Strategies for supporting attention, activity, emotions and behaviour

Many children find it difficult to focus and maintain their attention at times. Being able to pay attention varies depending on things such as anxiety, stress, quality of sleep, diet, life experiences, bereavement, trauma and neurodevelopment.

If your child is struggling with attention and concentration, here are support strategies to try.

• Give regular prompts to help them to maintain their focus.
• Set small goals to work on together.
• Present work and tasks in small chunks.
• Use their name before speaking to them to check they are ready to listen.
• Give short and specific instructions when asking them to do something. For example, instead of asking them to tidy their room, ask them to put their toys into the box and books onto the shelf. This makes the task clearer.
• Break instructions down and give one at a time, allowing them to complete the first before moving onto the next. Repeat instructions as necessary.
• Try to adapt tasks to make them either of interest (related to something they’re interested in), novel (doing something a new way), or have a sense of competition. This will increase their motivation and help them to keep focus.
• Try to make the task more visually interesting eg with pictures or colours.
• Give positive encouragement to continue with tasks.
• Identify possible distractors and discuss these with your child to help them spot these themselves. Remove visual distractions. Noise cancelling headphones may minimise noise distractions.
• In school they may benefit from sitting near the teacher, away from distractions like a window or door and away from other children who may distract them (or who they may distract).
• Offer regular breaks. Some children need regular movement breaks or ‘brain breaks’ to keep their attention, or they may need to fidget to sustain attention. Using fidget toys may help them to stay focused.
• Consider what time of the day your child does a task that needs more mental effort. For example, your child may focus better in the mornings so this is when more difficult tasks should be required of them.
• Classical music, audiobooks or white noise may help with keeping focus.
• For older children, you can try ‘The Pomodoro Technique’, this is a time management method used to break work into chunks of focus separated by short breaks.

Some children and young people can show increased levels of hyperactivity.

If this is the case for your child, we recommend trying the following.

• Make sure they take regular breaks from their tasks. Look out for early warning signs and intervene early.
• Movement breaks give a child the chance to move around and regulate before going back to their work. This can reduce restlessness. In school consider a time out card or a signal to let teachers know that they need a break.
• In school, they may need the chance to sometimes stand up or walk around the class in a non-disruptive way. This can reduce the frustration of sitting still for long periods. For example, they may be able to give out books or sharpen pencils.
• Ask them to complete tasks which involve movement/physical activity. For example, putting away the dishes or classroom resources.
• Encourage regular exercise or involvement in sports clubs to give them an outlet for their hyperactivity and restlessness. This will also help with motor skills.
• Allow them to use fidget toys or play with small objects such as a tangle or a hairband. Different fidget toys may need to be trialled to find ones which aren’t distracting, but which help your child.
• If possible do not remove breaks as a punishment or as a way to make up for missed schoolwork.

Children and young people are naturally more impulsive than adults as their brains are still developing. Some children can display more impulsivity than others, which may mean they find it hard to take turns, think before acting or making decisions, and think about the result of their actions.

The following strategies may help.

• Try the ‘Stop and Think’ strategy. This involves encouraging your child to say ‘stop’ and if possible remove themselves from the situation. They will then tell themselves to ‘stay calm’ and ‘think before you act’. Learn about this on the Life Skills Advocate website and the OT Toolbox.
• The ‘Traffic Light System’ can help your child notice when they are feeling calm and are more likely to make better decisions compared to when their emotions are heightened and they may make more impulsive decisions.
• If they interrupt others during conversations, agree a word or gesture which can be used as a signal that they have interrupted someone. This can help protect their self-esteem. Your child may not mean to interrupt people and there may be times when it’s okay to allow them to.
• Ignore minor inappropriate behaviour if possible, especially if it seems that it was not done on purpose or isn’t likely to happen again, or if it is intended just to gain the attention of teachers or classmates.
• Offer a break or redirection if impulsivity appears to increase.

Working memory means being able to keep in mind the information needed to complete a task, while you are doing the task. It’s an important part of learning and being able to follow instructions.

Some children struggle with working memory. Try the tips below to help.

• Use visual reminders like lists, post-it-notes, phone reminders, alarms or sticking a weekly planner or visual timetable on the fridge.
• Break instructions down and give one at a time. Let them complete the first before moving onto the next.
• Repeat instructions as needed.
• Write down instructions – it can be easier to forget verbal instructions.
• Repeat information.
• Help them to set up and use their own routines, for example putting items in the same place when they aren’t being used so that it becomes a habit and they are less likely to lose it.
• Practice and use memory aids like forming links between tasks or items.

