A Resource for Teachers, Clinicians, Parents, and Students by the Brain Injury Association of New York State.
 

At Home #6: difficulty paying attention

Problem: The student appears to have difficulty paying attention (focusing, maintaining attention, shifting attention focus, dividing attention) in academic or other domains.


I. GENERAL MEDICAL POSSIBILITIES

II. COGNITIVE/SELF REGULATORY POSSIBILITIES

III. BEHAVIORAL POSSIBILITIES

  1. Oppositionality
  2. Manipulativeness
  3. Attention Seeking
  4. Task Avoidance

IV. SOCIAL- EMOTIONAL POSSIBILITIES

  1. Depression
  2. Anxiety
  3. Frustration


I. GENERAL MEDICAL POSSIBILITIES 

1.Medication Side Effect:Some students may have difficulty attending as a side effect of medication.  

2.Medication Interactions:Some students may have difficulty attending as a side effect of medication.  

3.Hearing Impairment:Some students may have difficulty attending as a side effect of medication.  

4. Chronic Pain: Some students may fail to do what they are told to do as a result of being in chronic pain.

5. Fatigue: Some students may fail to do what they are told to do as a result of fatigue (e.g., insufficient sleep) or hunger.

6. Seizures: In rare cases, lack of compliance may be a result of seizures that may or may not be diagnosed. If seizures have been diagnosed, staff should ask the physician if difficulty persisting in activities is a likely or possible consequence of the seizures. If seizures have not been diagnosed, but are suspected, a seizure evaluation should be recommended. If seizures are diagnosed, the prescribed medication regimen should be followed along with environmental management of the lack of compliance. (See Tutorials on Seizures)

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II. COGNITIVE/SELF-REGULATORY POSSIBILITIES

1.Specific Attention Deficit: Some students may have a specific and isolated problem with components of attention. (See Tutorial on Attention)

2.Initiation Impairment: Some students may have difficulty attending as a result of initiation impairment (frontal lobe injury). (See Tutorial on Initiation)

3.Generally Impaired Self-Regulation: Some students may have difficulty attending as a result of general difficulty with other aspects of self-regulation. (See Tutorials on Self-Regulation; Self-Monitoring and Self- Evaluating; Organization; Impulsiveness/Disinhibition; Problem Solving)

4.Weak Orientation to Task: Some students may have difficulty attending as a result of uncertainty regarding what is required of them. (See Tutorials on Language Comprehension; Organization)

5.Organizational Impairment: Some students may have difficulty attending as a result of organizational impairment. (See Tutorial on Organization)

6.Generally Weak Cognitive Functioning: Some students may have difficulty attending as a result of excessive demands placed on their memory, organizational ability, academic skill or other cognitive ability. (See Tutorials on Cognition; Memory; Organization)

7. Inflexibility: Some students may have difficulty attending as a result of difficulty with change; they may be rigid and inflexible; they may have particular difficulty with novel versus routine tasks. (See Tutorial on Flexibility)

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III. BEHAVIORAL POSSIBILITIES

1.Oppositionality: Some students may appear to have difficulty attending as a result of oppositional behavior. (See Tutorials on Behavior and Behavior Problems after TBI; Behavior Management: Prevention Strategies)

2.Manipulativeness: Some students may appear to have difficulty attending as a form of manipulation (other than oppositional behavior). (See Tutorials on Teaching Positive Communication Alternatives to Negative Behavior; Behavior Management: Prevention Strategies)

3.Attention Seeking: Some students may appear to have difficulty attending as a way to seek adult and/or peer attention. (See Tutorials on Attention; Behavior Management: Prevention Strategies; Behavior Management: Contingency Management)

4.Task Avoidance: Some students may appear to have difficulty attending as a way to avoid specific tasks. (See Tutorials on Noncompliance; Errorless Learning; Problem Solving; Behavior Management: Prevention Strategies; Behavior Management: Contingency Management)

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IV. SOCIAL-EMOTIONAL POSSIBILITIES

1.Depression: Some students may have difficulty attending because they are upset, depressed, and/or lack positive relationships with peers and/or adults. (See Tutorials on Depression; Peer Relationships)

2.Anxiety: Some students may have difficulty attending as a result of anxiety. (See Tutorial on Anxiety)

3.Frustration: Some students may have difficulty attending as a result of feeling frustrated. (See Tutorials on Self Regulation/Executive Function Routines after TBI; Teaching Positive Communication Alternatives to Negative Behavior)

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