Children with special needs (hereafter CWSN), irrespective of the type of disability they have, have one thing in common: Reduced attention span. Attention is a skill that is required across activities such as fixing a puzzle, catching a ball, writing or constructing a castle on the beach sand (see pic). Attention is a prerequisite for learning and hence they develop secondary learning difficulties due to lack of attention.

Distraction is the main enemy of Attention. Hence we will discuss about distractions here. There can be two types of distraction 

- Intrinsic Distraction; in which the child is not focused on the task at hand due to internal factors such as boredom, lack of motivation, health issues, general physiological parameters including hunger, sleep etc. 

- Extrinsic Distraction; in which there is a rival stimulus that is competing for attention with the task at hand.

EXTRINSIC DISTRACTION

As you can easily guess, extrinsic distraction is much easier to overcome than intrinsic distraction. 

1. The first step is to provide a DISTRACTION FREE ENVIRONMENT!

So what is a distraction free environment? We recommend that you have a separate room for your child - smaller the better. A bigger room is an invitation to 'run'. The child is seated on a chair (with table in front) in a corner facing the wall away from the entrance. The child is now surrounded by walls in front as well as on one of the sides, the parent can sit on the other side. This will effectively block the child's visual field. Any cupboard / shelf in the room must be closed. There should be no calendars, posters or even a clock. The table is not cluttered and the child has only the task (to be done) on the table. The child is encouraged to replace the items before taking a new task. Needless to say, people should not be entering / leaving the room on a regular basis (You can display a 'DO NOT DISTURB' sign on the door). The sound of TV or songs in the next room are also potentially distracting, so avoid them. 

If you cannot afford to have a separate room in your house, you can pull the iron almirah away from the wall and create a 'cabin' for your child behind it. Ensure that the child is well inside the space and sitting facing you. You might have to relook at the lighting there. 

2. Avoid multiple stimulus. If you are playing with building blocks, do not empty the entire content on the table. Give 2 or 3 blocks initially and ask the child to join them. You can gradually increase the number of blocks based on their level of performance. CWSN have difficulty with organizing themselves and in when you provide multiple objects, it creates a mayhem!

3. Lock-In Chair is used at times. This is helpful for children who are impulsive and always on the run. In this chair, you can lock them in place. Let me make this clear, this should never be used as a punishment. You will not lock them on the chair because they are running. Instead, you will place them in the chair and ask them to do an overly simplified task e.g. collect blocks in a container. This may initially last for less than 10 seconds. Once they complete the task, you will let them out. This is continued for a time by which the child learns that 'If i do the task assigned to me, i can come out'. There is always a 'demand' on the child while he / she is on the chair. Gradually the complexity and duration of the task is increased as the child makes progress.

Note: In school, you cannot remove the external distraction for obvious reasons. Whenever the child has difficulty learning a concept, a one-on-one instruction may be required. Often we find that the child has problem in completing a work due to distraction. The solution then is to train the child to be responsible for his own actions. The child should be given small tasks and encouraged to do 'on his own'. Be profuse in appreciating the child in front of others for being 'responsible'. Responsibility is a trait that has to be nurtured across settings / location. Hence it is important that the child is given responsibilities at home as well as in school. Give responsibilities that the child can do e.g. locking the door before going to bed, or drop used clothes in the bin. At school, the child can be asked to erase the blackboard or distribute notebooks. Responsibility overrides distraction, isn't it?

We will discuss about INTRINSIC DISTRACTION in the next article. Please provide your feedback to karphysio@hotmail.com