As a psychologist, I am often struck by the number of factors that make ADHD a complicated diagnosis to make. In fact, so many things can go wrong in the formation of an ability to attend to information that I have gradually changed the way I view attentional functioning.
My view is based on the premise that children need multiple factors or tools in place in order to optimize their attentional functioning. This view looks at the components that are necessary to support good attention, not simply what problems exist as a result of attention problems.
Here are just a few of the necessary components to developing optimal attention: . Prenatal development: Lack of nutritional deficits and/or exposure to toxins such as drugs and alcohol . Early development (0-3): Adequate nutrition, bonding with parent/caregiver, active engagement such as being held and making eye contact with others, and opportunity to play and explore the environment . Middle development (4-6): Regular opportunities to practice and exercise focused attention, gentle encouragement from adults and peers to stay focused when working on tasks or playing games, plenty of time for creativity and free play . Grade school and on (7+): Use it or lose it, regular engagement in activities where paying attention is required, expectable and reasonable consequences when attention is not kept, rewards when it is. Periods of unstructured free time (including time away from electronics), where boredom is allowed to emerge and creativity can be generated . Lack of unprocessed traumas, anxiety or depression . Sufficient sleep . Regular exercise . Healthy eating . Lack of medical problem that could cause inattention as a symptom (e.g., repeated and/or severe concussions) . If there is a learning disorder, then an adequate plan is in place to address deficits, as being behind in class while trying to pay attention is nearly impossible
Diagnosing someone with ADHD is important for the purpose of identifying who needs services and/ or medication, but determining what will help children optimize their ability to attend to their environment is necessary for building a society where children learn how to and are able to stay engaged.
Each month a mental health therapist will discuss an area of mental health. This week’s column comes from Matt Webb, Psy.D. of the Human Development Center.
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