N.B. The main website covers the published books and articles etc about attention seeking. If you want these, please go back to the home page of this supplementary website and follow the link to www.nmellor.com
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There are many definitions of function. Some are very technical. The one I like best, and seems to capture the essence of the term for the present discussion (although purists may disagree) is from Collins dictionary: the function of a behaviour is its "intended purpose".
Now, determining that a particular set of behaviours is part of an attention seeking pattern is generally pretty straightforward. The children usually make themselves very obvious. At times, however, attention seeking can seem to "masquerade" as almost any other problem such as language difficulties, learning difficultuies, ADHD, phobias of many kinds and so on. It is then that we need to be especially careful about determining the functions of the behaviours.
Some of you may have read the recent paper "ADHD or attention seeking? Ways of distinguishing two common childhood problems" which is appearing in the British Journal of Special Education. In this I briefly mention that finding the function of a set of behaviours can be a long (and tricky) business. Texts such as A. Repp and C. Horner (1999) "Functional analysis of problem behavior: From effective assessment to effective support" or O'Neill et al. (1990) "Functional analysis of problem behavior: A practical assessment guide" can be very technical. My own approach is not as technically difficult, but may still involve a deal of effort.
Listed below are some ideas to take into account when looking at functions. They are taken from my manual for working with parents (which is not yet published) and from the book "Attention seeking: a complete guide for teachers" published by Sage. I discuss this process as more of "making a judgement" in a situation of "progressive focusing". I hope the extracts below help to clarify these ideas. At the end of the day, it is basically just you, as practitioner, making the best stab at understanding the information you are acquiring, and proceeding carefully from there!
I am sorry I can not include all the appendices etc I refer to from the books or I would simply end up putting whole books on the website. You should be able to figure most of it out from these notes I trust. Please email me if any points are totally obscure and I'll do my best to reply.
The problems with determining functions, particularly with regard to distinguishing attention seeking from ADHD, are basically in three parts:
(1) Children's behaviours, such as painting their hair purple or standing in front of the TV when your favourite programme is on, might well be due to impulsivity, inattention or overactivity i.e. due to to ADHD. But if this happens every day, then we might start to question whether impulsivity etc. are at the root of the problem. The problem may begin to look a bit more like seeking attention.
(2) There can be a totally bewildering variety of behaviours produced in order to gain attention - see for example the case of Barry Sheen in Mellor (2008) p.9 (copied below). The trick is to not focus on individual behaviours but to try to see the common pattern behind them all.
(3) As attention seeking seems at times to "masquerade" as other problems we need to take extra care in spotting the clues that this may indeed be attention seeking and not some other pattern. The usual tell-tale give-aways are (a) situational variation and (b) the presence of other attention seeking behaviours, alongside, for example, the apparent "phobia" or "language difficulty" or whatever, that has been the original source of concern.
This will usually require obtaining very detailed information from home and school and from any other sources, and considering all these together. For instance, how the child behaves at Grandma's house or at a club or at a friend's house or in respite care may give a rather different picture - we might normally expect most supposed "medical" problems or "within child" problems to remain fairly constant across settings. Children who are very attention seeking, by contrast, may show different patterns in different settings (e.g. being quite calm and settled at Grandma's house while being fantastically overactive at home; or they might show, sometimes subtle, variations between settings e.g. Dan Usher or Billy Harvey p.23 and p.91 in Mellor 2008) as their difficulty is due to an interaction.
Parents may actually have much of this information, but may not be able to analyse it dispassionately, given the pressures they are under at home!
1. EXTRACTS FROM MANUAL: Helping parents deal with attention seeking behaviour: a training pack for practitioners ( N. Mellor and E. Harvey, 2008) avaialble at www.lulu.com
CHAPTER 4
THE FIRST INTERVIEW WITH PARENTS
SOME FINER POINTS
Although the basic structure of the interview should be clear from the DVDs and the previous chapter, there are many issues which need to be highlighted. In some ways the approach is deceptively simple. Eric Harvey, my mentor, was, however, a master of the art and each aspect of the work was carefully thought through. In the pages following, and the next chapter, are some of the additional points I have managed to glean from his work, and from my own struggles over the past couple of decades.
1. Making a judgement
Part way through the interview is the time when practitioners need to decide whether or not they are on the right track – is this or is this not a case of attention seeking? This event is fairly clear on Linzey’s DVD (7.57-58). How valid such a judging process is, and whether a better model would be to “co-create” an understanding with parents, are issues which will not be covered here.
