Remember that your child or student does not choose to not pay attention. Although the long-term goal is self-regulation of attentional skills, completely independent functioning may not be realistic. A Child with attention difficulties requires a greater degree of adult supervision and environmental support than is typically provided for same-age peers.
Use everyday settings and activities
1. Use verbal, visual, and physical cues to get your child’s attention before giving an instruction:
- say his name
- tap on his shoulder
- sit in front of him
- point to the activity or task
2. To help your child improve his ability to stick with and complete tasks, practice simple everyday chores like folding laundry, emptying dishwasher, setting the table. Your child will require your participation to get the job done. Plan to work cooperatively with your child to complete chores using a routine that he will employ each time. Select a chore that is relatively short and work through its completion cooperatively with him.
3. For children who are fidgety, over-active, and/or inattentive, provide scheduled time each day for supervised or structured physical activity.
4. A child with poor attention may respond to one detail instead of recognizing that there are multiple aspects that are relevant to the task at hand. Often, he may react without stopping to check if he is using the correct data. He may miss the fact that the addition sign has changed to minus, and proceed to add every problem on the page. If, for example, you say "We need to stop at the store, pick up Jane from soccer, and then if we have time, go to Dairy Queen," he may only focus on going to Dairy Queen and nag you about going. It is better to tell your child about only one event at a time.
5. Restriction from recess or physical activity is not an effective consequence for incomplete work or inattentive behavior.
6. Involve your student in games and activities that require varying lengths of attention including card games, quick moving board games, and time limited physical activities.
Change the environment:
1. Keep instructions clear, short and concrete. Ask your child to repeat the instruction before acting:
- "Homework in the basket and go to the science center."
- "Feed the dog first, then take out the trash."
2. Help your child to focus attention, by reducing the number of available choices. Offering limited and specific choices will help him participate in the decision-making process without becoming distracted:
Do you have any homework?
Are you going to do your math or spelling homework first?
What should we rent from Blockbuster?
Do you want to rent “Young Frankenstein” or “Willy Wonka and the Chocolate Factory?”
Who are you going study with?
Are you going to work with Mike or Letitia?
3. Try not to become irritated if your child needs reminders. When you have to repeat directions, do so calmly, and as if for the first time. Avoid saying things like, "I’ve told you this a thousand times already." Children with inefficient attention skills are not being stubborn or willful when they don’t remember.
4. A child with attentional problems will often annoy you. It’s easy to find yourself constantly correcting or criticizing. Maintain a positive environment. Try to say two positive things for every one negative thing you say. It is exhausting to parent children with attention problems. Alternate "on" and "break" times with your spouse. Play active, physical games with your child.
5. When you need your child’s attention, eliminate other distractions. Ask him to pay attention to only one thing at a time. Make sure he has finished one task before directing him to the next. Help him focus by minimizing unnecessary conversation.
6. Children with attentional problems often talk excessively and have a hard time focusing their conversation on the point. You can help by giving your student a "challenge" to structure his verbal output, as follows:
- "Tell me what you mean in five words."
- "Tell me the best thing about your day."
- "Tell me the worst thing that happened today."
7. Consequences should be of short duration and immediately follow the offense. Reward your child for engaging in behaviors, which you are attempting to cultivate. Remember: Rewarding desired behaviors will always be more successful than punishing undesired ones. Too often we focus on behaviors to be eliminated rather than reinforcing those behaviors that we would like to see more frequently.
8. Set up a quiet environment for homework where distractions are minimal. Use a timer to divide the total time into short work segments. Allow a "stand up and stretch" or short listen to music break between segments.
9. For children who are forgetful and lose things, use a visual reminder system and develop a system for housing important personal and school items. Items used on a regular basis should always be kept in the same place at home and in school.
Set the stage for success at school
Because we know that paying attention in the classroom is such an important ability, we are offering the following suggestions for teachers:
1. Seat the student near the teacher if possible, near a wall, and away from other distractions.
2. Teacher and student should agree on a private non-verbal system for cueing the student to refocus his attention, such as a wink, a pull of the ear, or a tap on the shoulder.
3. Point to where the child should be focusing his attention.
4. Signal your student when you are about to begin something especially important.
5. Give directions that specify how long the child is to sustain attention on the current task. Provide a visual and verbal cue when the activity is completed. Examples include:
- a. "Work on your math page until I turn the lights on and off."
- b. Put 10 chips on the table. Tell your student you will take away chips as the time elapses, and that when the chips are gone, he should stop. Using this approach, the child is able to see how much longer he needs to focus and sustain attention.
6. To keep your student’s attention focused on the activity at hand, give him a job. Examples:
- a. Have him lead the class to gym or lunch.
- b. Have him collect homework papers.
7. For seatwork and homework, make sure the assignment is at the students’ independent ability level. Tasks that are too difficult make it very hard for a student to stay on task.
8. Keep paper and pencil work as clean in design as possible, reducing distractions (e.g. cartoons, comments). Provide adequate space for your student to write his complete answer on his worksheet. In particular, provide space on math worksheets for all computations involved. Have your student circle his final answer at the end of the work. Don’t use separate answer sheets.
9. Divide assignments into small and manageable segments. Provide a reinforcement or reward for each completed section (e.g. sticker, compliment).
10. Alternate periods of quiet seat work with more active hands-on learning and cooperative work group activities.
11. When giving multiple step directions, wait for your student to complete each step before proceeding to the next.
12. Use adult helpers in the class; ask them to look for specific opportunities to praise the student for on task behavior.
13. Decide on the most essential aspect of the child’s work and grade him on the completion of that component. For example, on math work, focus on the quality of the work and correctness of the answers given rather than the neatness of the paper or the quality of the handwriting.
Teach new skills
1. Children who have difficulty maintaining attention often have poor social skills. A structured social skills treatment group focused on developing and rewarding appropriate peer skills can be an enjoyable and effective way for your child to develop friendships and improve social interactions that may have been restricted by his poor attention.
2. Make an attention training tape* for your student. Get a 30 minute long audiotape and record a pleasant sound at random intervals, about every three to four minutes. Have your student play the tape during seatwork or homework and instruct him to ask himself “Am I on task?” each time he hears the sound on the tape.
*This technique was developed by Glynn, E. L. and Thomas, J.D. (1974). Effects of cueing on self-control of classroom behavior. Journal of Applied Behavior Analysis, 7, 299-306.
3. Waiting his turn is likely to be difficult for your child. Practice turn-taking in your daily activities. For example, at the dinner table take turns having each person tell one or two things about his day. Seat your child next to a parent. If he interrupts, tap him on his knee, tell him you are interested, but remind him that someone else is talking.
The BrainSTARS manual was written by a team of professionals who have worked for many years with children and young adults who have brain injury. We wrote it because pediatric brain injury is very confusing for parents and teachers — and you are the most important people in the recovery of your child. It is important that a child's parents and teachers are well-educated so that they can work well together to provide the best chance for a child's recovery. Our goal is to make sure that every child has a safety net of support and understanding underneath him as he makes the leap back into life following a brain injury.
From BrainSTARS, Brain Injury: Strategies for Teams And Re-education for Students, © 2002 Jeanne Dise-Lewis, PhD. Used with permission. The manual is available in English and Spanish. For more information or to order copies, call 720.777.5470 or email@example.com. A short video on how to use the BrainSTARS manual is available at www.youtube.com/BrainSTARSprogram.