ADHD: More Than Just An Attention Problem

Attention Deficit Hyperactivity Disorder has become one of the most widely recognized and well researched disorders during our time. Every mother has heard of it, and at one time or another has quizzically assessed their own child wondering if they were showing symptoms. It is unquestionable that these days, being diagnosed with an attention problem as a child or adult is becoming more common place. But ADHD is not simply a problem with attention or concentration; depending on its severity it can be considered the gate way symptom to more complex cognitive and social problems.

Attention can be divided into five different types. They are selective, focused, divided, sustained, and alternating attention. Selective attention is the ability to continue focusing on a task despite distracting or competing stimuli. Focused attention is the ability to focus on the stimuli (e.g., auditory, visual, tactile).  Divided attention is the highest level of attention and is the ability to respond simultaneously to multiple tasks. Sustained attention (also known as vigilance) is to maintain attention during continuous and/or repetitive activity. Alternating attention is the ability to shift attention between varying tasks.

Reviewing the types of attention, it is easy to see how vital they are to our daily lives. Even more important, the inability to pay attention leads to learning and memory problems. Being able to attend to information in our environment is the first step to both learning and creating memories. Simply stated this process begins with attention, bringing information into the brain. The brain identifies the new information, categorizes it by learning what it is, and encodes it into the memory. Later the information is retrieved from the memory.  For example, I bought a new pen last week. My attention was focused on the pen, and brought the details of the physical description of this pen into my brain, where I identified it as a pen. My brain took this information and stored it in my memory for safe keeping. Today when I saw a pile of pens on my desk, I was able to retrieve the memory of what my pen looked like and successfully picked it out of the pile.

Without good attending skills, I would not have been able to learn what my new pen looked like or have been able to remember the following week which one was mine. Attention is the gateway for all information that enters our brain. If we struggle with deficits in paying attention then we are unable to learn and remember things. Imagine how this can become problematic when trying to make it in the world.

Jimmy has severe ADHD and was never diagnosed or treated. He struggles with maintaining personal relationships because he doesn’t always notice how other people around him are feeling. He struggles maintaining a job because he can’t attend to his boss’s instructions. He may complete tasks incorrectly, not complete them at all because he was distracted, or take too much time to get the work done because of poor concentration. Jimmy can’t keep a job, has poor social support, and eventually loses his apartment ending up homeless and unemployed.

Jill has been trying to achieve her college degree for 6 years now. She attends all her classes and works very hard to get extra help from her peers and professors. Her inability to concentrate has prevented her from truly understanding, learning, and encoding the information presented in class. When finals come, she is unable to remember what she studied and has repeatedly failed classes.

These scenarios are very extreme, but they are examples of how severe attention problems can impact many areas of life. Not everyone is such a severe example of an attention deficit, and depending on the level of impairment there are varying treatment options. Mild attention problems may be compensated for though compensatory strategies. These could be having someone help you get and stay organized, writing down or recording instructions at work, using your cell phone to program in reminders and schedules. For more moderate attention problems, one may want to try the above strategies in addition to medical assistance through medication and neurofeedback therapy. Severe impairment of attention may require all of the above suggestions in addition to case management help from social services. Local communities often have some type of service that can be offered through insurance or for a fee depending on the severity. Other options are to consider life coaches who specialize in ADHD.

Without our ability to attend to our environment, we are unable to bring in information to learn and store in our memory. The most common types of attention problems are the result of slow activity in the brain, and stimulant medication is often prescribed to help the brain get “caught up” to speed, allowing it to pay attention. Less frequent types of attention problems are the result of over arousal of the brain, meaning that the brain is so overwhelmed it can not attend to environmental information. In this case, stimulant medication would not be beneficial and you should discuss alternative options with your physician.