and frustration, difficulty sitting still, significant disruptive behavior in most settings due to impulsivity, there are other, less disruptive symptoms that are often overlooked or attributed to other motives.
An additional, less commonly talked about characteristic, is a difficulty in shifting attention as needed. This is often referred to as hyper-focus. Hyper-focus is demonstrated when a child (or adult) can become so focused in an activity that they are unable to shift attention appropriately as necessary, to another task, person, etc. This is most often seen when a child becomes engrossed for hours on end with a specific activity, such as Legos, reading, or a video game. However, this is not where it interferes with day to day life, in fact, depending on the activity, it can be seen as beneficial (i.e. most parents don’t complain about a child reading too much!).
A common concern/complaint that may indicate the presence of hyper-focus in a child that is heard from parents is a parent’s frustration with their child who is ignoring them when they make a request of them. When I hear this from a parent, my first thought is to try to determine if there is a level of hyper-focus in action. Is the child “ignoring” their parent, or, is the child just engrossed in an activity to the detriment of being able to shift their attention when their parent is making a request? However, to be clear, this singular trait, in and of itself, does not solely indicate the presence of attention deficit hyperactivity disorder in a child as this is a common trait in many children.
When working with a parent and child with this complaint, I will first ask to get more information about the context of the situation(s). Where is the child relative to the parent? Are they in the same room? What is the distance? Is the child engaged in a task or is the child demonstrating that they are giving the parent their full attention when the request is made (i.e. making eye contact, responding to the prompt verbally)? Why do I ask these questions? They provide me information to determine if there is an attentional issue at play, or if there is a behavioral issue to be addressed.
Where is the child relative to the parent? Are they in the same room? What is the distance?
Often times, parents or caregivers will make requests of a child from a separate room. Often the child will be in the living room or their bedroom and the parent will call from another room for the child to complete a task, for example, telling the child to take the garbage out. Ten minutes later, the parent is frustrated, if not angry, that the child has not complied. They may should the demand once more. Often times with an errant “I’m coming” from the child. Again, ten minutes later, the garbage remains in the home rather than disposed of in the garbage bin. This cycle often replays until the parent reaches peak frustration and enters the room enraged that they have been ignored repeatedly.
Is the child engaged in a task? Are they demonstrating that they are giving their full attention?
Children, particularly those with attention-deficit hyperactivity disorder, often will fully immerse themselves in a task, to the exclusion of most other stimuli, particularly if the task is an enjoyable one, such as watching a favorite television program or playing the latest video game (Fortnight anyone?) Often times, if a child is fully engaged (read IMMERSED) in an activity, they will unconsciously “tune out” intrusions into their attentional field. A parent will be trying to talk to them and the child’s response may vary from no response to the prompt, sometimes an automatic response to the prompt (i.e. that “I’m coming” response from earlier) or often we’ll see the tell-tale headshake as they break their attention to focus on the parent making the request as they process what was just asked of them.
So then the question is- What can you do as the parent who is desperately trying to teach your child responsibility by having them take the garbage out? You have a few options.
My first recommendation to a parent is to always make a request to the child from within the same room. While I understand that this is not always ideal, it serves a purpose. When a parent is in the same room as the child, they are able to visually note whether the child is immersed in a task. They can determine if or how the child is responding non-verbally to the request.
When the parent enters the room, does the child notice?
When the parent speaks, does the child look up in the direction of the parent?
Do they make eye contact with you while you are talking?
If the answer is “no” there is a chance that they are fully immersed in their activity. (And yes, there is still also a chance that they are, in fact, ignoring you. But let’s test it out.) If this is the case, walk up to the child. When you speak, pair it with another source of input/stimulation. When you are talking, place your hand on their shoulder or arm to gather their attention. Sometimes it can be helpful to break their line of vision if they are engrossed in a video game or television program. Often times this will prompt the child to look in the direction of the intrusion- you. Behaviorally speaking, this should help enable the child to, over time, once successfully paired, to attend to a verbal command without the presence of the tactile or visual input.
Now that we have successfully intruded upon the child’s attention field, it is necessary to ensure that we have their sustained attention prior to asking them to take out the dreaded trash. Before making your request, make sure that the child has their face directed towards you, and more so, they attending to YOU. There are so many times that a child will turn their head, but their attention is still focused on the brightly colored screen that has so aptly captured their attention. If necessary, make this your first prompt to them. Tell them to look at you (at least briefly, sustained eye contact is not the goal, rather to just break their attention from the screen), or a personal favorite, particularly for young children, tell them to look here and point to the tip of your nose.
Once you have their sustained attention, and they are not resorting back to the colorful screen, make your request. If it appears that the are not paying attention, and sometimes even if they are, I will also ask them to repeat the directions. Children have amazing acting skills when it comes to looking as though they are attending, when, in fact, they are not. It provides you as the parent an opportunity to ensure that they have taken the important information, particularly if it is a multistep task, such as “take out the garbage and then make sure to feed the cat and clean the litter box.” Having the child repeat the list will help not only to ensure that they have successfully listened, but this step will also help, though not guarantee, that they will remember the tasks.
For the child that does have some difficulty with memory or retaining information over a period of time, or for a child that is particularly prone to distraction, it may be necessary to either make requests one at a time, or to provide the child with an additional aid, such as a list of the tasks for them to refer to as they complete each step. It would also be beneficial, at least while initially working on improving this skill, for the parent to stay in the relative area to be able to redirect should the child become distracted during their task. If the child should become distracted, repeat the same procedure to get them back on task. Ensure that you have their attention and redirect them back to the task at hand. As your patience wears, it is important to try to remember that this is a skill that you are helping them to learn. It is not an automatic, intrinsic ability that we are born with, particularly those with identified attentional deficits. As with any skill, it will take time, patience, and perseverance, both on the part of the child, and on the part of you, the parent or caregiver. If this does not work, it may be necessary to speak with someone to help either trouble shoot the procedure, explore additional options, and/or to address additional behavioral problems that may be indicated by the child’s ignoring behavior.