In summary all the sources of information brought to bear are covered in Figure 4.1 below.
Figure 4.1 Making a Judgement
(Sorry colleagues, this diagram totally refused to transfer over to this website. Please go to the attachment at the very end of this web page Figure 4.1 It may misbehave when you try to print it, if so try copying it and saving it in a new WORD file first)
Prior discussions with child and teachers and observation in class etc. are outlined on the other pages of this web site. There are other sources:
A vital but often overlooked source of clues about attention seeking is the collection of dog-eared old reports in the child’s file (either at school or in the office). The case of Billy Harvey illustrates how attention seeking can go unrecognised over many years (see Mellor's "Attention seeking" 2008 p.91).
For another sad tale, I recently obtained a file from archive for Jim Robson, the 20 year old brother of a boy we were then assessing. This “file” was actually three files, standing about four inches thick. Jim had been in just about every type of special school and care setting. He was diagnosed eventually with ADHD and Asperger’s syndrome. However, sitting there in the file, on page 1 of file 1, some 15 years previously, was a strong indication that Jim’s problems had at least begun with attention seeking (see below).
Apparently Jim’s attention seeking had never been fully recognised and comprehensively dealt with. His behaviour escalated and after many placements he eventually transferred to a residential special school. This is not to criticise colleagues - I guess few of our files would stand close scrutiny- but it does leave a strong feeling of “what if…?” (for further discussion on attention seeking and ADHD and Autism see Mellor 2008 chapter 11).
Page 1 of Jim Robson’s four inch thick file (now age 20):
Jim age five, is the second of three children. Jim’s behaviour deteriorated markedly since baby David was born. Mrs Robson talked about Jim as being very attention seeking. He had been going into neighbour’s gardens and taking the flowers, shoplifting, getting into trouble in the street and, most worryingly, had set fire to his older sister’s bedroom… he had kicked a hole in the kitchen wall … which mum showed to everyone who came in, as well as telling them the story about the fire in the bedroom… he was also doing a lot of soiling and wetting in his own bedroom.
In most instances, careful screening of prior information to select the most appropriate families for this type of intervention, will ensure that by the time you reach this vital point in the interview (building on the parents’ detailed comments) it will be clear that attention seeking is indeed the issue. This is not a “self-fulfilling prophecy” but simply due to the fact that you would not have been going down this route if you had initially suspected some other problem – this manual is, after all, devoted to tackling attention seeking! Diligent prior screening is a “must” for efficient, targeted working.
Even so, despite early indications, part way through the parent interview it may become increasingly clear that attention seeking is not the problem in some particular case (as the screening is in fact progressive). For completeness, this situation is covered in appendix C, but is not the main focus of this set of materials. That is not to say that the umpteen other problems of childhood are not important – just that they need other approaches and this manual is not intended to be an encyclopaedia of child psychology.
To further aid this process of “making a judgement”, appendix G provides brief examples of rough patterns you may become familiar with. But part of the skill in coming to any such judgements (with the caveats noted earlier concerning the whole process of practitioners “making a judgement”) is in understanding the functions of behaviour – a tricky issue which we turn to next.
(2) The functions of behaviour and progressive focusing
The key question to ask is “What does the child appear to gain from behaving this way?” This question shifts discussion away from concern about possible “underlying causes” and away from simply describing the child’s actions. But a bewildering variety of behaviours, some quite bizarre, has been judged, in certain circumstances, to be attention seeking. Evan Moore provides a god example.
Several teachers came after school to discuss Evan. They brought a wide range of, often bizarre, problems that Evan displayed: hiding in the cupboards; walking into walls; cutting things inappropriately; sitting in the middle of the floor, refusing to move; making peculiar comments and shouting out; having an imaginary friend; over-reacting if he was hurt; when children were absent at register saying they were dead; making random “animal” noises; making karate chops and saying he wanted to eat everyone; swinging on the chair then crawling round the room; putting a noose around his neck and tightening it; shouting out “penis” and “vagina”; curling up in a ball on the floor; using his shoe as a mobile phone; banging his head on a glass panel; climbing onto a coat rack at the end of the lesson and calling the teacher a penis.
