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Attention Problems in Children and Their Causes

Attention Problems
Difficulties with planning sequences of behavior, comprehending verbal or visual information, or reacting to sensations all influence our attention. Each child may have a different reason or reasons for having a hard time paying attention. Clinically, my sense is that the difficulty in planning or sequencing actions or behavior is the most common contributor to attentional difficulties. A child with this difficulty cannot do things on "automatic pilot," as other children may. Obvious behaviors, such as checking your book bag to see if you have your homework books, require conscious effort and therefore can be forgotten.

Motor planning or sequencing difficulties will be discussed later in this chapter. We will discuss each general area that can influence attention, beginning with comprehending sensations.

Information-Processing Difficulties
As I explained earlier, some children have difficulty paying attention because of the way they take in and interpret what they hear or see. They are easily distracted because sights or sounds (words) haven't sufficient saliency and meaning to hold their attention.

Problems in processing information that a child hears are known as auditory-verbal processing difficulty. It is hard for such a child to hold a sequence of sounds or words in her mind. As a baby, she may not respond as pleasurably as other babies to complex rhythms. For example, she may only brighten up and look interested with simple rhythms, such as "BUM bum, BUM bum." If you hum the rhythm "BUM bum-bum-bum-bum BUM BUM" ("Shave and a haircut . . . two bits") she may turn away. She can't decode or comprehend the pattern, and she loses interest. (It's like playing classical music to someone who is unfamiliar with it. Because he doesn't comprehend the pattern in the music, he doesn't find it interesting and begins daydreaming rather than listening.) A toddler with auditory processing difficulty has trouble following simple instructions because it's hard for her to hold sounds in her mind. For example, she reacts with puzzlement to the instruction, "Come here!" But if you point to the child and then point to yourself, saying "Here, here," she sees and responds to your gesture. By the age of two to two and a half, when most children can comprehend a couple of instructions in a row, such as "Please pick up your plate and give it to Mommy," this child may obediently pick up her plate, but then stop, staring at you in puzzlement. You may then have to repeat, "Give it to Mommy."

As a preschooler, she may have problems opening and closing what we have described as circles of communication. For example, when you are playing with her and you wonder aloud why one doll is beating up another doll, she may look confused and simply repeat what she has just said.

As a school-age child, she encounters difficulties comprehending instructions. When the teacher says, "Get a piece of paper and a pencil out of your desk and write down these words," she may be confused because there are too many commands at once. Distracted, she tunes out, daydreaming until the teacher asks her why she hasn't taken out her pencil and paper. Remembering school lessons or phone numbers poses a problem, and reading skills may come slowly because she has difficulty connecting sounds to letters.

As she gets older, she may have difficulty comprehending abstract concepts that are communicated through what she hears. She may have a hard time with words that portray abstract concepts and may reason more in terms of action patterns and spatial concepts. For example, when most of us as children heard a new word, we thought about other words in association with that new word in order to figure out its meaning. (A child might, for example, hear the word "objectionable" for the first time. When a parent explains it in terms of a series of simpler, more familiar words, such as "not nice," she must hold in her mind the series of simpler words and the new word and understand the connection between them - quite a challenge for someone who has trouble holding in mind verbal patterns.) Similarly, trying to figure out the meaning of a story involves understanding the author's use of metaphor or other descriptive techniques, a hard chore if verbal patterns are not easily understandable.

Many children with verbal processing difficulty go on to become gifted interpreters of literature or become erudite in philosophy or social sciences. What many such individuals have done is to use their superior spatial abilities to buttress their weaker verbal pattern comprehension abilities. In other words, they may take a little more time to study a passage, visualize it, and then dissect it with almost mathematical precision and logic.

Often, a child with weak auditory processing skills may have excellent analytic or "big picture" thinking abilities. She is less oriented toward detail and more toward how the parts fit together. Academically, she struggles with the rote, memory-based skills that characterize the early school years, but has an easier time in high school, college, and graduate school when concepts and analytic reasoning skills become more central.

