Article: Hong Kong Speech and Swallowing Therapy Center
Speech Therapist: Lee Man Kit

Children who are studying at home may find it extremely difficult to sit still and have low attention span. They are easily distracted and often forgetful. Naturally, parents may feel frustrated, but they should pay attention to whether their child exhibits other symptoms, such as avoiding tasks, excessive talking, or difficulty following rules. It could be a case of Attention-Deficit Hyperactivity Disorder (ADHD).

Let’s start with a simple psychological test. If you were given the chance to choose one superpower to give to your child, which one would you choose from the following ten options: superpower of mind reading, superpower of exceptional memory, superpower of keen observation, superpower of social skills, superpower of creativity, superpower of language abilities, superpower of analytical thinking, superpower of athletic abilities, and superpower of focus. Take no more than twenty seconds to think about it before continuing to read the following text.

Among these numerous superpowers, it’s not easy for parents to make a choice! Regardless of the superpower you choose for your child, it shows that you want your child to excel. When you read the above text in the last minute, your attention was already at work. You had to concentrate on reading the text displayed on the computer or phone screen and ignore other irrelevant information, such as things you saw beyond the screen or noises around you. If you demonstrated a high level of focus and observation, you may have even noticed that the author mistakenly wrote “起強” instead of “超強” for the seventh superpower, and there were only 9 superpowers mentioned instead of 10.

Attention is a critical cognitive ability that is essential for learning. Attention refers to the ability to maintain concentration on a specific important task while ignoring irrelevant distractions. Attention is not a special skill, but it is indispensable. This is especially true for young children who are in the learning stage. Learning new things involves multiple cognitive steps: the brain needs to absorb various information, analyze it, and then store the processed data in long-term memory. Attention is a prerequisite for these cognitive activities. If attention is lacking, learning anything will be difficult and may lead to frustration.

Attention-Deficit Hyperactivity Disorder (ADHD)

Many parents may have the following questions: “What qualifies as attention deficit? Does attention deficit equate to having ADHD?” According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), ADHD has two main symptoms: inattention and hyperactivity/impulsivity. These two symptoms can occur together or separately.

Most individuals with ADHD are diagnosed during elementary school because their symptoms become more noticeable during this period. Some cases of ADHD with significant symptoms can be diagnosed between the ages of 4 and 6. If parents suspect that their child has ADHD, they should seek professional help.

For children, if they exhibit six or more of the following symptoms persistently for six months or more, on two or more occasions, and if these symptoms significantly impair their daily functioning, it may indicate inattention:

1. Often fails to give close attention to details or makes careless mistakes in schoolwork or other activities
2. Often has difficulty sustaining attention in tasks or play activities
3. Often does not seem to listen when spoken to directly
4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace
5. Often has difficulty organizing tasks and activities
6. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
7. Often loses things necessary for tasks or activities
8. Often easily distracted by extraneous stimuli
9. Often forgetful in daily activities

Additionally, if they exhibit six or more of the following symptoms persistently for six months or more, on two or more occasions, and if these symptoms significantly impair their daily functioning, it may indicate hyperactivity/impulsivity:

1. Often fidgets with or taps hands or feet or squirms in seat
2. Often leaves seat in situations when remaining seated is expected
3. Often runs about or climbs in situations where it is inappropriate
4. Often unable to play or engage in leisure activities quietly
5. Often “on the go” or often acts as if “driven by a motor”
6. Often talks excessively
7. Often blurts out answers before questions have been completed
8. Often has difficulty awaiting turn
9. Often interrupts or intrudes on others

Strengthening Concentration through Language Activities

Language skills are closely related to concentration, so children with poor concentration may also experience language difficulties. Even if a child does not have obvious attention deficits, improving concentration can still be beneficial for their language and other learning activities.

There are many simple and fun activities that can effectively enhance a child’s concentration. For example, in a spot-the-difference game, children are required to find the differences between two similar pictures. This game requires children to focus their attention, constantly scanning back and forth between the two pictures, carefully analyzing the differences, and ignoring the similarities as well as visual or auditory distractions outside the pictures. Moreover, the difficulty of the game can be adjusted based on the child’s abilities. Similarly, puzzle games serve a similar purpose. In puzzle games, children also need to concentrate and use visual observation and analysis to put the puzzle pieces together, while ignoring visual or auditory distractions outside the puzzle. Engaging in games that require concentration in a moderate and step-by-step manner can train a child’s concentration.

By incorporating elements of language expression into concentration games, parents can not only improve their child’s concentration but also enhance their language skills. For example, in the spot-the-difference game mentioned above, parents can encourage children to describe the differences between the two pictures using different sentence structures while playing, such as saying, “The apple in the left picture is red, and the apple in the right picture is green.” If the child’s answer is too simple, parents can use sentence restructuring to help the child learn appropriate sentence patterns.

Similarly, by adding elements of language comprehension into concentration games, parents can simultaneously train their child’s concentration and language comprehension skills. For example, parents can start by drawing five stars and five circles on a piece of paper and then give instructions like, “Add a smiley face to all the stars!” or “Add eyes to all the circles!” In these games, children need to concentrate and use auditory skills to absorb and understand the instructions given, and then concentrate visually to identify the correct shapes and add the appropriate patterns, while ignoring visual distractions other than the target shapes or auditory distractions other than the instructions.

Seeking Professional Help

If parents suspect that their child has attention-deficit hyperactivity disorder (ADHD), it is advisable to seek professional assessment from a pediatrician, child psychiatrist, clinical psychologist, or educational psychologist. If a child shows significant learning difficulties, the doctor or psychologist may also refer the case to an occupational therapist or speech therapist for further assessment and treatment.