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ADHD Signs and Symptoms: Attention Difficulties

Margaret V. Austin, Ph.D., edited by C. E. Zupanick, Psy.D.

boy with ballThe "attention deficit" component of ADHD (attention-deficit- hyperactive disorder) refers to inattention. The second primary symptom, hyperactivity, is not always present. Without hyperactivity, the diagnosis is called ADD, or ADHD, predominantly inattentive presentation. Thus, some people have 'only' the inattention difficulties described below. Others have both inattention and hyperactive aspects of the disorder.

This lack of attention, or inability to sustain focus on a task, means people are easily distracted. People with ADHD often have trouble organizing their thoughts and prioritizing activities into a logical sequence. As a result, they can appear scattered in their approach to many tasks. We are all bombarded with many things that can capture our attention. Imagine what it would be like if all these things seemed of equal importance. What if a butterfly flying by your kitchen window, a television show in the next room, and a fire on the stove in front of you, all seemed equally interesting and important? While most of us would naturally, without effort, pay quick and exclusive attention to the fire, people with ADHD cannot easily do this.

A similar, but seemingly opposite, difficulty may be evident. Instead of inattention, some people with ADHD "hyperfocus." This means when a topic or activity is very interesting, they become so focused that they lose sight of everything else. This ability to hyperfocus on interesting tasks makes the identification of attention problems more difficult. This is because the person can focus, at least for some (interesting) tasks. However, problems with focus become apparent when the tasks are less interesting.

You may wonder why hyperfocus is a problem. Well, most people are highly interested in only a few topics. As such, most of the tasks and activities in any given day are not particularly interesting. This leaves the person with hyperfocus bored and under-stimulated. They struggle to remain focused during the mundane tasks that are necessary to complete a project or assignment. Instead, they become restless, looking for something more interesting to do. Although this may be true for all of us at times, people with ADHD experience this difficulty frequently. This becomes problematic because sustained attention is necessary to bring projects to completion; a key element of success.

Inattention is often associated with poor school and work performance. This is because it is hard to perform well, or to acquire knowledge, when someone is unable to sustain concentration long enough to complete the performance, or learning task. Because of this difficulty, projects that require a lot of mental effort, or require sustained concentration, may be avoided. Completing homework is quite difficult for inattentive children. This often leads to frustration for both students and their caregivers. A lack of organizational skills, coupled with an impaired ability to develop these skills, can create further challenges for individuals with inattentive ADHD.

Symptoms of Inattention during infancy can include:

  • Difficult to soothe;
  • Less babbling speech the first year;
  • Poor suckling or crying during feeding;
  • Infrequent smiles; and,
  • May not enjoy soft touch.

Symptoms of Inattention during the preschool years can include:

  • Strong will;
  • Unresponsive to discipline;
  • Language difficulties;
  • Difficulties with structured play; and,
  • Toilet training problems.

Symptoms of Inattention during the elementary school years can include:

  • Failing to pay close attention to details;
  • Making frequent and careless mistakes during schoolwork or other activities;
  • Trouble keeping attention focused during play or tasks;
  • Appearing not to listen when being spoken to;
  • Failing to follow instructions;
  • Difficulty completing tasks;
  • Avoiding tasks that require a high amount of mental effort and organization, such as school projects;
  • Frequently losing items needed to complete activities, such as school supplies;
  • Excessive distractibility;
  • Forgetfulness;
  • Procrastination, inability to begin an activity; and,
  • Associated problems such as low self-esteem, depression, or anxiety.

Symptoms of Inattention during adolescence can include:

  • Frequently shifting from one incomplete task to another;
  • Difficulty organizing activities;
  • Serious academic inconsistencies;
  • Ongoing underachievement;
  • Difficulties with routine household chores (cleaning, paying bills, etc.);
  • May appear lazy or disinterested; and,
  • More pronounced mood or behavior problems.