Attention Deficit Disorder (Short Attention Span)
Also called ADD, ADHD, or hyperactivity, a short attention span
occurs in 3% to 5% of children, most of them males.
A normal attention span is 3 to 5 minutes per year of a child's
age. Therefore, a 2-year-old should be able to concentrate on a
particular task for at least 6 minutes, and a child entering
kindergarten should be able to concentrate for at least 15 minutes.
(Note: A child's attention span while watching TV is not an accurate
measure of his or her attention span.)
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If you suspect that your child has a short
attention span, ask another adult (a teacher or day care provider, for
example) if they have observed this also.
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- A child hasn't learned to listen when someone
talks, wait his turn, complete a task, or return to a task if
interrupted. (These can be normal characteristics of children less
than 3 or 4 years old.)
- 80% of boys and 50% of girls are also hyperactive. A child
who has symptoms of hyperactivity is restless, impulsive, and in a
- 50% of children also have a learning
disability. The most common learning disability is an auditory
processing deficit (that is, they have difficulty remembering verbal
directions). However, the intelligence of most children with ADD is
- Similar conditions
Disruptive children, children who don't
mind, and aggressive children are sometimes included under the broad
category of hyperactivity. Many problem 2-year-olds are considered
"hyperactive." These children should be looked upon as children with
behavior problems and approached with appropriate discipline
Attention deficit disorder (ADD) is the
most common developmental disability. "Developmental" means that the
disability is caused by delayed brain development (immaturity). This
delay results in poor self-control, requiring external controls by the
parents for a longer period of time. Often this type of temperament
and short attention span is hereditary. A small percentage of children
with ADD are reacting to chaotic home environments, but in most cases
the parents' style of child-rearing has not caused the disability.
Minor brain damage has not been proven to be a cause of ADD but
scientists are conducting research into this area.
- Expected course
Children with ADD on a developmental basis
can improve significantly if parents and teachers provide
understanding and direction and preserve the child's self-esteem. When
these children become adults, many of them have good attention spans
but remain restless, have to keep busy, and, in a sense, have not
entirely outgrown the problem. However, not only does society learn to
tolerate such traits in adults, but in some settings the person with
endless energy is prized. Children with severe ADD may need vocational
counseling as adults.
Call Your Child's Physician for Referral to a Child
Psychiatrist or Psychologist If:
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- Your child shows unprovoked aggression and
- Your child has repeated accidents.
- Your child has been suspended or expelled from school.
- Your child can't make or keep any friends.
- You have "given up" hope of improving your child.
- You can't stop using physical punishment on your child.
- You are at your wit's end.
Living with a Child Who Has Attention Deficit
Attention deficit disorder is a chronic
condition that needs special parenting and school intervention. If your
child seems to have a poor attention span and is over 3 years of age,
these recommendations may assist you in helping your child. Your main
obligations involve organizing your child's home life and improving
discipline. Only after your child's behavior has improved will you know
for certain if your child also has a short attention span. If he does,
specific interventions to help him learn to listen and complete tasks
("stretch" his attention span) can be initiated. Even though you can't
be sure about poor attention span until your child is 3 or 4 years of
age, you can detect and improve behavior problems at any time after 8
months of age.
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- Accept your child's limitations.
Accept the fact that your child is
intrinsically active and energetic and possibly always will be. The
hyperactivity is not intentional. Don't expect to eliminate the
hyperactivity but merely to bring it under reasonable control. Any
criticism or other attempt to change an energetic child into a quiet
or model child will cause more harm than good. Nothing helps a
hyperactive child more than having a tolerant, patient, low-keyed
- Provide an outlet for the release of
This energy can't be bottled up and stored. Daily outdoor
activities such as running, sports, and long walks are good outlets. A
fenced yard helps. In bad weather your child needs a recreational room
where he can play as he pleases with minimal restrictions and
supervision. If no large room is available, a garage will sometimes
suffice. Your child should not have too many toys, for this can cause
him to be more easily distracted from playing with any one toy. The
toys should be safe and relatively unbreakable. Encourage your child
to play with one toy at a time.
Although the expression of hyperactivity
is allowed in these ways, it should not be needlessly encouraged.
Don't initiate roughhousing with your child. Forbid siblings to say,
"Chase me, chase me," or to instigate other noisy play. Encouraging
hyperactive behavior can lead to its becoming your child's main style
of interacting with people.
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Keep your home well
Household routines help the hyperactive
child to accept order. Keep the times for wake-up, meals, snacks,
chores, naps, and bed as regular as possible. Try to keep your
environment relatively quiet because this encourages thinking,
listening, and reading at home. In general, leave the radio and TV
off. Predictable daily events help your child's responses become more
predictable. ADD symptoms are made worse by sleep deprivation and
hunger. Be sure your child has an early bedtime and a big breakfast on
- Try not to let your child become
When a hyperactive child becomes
exhausted, his self-control often breaks down and the hyperactivity
becomes worse. Try to have your child sleep or rest when he is
fatigued. If he can't seem to "turn off his motor," hold and rock him
in a rocking chair.
