Attention-deficit/hyperactivity disorder and sequential organization difficulties

This chapter deals with two separate areas of learning: attention and sequential organization. Difficulties in either area can occur in isolation or in combination with other forms of specific learning difficulty. The ability to ignore distractions and to focus on one activity at a time is a skill that children usually develop gradually as they grow. It is quite normal for toddlers and pre-school-aged children to be easily distractible, but the ability to channel attention selectively usually increases progressively once children start school. Some children experience significant difficulties in learning to attend. As a result, they are easily distractible and do not persist for long with tasks. If this is a significant problem, it is referred to by the umbrella term ‘attention-deficit/hyperactivity disorder’ (ADHD). This means attention-deficit with or without hyperactivity. Such children may be overactive and impulsive, although this is not always the case. It is this overactivity that has given rise to the term hyperactivity (‘hyper’ is Greek for ‘over’). All children with attention-deficit/hyperactivity disorder experience difficulty with concentration. There are two forms of the condition: one where overactivity and impulsivity are present and the other where these coexisting problems are absent. The two forms of attention-deficit/hyperactivity disorder may be clarified by describing two children, each with one of the forms of the disorder. George is his mother’s third child. She describes him as completely different from the other two. As a baby he slept very little and cried constantly. As a toddler he was always on the go, ‘as if driven by a motor’. Now, aged nine years, his teacher describes him as ‘disorganized, disruptive, and fidgety’. His mother reports that he hardly ever sits still at home. He will not sit through a favourite TV programme or a meal. He is still so disorganized that if she did not help him to dress in the morning, he would not be in time for school. He is also very impulsive. He does not seem to think before he acts. He takes terrible risks and often says the first thing that comes in to his head.