Sometimes a child with auditory processing difficulties faces problems finding the right words to express herself - a word retrieval difficulty. She may have trouble describing her day or answering teachers' questions. She tunes out and daydreams while talking, causing endless annoyance to parents and teachers. "You're not answering my question!" they say in exasperation over and over. Two-way conversations are hard for a child who has word retrieval difficulties. Sometimes she knows the answers but can't find the words to express them. This difficulty with word retrieval may be part of a problem with the motor system (which will be discussed shortly) or it may exist on its own.

Another processing problem is visual-spatial difficulty, in which a child has trouble comprehending what she sees. A baby with such a challenge may be able to look at you more easily when you simply smile at her than when you smile and wiggle your hands at her, for example. A toddler may tune out and get distracted when pictures in a book become too intricate. She is better able to focus on simpler pictures. A preschooler might get confused by such games as sorting blocks by shape. A school-age child would probably have difficulty in such subjects as math and geography because they involve picturing objects in space. She will have more trouble solving a maze or finding her way around unfamiliar places, such as a new neighborhood or new school.

Sometimes the child who is relatively weaker in visual-spatial abilities may be stronger in the auditory-verbal processing area. Thus she may be more sensitive to nuance, subtlety, and detail and have a harder time with the big picture - she has more difficulty in understanding how the pieces fit together. For example, she tends to learn math in a rote way - memorizing addition and subtraction rather than picturing the concepts in her mind. She hasn't a feel for quantity. She will, for instance, simply memorize that 8-2=6, rather than visualizing, say, eight apples and then imagining two taken away to leave six.

This child is likely to have difficulty with abstractions that are communicated through what she sees, such as mathematical and scientific concepts. Understanding the concept of velocity or acceleration in physics, for example, involves picturing different types of movement patterns and requires visual imagery rather than just memorization of a formula.

Most children tend to have a mixture of strengths and weaknesses. Children who are weak in visual-spatial skills tend to have strong auditory-verbal skills, for example. So the child who may not be able to find her way around a new neighborhood or school easily, for example, because of weak visual-spatial skills, will probably pay more attention to what people say. Since she is sensitive to subtlety and nuance, she may turn out to have strong writing or critical skills. Conversely, the child who is strong in visual-spatial skills may lean toward science or mathematics or architecture or enjoy working in hands-on situations, in mechanics or with computers.

An interesting point worth remembering is that our schools, in the early years, tend to be biased toward children who are strong auditory-verbal learners. Verbal systems are highly valued as children learn to talk, read, and write. Even if they have trouble picturing math concepts, they can master them in these early years because the simple concepts can easily be memorized. Because the verbal system is so overvalued in those early years, visual-spatial learners, who can understand math concepts but may not be able to memorize multiplication tables and have more difficulty with reading and writing, are thought to be slower in learning. Verbal children are more apt to be labeled "gifted" in those early years. Later, in high school and beyond, when science and math become more challenging and when even subjects like English and history are more analytical than factual and descriptive, visual-spatial learners (who are very analytical) may begin doing better. Some of the gifted auditory-verbal learners who depended too much on their outstanding memories and never grasped the concepts or principles behind what they were learning may begin to struggle.

Instead of assigning equal value to strengths in different areas in the early grades, we tend to try to explain away this bias. The child who struggled in earlier grades but now performs well is called an "overachiever," while the "gifted" student who is now struggling is "lazy" and not trying - an "underachiever." These labels may not fit at all. Nor have the "less smart" kids suddenly become smart while the "smart" kids have suddenly become average. Rather, the criteria for success have changed. Ideally, we should value different types of skills even in the early school years, so that children get a sense of their relative strengths, no matter what they are. The child who can find his way to his grandma's house, even after going there only once, should feel just as smart as the child who can read directions about how to go to grandma's house. Also, if we value different types of abilities in the early school years, we can be more tolerant of children's relative weaknesses. Children who fit a certain mold will not get a false sense of "I'm good at everything," leaving them unnecessarily depressed when they discover in college that certain areas are very hard for them. Instead, they would have had the opportunity to work on their more vulnerable areas as they were growing up.