Some children have a slower processing speed than others, this means it can take them longer to process information and carry out instructions.

They would benefit from:

• More time to process information, make decisions, respond and complete tasks.
• Not being required to work under time pressure.
• Being reassured that it is ok to take their time while doing tasks, for example copying slowly from the board.
• Extra time for proofreading.
• Being given copies of notes rather than being expected to copy notes from the board in a limited time.

Some children may need more support with staying organised.

You might find the following strategies helpful.

• Plan the day so your child knows what to expect.
• Visual timetables can help them to understand what will happen at each stage of their day. Set schedules of activities and help them to estimate how long each task will take.
• Use visual reminders like lists, post-it-notes, phone reminders or a weekly planner or visual timetable on the fridge.
• Visual clocks, egg timers or stop watches can help them to see how long they have left of each activity and to prepare them for moving to the next.
• Keep routines as consistent as possible. For example, keep the order of tasks during a morning routine the same.
• Use visual cues, like sticking a reminder on the bathroom mirror to explain the next step that comes after brushing their teeth.
• Keep their room or desk clear of unneeded material. Help them to organise and pack their school bag the night before.
• Encourage them to consider what is needed for a task before they make a start on it.

Always try to understand the reasons behind your child’s behaviour. Behaviour is a form of communication. Things like the sensory environment can increase distress and result in challenging behaviour for a child who is sensitive to noise. A child experiencing hidden anxiety may come across as defiant.

Children are not able to regulate themselves in the same way as adults - they are learning how to manage their emotions! When difficulties arise, try to discuss these openly and carefully with your child. Offer them choices and be flexible where you can. Describing their emotions, setting consistent boundaries and consequences, and talking through expected or consistent reactions can help.

It may be helpful to change the language you use when your child is stressed. Say their name first. Use ‘I’ language, for example “I can see that you are upset”. Give them time to process what you say. Repeat the sentence with the same words if you need to. Break down instructions into simple steps.

Confrontation is rarely helpful. If your child seems to be choosing not to comply on purpose, think about the reasons for this. If they are struggling to overcome the situation, a calm approach that offers choices, options and flexibility is often helpful.

Make sure you set clear and consistent boundaries for your child. Be clear about what behaviour is acceptable and what is not and help them to understand why.

Acknowledge their feelings

• Acknowledge and validate your child’s feelings of anger or frustration rather than dismissing their emotions. This will help them to feel understood. You could say something like ‘I can see that you are upset, I wonder if this is because you feel hurt by…’.
• Help your child to express their feelings. Ask them to show you how they are feeling, by encouraging them to:
  - Use their words
  - Draw a picture
  - Go to a chosen calm place
  - Walk away
  - Count to 20
  - Focus on breathing in and out
  - Tense and relax their muscles
  - Exercise (eg run or jump)
  - Hit a cushion
  - Rip up scrap paper
  - Splash cold water on their face
• Create some communication flashcards together that your child can write or draw on to tell you how they’re feeling if they can’t say it. Have some prepared in advance that they can choose and some they can write on.
• Use an emotions wheel if they are struggling to identify their feelings.
• Consider using the Zones of Regulation resources (their resources section has some free downloads).
• Create a calming box or self-soothe toolbox with items in that will help them to calm down or cope when they are struggling. Items might include headphones to listen to music, paper and pens to draw/write, fidget or sensory toys, paper to rip, communication cards, a soft toy and activities such as bubbles, paints or wordsearches.
• Set a time each day for 1:1 time where you and your child can spend 15 minutes talking about their day and their emotions. If they struggle with anxiety, this could be called ‘worry time’ to allow them a set space to talk about their worries.

Create a safe space

• Talk to the school about your child having a safe space to go to when they are beginning to feel frustrated or anxious.
• Find a safe space at home (for example their bedroom or a playroom) where they know they can go to for space when they need to.
• Build time in for relaxation and physical activity into their daily routine. This could be watching a movie under a weighted blanket, using a sensory light projector, jumping on a trampoline, listening to music, time in a sensory swing, looking after a pet or reading/writing/doing art.
• Redirect challenging behaviour into an activity that releases energy/emotions, for example trampolining, running around the garden, or listening to music.

Rules

• Set clear ground rules for behaviour. It may be helpful to describe these rules as being for everyone including yourself, not only your child.
• Use as few rules as possible (eg 4 or 5) so they are more likely to remember and stick to them.
• Agree rewards and consequences for sticking to or not sticking to the rules.
• Involve your child and the whole family with creating the rules to make sure everyone understands and is an active participant in the rules.
• Write down the rules and stick them somewhere visible.

