Attention and concentration help us to select and focus on what is important and maintain our attention over time. After an acquired brain injury, attention and concentration may be disrupted, leading to a variety of problems.

What is attention?

Attention is the process of concentrating on one thing. We use our attention and concentration skills every day, often without really noticing them. Sometimes we need to pay attention to two or more important things at the one time, and may need to switch back and forth between activities quickly (e.g. copying work from the board at the same time as listening to the teacher explain the information).

Examples of difficulties with attention and concentration

• Unable to focus in a busy environment.
• Being easily distracted, for example by other children, nearby activities or objects.
• Inability to sit still, being restless and fidgety.
• Difficulty following instructions.
• Talking in class, interrupting others and changing the subject.
• Becoming easily overwhelmed by large amounts of information or stimulation.
• Difficulty choosing important or needed information from a large amount of information, or from a cluttered full page.
• Difficulties coping with competing demands or multiple activities.
• Difficulties adapting to change and moving between different tasks.
• Poor persistence in activities and problems staying on task independently.

What strategies might help?

• Schedule important and demanding activities early in the day or after a longer break.
• Keep activities brief, or structure them into short blocks providing a clear beginning and end.
• Allow time for regular breaks, and give the child another activity to do that allows them move around.
• Alternate activities between mentally demanding and less challenging or physical ones.
• Limit the amount of information given to a child, and present one activity or idea at a time.
• Keep instructions brief, break them down or provide a written copy.
• When giving instructions, get the child's attention by calling their name and making eye contact before you tell them something.
• Reinforce instructions with written cues or instructions on the black/whiteboard.
• Minimise potential distractions. Sit the child at the front of the class and keep their desk free of unnecessary material.
• Seat the child near the teacher or with children who will be good role models.
• Provide direct prompts to return to task and positively reinforce on-task behaviour.
• Simplify and reduce material on worksheets and on the black/whiteboard.
• Develop and stick to a daily classroom routine.

When to see a doctor?

Attention and concentration difficulties can be formally identified by having a neuropsychological assessment. A neuropsychologist can develop ways to manage and help a child with attention and concentration difficulties that are tailor made to their particular cognitive strengths and weaknesses.

Key points to remember

• Attention allows us to select and focus on what is important. Concentration allows us to maintain our attention over time.
• After an acquired brain injury, a child or young person may have difficulty with attention and concentration.
• Attention and concentration difficulties can be formally identified by a neuropsychologist who can help develop ways to help each individual child.

For more information

• The Royal Children's Hospital
  Paediatric Rehabilitation Service
  T: (03) 9345 9300
  E: rehab.service@rch.org.au
• The Children's Hospital at Westmead Brain injury Service
• Kids Health Info series of factsheets listed under 'Brain injury'
• Kids Health Info ADHD - ways to help children with ADHD may also be helpful

Developed by The Royal Children's Hospital Paediatric Rehabilitation Service based on information from the Brain Injury Service at Westmead Children’s Hospital. We acknowledge the input of RCH consumers and carers.

Reviewed September 2020.

Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.