The head of year and several teachers commented Evan was doing these “to be irritating, for attention” or “he has to be the centre of attention”. It was pointed out that there had been a great improvement in his work and behaviour in all subjects when he was on report and the report was sent home. Evan liked that. This was, they felt, because he was getting attention at the beginning, during and at the end of each lesson (Mellor 2008 p.76)
In one recent example, a child was able to, quite painlessly, dislocate her own knee – this reliably brought an immediate, powerful reaction from mum. However, it is the function of the behaviour1 - its impact on the adult, its “intended purpose” - not its description, which counts: one behaviour can serve a number of functions.
This issue takes us on to a puzzle at the heart of attention seeking. We need to consider not just the confusing variety of behaviours which can be included under the label attention seeking, but the subjective perception of these by the adult, and that adult’s subsequent reactions. What might be seen by one adult as a behaviour that could be overlooked or handled in a low key manner, such as humming, for another might engender intense feelings of irritation and an inability to ignore it. We are, after all only human, and have our own unique vulnerable spots.
The nature of the adult’s response is a key factor here. An observer will note a relatively predictable set of reactions to whichever of the child’s activities are perceived by that particular adult to be irritating; in the classroom this can be seen as follows:
If teachers wish to know the purpose of a student’s misbehaviour, they must observe their own spontaneous … reaction … Whatever teachers feel like doing is precisely what the students want them to do… for instance a student who seeks attention may come late to class, clown, ask incessant questions, fail to return materials …some teachers become impatient and annoyed by these behaviours and respond by giving the student the attention he or she desperately needs (Balson 1982 p.78)
This pattern, of playing on the individual sensitive areas of the parent or teacher to get a response, is discussed further in Dreikurs et al (1982). In this text, the authors ask teachers to look at their “gut reaction” of irritation ( p.25) to begin to understand the patterns of interaction which arise. There is, of course, a danger in relying on “gut reaction” as more than simply an initial guide, careful observation is also needed. In the accompanying DVD of Robynn it is noticeable how she picks up on father’s irritation about not leaving shoes tidy (8.52) – probably stemming from his disciplined army background.
Now, in the case of attention seeking, all these adult reactions, verbal and non verbal, subtle and overt, will ultimately serve the same function: to provide the child with attention. However, it should be emphasised that any report, say by a teacher, of an intense feeling of irritation must be backed up with careful observation, discussion with all interested parties and review of all available evidence, for a full analysis of the pattern of interacting in order to clarify the function of the behaviours. It is the underlying pattern that counts, no single behaviour, such as shouting out or throwing books or crawling along the floor, can, on its own, disclose the function involved. Such a pattern needs careful timed observation as below in figure 4.2 where the teacher and Susie seem locked in a cycle of actions and reactions with no clear beginning or end point. But this cycle is one where Susie gains a great deal of teacher attention.
Balson (1982) explores other emotions teachers may commonly experience such as feeling challenged, hurt or helpless. These, he argues, characterise reactions to pupils seeking not attention but power, revenge or withdrawal respectively. Other functions which may be observed might include “seeking nurturance/comfort”, “seeking support”, “maintaining pecking order” “seeking stimulation” etc. Typical behaviours associated with other functions might be for example: Fidgeting (to reduce boredom). Constant chattering to friend (to maintain relationships). Throwing a chair (to re-establish status, because he called her a “slag”). Putting on lipstick (to overcome low self esteem). Constantly asking questions (quite simply seeking help because she can’t cope with the work). Swearing (showing-off to mates as a way of maintaining relationships). Again the art is to discover the pattern.
Figure 4.2 A cycle of interactions in class
Time Susie
10.24 Looking at wall
“Need a pencil”
“Need a calculator Sir”
“Are they in the drawer?”
10.25 Pokes Carol
Pats Carol on back and talks
10.26 Idling
10.27 Idling
10.28 On task working quietly
10.29 On task working quietly
10.30 Chews sweets very openly
10.31 Idling
10.32 Pokes Carol with book and says in
bad-tempered voice,
“Pass me that pencil”
“Is there a ruler in here Sir?”
“Can I go to the canteen?”
10.33 Pokes Carol and talks
“But I’m doing my work”
10.34 Idling
10.35 Idling
10.36 Pokes Carol
“I’ve dropped my money”
10.37 Gets eraser, rubs on bench, argues with Carol.
10.38 “Why are you always picking on me?”