Rewards and praise

• Focus on positive reinforcement of desired behaviours and effort rather than sanctions. Notice when your child achieves the desired outcomes and what made it successful.
• Praise your child often and offer rewards to encourage desired behaviour and to make sure your child knows what you want them to do.
• Pay attention to positive behaviours and praise these. Otherwise, they may decrease. For example, if you are working on your child using unkind language, it would be important to praise and reward them when they use kind language.
• If your child wants something and isn’t able to have it and then they tolerate this without arguing, praise or reward them for this.
• Be specific with praise, for example ‘the compliment you gave your brother was really kind, well done’.
• Use hugs, kisses, hi-5s (whatever your child prefers) alongside verbal praise.
• Rewards may include favourite activities, toys, tokens or small amounts of favourite foods or drinks.
• Try a token system/reward chart. This involves setting up a chart of positive behaviour somewhere visible and your child gaining points for positive behaviour, then receiving a prize after getting a certain number of points. Make sure they understand what they need to do and encourage them to help set up the system. Don’t take away points that have already been earned.
• Praise should be immediate to make sure the positive behaviour is reinforced.
• Show enthusiasm when offering praise, for example be energetic, smile, hug and speak enthusiastically to show how pleased you are.
• Give your child ‘special’ tasks around the house which are theirs and nobody else’s. For example, watering a plant that is only theirs, feeding the pet every morning. This will give them a sense of pride and ownership and help to build their self-esteem. Write out their responsibilities clearly and offer reminders when needed.

Diversion

• Try and notice early warning signs and divert behaviour before it occurs by distracting your child with another activity.
• Have a secret supply of games/activities/treats you can use.
• The diversion needs to happen before any challenging behaviour occurs, otherwise you may accidentally reinforce the behaviour. For example, if they shout and then you give them a fun game or chocolate bar, they will learn they get this when they shout.
• Help them to calm down when they are becoming frustrated. Identify calming activities (for example the calm toolbox) to use.
• If your child is injuring themselves or others, consider placing a barrier such as a pillow or cushion between them and whatever they are harming or using to harm themselves.

Families Under Pressure provide evidence-based tips and advice to deal with challenging behaviour from researchers and NHS mental health experts.

Find out how to help with anxiety

Find out how to help with anger and aggressive behaviour

Self-esteem is how we think and feel about ourselves. Children who struggle with inattention, hyperactivity and impulsivity are more likely to experience low self-esteem. This may be because they hear more negative messages about themselves and may be criticised more often.

Try the following strategies:

• Tell your child regularly that you love them and why they are special.
• Carefully challenge the negative things that they say about themselves.
• Make sure you regularly spend quality 1:1 or ‘special time’ together.
• Remind them that you believe in them.
• Show interest in the things they enjoy and want to talk to you about.
• Encourage them to identify what helps when they feel bad about themselves.

Read more about self-esteem on the Young Minds website.

Good quality sleep is important for children’s growth and development. Some children find it hard to fall asleep or stay asleep at night. Encouraging good sleep hygiene and establishing a good sleep routine is important.

• Avoid naps during the day as this may make them feel less sleepy at nighttime.
• Children with higher levels of energy may need to do more physical activity during the day so that they feel tired at bedtime, for example playing sports, trampolining or going on walks or to the park.
• Avoid caffeine for at least six hours before bedtime. This includes tea, coffee and fizzy drinks.

Creating a good sleep environment

• Make the sleep environment the best it can be for your child. Consider all the things around them that may affect their sleep.
• Minimise noise levels. Some children though may need some sound to settle, for example relaxing background music, white noise, the sound of a fan or listening to an audiobook.
• Make sure the room is a comfortable temperature and the bed is comfortable.
• Weighted blankets may help some children to sleep.
• Use a night light if your child is afraid of the dark.

Creat a sleep routine

• Introduce a consistent bedtime routine which is the same every day. This should help your child to wind down and relax before bed.
• A bedtime routine may involve finishing an activity by a certain time and doing a less stimulating activity, such as reading a book or being read to, having a bath, making up a story together, drawing or colouring or listening to music or an audiobook. Offer them choices of what they would like their bedtime routine to include.
• Screens (phones, TVs, computers, games consoles, tablets) should be switched off at least an hour before bed. The light from electronic devices is thought to block the release of melatonin (a hormone which helps us to sleep).
• The routine may also include packing their school bag for the next day, brushing their teeth, tidying their room, or having 1:1 time.
• Establish a set time they should be in their room and a set time they should be in bed. Going to bed at the same time every night (including on weekends and holidays) helps the body to develop and sustain a good sleep cycle.
• Write out the bedtime routine and put it in your child’s bedroom so they can remember the steps of the routine and what time it starts.

