Attention Disorders

Attention disorders are very common, affecting 5-9% of children and 4-5% of adults worldwide. They are caused by genetics or neurological development, not bad parenting, video games or diet. These biological factors affect the development and transport system of some of the brain’s important neurotransmitters, resulting in under-activation of the neurons in different regions, particularly the frontal lobes. This under-arousal, the neurological signature of attention disorders, compromises the brain’s regulation of executive functions – the abilities needed by children, adolescents, and adults necessary to successfully carry out ordinary tasks in their daily lives. Attention disorder is the name used when executive functions are not sufficiently developed to permit adequate self-management.

Executive functions involve considerably more than just being able to focus and concentrate. Like the conductor of an orchestra cueing, speeding up, slowing down, modulating intensity, and integrating individual players, executive functions regulate a variety of cognitive, emotional, and behavioral functions. Executive functions influence what we notice and remember, how we think, feel, and act. Martha Denckla, M.D., a leading neurologist at Johns Hopkins Medical School, illustrates the need for executive functions this way:

“Imagine a cook who sets out to cook a certain dish, who has a well-equipped kitchen including the right utensils, shelves stocked with all the necessary ingredients, and who can read and understand the recipe in the cookbook. Now imagine, however, that this individual does not take from the shelves all the ingredients relevant to the recipe, does not turn on the oven in a timely fashion so as to have it at the proper heat when called for in the recipe, and has not defrosted the central ingredient. Despite possession of all equipment, ingredients and recipe, this motivated but disheveled cook is unlikely to get dinner on the table at the appointed hour.”

Executive functions develop very early in life, at about 6 months of age. Their early emergence means that attention disorders can be reliably detected and treated as early as preschool, though it is often the increasing demands for self-management in middle, high school, college, graduate school, or even the work place that bring them to light.

Attention disorders impact every aspect of life. Sleep, language, motor development, school achievement, behavior, emotional adjustment, parenting, family and social relationships can all be affected. Attention disorders are typically accompanied by learning, anxiety, mood, or behavior disorders, so they require careful, specialized diagnosis and individualized, comprehensive treatment.