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Inattentive ADD: Working with
the Wandering Mind Although the
specific nature of inattentiveness may still be debated by clinical specialists,
the most recent edition of the Diagnostic and Statistical Manual of Mental
Disorders (DSM-IV) recognizes the condition as a distinct subtype of Attention
Deficit Hyperactivity Disorder (ADHD). The criteria for this predominantly
inattentive variation mirrors many of the same problem areas associated with
the hyperactive subtype, including difficulties with tracking details,
sustaining attention, and organizing tasks. However, inattentiveness is most
often defined in terms of how it differs from hyperactivity. Usually,
inattentive students do not fidget, talk excessively, or have problems staying
seated. Unlike hyperactives, they are overwhelmed rather than energized by
stimulating situations, and they don’t have problems finishing tasks so much
as getting started on them. They don’t react impulsively; in fact, they may
not appear to react at all. As disorders come and go, inattentiveness definitely
qualifies as understated. The condition’s low profile is reflected by the lack of information available on the topic; research and professional publications devoted specifically to inattention are scarce in comparison to the volumes of material generated on hyperactivity. Moreover, while hyperactive children are often identified through behavioral evaluations in their early school years, inattentive individuals may not be diagnosed as having learning problems until late in life, if they are identified at all. Clearly, the dramatic and observable behaviors of hyperactives receive more attention from ADHD experts and from society as a whole, but it would be a mistake to categorize inattentiveness as a mild form of ADHD. While inattentive behaviors may not be colorful or spectacular, the consequences of these behaviors can be equally tragic. Inattentive
Tendencies In order for
educators, counselors, and parents to assist inattentive students with
successful management strategies, they must reach an understanding of the
condition, but reaching this understanding is a challenge in itself. In terms of
emotional issues, inattentive people tend to channel their feelings inwardly
rather than express themselves openly; when faced with a crisis, they typically detach
from the situation instead of taking action. Often characterized as passive daydreamers,
their general unresponsiveness constitutes a barrier between themselves and
others. Penetrating this barrier, even in face-to-face conversations, is an
endeavor that frequently ends up as an exercise in frustration. Another
inattentive tendency could be summarized by the adage, appearances are
deceiving. Inattentive students often seem to be paying attention as they
sit quietly, and, indeed, they may stare directly at the instructor for an
entire class period. Yet, during this time, their thoughts have drifted from the
real world around them. In such instances, their bodies remain stationary
while their minds wander aimlessly through a universe of ideas and images;
frequently, their academic performance reflects this lack of connection with
classroom activities. Personal Issues The personal lives
of inattentives also tend to be less than satisfactory. They often have
difficulties acquiring the basic communication skills necessary for
socialization with peers and for negotiation with authority figures. Their
inability to maintain concentration makes them poor listeners, and their lack of
assertiveness makes it easy for them to be overlooked and to be lost in
the crowd. Family dynamics can
be equally troublesome, particularly if parents become trapped in a cycle of
protecting an inattentive child from the consequences of his/her inactions.
What may have begun as well-meaning attempts to help a child through a series of
crisis situations soon falls into a pattern in which the inattentive individual
automatically expects rescue, a condition which experts call learned
helplessness. While parents focus on helping the child survive the immediate
crisis, they hold to the hope that next time will be different. In the
long run, their attempts to help actually reinforce the behaviors that triggered
the crisis in the first place. Denied the opportunity to take charge of the
problem and work toward a solution, the inattentive child does not develop the
skills or the confidence needed to face the next emergency.
Management
Strategies Managing the
complexities of inattentiveness requires multiple strategies to address the
multiple facets of the condition; however, the success of all remediation
strategies rests upon improving the person’s general ability to focus and
sustain attention. For many inattentives, achieving sustained attention may
involve therapeutic medications as well as specific practice with concentration
exercises. In most cases, medication can facilitate the acquisition of skills,
but research and clinical experience have demonstrated medication alone will not
cure the skill deficiencies which have plagued the inattentive individual
throughout her or his lifetime. Remediation
programs for inattentive clients at Brainworks
typically include attention span training in fundamental areas such as listening
skills and reading comprehension. On more advanced levels, clients may practice
maintaining concentration for taking lecture notes as well as sustaining
attention during lengthy test-taking sessions. As training sessions begin,
clients work with high interest materials for only a few minutes at a
time, but as their ability to concentrate improves, they move to less
interesting materials and gradually extend the length of time they maintain
their focus. Also, attention span training involves strengthening the
individual’s ability to screen environmental distractions; at the
start, students practice maintaining attention in isolated study rooms, but as
training proceeds, they work on maintaining their concentration in open areas
with higher degrees of visual and auditory distractions present. Lines of
Communication Listening skills
are given special emphasis in the lesson plans of many clients because the
ability to capture auditory information has a direct impact on school
achievement. However, listening exerts an even more pervasive influence as an
element in the communication process. Although listening appears to be a passive
activity, effective listening requires the active engagement of both the brain
and the ears. If the person on the receiving end of a spoken message does not
capture the incoming information accurately, that person’s response to the
information will also be inaccurate. At this point in the conversation,
communication stalls from lack of feedback, or (worse) it degenerates into
confusion or conflict because the listener’s feedback was inappropriate. In
conjunction with improving listening skills, clients address the skills on the
other side of the communication coin by working on personal expression.
People who are able to express themselves clearly will usually find success at
getting their needs met; they will also feel more confident in their
relationships and will experience less frustration. As our inattentive clients
work on improving their expressive skills, they begin by exploring the emotional
responses words can prompt and by learning how to rephrase statements to achieve
the desired response from listeners. Inattentive clients at Brainworks
also devote time to increasing their awareness of other areas of communication,
such as body language, facial expressions, eye contact, and tone of voice.
Eventually, all the tools of communication are tested in face-to-face
conversations on a wide range of topics. Independent
Problem-Solving After an
inattentive individual is able to maintain an attention span and communicate
successfully, he or she is ready to put these skills into action in
problem-solving applications. In these advanced activities, clients review the
principles of basic logic and critical thinking, including the errors in logical
thinking which can hinder a person’s ability to perceive a problem accurately.
In addition, they learn structured strategies for analyzing problem situations,
developing multiple options for solutions, and evaluating which options would
produce the most positive outcomes. Clients also review how to monitor their
solutions for effectiveness and how to adjust their solution strategies when
necessary. As clients are
introduced to the skills, they practice applying them to sample problem
situations, which reflect typical real life problems. Because these
problem scenarios are about fictional third-party characters, the exercises are
less personally threatening and thus more approachable. However, as the
inattentive client begins to grasp the principles and processes for dealing with
these fictional problems, the lesson plans gradually shift to addressing the
actual problem situations faced by that individual. Eventually, the client
assumes a take-charge role in terms of negotiations and crisis
resolution; the formerly dependent helpless inattentive becomes an
independent problem-solver. Lost and Found The most insidious
quality of inattentiveness is its quiet invisibility. While it has the power to
erode the lives of those who exist in the world of the wandering mind, it does
so without fanfare or fireworks. Inattentives can easily become lost in the
shuffle of society and may never experience the power of self-direction and
personal accomplishments. However, with the proper management strategies, these
same individuals can find themselves by finding success in school, at the
work place, and in relationships. For the complete article, become a member and receive our newsletter.
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