Related to auditory-verbal reasoning and visual-spatial reasoning are other unique abilities that children possess. The ability to see beauty in nature and re-create it in art certainly is enhanced by strong visual-spatial perception, but it involves much more, such as motor performance. Creative writing ability, as opposed to simple verbal fluency and competence, is certainly related to the auditory-verbal system, but the creative aspect cannot be reduced to one skill. Musical ability does involve aspects of auditory perception, but characterizing it in that way alone would be simplistic. The ability to perceive subtlety and nuance in musical sounds, while more prevalent in people who have sensitive auditory perception, has many other aspects that stand on their own. Children's talents are best described in their own unique terms. While for discussion purposes I have to simplify the world into broad areas, such as auditory-verbal, visual-spatial, motor, and so on, we shouldn't lose sight of the fact that many of our unique human talents involve combinations of these skills and have their own, often indescribable characteristics.

Attention Problems and the Motor System
A child's motor system also influences the way she pays attention. Unlike information processing, which is how the child takes in data, the motor system is the "outflow" system - how the child communicates to the world her feelings, thoughts, and ideas. The motor system contributes to how she organizes her behavior in terms of sequences or patterns of movements, so if it is difficult for the child to organize her body and movement patterns, it will be hard for her to pay attention. The very act of looking or listening involves organized, purposeful movement patterns. If something is hard for us, such as sequencing three or four motor acts together, we tend to get distracted more easily.

A child's difficulties with her motor system tend to fall into certain categories. She may have problems with motor tone, motor planning, or perceptual motor tasks (in such tasks as copying shapes). Motor tone depends on balance between the "flexor" muscles (used to bend knees, bend at the waist, and so on) and the "extensor" muscles (used to help us stand erect). A child with "tight" (or high) motor tone probably has greater extensor tone than flexor tone. She may appear stiff and perhaps awkward. Low motor tone involves greater flexor tendencies. A child with low motor tone will appear loose, even floppy. As a baby, she may have had a hard time holding her head up, for example. As an older child, she may be extremely flexible, but also have to put so much effort into routine activities, like walking and sitting erect, that she tires easily.

Motor planning is the ability to carry out a series of physical activities - such as crawling, sitting, skipping, buttoning, tying shoes, or writing - in short, anything that involves sequencing a series of actions into a pattern. Motor planning also involves behavioral sequences, such as greetings (saying hello and waving your hand), waving good-bye, and other social sequences that we often take for granted. These social behaviors also involve creating a sequence pattern - one behavior after another. A child with motor-planning difficulties, however, may have to think through behaviors that for others are automatic. Figuring out how to start a conversation, or choosing the appropriate distance between yourself and another person to avoid invading the other's space, or knowing where assertiveness ends and aggressiveness begins can also involve motor planning.

Perceptual motor ability has to do with taking in information, comprehending that information, and then translating it into a motor action. For example, when a child has to copy a triangle, she has to absorb the visual image of the triangle, comprehend that image, then carry out a physical task based on that image. A perceptual motor problem refers to a glitch anywhere along that pathway - taking in the image, comprehending the image, and going from comprehending the image to a plan for a motor pattern. Or there may be a problem in actually carrying out the motor pattern (that is, getting the hand to do what you want). "My hands won't do what my eyes see" is how some children have described their difficulty.

Since perceptual motor skills involve motor planning, some professionals lump all of these steps under the category of "motor planning." You need to be aware that these terms are sometimes used differently. But no matter what you call it - a motor-planning problem or a perceptual motor problem - parents will find it helpful to figure out whether their child is having a problem in taking in information, comprehending the information, or planning or implementing her motor response. If the challenge is in implementing, parents will also find it helpful to note whether the problems are more with gross motor skills (running, jumping, climbing, kicking) or fine motor skills (writing and drawing).

