8 Issues (Other than ADHD) that could Be Causing Attention Problems - Hallie Smith, MA CCC-SLP

Hyperactivity, lack of attention, and/or impulsivity are commonly associated with ADHD in kids, but there are many other causes of those symptoms. It’s important to look at the full picture, which means having a solid understanding of what ADHD really looks like and what other issues could be causing a child’s attention problems.

According to the National Institute of Mental Health, “Attention-deficit/hyperactivity disorder (ADHD) is a brain disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.” There are three subtypes of ADHD, and depending on how a child presents, their behavior may look drastically different than others with an ADHD diagnosis:​

·    ADHD, Predominantly Inattentive Type (commonly called ADD): Kids who have been diagnosed with ADHD, Predominantly Inattentive Type are easily distracted and have difficulty paying attention, but don’t struggle with impulsivity or hyperactivity. They typically aren’t disruptive in class, and often come across as shy. They typically don’t run into behavior issues caused by their ADHD, but their inattention is a problem.

· ADHD, Predominantly Hyperactive-Impulsive Type: Children with ADHD, Predominantly Hyperactive-Impulsive Type are always on the move and struggle with impulse control regularly. They have a hard time sitting still in class, talk non-stop, blurting out comments and interrupting conversations or class time. These kids typically don’t share the same attention struggles as those with ADHD, Predominantly Inattentive Type.

· ADHD, Combined Type: Kids with this type of ADHD struggle with both hyperactivity/ impulsivity and inattention. They meet the criteria for both of the other ADHD diagnoses.

Inattention, hyperactivity, and impulsivity are three common behaviors associated with ADHD, but a comprehensive evaluation is necessary for diagnosis. All kids struggle with focus, impulse control, and energy levels at times, but for kids with ADHD, these behaviors are more severe and more frequent. They interfere with the quality of the child’s life and are long-lasting.

If your child is displaying some of the signs, or only displays symptoms in some situations, you may just be facing typical childhood behavior, or you may be noticing the signs of something else. Certain medical conditions can cause very similar symptoms to ADHD, and it’s important that you see a professional to receive an evaluation for your child. The following conditions can cause symptoms that look like ADHD:

• Sleep Deprivation: If a child isn’t getting enough sleep, they will have a harder time concentrating, remembering things, controlling their emotions and impulses, and show signs of hyperactivity.
• Stress and Anxiety: Excessive stress or anxiety in a child’s life can cause physical and behavioral challenges, including emotional outbursts, impulse control issues, and lack of focus. They can appear disengaged if they’re preoccupied with other worries.
• Vision and Hearing Problems: If a child can’t see or hear well, their behavior, attention, and impulse control can be affected (especially in a classroom setting).
• Auditory Processing Disorder: Children with auditory processing disorder can hear normally, but struggle to make sense of sounds. There is a breakdown between the ears and the brain that can affect the child’s ability to listen, understand, and remember what they’re hearing. It can be hard for them to follow spoken instructions and stay focused.
• Sensory Processing Disorder: When a child’s body receives sensory information from the outside world in an unorganized way, their responses can cause major behavioral challenges. They may refuse to engage with others, have difficulty following instructions and controlling their impulses, or appear hyperactive.
• Blood Sugar Imbalances: When kids suffer from low blood sugar (hypoglycemia), they’ll often act irritable, have shorter attention spans, lack focus, and have low energy. If they are dealing with high blood sugar (hyperglycemia), they may have attention deficits, and trouble concentrating.
• Thyroid Issues: When a child is producing too many (or too few) thyroid hormones, they will suffer from energy imbalances, mood swings, memory and concentration problems.
• Anemia: As an iron deficiency develops, children will experience tiredness that can be mistaken for attention difficulties, and irritability that may present as a lack of impulse control.

A child that can’t sit still, has difficulty following instructions, or loses homework and toys often could be displaying signs and symptoms of ADHD. Or they could be struggling with something else entirely. The most important steps you can take if you feel your child may be struggling is to talk to a professional you trust. Be sure to observe your child and take notes, talk to your child’s teacher and find out what’s happening at school, and share your notes with your child’s doctor. Ask about a referral to a specialist who can diagnose or rule out ADHD with a comprehensive evaluation.

Inattention, hyperactivity, and impulsivity are three common behaviors associated with ADHD, but a comprehensive evaluation is necessary for diagnosis. All kids struggle with focus, impulse control, and energy levels at times, but for kids with ADHD, these behaviors are more severe and more frequent. They interfere with the quality of the child’s life and are long-lasting.

