I was concerned to hear a report in the news the other week regarding an increase in the diagnosis of attention deficit hyperactivity disorder (ADHD) among children and adults resulting in the steady rise in "attention drugs". According to the Care Quality Commission in the UK prescriptions have gone up by 56 per cent since 2007.
I question as to whether the diagnosis of ADHD is always accurate? Are drugs to treat ADHD given out to quickly before a thorough assessment is established?
Since working with children that attend our language groups within schools and children’s centres, I have found that the majority of children have very poor attention and listening skills. These skills are essential for all learning especially for speech, language and communication development. Furthermore, social communication can be greatly affected if a child or adult cannot attend to people by looking, smiling etc.
There are many factors that can affect a child’s attention i.e. neurological components, medication, environment, poor motivation etc. As accurately described by Libby Hill, ‘It is a known fact that today we live in a very visual, fast- paced world, and often the first time a child is required to do any formal listening is when they start school. Many children have to be taught to attend and listen before they can begin the demands of the national curriculum.’ All these possibilities and potential reasons for poor attention and listening need to be considered in our assessments as speech and language therapists; and those of other professionals; i.e. we need to remain holistic.
Some children are naturally more energetic, restless and excitable; with these more ‘lively children’ I try to take the following approach:
· I always have a positive approach to all children, providing praise when necessary no matter how big or small others may observe their achievement to be.
· I always remember that all children have their own strengths and weaknesses; and I will often reassure parents by highlighting these strengths.
· I will include an activity I know they enjoy
· I implement a routine so that they know what to expect
· I will often include energetic activities; therefore putting their energy to a positive use, goals can still be met
· Observe when their attention is better i.e. particular times of the day, particular activities, with particular people etc. All of which can inform your management of that child so that these opportunities can be repeated more often resulting in success.
· Depending on the child/children I will include a reward; given at the end of the session i.e. stickers, or a particular activity etc.
· Reduce my demands on that child i.e. reduce the level of information given at a time, ensure to reduce questions.
· If needed repeat instructions/comments several times.
These are things that I find useful when working with children that ‘struggle’ with their attention and listening. I would love to hear about your experiences and suggestions.