ADHD Inattentive Type,Can't see Forest For Trees

Most researchers and scientist believe that people with ADHD Inattentive type (ADHD-I, ADHD-PI) cannot pay attention to details. They report that the inattention of ADHD-PI is best described as a failure to pay close attention to details. A new study just published in the Journal Brain Development believes that the problem is not that.

The researchers of the Brain Development study believe that the problem in ADHD-I is related more to the fact that people with ADHD Inattentive type cannot "see the forest for the trees". They believe that the problem is a failure to screen out the trees (the details) in order to be able to concentrate on the global or big picture.  These findings are brand new and will be controversial but the study scientist state that their study shows that the ADHD-PI 'failure to pay attention to detail' theory is wrong.  They believe that the problem is with 'global' attention, big picture attention, and not with focused or detail attention.

This study (which I have included below) reads like gobbly-gook but essentially what the study found is that people with ADHD-PI continue to concentrate on the trees and screen out the forest even when they are supposed to be focused on the forest. It is not that they are not paying attention to details, it is more that they are paying too much attention to the details and failing to see the 'forest'.
This naturally is complicated because at my house the details that I or my son get focused are sometimes the 'shiny' details and not the details that we probably should be focused on. The implication of these findings are huge because the treatment traditionally used for ADHD-I , the stimulants, are supposed to improve focused attention. If focused attention is not the problem, as this new study reports, then these medications are not going to help very much.   Furthermore, if, on top of everything else, the medications make us more focused on the 'shiny' details as opposed to the appropriate details, we are going to be in even more trouble.

My pediatrician told me a story of a teenage boy that she treated for ADHD Inattentive type. She had placed him on Adderall LA and when she saw him 12 weeks later he reported that he felt that his attention was much better. His mother however felt that he was still not getting his homework done and his teachers reported that he was still not paying attention in class. When my pediatrician asked him why he felt he was more focused he told her, "I have been wanting to talk to this girl that I like in school for months and after I went on the medicine, I was able to talk to her." He was more focused, he just was not focused on what his parents and his teachers wanted him to be focused on.

Brain Dev. 2011 Aug 19. [Epub ahead of print]

The interference of local over global information processing in children withattention deficit hyperactivity disorder of the inattentive type.


School of Psychology and Cognitive Science, East China Normal University, China; Faculty of Human-Environment Studies, Kyushu University, Japan.


A classic finding in perception of compound patterns is normal individuals cannot skip global analysis in local-oriented processing, but they can successfully resist local analysis in global-oriented processing-the so-called global interference [1]. Recently, studies examining the role of brain hemisphere activity in the Navon task have indicated that the processing of global and local information can be, respectively, attributed to the right and left hemispheres. Moreover, many neuroimaging researches have revealed that certain core symptoms of attentiondeficit hyperactivity disorder (ADHD) are related to dysfunction of right hemisphere. These findings imply that global interference will be substantially less evident, and possibly even replaced by local interference in ADHD. The present study compared the performance of children with and without attention deficit hyperactivity disorder of theinattentive type (ADHD-I) in the processing of global and local information to examine the local interference hypothesis in ADHD. An ADHD-I group (n=15) and a paired control group (n=19) completed tasks using two versions of the Navon task, one requiring divided attention, in which no information was given to participants regarding the level at which a target would appear, and the other requiring selective attention, in which participants were instructed to attend to either the local or the global level. The results showed that children with ADHD-I exhibited local interference, regardless of which attention procedure was used. These results support the weak right hemisphere hypothesis in ADHD, and provide evidence against the deficit hypotheses for ADHD in the DSM-IV criteria [29], which postulates that inattention symptoms may manifest as a failure to provide close attention to details.

1 comment:

  1. The forest/tree analogy is very apt, do you mind if i borrow it for a paper I'm writing? Focus is all relative as your anecdote points out.


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