If your child is displaying some of the signs, or only displays symptoms in some situations, you may just be facing typical childhood behavior, or you may be noticing the signs of something else. Certain medical conditions can cause very similar symptoms to ADHD, and it’s important that you see a professional to receive an evaluation for your child. The following conditions can cause symptoms that look like ADHD:

• Sleep Deprivation: If a child isn’t getting enough sleep, they will have a harder time concentrating, remembering things, controlling their emotions and impulses, and show signs of hyperactivity.
• Stress and Anxiety: Excessive stress or anxiety in a child’s life can cause physical and behavioral challenges, including emotional outbursts, impulse control issues, and lack of focus. They can appear disengaged if they’re preoccupied with other worries.
• Vision and Hearing Problems: If a child can’t see or hear well, their behavior, attention, and impulse control can be affected (especially in a classroom setting).
• Auditory Processing Disorder: Children with auditory processing disorder can hear normally, but struggle to make sense of sounds. There is a breakdown between the ears and the brain that can affect the child’s ability to listen, understand, and remember what they’re hearing. It can be hard for them to follow spoken instructions and stay focused.
• Sensory Processing Disorder: When a child’s body receives sensory information from the outside world in an unorganized way, their responses can cause major behavioral challenges. They may refuse to engage with others, have difficulty following instructions and controlling their impulses, or appear hyperactive.
• Blood Sugar Imbalances: When kids suffer from low blood sugar (hypoglycemia), they’ll often act irritable, have shorter attention spans, lack focus, and have low energy. If they are dealing with high blood sugar (hyperglycemia), they may have attention deficits, and trouble concentrating.
• Thyroid Issues: When a child is producing too many (or too few) thyroid hormones, they will suffer from energy imbalances, mood swings, memory and concentration problems.
• Anemia: As an iron deficiency develops, children will experience tiredness that can be mistaken for attention difficulties, and irritability that may present as a lack of impulse control.

A child that can’t sit still, has difficulty following instructions, or loses homework and toys often could be displaying signs and symptoms of ADHD. Or they could be struggling with something else entirely. The most important steps you can take if you feel your child may be struggling is to talk to a professional you trust. Be sure to observe your child and take notes, talk to your child’s teacher and find out what’s happening at school, and share your notes with your child’s doctor. Ask about a referral to a specialist who can diagnose or rule out ADHD with a comprehensive evaluation.

The Little-Known Truths About Reading Aloud

Reading aloud is something usually associated with children or unsophisticated readers, a remedial technique to be phased out as soon as people learn to read silently. But a growing body of research suggests that reading out loud may actually have significant cognitive benefits - even for experienced readers.

The recent study, conducted by researchers Colin Macleod and Noah Forrin at the University of Waterloo and published in the journal Memory, found that reading words aloud made them easier to remember compared to reading them silently.

However, this doesn’t mean you should replace your entire library with audiobooks just yet. The study used four different experimental conditions to isolate exactly which elements were responsible for improved memory retention. The subject group of 95 students were asked to either read silently, read aloud, listen to recordings of other people reading, or listen to a recording of themselves reading. Memory retention was strongest when reading aloud directly, suggesting that the impact came not just from hearing the words, but also speaking them.

This is because verbally pronouncing a word creates a memorable experience - a phenomenon the researchers call the “production effect”. The active cognitive process of encoding the word into speech also helps to encode it into long-term memory. Additionally, when it came to words heard through recordings, students were better able to remember those recorded in their own voice than those pronounced by someone else. According to the authors, this suggests that hearing one’s own voice provides a distinct stimulus of self-recognition, which also helps make the content memorable.

These findings build on previous research demonstrating that the production effect’s memory boost relies on distinctiveness. In an earlier 2010 study by Macleod et al., this was shown to disappear when all the words in the study list were read aloud, as verbalization became a default experience rather than a distinct one. Rather, the production effect manifested when participants were given a mixed list, with some words read silently and some read aloud. Yet another study by Macleod in 2011 showed that the strength of the production effect was also reduced - though not eliminated - by having another person sit next to the participant and pronounce the words at the same time. Rather than adding another memorable element, the repetition by another undermined the distinctiveness of the participant’s own pronunciation, leading to worse memory recall.