From Mellor (2008) p.17
Teacher
“Can you make a start?”
“You know where they are”
“If you two can’t sit together”
“One and only one warning you two”
NO RESPONSE
NO RESPONSE
“If you’re going to eat sweets,
keep your mouth closed”
“Susie!”
“Listen, stop the chatting!”
“Just do your work Susie”
“Can you just stop your messing about you two? Susie, move across”
“Look, settle down”
Discovering the likely function (if any) of the behaviours is a complex process of progressive focusing:
It begins with the first information received about the pupil in question (which may hint at attention seeking)
Then careful reading of all reports available, for further clues
Followed by discussion with the teacher, and other adults who may have had substantial contact, and with the pupil themselves
Linked with observation in class (and the problems involved with that are explained on the website materials)
The structured interview with parents provides the last few pieces of evidence which the practitioner “sizes up”, bearing all the rest in mind.
Finally the parents are offered a description of attention seeking and asked if this seems to describe their child.
As outlined in Mellor (2009) distinguishing attention seeking from ADHD is a particularly thorny problem. Several guidelines are offered. One of these is whether or not problems are shown only at home (especially for younger children). Analysing the cases in Mellor (2004), 2 out of 10 (20%) only showed challenging behaviour at home (and this may have been an underestimate as families were referred through school systems mainly, where additional school based problems may have prioritised referrals).
[1] More detail on ways of analysing the functions of behaviour and limitations of the approach generally are outlined in Repp and Horner (1999). The authors, however, describe a much more formal “experimental” analysis of functions (linked with observation and interview) which seems very time-consuming for everyday use. The term “analysis” in the current text is used in a much less rigorous way.
The notes below are from an appendix to the manual. In some ways they are light-hearted ideas I have been toying with for some time. They do, however, have a serious purpose but really need a great deal of research :
APPENDIX G
VARIETIES OF ATTENTION SEEKING – USE WITH CAUTION!
Children are an eternal delight and deserve endless respect. Nevertheless, some become embroiled in attention seeking interactions which can lead to great difficulties and which can be extremely difficult to analyse. There may be many varieties of attention seeking (see Dreikurs et al 1982). I apologise for the stereotypes listed below – the intention is to give rough-and-ready ideas to help understand what may be going on. The field of attention seeking is confusing enough already, trying to separate out “sub-types” might lead to an additional level of confusion; or it might help the practitioner see “the big picture”. However, this exercise should be carried out without losing sight of the strengths and individuality of the child in question. These descriptors are meant light-heartedly, for those who can exercise appropriate professional care, and are not intended to become derogatory labels – USE WITH CAUTION! Our focus in these materials is on children who broadly fit the fourth (rather unkind) description. Readers may also recognise certain adult colleagues in these descriptions.
1. Teacher’s Pet (gets attention in positive ways)
2. The Ragged Waif (neglected - simply needing more adult support and nurturing)
3. The Gang Member (street wise, well socialised into his/her peer group - wants the attention of peers, not bothered about teacher attention)
4. Darren Irritating (gets attention by being a nuisance in class/ at home)
5. Mr Helpless (gets attention by “I can’t do it”)
6. The Charmer (gets adults to run round after them by using charm / flashing their eyes etc.)
7. Miss Insecure-Beautiful (the “fashion model” - desperate to be noticed, desperately unsure of herself)
8. Mr “I am” ( the self-centred, egotistical, centre of the universe - feels they deserve to be worshipped)
Balson M (1982) Understanding Classroom Behaviour: Hawthorn: The Australian Council for Educational Research
Dreikurs, R., Grunwald, B.B. and Pepper, F.C. (1982) (2nd edn.) Maintaining Sanity in the Classroom: Classroom management techniques. New York: Harper & Row.
Mellor, N. (2004) TIPS: Time-limited intervention with parents service. DECP Debate, 112, 9-13.
Mellor, N. (2008) Attention seeking: A complete guide for teachers. London: Sage
Mellor, N. (2009)(in press) ADHD or attention seeking? Ways of distinguishing two common childhood problems. British Journal of Special Education
O’ Neill, R.E., Horner, R.H., Albin, R.W., Storey, K. & Sprague, J.R. (1990) Functional Analysis of Problem Behaviour. Sycamore, IL: Sycamore Publishing.
Repp, A.C. and Horner, R.H. (1999) Functional Analysis of Problem Behaviour: From effective assessment to effective support. London: Wadsworth / International Thompson.
