We have been getting a lot of requests on how to address students with attention issues, such as how a classroom professional can eliminate other options or differentially determine what truly is a pure attentional issue versus a symptom of something deeper.

For those students who appear to shift attention every few minutes or few seconds, yet are able to keep academically, may have an isolated problem with attention, a product of executive function. One way to determine this is to complete the Executive Functioning Survey that Dr. Richard Guare has offered in his book, “Smart, But Scattered.” However many of the students we are discussing are those who have a sudden, out of nowhere meltdown, or those who previously have not shown any deficiencies in generalized attention to tasks being given until one specific period of time. The meltdowns come fast, usually without warning and upon initial look, unprovoked.

 When these happen, the professionals are left with this sense of urgency: WHY IS THIS HAPPENING?  WHAT IS WRONG WITH THIS STUDENT? HOW DO I FIX THIS? As much as there is a wealth of information and assessments, there are several essential questions which can effectively initiate the investigation:

1.  Review Medical/Educational History: 

Does the student have a history of medical conditions that may have affected behavior?

Has the student taken or omitted prescription medication/s?

Has the student complained of being anxious or emotionally unstable?

Has the student complained of headaches or wears glasses?

Does the student have an IEP or updated psycho-education evaluation?

2.  Assess current behavior and/or basic needs: 

     Did the student get enough sleep? Hydration?

What are the most recent grades of the student? Is there a pattern of incline or decline?

3. Assess basic executive functioning skills: 

    Has the student ever had difficulty following directions when given plain verbal instructions without demonstration?

Does the student require both verbal and demonstrated instructions when asked to complete school      tasks?

Does the student perseverate or obsess consistently with certain task steps or instructions?

Does the student omit consistently certain task steps or instructions?

4. Determine the student’s need for routine: 

Did the home/ en route to school  routine change?

Did the school routine change at any point of the day?

Was instruction different than any other day?

5.  Isolate the antecedent:

What was the situation at school prior to the outburst?

What was the situation at home prior to the student coming to school that day?

Was seating arrangement a factor in the student’s meltdown?

These are the first questions that need to be asked so that a clear profile or snapshot of the student can be established and next steps determined.  Isolating the area in which the student is struggling will allow for an effective intervention strategy to be created and implemented. If the child’s outburst stems from weak executive function skills determined by areas 3 & 4, then isolate the antecedent and complete the executive function survey.  However, if other factors are the cause than they need to be addressed outside of school or in conjunction with the school. The antecedent needs to be identified and an intervention plan created so the deficits or concerns can be addressed.