Colleen Beck, OTR/L is a pediatric occupational therapist and the owner and author of The OT Toolbox website. She manages all of The OT Toolbox social media accounts and runs the popular newsletter.
Colleen created The OT Toolbox in 2011 and since then has written thousands of blog posts designed to support therapy providers, educators, parents, counselors, admin, and caregivers in promoting the healthy development of kids.
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by
Colleen Beck OTR/L
Children with ADHD, ADD, or even just difficulties with focus and attention can have resulting struggles with executive functioning skills. There are many executive function skills tied to attention and focus that interfere with success in the classroom, home, extracurricular activities, and community. Consider all of the areas that make up executive functioning skills. These are abilities that develop through maturation and developmental progression. For some, these skills develop more easily than others. For the child who struggles with attention, these executive functioning abilities may lack, causing difficulties in all areas of life.
Executive Function Skills and Attention
There are many executive functioning skills that allow us to complete tasks. On this executive functioning skills page, I’ve linked to several of the skill areas that we’ve covered here on the site. Be sure to stop back, because I’ve got more activities and information in store for you.
When kids have trouble with attention, there are executive functioning skills that lack.
Does any of this sound familiar?
Emotional Control- Kids with attention issues may not be able to attend for extended periods of time on a situation that enables them to control their emotions. They can perseverate on the emotions of a specific situation or may not be “up to speed” on the situation at hand or be able to process their emotions as they attend to a different situation. Issues with emotional control can then lead to behavioral responses as they struggle to keep their emotions in check.
Task Initiation– Children with attention difficulties can be challenged to start tasks. It can be difficult to pull out the starting point or the most important parts of a multi-step project so that just starting is a real struggle.
Task Completion- Similar to the initiation of specific tasks, completing a task or project can be a real challenge for the child who is limited in attention. Reading a multiple chapter book can seem overwhelming and quite difficult and just never is finished. Cleaning a room can be a big challenge when there are visual, auditory, or other sensory-related distractions that make up the project.
Working Memory– Attending to past situations and pulling that information into a current situation is a difficulty for some kids with attention issues. Attention issues can interfere with parts of working memory including encoding, storage, and manipulation of information. This can result in safety issues when it comes to skills like crossing a street or even conversations.
Planning and Prioritizing- Planning out and picking the most important tasks of a project can be a struggle for the child with attentional issues. It can be easy to become overwhelmed and distracted by the options for importance.
Processing Speed- Processing speed refers to the ability to receive, understand, and process information in order to make a decision or response. It also involves using working memory in a situation or experience. Children who experience attention struggles may experience difficulty in retrieval of information (using working memory) and responding using that information (initiation). This carries over to missed information, difficulty keeping up with a conversation or lesson in school, or a fast-moving game or activity.
Organization– A child with attention challenges can easily become disorganized with tools, books, clutter, and trash. Focusing on a project such as cleaning out a desk or locker is a multiple-step task that might not ever happen without intervention from a teacher or support person. Organization requires attention to detail and separation of pieces into sections, whether that be folders of a similar subject in school or matching colors of socks. It’s easy to see how the child with attention issues can get off track very easily with organizational tasks
Self-Monitoring- This executive functioning skill goes hand in hand with attention and focus. Self monitoring allows us to keep ourselves in check in a situation. We need to stay on task and focus on that a person is saying and respond in appropriate ways. If the child with attentional issues can not focus on what a person is saying for more than a few minutes, than the ability to respond appropriately can be a real issue.
Impulse Control– Attention and impulses are another set of executive functioning skills that are very closely related. When the distracted child can not focus on a specific task or conversation, or situation, then the tendency to impulsively respond is quite likely. A great tool for assessing and monitoring impulses in the child with attention struggles is the impulse control journal.
Cognitive Flexibility- The ability to think with flexibility is what makes the human brain superior to other species. We are able to think in the future and assess different situations using cognitive flexibility.
Cognitive flexibility is the ability to stop a thought process and change a way of thinking. When the child who struggles with attention can not focus on a thought or process for a period of time, they are distracted by things in their environment or thoughts, limiting the ability to focus on flexible thinking patterns.
Foresight- This skill is also related to distractibility and focus. Interference from outside interruptions can limit the thoughtful foresight that allows us to make safety decisions. For the child with impulsivity and hyperactivity, being on-the-go, or constantly in motion can interfere with the ability to pause and consider consequences from a single action.
Hindsight- Similar to thinking ahead, the ability to process that “20/20” vision of our our past mistakes and actions is what allows us to use experience to make better decisions.
Self-Talk– The skill used for assessing situations and monitoring our behaviors related to consequences is a difficult task for the child with attention issues. Distractions interfere with self-talk and the positive result of our inner mind.
Problem Solving- When distractions and impulsivity are at the forefront of thought processes, it can be difficult to solve problems as they are presented to the child with attention difficulties. This area is closely related to working memory.
Persistence- For the child with attention struggles, it can be very difficult to persist through a lengthy task or assignment. Distractions, impulsivity impact the ability to power through a task. A tendency of ADHD is the difficulty in follow through during tasks like homework, reading, chores, or duties.
Shift- Switching through processes in order to problem solve or attend to various tasks can be quite difficult for the child with attention struggles.
You can see how all of these areas are related and work cohesively with one another in typical daily tasks. It makes sense that the child who struggles with attention and sustained focus will have difficulty with a multitude of executive functioning skills.
More tools for addressing attention needs in kids
HUGE Sensory Resource
There are so many strategies to address attention in kids and activities that can help address attention needs. One tactic that can be a big help is analyzing precursors to behaviors related to attention and addressing underlying needs. The Attention and Sensory Workbook can be a way to do just that. The Attention and Sensory Workbook is a free printable resource for parents, teachers, and therapists. It is a printable workbook and includes so much information on the connection between attention and sensory needs. Here’s what you can find in the Attention and Sensory Workbook:
Includes information on boosting attention through the senses
Discusses how sensory and learning are connected
Provides movement and sensory motor activity ideas
Includes workbook pages for creating movement and sensory strategies to improve attention
A little more about the Attention and Sensory Workbook:
Sensory processing is the ability to register, screen, organize, and interpret information from our senses and the environment. This process allows us to filter out some unnecessary information so that we can attend to what is important. Kids with sensory challenges often time have difficulty with attention as a result. It’s been found that there is a co-morbidity of 40-60% of ADHD and Sensory Processing Disorder. This workbook is an actionable guide to help teachers, therapists, and parents to help kids boost attention and focus in the classroom by mastering sensory processing needs. You will find information on the sensory system and how it impacts attention and learning. There are step-by-step strategies for improving focus, and sensory-based tips and tricks that will benefit the whole classroom. The workbook provides tactics to address attention and sensory processing as a combined strategy and overall function. There are charts for activities, forms for assessment of impact, workbook pages for accommodations, and sensory strategy forms.
Grab the Attention and Sensory Workbook below.
References:
Adi Stern, Adina Maeir; Validating the Measurement of Executive Functions in an Occupational Context for Adults With Attention Deficit Hyperactivity Disorder. Am J Occup Ther 2014;68(6):719-728. doi: 10.5014/ajot.2014.012419.
“Attention-Deficit/Hyperactivity Disorder (ADHD): The Basics.” National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder-adhd-the-basics/index.shtml
Colleen Beck, OTR/L has been an occupational therapist since 2000, working in school-based, hand therapy, outpatient peds, EI, and SNF. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. Read her story about going from an OT making $3/hour (after paying for kids’ childcare) to a full-time OT resource creator for millions of readers. Want to collaborate? Send an email to contact@theottoolbox.com.