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What is attention?

Attention is the brain’s way of focusing on selected things in the world around us (our environment) while blocking out others. The brain can rapidly filter all the things that we see, hear, touch, taste and smell. Attention can then be focused on what is important at a single point in time.

What we attend to may be:

  • Automatic – things that that we are ‘programmed’ or have learned to pay attention to eg something that signals danger, a baby crying, hearing our name.
  • Intentional – when we have something specific we want to do (a goal) we will pay attention to the things that are most relevant to that goal.

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How is attention involved in behaviour?

By focusing on the most important things at the right moment, a person has a better chance of being able to work out what action is needed.

Deciding what information is important will be affected by:

  • Personality/preferences
  • Mood/motivation
  • Urgency/danger
  • Desire/need/intention

What you pay attention to will affect how you choose a solution and plan of action. The ability to focus on the right things and hold them in mind long enough to think and act can be affected by hydrocephalus.

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What happens to attention when someone has hydrocephalus?

As well as information coming into the brain, we might also make use of information already learned (memories) to help us pay attention. This allows the brain to understand (comprehend) the information then decide what is most important. The important information may then need to be held in mind while the brain works out what to do and how. Attention needs input from lots of other processes.

It relies on:

  1. The brain’s ability to co-ordinate all the different activities involved: the brain’s executive functions.
  2. The connections or pathways within the brain (that allow the executive functions and other processes to do their jobs).

Hydrocephalus can cause damage to any area of the brain or the connections that link them up (see About Hydrocephalus). This could change the working of the processes involved in ‘paying attention’.

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Getting the right information in/'Selective attention’

Selecting and attending to the right information means being able to filter out any information that isn’t needed for the task. The brain needs to do this so that a person doesn’t react or respond to the ‘wrong’ thing. For example, it is disruptive when a child is distracted by their own thoughts when they need to be concentrating on class work at school. There might be two reasons that the ‘wrong’ information is selected:

  • There may be too many things to choose from. If the right information is among lots of other things, the child may need to work out which ones are most relevant.
  • The child may not be able to stop or ‘inhibit’ a reaction or response to something, particularly if it is something they really like or enjoy.

One of the brain’s executive functions, ‘inhibition’, is strongly linked to the ability to stop a response and the ability to choose or select the right things. This gets better as children grow. Problems with inhibition could be linked to poor attention or concentration. You can read more about inhibition here.

If a child or young person is regularly distracted by their own thoughts or by something they see or hear, they will not be focussing on the ‘right’ things. If they are not focused on the right information, they won’t be able to work on the task in hand. A child or young person with hydrocephalus may have problems in selecting and focussing on the right things, or inhibiting responses to the wrong ones.

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Paying attention/concentrating over time

Many tasks mean that we need to pay attention over a period of time: we need to ‘sustain’ attention. As children get older they get better at focusing on one thing for longer. Generally speaking it is easier to sustain attention or concentrate on something when it is enjoyed eg most children will readily watch a film but may struggle to concentrate on their homework.

Things that can make it difficult to concentrate or attend for longer are:

  • New or difficult tasks
  • Tiredness/fatigue/hunger
  • Emotional distress
  • Boredom
  • Lack of motivation

A child or young person with hydrocephalus may lose concentration for any of the above reasons.

However, their loss of concentration or difficulty in re-focusing may also be because:

  1. They find it difficult to remember what it is they need to do.
  2. They are easily distracted by something around them (eg noises in their environment) or by their own thoughts: they cannot inhibit their responses to intrusions.

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Doing more than one thing at a time

Many tasks need us to pay attention to more than one thing at a time. An adult may be able to concentrate on driving while holding a conversation, for example. Children may be asked to write down their homework while listening to the teacher. There is a limit to how much we can take in and a limit to how long we can attend to something. When two tasks are done at the same time the brain needs to split its resources.

Splitting the brain’s resources is thought to be easier when the two tasks use different parts of the brain eg driving is a very ‘visual’ task while talking is ‘verbal’. However, doing two things at once can be more difficult if both tasks are visual, or both are verbal eg listening and writing are both ‘verbal’. Being able to do two tasks at once relies on holding information in mind about one task while switching attention to the other task. It also requires the brain to process information quickly so that nothing is missed in either task, and information from one task is not forgotten.

There are three key processes involved in making this happen (you can click on the links to read more about each one):

Children and young people with hydrocephalus may have difficulty paying attention to more than one thing at a time. This could be because one or more of the above processes is not working as well as it should. It can be difficult to know which so you may need to experiment with different strategies to see which work for your child.

See below and the Living with Hydrocephalus section for more information.

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Possible problems

Children with poor attention are often reported to:

  • Drift off/be distracted easily.
  • Have difficulty getting a task finished.
  • Have to stop everything to be able to hear instructions.
  • Appear not to listen.
  • Have difficulty in social interactions particularly groups (one to ones may be easier because the pace is slower and fewer things are happening at one time: there is less to attend to).
  • Daily routines like getting dressed or doing homework.

Hydrocephalus affects people in different ways. While this site aims to give something to suit everyone, it is important to think about each individual’s pattern of strengths and difficulties. Patience, determination and trial and error are likely to be needed to find solutions that suit your child’s unique needs. Dip into the Living with Hydrocephalus section to find hints and tips on how to deal with different issues and difficulties.

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