At first, it may not be obvious why a child's "outflow" - how she sequences her behavior - contributes to attentional difficulties. But keep in mind that "paying attention," as I have said, is not a passive process. It is an active, dynamic process, usually involving some kind of interaction with a person or object. Consider a child who wants to take a toy car and move it from her house to your house as part of pretend play. She then plans to pick up "passengers" at your house and take them to the doctor, where she will be the nurse and the doctor and give them all kinds of interesting injections. But because of motor-planning problems, her hands aren't easily able to implement this well-constructed drama. As she is trying to get the car out of the garage, the simple motor act of putting up the door on the toy garage and slipping the car out before the door comes down is too great a challenge for her limited sequencing abilities. How can she go on a trip if she can't get the car out of the garage?

There are two consequences here. The first is that the motor pattern, which has many elements to it, gets cut short. The attention associated with this potential pattern also gets cut short. What started out as nice make-believe now looks like a very fragmented sequence as the little girl simply bangs the garage door. When a child can't easily carry out what her mind wants her hands to do, frustration is likely to set in, and that often breeds chaotic, seemingly aimless behavior. Some children with this motor-planning problem may gradually give up their active, organized imagination. It's a bit like a writer who has no access to pencil, typewriter, computer, or paper and no one even to talk to about her great plot ideas. Through simple disuse and lack of feedback, she may stop conjuring up stories. The old saying about adults' mental skills - "Use it or lose it" - is often true for people at all stages of the life cycle. Some children are fortunate in that their parents or teachers provide an excited audience for their ideas and plot lines. Even though they can't perform the drama, they can describe what they want to do and receive appropriate feedback. But before learning to talk fluently, or if she is in a family or educational system where paying attention to a child's creative thoughts or play is not a priority, the child may give up her ability, especially when she can't perform the motor acts that bring to her creative planning a sense of mastery.

In a number of instances, I have seen a child with motor-planning trouble, whose teachers and parents believed that she had a paucity of ideas, blossom into a rich, creative thinker overnight when she is given a tape recorder. Her "outflow" track has been made easier. That is, rather than having to craft each letter painfully and arduously, the child now simply speaks into a machine. The child who also has word retrieval problems can be assisted by a parent or teacher who helps her find a word to express herself when she hits a stumbling block.

Motor planning, as you can see, is a key component of attention. It can even affect one's thinking ability. The longer and more complicated the motor pattern the child can navigate, the more attentive she appears. The shorter the child's sequence of expressive behavior, independent of the creativity of the thoughts underneath stirring her desire to act, the shorter the attention span. There are many children who, as our earlier example suggested, literally can't get the "horse out of the barn."

Let's illustrate that once again with shooting a basketball. An experienced basketball player with good motor sequencing skills will dribble the ball up to the net, and then shoot the ball into the hoop. The different steps involved in dribbling the ball, planting the heels and pulling up, rising in the air, bringing the ball up, rolling it onto the fingertips of one hand, sliding the other hand down to the side of the ball, and then shooting it toward the basket are all part of a smooth pattern. Each element of the sequence is no longer separate but a step in one apparently seamless movement. Once the player starts this movement pattern, it's easy for her to continue in an organized, focused, and attentive way, because the elements are part of a larger pattern. She doesn't separate out the components in her mind. But when this player was just starting to learn to play, her coach probably broke the sequence into separate parts - dribbling the ball, picking it up with one hand, raising her arms, balancing it on her fingertips, and pushing it up and toward the basket. As a beginner, she needed quite a bit of concentration to sustain that five or ten seconds of attention to produce one smooth movement. If each separate element, which took only a split second, was hard to master, the basketball player could easily lose her concentration. The more conscious effort it takes to sustain the sequence of motor movements, the more opportunity there is to lose one's attention between two movements.