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Extracts from book "Attention seeking: a complete guide for teachers" (N.Mellor 2008) published by Sage.
Extract from p.8
Attention seeking behaviour is immensely frustrating for the teacher:
He blocks me from all the other children. I’ve tried all sorts of ways of dealing with him and I get nowhere. He absorbs my energy, my attention. I give him so much and he gives nothing back. I start off feeling compassionate, I’d like to spend more time with him, then frustrated, then angry. He drains all the compassion from me. I feel like screaming. I feel like it's my fault. I’m just drained at the end of it. (Art teacher discussing Michael Platt age 13 in high school).
The secret in trying to understand such patterns is not to ask question “Why do they do it?” but to ask instead “What does the pupil appear to gain from behaving this way?” As McManus (1995) points out, asking a “Why?” question often leads to a pessimistic answer such as “It's the home background; what can I do about it?” If we consider instead the function that the behaviour serves for the pupil ( by looking at what the pupil might be gaining) we then discover clues to the practical steps we can take:
Kim seeks adult attention most of the time; this can either be by good behaviour, seeking praise for her work, or poor behaviour by making loud outbursts against others or leaping around the classroom. (Teacher’s comment on Kim Thomas age 10).
Barry Sheen, age 7, gives a good example of the thousand and one ways children can act to gain attention in class.
Mrs. Lyons, Barry’s teacher, described him as an intelligent boy but one who seemed unable or unwilling to follow instructions. If she said "walk" he would run; if she said "line up" he would continue writing or playing; in P.E. if she said "jump" he would skip.
Barry found it hard to co-operate and play with other children and had little idea of how to share. Generally, whoever he was working with or playing with would complain that Barry was cheating. If Barry was allowed to play in a group there was a constant stream of children complaining about him, coming to the teacher’s desk, saying that he was snatching toys, pulling things apart etc. One of his favourite tricks was to bend other children’s fingers and either kick, nip or punch them.
Mrs. Lyons mentioned several problems Barry displayed when working (it should be pointed out that the work was well within his ability). He clearly had heard instructions yet he regularly carried them out incorrectly. This rapidly drew the teacher over to him. Whenever Mrs. Lyons spoke to the class, Barry would question and challenge her. When she said, “Let’s draw some people” Barry shouted out, “Why do we have to draw?” When his teacher was out in the yard preparing to ring the bell, Barry would immediately turn to run off. He would eventually saunter back to join the line.
When lining up in class he could not stand still. He would jump up and down, wave his arms about or run out of the line or change his position. When at the teacher’s desk he would make a variety of noises: blow raspberries, click his tongue, break wind, burp, stamp his feet, thump the desk, anything to cause a disruption.
He seemed unable to keep his hands to himself, he was constantly fiddling with things, poking into other children’s books and papers (as well as the teacher’s), prising pictures off the wall, poking the tops of milk bottles, picking up other people’s equipment and often throwing it across the room.
If he was sent out of the room for being naughty or allowed to go to the toilet, he would tear down displays, go through other children’s coat pockets, throw the coats on the floor or mix them up on the pegs.
In P.E., Barry shouted and pushed all the way to the hall. He jumped under the safety rail instead of using the steps and pushed other children around. When told to stand apart from the other children Barry blew raspberries and pulled faces. When he was eventually sent out, he stood at the door pulling faces until he was told off again. On one occasion he held a sheet of paper in front of his face. When told by the head and various other teachers to lower it, Barry simply raised it further.
Mrs. Lyons said that he was a lovely child in the one-to-one setting and could be very endearing and affectionate and would also admit his mistakes. She also observed that “He just enjoys winding me up” and that he just seemed “to see how far he could go in disrupting the class”. She added finally “I sometimes wonder if I am watching him too much”. She was in fact quite close to realising herself that she had fallen into the trap that good, caring teachers fall in to - responding to the misbehaviour of a child who she was very concerned about. Her very strength became her weakness.
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Extract from p. 20
4. Is the pupil actually seeking attention? Is your analysis accurate?
Attention seeking is curiously ignored by most professionals (see Mellor 2005a), but spotting such behaviours is usually not terribly difficult. The children generally make themselves very obvious. In a busy classroom, however, matters are not always so clear cut. In some cases clues to attention seeking patterns can be found in the child’s file, in old reports or comments from past teachers. Often colleagues may not use the term “attention seeking” but it becomes clear that is probably what is meant, for instance regarding Colin Lawton (Yr 3) his last teacher said “He shows silly behaviour in some lessons - he sits on the floor and makes silly noises. He responded to behaviour targets for a while. He seems to want to irritate”.
