Inattention (distractibility) and motor restlessness (hyperactivity) are common attentional issues observed across the lifespan. In young children, these behaviours can be developmentally appropriate and no cause for concern. In older children, adolescents, and adults, these attentional issues can range from mildly annoying to extremely challenging. For instance, these issues can make it challenging for an individual to be productive, stay organized, regulate their emotions and behaviours, and function on a daily basis.

With respect to attentional functioning, behaviour in the typical range for preschool children and early primary grades may include the following:

• Runs in circles without rest.
• Runs into objects or people.
• Asks many questions.

In contrast, atypical attentional functioning in this population may look like:

• Frequently runs into people or objects.
• Becomes injured easily.
• Does not want to sit for stories or games.
• Jumps or climbs excessively on furniture or objects.
• Overly active, to the point where it becomes problematic at home/school.

For older children and adolescence, typical behaviour may look like the following:
• May be impulsive or engage in risky behaviours, especially if excited or if pressured by peers.
• Plays games or engages in social activities for long periods of time.

However, atypical behaviour may include:

• Frequently interrupting others.
• Difficulty completing chores or schoolwork.
•  Often talking out of turn.
• Difficulty sitting still at mealtimes.
• Often fidgeting and/or making disruptive noises.
• Annoying others with their behaviours.
• Unable to listen to instructions.
• Getting into trouble.
• Feeling restless or bored.
• Not respecting others’ personal space.
•  Acting without considering the consequences.

Symptoms of ADHD are most often noticed when children enter elementary school, when their day is more structured and when they are expected to exert more self-control (e.g., stay seated for longer periods of time). While most children gradually become more attentive and less impulsive/hyperactive, some may still have difficulties in one or more of these areas. Individuals with ADHD demonstrate difficulties in at least two environments, such as at home and school, lasting consistently for at least six months. At least some of their attentional symptoms must be present prior to the age of 12.

There are three categories of ADHD. While all are associated with functional impairment and cannot be due to a pre-existing physical or mental health condition, they differ based on the primary symptom presentation. The three categories are:

1. Primarily inattentive symptoms
2. Primarily hyperactive and/or impulsive symptoms
3. Both inattentive and hyperactive/impulsive symptoms

The combined presentation of symptoms is the most common; while boys are more likely to have ADHD in general, girls are more likely to have primarily inattentive symptoms.

Children suspected of having ADHD should have an updated medical examination, including hearing and vision tests, to rule out any physical health issues. Meeting with a pediatrician or psychologist is then required; they will observe the child and obtain information from parents/caregivers, the child, and teachers or other adults. This typically includes both answering questions and completing various behavioural checklists.

This process is quite similar for diagnosing ADHD in adolescents. For adults, there is a similar diagnostic process as well, although you would meet with a physician, psychiatrist, or psychologist. Although not necessary, it is helpful to bring along a close friend or partner that can speak to your attentional issues.

Symptoms of inattention and motor restlessness, with or without a formal ADHD diagnosis, can be managed successfully. In most cases, behavioural-based parent training, cognitive behavioural therapy, and/or medication are used.

Parent training is recommended for children with ADHD, as parents play a key role in the treatment process. This type of training focuses on educating parents and teaching them behaviour-based strategies for addressing their child’s issues with attention and hyperactivity. For instance, this may include monitoring the child’s behaviour and giving them praise or rewards for acting in a desired way (e.g., thinking before acting). It may also include teaching the child strategies for de-escalating and regulating their emotions (e.g., deep breathing, counting to five before reacting).

For adolescents, parent training can also be helpful to assist with adding structure and routine in the home environment. Positive reinforcement for desired behaviours can also be implemented.

Adolescents and adults can engage in cognitive behavioural psychotherapy as well, which teaches you how to be aware of your thoughts and feelings to improve focus. You can also learn skills to improve working memory, social functioning, and emotion regulation. Further, psychotherapy can be used to monitor your behaviours and implement skills for self-regulation (e.g., thinking before acting, resisting the urge to engage in unnecessary risky behaviours).

School accommodations for both children and adolescents may also be beneficial, such as strategic seating, additional time to complete work, movement breaks, and access to a distraction-reduced environment for seatwork. Similar accommodations can also be provided to adults in the workplace to increase productivity.

In more severe cases, medication may be implemented. Usually stimulant medication is administered (e.g., Concerta, Ritalin), which works by increasing brain chemicals dopamine and norepinephrine that contribute to attention and thinking. Sometimes, non-stimulant medication (e.g., Strattera) is prescribed when stimulant medication is not effective or when the individual is unable to tolerate certain side effects. These take longer to start working compared to stimulants but can also be helpful to increase attention and decrease impulsivity.

Here are some easy strategies to improve attention, focus, and productivity:

• Write things down.
• Use calendars and/or organization apps.
• Make lists and prioritize important tasks.
• Break larger tasks down into smaller parts; assign a timer on your phone to notify you when a break may be required.
• Set alarms and reminders on your computer or phone for appointment deadlines, meetings, etc.
• Take microbreaks to prevent restlessness.
• Set aside time for organization.
• Reward yourself for completing tasks.
• Repeat verbal directions aloud to make sure you got it correct.
• Minimize external distractions (e.g., keep your desk clean, hang a “do not disturb” sign, use noise-cancelling headphones or white sound machine, turn off your phone).
• Give yourself more time than you think you need and plan to be early. Write down appointments 15 minutes earlier than they actually are.
• Address procrastination: if a task can be addressed in two minutes or less, deal with it now rather than putting it off.
• Learn to say no. This will help control the number of tasks on your plate at once.
• Create a predictable and quiet “bedtime” routine.
• Get plenty of sleep and stick to a regular sleep-wake schedule.
• Avoid alcohol and illicit substances (particularly stimulants).
• Eat healthy whenever possible and avoid over-reliance on caffeine or energy drinks.
• Exercise.
• Practice mindfulness to reduce stress, resist distractions, improve focus, and provide more control over your emotions and behaviours.