The same is true with a child with a motor-planning difficulty who is writing the word "store." Her motor system can't organize itself in terms of a long pattern. So each component - putting the pencil down to the paper, making the curved line for the letter s, lifting the pencil back up, putting it back down to make the vertical line for the t, and so on - involves separate motor acts by the child, each one providing an opportunity for a loss of attention. On the other hand, a child who can effortlessly put together the whole pattern can start the word without even thinking about finishing it. The whole word flows as one - it is taken for granted. She doesn't have to stop and think, "Now I am making the ss and now I am making the t," unless she is just beginning to learn to write the word. If this motor action flows effortlessly, one's attention is sustained easily and effortlessly. But if one sees a series of separate motor acts, like the novice basketball player or the struggling young writer, these separate components remain isolated - each one with its own task of attention. And it's easy to see how stringing together ten separate units of attention is a lot harder than having one ten-second pattern of attention.

Children who have difficulties with perceptual motor skills - perceiving and then translating what they perceive into activity, such as copying a teacher's sentence off the blackboard - have the same troubles. A child with good perceptual motor skills will effortlessly copy the sentence on the blackboard onto the paper at her desk. Those letters and words are part of one large perceptual motor pattern; the child does it almost without thinking. But a child with poor perceptual motor skills has to separate out each step in her mind. The child pictures the word "cat," trying to hold in mind the word and print letters that look like the word "cat." But it's no longer a smooth, automatic motor pattern. As she writes, the c starts to look like a d, the a looks like a v, and the t looks like an l. The child looks at her work. It doesn't look like the word the teacher wrote on the blackboard. Her work was a series of separate efforts - picturing each letter, trying to copy them, getting dissatisfied. At each juncture, there is a breakdown in attention because the work requires sustained conscious effort.

When you have smooth, automatic patterns of motor planning or perceptual motor behavior, you have a large "unit" of attention. It's easy, then, to string these large units of attention together into minutes and hours. On the other hand, when you must undertake a separate, planned, conscious action every few seconds, there is room for lots of interruptions in the breaks between each action.

With a series of smaller attention units, there is also more room for frustration and avoidance. This, of course, compounds the opportunity for inattention because anytime a child (or adult) feels uneasy or unsure of herself, she is going to be more easily distracted and more willing to "escape" (either physically or through such tactics as daydreaming).

The challenge is a little different for a child with low or high motor tone. But the result is the same: a child who has trouble performing certain tasks will find more opportunities for interruption and more chances to become frustrated and inattentive. A child with low muscle tone may have trouble holding her head up to watch the teacher move back and forth in front of the blackboard. A child with high muscle tone may have difficulty controlling her pencil enough to make the subtle movements that are necessary to copy a letter. Normally, the balance between extensor and flexor muscles carries one along, whether the activity is walking, writing, or riding a bicycle. One's muscles work automatically. But when the extensor and flexor muscles aren't working together easily, a child has to put more of a conscious effort into activities that, for the rest of us, are easy and effortless. Imagine, for example, taking a stroll through a garden with a friend. You walk along, lost in conversation. It's effortless and relaxing. But picture yourself on ice skates for the first time. You have to think about every little muscle movement. You are exhausted after ten minutes because you are thinking so hard and because you are training your muscles to do something new. A child with low motor tone has much the same challenges as you would as you struggle on ice skates. For her, every new skill - whether it is writing a word or holding her head up - is like learning to ice-skate. Each of these motor acts must be conscious rather than automatic. And each time the child has to make a new conscious effort like that, there is an opportunity to lose concentration.

Reactivity Problems
Attention also lags because of the way the child reacts to sensations. Children who underreact or overreact to sensations may find it difficult to tune in and concentrate.

