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Caring for the High Maintenance Child
By Kate Andersen.

Activity, Attention Span and Persistence. Nov/Dec, 2017.
Dear Kate:
I have a 9 month old who sleeps fairly well. Not a problem until lately, she wakes up and can't go back to sleep.....
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Activity, Attention Span and Persistence.

Channelling the behavior of children who also have short attention spans and low persistence is not as easy as steering the highly energetic, active child into physical play. Even climbing a Jungle Gym requires some ability to stay on task. One form of channelling which can be used at times is watching a video or playing a video-game. These fast-paced activities often do captivate the attention of such youngsters. There is concern that engaging too long in such activities trains a short attention span, so caution needs to be exercised here. However, there are times when parents need to be able to settle their child. Often a non-violent video or educational video-game is the only way to accomplish this. Parents have many tasks to balance. They should not be criticized for resorting to such methods for legitimate purposes, such as paying attention to another child in the family or taking a quick shower. However, it's a good idea for parents to document the amount of time they are using these methods so that the situation can be monitored and excessive video or television-viewing dealt with.

Another to coping with a short attention span is to break tasks down into smaller units and to see the child through each unit, a method commonly known as chunking. Sometimes praise at the end of a unit, a sticker or other tangible reward, can help the child refocus and continue through the next unit. Or the parents can scaffold by doing some units with the child or even for the child. Very systematic approaches to increasing attention span by setting the child at a task with a timer and gradually increasing the expected time, using praise or tangible rewards for reaching specific lengths of time can be helpful, particularly for tasks which are of low interest to the child but important to their development.

With ingenuity, parents can help to compensate for temperament where it may be creating developmental risk.

"We always read to our daughter, even when she was a baby. She became a bright, articulate early reader and we know that the early reading helped. When our son arrived, we expected the same experience. But Nicky was an active child with a short attention span and low persistence. Reading Nicky stories was a struggle, even at age three. He would start off on our laps, quite interested. But once we started to read, he would play with the page and change the subject. He would turn the book upside down and laugh. Sometimes he would just wriggle off our laps and leave. We didn't want to give up this valuable activity so we asked our day care teacher for some help. Together we developed an inventory of Nicky's interests. We made our own books for Nicky, about the things he liked. Every page had something for him to do. For instance, he loved trains. We made a book about trains. One page had a real whistle taped into it. Another page had some removable tracks. And so on. The implicit rule was: 'First Nicky listens, then Nicky plays'. Slowly we weaned him over to regular books, making sure that there was something he could do when we were reading those, too. (We selected them carefully.) Nicky is nine now. He's still active and still has a short attention span but he's a terrific reader, as long as the books are on subjects that interest him".

A child who is highly persistent may get 'stuck in' to activities and, especially when young, may tantrum if forced to disengage. This trait often causes conflict with parents especially when the trait is combined with other 'difficult' ones, such as low sensory threshold, negative mood, high intensity and poor adaptability. Then the child may go on and on about something which seems quite trivial to parents: "Carolyn gets really bothered by the way her pony-tails feel. She insists on wearing pony-tails, but whatever way I do them, they feel 'wrong'. I spend half an hour every morning, redoing them and redoing them, listening to her complain and complain. I have come very close to hitting the child with the hairbrush. What's wrong with her? Why is she so constantly dissatisfied?"

High persistence is the opposite of distractibility. Even when parents offer a treat or remove the child from the situation, the child may persist in wanting something he or she cannot have, or may not give up complaining about something that happened earlier in the day. Because high persistence causes such intense and frequent conflict, parents and teachers need to learn to disengage early and firmly from the issue. Very persistent children, especially when very young, cannot be reasoned or bargained with. They need help disengaging. The best way to help is not to get involved in any way with the substance of the issue. Even comments such as "No, I did not promise ice cream" or "I don't think your teacher was being mean" tend to just add fuel to the fire. If the parent becomes emotionally or intellectually involved in the issue, then the power-struggle will intensify greatly. This tends to make the child even more persistent.

The most useful thing a parent can do is recognize early when a child is "stuck in" is to hand the control of the situation over to the child: "You're stuck into whining. I'll be listening again when you stop. Now I am not listening any more." When parents bring any negotiating to an end quickly and firmly, the child is greatly assisted in getting 'unstuck'. However, because this behavior is rooted in temperament, the child may be unable to disengage for a long time, and may cry and fuss. This should be ignored. One parent made a rather startling analogy:"We have an older child with epilepsy. We now see his younger brother's 'getting stuck' behavior as a lot like a seizure, even though we know from the pediatrician that this time it's temperament and not a neurological problem. But making the comparison helps us with our expectations. We don't expect to be able to talk him out of 'being stuck' any more than we can talk Randy out of a seizure."

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