Case study on Concentration & Attention

Background

D. is a six year old boy who attends a mainstream primary school. He has a diagnosis of autism and attention deficit hyperactivity disorder (ADHD). He displays difficulties with concentration and attention alongside his core issues with following an adult lead agenda, social communication and sensory regulation, often results in behaviour outbursts and negative responses at home and at school. He is often observed in a “fight or flight” state of arousal and as a result cannot process his environment and what is expected from him in this state. He is negative about formal work and teaching and he frequently states he is “stupid”. He is fully aware of those around him and seeks and enjoys social exchange. He is engaging with a keen interest in Doctor Who and Star Wars, he will engage with this topic when he is anxious, unsure of what is expected of him and also when refusing to comply in a structured environment. He enjoys playing Doctor Who games on his computer and engaging in role play with his specific topics and interests.

Triggers

After consultation with his parents the following were identified as triggers for behaviour outbursts:

• Finding it hard to maintain focus and shift attention across settings both on a 1-1 and in a group situation
• When not in receipt of full attention from familiar adults
• When lose at a game
• Being told what to play with or how to play with certain objects
• Expectation to comply with demands

Strategies

On consultation with D.’s mother and teachers, the following strategies were used.

• Building up a positive experience for D. in the school and home environments with his interests and elements of learning
• Following a detailed sensory assessment – the consistent use of sensory regulation breaks throughout the school day e.g. taking a message to another classroom, movement breaks
• The development of a “core folder” to include visual displays of all the “good work” completed to date so as to enhance confidence in his ability and to focus his attention on the positive
• The delivery of the “Attention Autism” model to D. and his classroom assistant – then the extension of this to a group of 4-5 typically developing peers, with the focus on positive reinforcement and engagement
• The generalisation of the principles of “Attention Autism” into the classroom and home settings, to include key phrases: “lovely that you are sitting”, “good watching”
• The use of table top positive directives to keep D. on task: page1 – writing – copy from the white board etc…
• Amended work sheets (shorter) and fewer homework tasks to allow for success with completion and attention levels