- Avoid taking your child to formal
Except for special occasions, avoid places
where hyperactivity would be extremely inappropriate and embarrassing
(such as churches or restaurants). You also may wish to reduce the
number of times your child goes with you to stores and supermarkets.
After your child develops adequate self-control at home, he can
gradually be introduced to these situations. Be sure to praise your
child when he plays independently rather than interrupting you when
you are talking to guests or are on the telephone.
- Maintain firm discipline.
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These children are unquestionably
difficult to manage. They need more carefully planned discipline than
the average child. Rules should be formulated mainly to prevent harm
to your child and to others. Aggressive behavior, such as biting,
hitting, and pushing, should be no more accepted in the hyperactive
child than in the normal child. Try to eliminate such aggressive
behaviors, but avoid unnecessary or unattainable rules; that is, don't
expect your child to keep his hands and feet still. Hyperactive
children tolerate fewer rules than the normal child. Enforce a few
clear, consistent, important rules and add other rules at your child's
pace. Avoid constant negative comments like "Don't do this," and "Stop
- Enforce rules with nonphysical
Physical punishment suggests to your child that physically
aggressive behavior is OK. We want to teach hyperactive children to be
less aggressive. Your child needs adult models of control and
calmness. Try to use a friendly, matter-of-fact tone of voice when you
discipline your child. If you yell, your child will be quick to
Punish your child for misbehavior
immediately. When your child breaks a rule, isolate him in a chair or
time-out room if a show of disapproval doesn't work. The time-out
should last about 1 minute per year of your child's age. Without a
time-out system, overall success is unlikely.
- Stretch your child's attention span.
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Encouraging attentive (nonhyperactive) behavior is the key to
preparing your child for school. Increased attention span and
persistence with tasks can be taught at home. Don't wait until your
child is of school age and expect the teacher to change him. By age 5
he needs at least a 25-minute attention span to perform adequately in
Set aside several brief periods each day
to teach your child listening skills by reading to him. Start with
picture books, and gradually progress to reading stories. Coloring
pictures can be encouraged and praised. Teach games to your child,
gradually increasing the difficulty by starting with building blocks
and progressing to puzzles, dominoes, card games, and dice games.
Matching pictures is an excellent way to build your child's memory and
concentration span. Later, consequence games such as checkers or
tic-tac-toe can be introduced. When your child becomes restless, stop
and return for another session later. Praise your child for attentive
behavior. This process is slow but invaluable in preparing your child
- Buffer your child against any
overreaction by neighbors.
Ask neighbors with whom your child has
contact to be helpers. If your child is labeled by some adults as a
"bad" kid, it is important that this image of your child doesn't carry
over into your home life. At home the attitude that must prevail is
that your child is a good child with excess energy. It is extremely
important that you not give up on him. Your child must always feel
loved and accepted within the family. As long as a child has this
acceptance, his self-esteem will survive. If your child has trouble
doing well in school, help him gain a sense of success through a hobby
in an area of strength.
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From time to time,
get away from it all.
Exposure to some of these children for 24
hours a day would make anyone a wreck. Periodic breaks help parents to
tolerate hyperactive behavior. If just the father works outside the
home, he should try to look after the child when he comes home, not
only to give his wife a deserved break but also to understand better
what she must contend with during the day. A baby sitter one afternoon
each week and an occasional evening out can provide much-needed breaks
for an exhausted mother. Preschool is another helpful option. Parents
need a chance to rejuvenate themselves so that they can continue to
meet their child's extra needs.
- Utilize special programs at school.
Try to start your child in preschool by age 3 to help him learn
to organize his thoughts and develop his ability to focus. However,
you should consider enrolling your child in kindergarten a year late
(that is, at age 6 rather than 5) because the added maturity may help
him fit in better with his classmates.
Once your child enters grade school, the school is responsible
for providing appropriate programs for your child's attention deficit
disorder and any learning disability he might have. Some standard
approaches that teachers use to help children with ADD are smaller
class size, isolated study space, spaced learning techniques, and
inclusion of the child in tasks like erasing the blackboard or passing
out books (as outlets for excessive energy). Many of these children
spend part of their day with a teacher specializing in learning
disabilities who helps improve their skills and confidence.
If you think your child has ADD and he has
not been tested by the school's special education team, you can
request an evaluation. Usually you can obtain the help your child
needs with schoolwork by working closely with the school staff through
parent-teacher conferences and special meetings. Your main job is to
continue to help your child improve his attention span,
self-discipline, and friendships at home.
- Medications are sometimes helpful.
Some stimulant drugs can improve a child's
ability to concentrate. You may want to discuss the use of drugs with
your child's physician. In general, medications should not be
prescribed before school age. They should also not be prescribed until
after your child has been evaluated by a doctor and a school
psychologist or special education teacher, an individualized
educational plan (I.E.P.) is in effect at school, and you have
followed the suggestions in this handout. Medications without special
education and home management programs have no long-term benefit. They
need to be part of a broader treatment program.
Barbara Ingersoll, Your Hyperactive Child (New York: Doubleday,
Melvin D. Levine, Keeping a Head in School:
A Student's Book About Learning Abilities and Learning Disorders
(Cambridge, MA: Educators Publishing Service, 1990).