A child who underreacts needs a lot of input. If she underreacts to sound, it means that it takes a lot of noise before she responds. You need to speak to her in a persistent and energetic way and with a compelling voice tone. If she doesn't get that energetic input, her attention will wander. When she was a baby or a toddler, her parents may have needed to speak loudly and persistently in order to get her attention. If their voices became too soothing or quiet, she lost interest and looked away. As a preschooler, she probably preferred tuning into her own world in pretend play - not because she wasn't interested in the words of her parents, but because she couldn't pay attention to them unless their voices were clear and insistent. As a school-age child, she seems to be preoccupied with her own daydreams and inner thoughts, staring out the window during class. But if the teacher comes over to her and says in a commanding voice, "Jennifer, did you hear me? I said, 'Please turn to page 53 in your history book,' " she will turn, surprised, as if she hadn't realized until then that she was being spoken to.

In fact, it's easy to assume that such a child, with her dreaminess and inattentiveness, is deliberately not paying attention, that she doesn't want to listen. Others may find themselves repeatedly saying "Please listen to me" or "You're not listening to me!" What they often don't realize is that this child simply requires a more commanding, persistent sound before she can pay attention, and that it takes her a little while to turn from her own inner thoughts to tuning in to those who are talking to her.

Children who underreact visually need vivid, compelling imagery to command their attention, or else they also will stay tuned into their own thoughts. As babies, they don't necessarily respond quickly to a mother's smiling face or a father's big grin. They need parents to be persistent, with animated faces and big smiles, before they can really tune in. As preschoolers and school-age children, they need brighter colors, more vivid designs to help them pay attention to what is before them. Otherwise, their attention wanders. Teachers sometimes wonder why these children are riveted to Nintendo games or action movies, but unable to concentrate while writing on the classroom blackboard. That is because the fast-moving images and the bright colors of the games or movies hold their attention, while the static, black-and-white images of the blackboard do not.

On the opposite side of the scale are children who have difficulty paying attention because they are too sensitive to such sensations as touch, sound, movements, sights. We used to think that everyone's senses operated similarly - that we were all tuned to the same frequency. But we now understand that everyone has a unique level of response to sights, sounds, smells, touch. Many highly sensitive children are too "tuned in." Their senses lack an adequate filter: sights, noises, odors, and touch that bring other people pleasure can be overwhelming, irritating, and sometimes downright painful to them.

Such oversensitive children may have attention problems. A baby may have trouble focusing on her parent's faces because she is so distracted by other sights, sounds, and smells surrounding her. A toddler distracted by every new sight and sound darts around to look at this or that rather than focusing on one person or one toy for a time. A preschooler involved in pretend play with her dolls and toys turns from one toy to another because each one grabs her attention, and she can't decide which one to play with. A school-age child has trouble concentrating in the classroom because she is overwhelmed by the hustle and bustle. She may sit at her desk and hear not only her teacher's voice, but also the giggling and whispering of the children two rows back, a horn honking in the school parking lot, footsteps in the hall, and the paper being crumpled by the child seated next to her. Even her own thoughts are hard to ignore. No wonder it is hard to concentrate! If she is sensitive to touch, she may not be able to sit and listen to the gym teacher's instructions in gym class, or focus on the principal's words during assembly, because of the children pressed up against her on the gymnasium floor.

It's not that the sensitive child is stubbornly refusing to stick to one thing. Her sensitivity to every type of sensation in the world around her pulls her in many directions at once.

Not all overly sensitive children have attentional problems. This would depend on just how sensitive the child is and how her nervous system compensates for her sensitivity. As we will see, the type of parenting she receives can make a difference. If teachers and parents can help her focus (in spite of being pulled in every direction), she will have less difficulty.

Emotions and Attention
As we discuss the different ways in which children process information and react to sensations, we also need to be aware of the way emotion, or "affect" (a technical term to describe specific types of emotions), influences attention. We tend to think of a highly emotional child as being inattentive, driven by her emotional needs of the moment. But consider for a moment how all of us decide what to pay attention to and how vigilantly to attend to something. Some desire - that is, emotion - of the moment actually directs our attention. We are interested in a picture, we find that car exciting, we enjoy certain music. We are enthralled by a story, fascinated by a TV show, or bored to tears by a dull teacher. However, if we desperately want to get an A, we virtually will ourselves to pay attention. In all of these circumstances, including situations in which we force ourselves to pay attention, there is a desire or some feeling guiding the attention. In fact, we can think of attention in part as the persistence of a state of focused motivation or desire or emotion.