Note that attention seeking as such is not mentioned in the example below, taken from his previous teacher’s comments. It is, however, easy to begin to see a pattern in Eric’s behaviour in class that sounds suspiciously like attention seeking, although other potential explanations should obviously always be kept in mind.
Eric Harper (age 9)
When he is bored or tired he is very disruptive, making noises and restless movements (upside down sometimes!). When I or any member of the group are speaking, he interrupts with irrelevant and unrelated comments. With regard to reading he pretends he doesn’t know the letters or blends, and huffs, puffs and pulls faces.
He is keen to collect house-points and stickers. However, he wastes time by trying to involve others in debates about the merits of his work and the possibilities of rewards. Even when everything is in his favour, work within his grasp, attractive materials and built-in success, he looks for difficulties within minutes of being given a task. Almost everything distracts him. He is too hot, too cold, his chair wobbles, his equipment is faulty.
Eric reacts inappropriately to authority. He shouts about injustice before asked. He will laugh or wiggle his bottom if he has the class’s attention. He bombards adults with questions about organisation etc. but is not really interested in any answers. He tells tales in a loud and obvious way. If he feels that he is being ignored, he tries to goad his class members to arguments. He then complains they are stopping him from working.
Even with his work, pencil etc. prepared for him and work well within his ability, Eric will wander about or crawl under tables.
As mentioned in chapter 1 , your own “gut feeling” of intense irritation can often be a good starting guide. Sometimes hints come in reports from other agencies such as the school medical officer or speech therapist, and parents are often an excellent source of information. The most likely evidence arises simply in answer to the question “Does the pupil appear to gain anything by behaving in this way?” Some teacher comments in response to this powerful question have been, for one child: “He gains attention and an immediate 1:1 contact with adult”; for another : “He gets teacher/adults/children’s attention, whether of a positive or negative nature”; for a third, simply: “He likes to be the centre of attention”. Unfortunately, attention seeking can go unrecognised over many years and across different settings as the sad history of Billy Harvey illustrates (p.xx).
Now, because of the bewilderingly wide range of behaviours that can be part of the attention seeking pattern which we saw in chapter 1, attention seeking can readily be confused with a host of other behaviour problems. It is important to try to clarify whether there are other difficulties which might call for different forms of support (see below). Discuss these other aspects with your special needs co-ordinator. This book does not cover the whole range of school based troubles which might occur.
To further complicate matters, attention seeking can also occur alongside other problems. For instance, attention seeking behaviour has been reported in conjunction with a very wide range of special difficulties such as : ADHD; accident repeating; autism; cerebral palsy; deaf-blindness ; drug abuse; Down syndrome; Williams syndrome; hearing impairment; language difficulties; learning difficulties and children in mainstream with apparent learning difficulties; poor social acceptance; pseudoseizures; school refusal; self injurious behaviour; short stature; social skills difficulties; tuberous sclerosis; victims of bullying and false victims; visual impairment (see Mellor 2005a).
In the above list, a somewhat counterintuitive example, is the reported occurrence of attention seeking in autistic children. This area needs a great deal of research, however, and is discussed further in chapter 11.
Picking out one further facet, various pseudo-illnesses can be attention seeking in disguise, although this analysis must be treated with a great deal of sensitivity and care. The teacher’s comments on Barney Tyler, age 5, illustrate this aspect:
Barney is a very demanding, challenging child, constantly seeking attention until he gets the desired effect e.g. by doing the opposite to everyone else, aggravating the others around him by pulling their hats off at home time, poking them or leaning on them during quiet times. He enjoys showing adults and peers his “sore knees” or “spots” or “bleeding nose” to gain sympathy. After a recent nose bleed at home , he started to bring a hankie every day and look in the mirror to see if there was any blood.
The distinctions outlined below are not research-based but arise from experience. They are offered as rough “rules of thumb” to help guide the class teacher whose access to outside professional advice may be limited. They must be used with caution and, wherever possible, backed up with other opinion. The teacher should be aware that many of these conditions can appear in various combinations. They may all, in addition, respond well to the kind of individual support and careful management found to be effective with children who are seeking attention.