During the bedtime routine

• Set clear rules about getting out of bed and playing, and what they can and can’t do. Add these rules to the bedtime routine sheet.
• When your child is not sticking to the routine, remind them to go back to bed. Reinforce the routine by pointing to the bedtime routine sheet/checklist. Reset their bedtime music or audiobook to encourage them to settle.
• Try not to argue or shout as the aim is to keep them calm and settled.
• Remove items such as technology or games from their room at night that they may be tempted to play with.
• Make sure they have had a drink, been to the toilet and prepared for the next day before they go to bed to minimise reasons for getting out of bed.
• Use a star chart to mark when they have stuck to the bedtime routine.
• Talk with your child about how they feel the routine is working. Help them to recognise the positive effects of a good bedtime routine.

Keeping a sleep diary

• If sleep continues to be difficult, keep a sleep diary and record activities leading up to bedtime, all food and drink consumed before bed, time in bedroom, time in bed, time asleep, hours slept, sleep disturbances, time they wake up.
• Note what strategies appear to help and what don’t.
• Take this sleep diary with you if you do seek advice from a medical professional.

The Sleep Charity provides advice and support around sleep. They also have a Teen Sleep Hub for teenagers.

Read our blog on dealing with troubled sleep

Read our blog on teenagers and sleep

Alongside the other suggestions on this page, children struggling with inattention, hyperactivity or their behaviour may need their school environment to be adapted.

Schools can be a very difficult environment for children and young people with ADHD as they’re required to do all the things that they find difficult. They have to sit still for long periods of time, concentrate on tasks that might not interest them, keep quiet and not call out in class, remember equipment and organise themselves between various activities. If their behaviour isn’t understood in the context of ADHD, this can lead to them being seen as disruptive, which can have an impact on their peer relationships, their learning and their self-esteem.

Think about the following.

• Giving them access to work areas with less distractions.
• Sitting them near the teacher so they are less likely to be distracted and can be given extra support when needed.
• Background music that helps to filter distractions may help them to concentrate better.
• Earphones or ear defenders may help to block out noise distractions.
• Making the distance between desks bigger so they are less likely to be distracted.
• Sit them near peers who are positive influences.
• Making sure the desk and chair is the right size as they may be more likely to fidget if it isn’t. The general rule is that the child should be able to put their elbows on the desk and their chin sit comfortably in the palm of their hand.
• Movement breaks can be incorporated into the lesson as a whole class activity, eg a 2-minute break to do star jumps.
• Use visual clocks, egg timers or stop watches for them to see how long they have left of each activity and to prepare them for moving to the next.
• Regular 1:1 time with a keyworker or mentor, or when the child appears frustrated or struggling.
• Make sure there is consistency between home and school. It’s important to have regular and effective home-school communication to help with planning and to make sure parents and carers and the school are on the same page. There also needs to be a system for reviewing progress. Examples include communication books between home and school, Individual Education Plans and weekly communication sheets. This would help parents to follow through at home with appropriate rewards or consequences and inform teachers of events that may affect the child at school.
• Positive reinforcement of desired behaviours and effort should be prioritised rather than punishments. Notice when the child achieves the desired outcomes and what helped them to do this.
• The child should be involved in selecting their targets and rewards, as this will increase their motivation and make sure they understand what they are working towards.

Books that you may also find helpful include:

• The Incredible Years by Carolyn Webster-Stratton
• The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated, Chronically Inflexible Children by Ross W. Greene
• All Dogs have ADHD by Kathy Hoopman
• A Birds Eye View of Life With ADD and ADHD by Chris Zeiglar and Alex Zeiglar
• Mover Dreamers and Risk Takers: Unlocking the Power of ADHD by Kevin Roberts
• The ADHD Handbook by Alison Munden and Jon Arcelus
• ADHD Secrets of Success by Thom Hartman

Sensory processing difficulties can affect children with ADHD and other neurodevelopmental conditions.

Find out more about sensory processing 

We also run free online workshops on sensory processing in young people.

There is an excellent guide called Making Sense of Your Sensory Behaviours produced by Falkirk Council (easily found by a google search of the title).

Difficulty listening to others, initiating conversations at appropriate times, frequently interrupting, missing social cues, withdrawing, and talking excessively can be more common in young people with ADHD.

Find out more about social communication