Inattention in School and Disorders

by: Dan Florell, Ph.D.

“Tommy, could you read the next section in our book?” the teacher asked Tommy.

Tommy looked around sheepishly and said, “Where are we in the reading?”

The teacher was not surprised by Tommy’s response as she often had to remind him of what he was supposed to be doing in class. He also was having difficulty in turning in his homework and completing his class assignments. Overall, Tommy seemed lost in class and the teacher thought it was likely that Tommy had Attention Deficit Hyperactivity Disorder (ADHD).

Given Tommy’s symptoms, most teachers and parents would assume that Tommy has ADHD. While it is possible that Tommy has ADHD, his symptoms are also consistent with other mental health disorders that often get overlooked.

Anxiety is one of the most frequently diagnosed mental health disorders and yet it can go unnoticed in children. The reason is that many of the symptoms such as inattention and having difficulty focusing are the same as those seen in children with ADHD. However, the causes of those symptoms are quite different for anxious children.

Children who are constant worriers can escape teacher and parent notice yet the worry occupies so much of the children’s ability to think that they appear inattentive. These children also have to be frequently reminded of the directions and what to do next.

Other anxious children feel they have to be perfect in class and in their schoolwork. In this case, they will take a long time on their assignments because everything has to be perfect before it can be turned in. This tendency continues with their homework where children decide to not turn it in because it wasn’t done well enough. The need to be perfect also shows up in the classroom as children worry about making a mistake or embarrassing themselves. This leads them to be reluctant to volunteer or they try to look occupied so the teacher will not call on them.

A different form of anxiety that can have symptoms that look like ADHD is Obsessive-Compulsive Disorder (OCD). Children with OCD have thoughts that get stuck in their head accompanied by feeling the need to perform some sort of ritual in order to avoid something bad from happening. One example is the need to line up things on a desk or tapping a certain number of times before being able to leave a desk. These rituals can divert children’s attention away from classwork and slow their progress.

Another contributor to children’s inattention can be exposure to trauma. When children witness traumatic events such as domestic violence or other disturbing experiences, it is very hard for them to pay attention. Children who experience trauma also develop an exaggerated startle response and become hypervigilant which can make them seem out of it and jumpy.

While inattention in young children is relatively normal, teachers have the ability to compare children’s attention levels to those of their classmates. If teachers have concerns about your child’s inattention, it is worth taking note and following up as high levels of inattention are a sign something is wrong. However, care needs to be taken when finding out the exact cause of the inattention. Based on the answer, the inattention could be a sign of ADHD, anxiety, OCD, or trauma. A psychologist, counselor, or social worker can be a good resource in differentiating the cause of the inattention and getting the right intervention put in place.

This article was published in the Richmond Register daily Friday on October 16, 2015

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