One useful principle is that any instance of unusual behaviour which could be attention seeking should be part of a long standing pattern, embedded with many other attention seeking behaviours, to acquire the designation “attention seeking” correctly. Thus stealing, lying, truancy etc. which are not accompanied by other irritating, annoying behaviours in class would probably not be best handled as part of an attention seeking repertoire. Again, great caution should be exercised in making these subtle differentiations.
A. Attention deficit hyperactivity disorder, ADHD
Attention seeking is easily confused with many other difficulties in school. A similar sounding label is “attention deficit hyperactivity disorder”. Broadly speaking this label refers to children with problems of paying attention (to their work) not problems of demanding attention (from their teachers), together with associated difficulties of being overactive and impulsive. These are children who cannot concentrate and who may be constantly restless and prone to “butt in”. For further information see Taylor (1994) or Wells (2004).
As a very rough way of distinguishing the two we can focus on the “hyperactivity” aspects of ADHD and attention seeking. The child who displays a great deal of activity in class as a way of obtaining attention will almost certainly be happy to settle to work quite calmly with the teacher 1:1. If the child continues to fidget and move all the time and you suspect ADHD discuss this with your special needs co-ordinator and school medical officer. Management techniques (at home and school) and medication may both be necessary for ADHD as the following case illustrates:
Simon Jenkins had difficulties in first school which his mother and school agreed to tackle quite successfully as attention seeking. When problems recurred in middle school Mrs. Jenkins took a medical route. Simon was diagnosed as having ADHD and prescribed medication. His concentration improved greatly and his behaviour settled for a while then deteriorated. The underlying management issue remained. At a recent home visit his grandmother commented, “She [Simon’s mother] can’t get him to do anything. They argue all the time - like brother and sister”.
Mrs. Jenkins reported at a recent review that she had joined a parents’ group at the hospital and was relieved to find she was not alone in having problems. She agreed she still needed to change her approach because in the house “He likes to be boss”. His teacher also noted that, although the drugs helped, Simon required clear guidelines; he was not happy about them, however.
In view of the problems encountered, even by professionals, in trying to distinguish ADHD from attention seeking, a more in-depth discussion is devoted to this topic in chapter 11.
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Extract from p. 113
(ii) The function of the bewildering range of attention seeking behaviours
As noted earlier, a bewildering variety of behaviours, some quite bizarre, has been judged, in certain circumstances, to be attention seeking (see for example Barry Sheen p.xx, Barney Tyler p.xx, Dave Norris p.xx and Ken Turnbull p.xx). In one recent example, a child was able to, quite painlessly, dislocate her own knee – this reliably brought an immediate, powerful reaction from mum. However, it is the function of the behaviour - its impact on the adult - not its description, which counts. As noted below, one behaviour can serve a number of functions.
This issue takes us on to a puzzle at the heart of attention seeking. We need to consider not just the confusing variety of behaviours which can be included under the label attention seeking, but the subjective perception of these by the adult, and that adult’s subsequent reactions. What might be seen by one adult as a behaviour that could be overlooked or handled in a low key manner, such as humming, for another might engender intense feelings of irritation and an inability to ignore it. We are, after all only human, and have our own unique vulnerable spots (remember Debbie Dawson, p.xx, and her teacher’s frustrated comments).
The nature of the adult’s response is a key factor here. An observer will note a relatively predictable set of reactions to whichever of the child’s activities are perceived by that particular adult to be irritating (recall the quotation from Balson on p.xx). And these reactions, verbal and non verbal, subtle and overt, will all ultimately serve the same function: to provide the child with attention. However, it should be emphasised that any report by a teacher of an intense feeling of irritation must be backed up with careful observation, discussion with all interested parties and review of all available evidence, for a full analysis of the pattern of interacting in order to clarify the function of the behaviours.
While undoubtedly some child behaviours within the ADHD syndrome may also serve to gain attention, for attention seeking to be the appropriate description, the common underlying function of most of the misbehaviours that are observed, must be to gain attention. The case of David Fox in Mellor (2000 p.71) provides a good example of deciding on attention seeking rather than ADHD (David was initially medicated for “hyperactivity”). Dan Usher who we met in chapter 2, displayed different sets of behaviour at home, school and in respite care, but in all three settings these had the same function of gaining attention.