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I receive emails from parents regularly. I often get emails regarding inattentive symptoms in very young school age children.  The parents of these 4-6 year old children are writing to ask if the fact that their child does not pay attention when he/she is sitting "criss-cross applesauce" during story time, while writing his/her alphabet letters endlessly on a worksheet or while doing various math or reading drills is normal.

I want to scream at my computer. 'YOUR CHILD DOES NOT HAVE INATTENTIVE ADHD, YOUR CHILD IS FIVE YEARS OLD', but I do not.  The sad fact is that many of these spaced out five year olds, will be space out 4th graders and the parents that are writing me are doing so because they know their child and they know that the child's level of spaciness goes beyond an inability to write the letter 'C' on lined paper, 30 times.

I could go on an on about the stupid demands that most school's place on Kindergartners but instead I want to address the fact that most parents know well before there is an official diagnosis, that their child's inattention is a problem and that. as a parent, once you become concerned about your child's inability to focus, it is time to:

A. Figure out how out of the normal range your child's lack of attention is.

B. Alert the child that focus an attention are skills that take practice but that can be learned (before a teacher or anyone else decides that they are nothing but an inattentive mess).

C. Forge a plan to teach attention skills.

D. Be your child's biggest fan and love them for all the other great skills and talents that make them who they are.

To give you an example of what might happen to an inattentive five year old once they get to a kindergarten classroom, I would like to post part of a letter I received (the writer has granted me permission to do so), and my response.

"My five year old son just started Kindergarten. He went to a small preschool where there were only 10 kids to a classroom and though he was shy and quiet, he was a favorite of the teachers as he just loved to quietly observe everything around him and they found him easy and smart. He learned to read, in preschool, when he was four and he now reads better than most first graders...  

He is a dawdler and it often takes him 3 hours to complete a chore that could have been done in 5 minutes.  He is obedient at home and at school and despite the fact that he is slow, spacey and a procrastinator, he is otherwise a creative, funny, insightful and delightful kid.

I am writing because my problem is his new school. Since he started Kindergarten his teacher has been calling me almost weekly to report that he does not pay attention, that he wonders around the classroom when he should be sitting "criss-cross applesauce", that he is slow to complete assignments and that they are worried about him socially because, for example, when he is on the playground he does not play, he just sits and watches the older kids play and the teachers talk...

I have started using a timer to make him aware of his dawdling and I have started to try to make him understand the 'new rules of Kindergarten'...

I am concerned with all the teacher calls, can you give me some advise as to what else I might do?"

I get a variation of this letter at least once a month. My response:

Thanks for your email. Your son sounds like a sweetheart and it sounds as though you are doing all the right things. With your continued support and guidance his procrastination, dawdling, organization and attention will improve. 

My suggestions would include having him start walking or doing some kind of daily exercise, having him set some of his own goals to accomplish something HE wants and show him how the steps of that goal get performed in a timely way.

 He is only 5, at this point you have to teach timeliness. I used timers a lot because my son had no internal clock and needed an external one to help him.

He will continue to need lots of organizational support and charts, cues, routines, etc will be more and more important as he ages. 

His classrooms and teachers will need to have in place written and accessible assignments and deadlines. Many schools are using Schoology a program that keeps students and parents abreast of upcoming projects and homework. Some system, such as that, will be helpful so that you can help him help himself.

He will do great. Ages 5 to 7 are tough as are the start of middle school and high school. The good news is that once they reach middle school you will have been coaching him so long, the two of you as a team will be seasoned pros and will know exactly how to tackle the rising challenges.

Keep the faith and keep me posted.

Have a great summer, Please keep your letters coming! I love hearing from you. 

BTW, I wanted my readers to know that I have two articles in the Summer edition of Additude Magazine which I hope you will read and enjoy!

Inattentive ADD, Coordination and Sensory Processing

Inattentive ADD, Coordination and Sensory Processing
A study just posted in a Chinese medical journal and cited below confirms what I have observed in boys with Inattentive ADD.  Children with Inattentive ADHD are less likely to engage in sports, more likely to have problems with motor coordination and more likely to have visual processing issues.  These problems are bad enough but unfortunately, they also cause brain organization problems. 

I have posted in the past about the connection between Inattentive ADHD and Sensory Integration problems and I have also posted about Inattentive ADD and motor and coordination difficulties.
Coordination difficulties are problematic in sports but there is a growing body of evidence that suggest that children that are not coordinated also have problems with brain development.

Optometrist believe that the brain, through balance and coordination organizes itself.  As the body develops and practices tasks such as crawling and walking, a process called brain "lateralization" occurs.

Lateralization eventually leads the brain to establish a dominant side.  Developing a dominant side is important for brain organization and the importance goes WAY beyond the ideas first introduced by psychologist who wrote about right sided versus left sides brain dominance.

Through studies on brain mapping, we now know that the entire brain works together to accomplish both artistic and analytic tasks but that having a dominant side or lateralizing is important for writing, reading and math as well as for sports.

It is through physical activity , specifically activities that "cross the midline" or that use both the left side and right side of the body, that the two sides or hemispheres of the brain learn to work together. 

Coordinated children learn to use both sides of their bodies together to do things like crawling, pushing, pulling or walking. This coordinated body practice help the brains of these children become better organized for doing the tasks that will later be required at school and in life. Uncoordinated children get less practice at doing these things and are slower to develop a lateralized and well organized brain.

What the Chinese study confirms is that Inattentive boys (the study was performed on boys but likely applies to girls as well) are less coordinated that their non-inattentive peers and also less coordinated than their combined type peers.  So, are the brain organization problems in inattentive boys the result of the motor and sensory coordination problems or vice versa?  Well who knows. What we do know is that treating the coordination, motor and sensory problems with exercise and other modalities can help treat the brain organization issues that ultimately contribute to inattention.

Postural control and sensory information integration abilities of boys with two subtypes of attention deficit hyperactivity disorder: a case-control study.
Ren Y1Yu L2Yang L1Cheng J1Feng L3Wang Y4.

ADHD boys had a poorer static postural control ability and impaired function of processing visual and vestibular information compared with the normal control. Boys with ADHD-I showed particularly severe defect of static postural control and vestibular function integrating conflict information than normal boys. These deficits may be an important contributor to the clinical presentation of ADHD children and their cognitive deficits. Assessment and training of postural control function would be suggested during the diagnosis and treatment of ADHD children.