When there is persistence of an emotional interest, be it focused on a toy, a computer game, or a math problem, there is persistence of attention. Therefore, emotion, which can interfere with attention when it is extreme, is nevertheless the cornerstone of attention. This fact has a number of immediate implications. For example, when helping children achieve longer and longer states of attention, we have frequently found the most success by discovering areas of very high motivation (states of mind charged with feeling) in the child and working with these to expand attention. One child who flitted around the room, spending only a couple of seconds with each toy, decided he wanted to climb out the window. Here was a chance, I thought, to sustain his attention through his emotional interest. His parents got in front of the ground-floor window and, with my encouragement, started talking to him about what would be great about climbing outside and what he would do there and why climbing over the windowsill was more exciting than going through the door. To be sure, the child whined and pushed at his dad, but it was the only time during the session that he talked directly to his father. He stayed focused for a full seven minutes. This child, who had been diagnosed as having a severe attentional problem, was previously thought to be incapable of spending more than a few seconds on anything, let alone seven minutes involved not only in focused attention but also in a logical, purposeful interaction.

Sometimes what appears to be distractibility is actually the child's passionate, often stubborn, interest in something else. I remember one mother who was trying to engage her five-year-old child in a back-and-forth sing-along game. The child seemingly kept getting distracted by a little blue toy car he was fingering. "See?" said his mother to me. "I can't keep him on anything. He is so distractible." I wondered out loud if in this particular instance his stubborn refusal to engage in the sing-along game wasn't part of his keen interest in that blue car. We tried an experiment. His mother joined him in playing with the blue car and made the car begin to speed away from the boy, who diligently chased and caught it. After recapturing the car for a moment and quickly hiding it in her pocketbook, the mother had the car sing clues to its whereabouts to the boy. With a big smile, the eager boy found the car and then wanted to hide it for his mother. A focused game around the car evolved and went on for at least five minutes before we stopped it. In this instance, the child's lack of attention on one thing was actually his greater emotional interest and attention to something else. His emotional interest was guiding his attention. For this reason, as I suggested earlier, we could define attention in part as the persistence of an emotional interest. This does not mean that some individuals do not find it easy to pay attention even when they lack motivation or emotional interest - a type of dutiful attending. It does mean, however, that emotions are a very important component of attention. Looking at the persistence of emotional interest may open up new understanding of how we pay attention.

Attention and Learning Difficulties
While some children are very attentive despite having a learning difficulty in a particular area, such as reading or math, most children with learning difficulties tend to get easily distracted, especially in the areas where they are having difficulties. Traditionally, we have thought about learning difficulties (or learning challenges, as I like to call them) in terms of particular subjects: Jennifer is having trouble with penmanship, Matthew is struggling with reading, while Rena wrestles with math. It seems useful to relate these learning challenges in certain subjects to difficulties in the three areas we discussed earlier (as many educators are doing): processing information, motor problems, and under- or overreactivity to the world. Many "learning disabilities" can in part be related to these challenges. For example, difficulties with certain kinds of math problems are often related to visual-spatial processing. Difficulty with writing and penmanship is often a result of motor-planning trouble or perceptual motor challenges. Difficulties with following spoken directions or remembering a story are often related to auditory processing. Each type of difficulty can be broken down into more details or parts, and we are constantly learning new ways to conceptualize and remediate the processes associated with such basics as math, reading, spelling, and writing.

What are sometimes referred to as organizational learning problems (including remembering to get homework assignments, bring home the right books, hand in completed assignments, and many other details that are associated with being "responsible") are often related to motor-planning or sequencing problems and, not infrequently, to auditory or visual-spatial challenges, as well. There is difficulty either in carrying out a sequence of behaviors, such as writing down assignments or selecting the books (motor planning), or remembering the assignments (auditory processing).