This result forms an interesting contrast with a 2015 study by Victor Boucher and Alexis Lafleur at the University of Montreal. With a test group of 44 French-speaking students, researchers used a similar range of methods, asking them to read the words solely in their head, read them while moving their lips, or to read them out loud to themselves. For the fourth experimental condition, however, students were asked to read the words aloud to another person in the room. This proved to have the greatest impact on improving verbal recall. Unlike hearing another voice pronouncing the same words, the presence of a silent audience did not detract from the personal distinctiveness of the production effect but served to enhance it by placing the pronunciation into a specific context of interpersonal communication.

Although the studies tested different aspects of the production effect under different conditions, the results all supported the argument that distinctiveness improves memory. By engaging our motor system and self-recognition, speaking words aloud encodes them as unique experiences by forming additional memory pathways. And as Macleod points out, this is also consistent with research showing that exercise and movement can promote cognitive performance in children and adults alike by increasing blood flow to the brain.

Of course, silent reading has its benefits - especially in libraries. But if the situation allows, repeating important information aloud to yourself - or better yet, a study partner - can be extremely productive.

How kids pay attention and why some struggle with It

At a Glance

• Attention is what allows people to identify and take in useful information.
• Paying attention is a process with several distinct parts.
• Kids with attention issues can have trouble with any or all of the parts of the attention process.

Most people understand that attention plays an important role in learning. But they may not know that it’s the very first step in the learning process that occurs in the brain.

Attention is like a funnel that lets kids select and take in useful information. Once the information is there, the brain can make sense of it and store it in memory.

Paying attention may sound very simple. But it’s a highly developed process with several distinct parts. Kids with attention issues can have problems with any or all of these parts. And if they do, it can affect their ability to learn.

Here are the parts of the process and where some kids with attention issues have trouble.

Being Alert

What it is: To pay attention, a child must first be aware and alert, ready to take in information. For most kids, that means being wide awake and well rested.

A student who isn’t alert may literally have his head on his desk during class. But sometimes the signs are more subtle. A child can simply seem “tuned out” and appear to be staring at nothing.

Its relationship to attention issues: Poor-quality sleep and lack of sleep are the top culprits when it comes to alertness issues.

This is true for all kids—those who have diagnosed learning and attention issues and those who don’t. In fact, some kids who appear to have learning or attention issues actually turn out to have sleep disorders.

Sleep disorders include insomnia—problems with falling asleep or staying asleep. They can also affect a person’s ability to achieve deep, restorative sleep.

Kids with ADHD struggle with sleep disorders more often than other children do. If you believe your child is not as “awake” as he should be, talk to his doctor. She may want to adjust his meds or arrange for a sleep study.

Selecting and Sustaining

What it is: The next step is selecting what exactly to pay attention to. That’s followed by continuing to pay attention to it.

To some extent, people use judgement to decide what deserves attention. For instance, a student can choose to pay attention to the teacher and not the birds flying around outside.

But choice and judgement play a smaller role in this process than many people realize. For example, if the whiteboard falls off the wall, all the brains in the room will automatically focus on that. It’s basic instinct.

The same is true if a teacher stands and talks right in front of a student. That child’s brain naturally focuses on what’s taking up his immediate visual and auditory space.

Its relationship to attention issues: Many kids with attention issues want to focus on the “right” thing. But their brains may have trouble picking out what that right thing is.

The other big challenge: Even when kids can pick out what’s important, they may not be able to sustain attention for a meaningful amount of time. So a child may start out listening to the teacher. But then his mind may drift to the birds outside.

Shifting Focus

What it is: Nobody can completely ignore distractions. For example, a loud noise in the hallway will catch the attention of everyone in the classroom. People also frequently shift attention to something internal, like a thought, feeling or memory. But most students are able to shift their attention and then quickly shift back to the teacher.

Its relationship to attention issues: The mechanism that lets most students shift attention easily and quickly is sticky in many kids with attention issues.

A child with ADHD may stay focused on that loud noise out in the hallway long after his classmates have returned their attention to the teacher. By the time he tunes back in, he may have missed important information.

Or he may not return his attention at all. Instead he may move on to, say, what he’s going to have for lunch and what he’s doing on the weekend.

If your child struggles a lot with attention issues there are strategies you can try at home. Medication is also an option to consider. A combination of the right support and treatment can help your child absorb what he needs to know—in school and out.

Key Takeaways

• Paying attention is not as much of a “choice” as many people may think.
• Kids with attention issues have trouble determining where to focus attention, maintaining attention and shifting attention to and away from distractions.
• Educational therapies, as well as medication, can help many kids strengthen attention skills and focus more easily.