ADHD and Still Able to Pay Attention?
ByThis article comes from a subscriber’s question: “Dr. Handelman: I wanted to ask you my son has been diagnosed with ADHD but I have trouble accepting it. He is able to read books for a long time and he can play Nintendo for hours. How can they say that he’s got ADHD when he can pay attention?”
This is a great question and I’m glad that it’s been brought up because people with ADHD can pay attention.
Let me repeat that: People with ADD or ADHD still can pay attention.
The issue is that they are very inconsistent in their ability to pay attention.
Someone without ADHD can be consistent in their ability to pay attention. For example, a student with ADHD can be consistent paying attention to math in the morning, English late morning, and Science in the afternoon. For the student without ADHD, he or she can pay attention reasonably consistently on whichever day, at whatever the time.
Someone with ADHD can find it very hard to be consistent with paying attention. On a day to day basis, paying attention can be hit or miss. The level of attention can vary based on how interested the student is to the material, how important the material is, etc.
Even if he or she has trouble paying attention to a specific subject – i.e. Mathematics, if there is a big test coming up – he or she could put a lot of attention into paying attention for that test. However, if the next class is English (which is often easier to pay attention to for that person…) he or she could be totally distracted because all of the attention was ‘used up’ in the last class.
The important thing is that attention is inconsistent. I suggest that instead of thinking of an ‘Attention Deficit’ – you should think of an ‘Attention Difference’. People with ADHD can pay attention to things but they do it in a different way than people without ADHD.
One other angle with this issue is that ADHD symptoms are much less of an issue when someone is doing something that she likes, or in a small setting such as one on one. ADHD symptoms are much more significant when the individual is doing something she doesn’t like in a large group setting.
When I’m interviewing parents in my office about their children and the symptoms they have, I need to keep this in mind. If I ask: “Does your child have trouble paying close attention to details?” Some parents will say, “it depends”.
I then clarify – by asking: “Tell me what it’s like in a larger class in a subject they don’t like – or in a large group setting”. It then may be easier for a parent to recognize the difficulty.
The analogy here is cardiac disease. If someone has blocked heart arteries, he may not have symptoms sitting in front of the TV relaxed. But, if you make him run up two flights of stairs, he may get chest pain. When he is sitting on the couch, does that mean he doesn’t have cardiac disease? Of course not. The same applies in ADHD. If one is doing something fun, stimulating, easy and in a small group, it is easy. However, under ‘stress test’ conditions, the symptoms come out.
And why can just about all kids with ADHD spend hours playing video games (if you let them)?
Because video games are designed to be tremendously stimulating. In fact, they are designed in such a way that the ADHD brain may excel – compared to non-ADD’ers.
Thank you for discussing this.
My son has inattentive type ADHD, a non-verbal learning disability, and giftedness in verbal reasoning and processing.
This issue of paying attention has been the point that my son’s grandparents keep harping on in their refusal to see that there may be something ‘wrong’ with their grand son. He can pay attention sometimes, in certain situations, especially when he is interested in the topic. I will forward this link to them to read
Had to laugh. My son was diagnosed and put on ritalin in 1984! He read when he was 4. He could beat me at Concentration. But ADD and ADHD are about a BOREDOM threshold. All 3 of my adult children have severe ADD or ADHD. They can’t focus on ANYTHING unless it is very creative or is “coming at them” (like a video game or being a cashier at the grocery store.) My very bright son once told me, “Being a cashier is a great job because I can be aware of the “beep” but think about –whatever–BUT IT IS SO HARD TO COME BACK TO REALITY WHEN THE GROCERY CART IS EMPTY AND I HAVE TO TAKE THE MONEY. This is the heart of ADD, and it’s SAD.