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Attention Different

This is a term I coined in my book Survival Strategies for Parenting Your ADD Child (Underwood Books, 1996) to designate children who pay attention differently, not necessarily dysfunctionally, to people and events around them. For example, children diagnosed with ADHD pay attention exclusively to things that interest them. Children with Bipolar Disorder pay attention, and are captivated by, powerful inner emotional states. Children with Tourette’s syndrome pay attention to propreoceptive feelings of discomfort—the feeling of "muscle itch" that comes before a tic. These idiosyncratic attentional styles become "deficits" when they interfere with task accomplishment in the modern classroom (or cubicle at work).

Attention Deficit Hyperactivity Disorder

A condition in which a child, adolescent, or adult shows evidence of:

  • Difficulty paying attention to events or input from others

  • Difficulty keeping on task, the mind wanders

  • Difficulty with working memory

  • Difficulty mentally activating to get things done that are not interesting

  • For some, a tendency to get stuck or to show patterns of rigid thinking

  • For some, a co-occurring mild depression that comes and goes

  • For some, slowed cognitive processing at school—he is still on lesson 1 when the other kids are already to lesson 3.

Autism Spectrum Disorders

In autism we see the following cognitive and behavioral issues:

  • "Mind-blind" There is an inability to understand one’s own mind and the minds of others. S/he does not distinguish his/her mental set from others—s/he is blind to their intentions and motivations. S/he believes s/he and others share the same "desktop," the same history, thoughts, feelings, and beliefs.

  • "In a world of his/her own." S/he shows great difficulty in having "shared attention" —the ability to merge into social settings and share a common focus.

  • Field-indifferent. S/he lacks the ability to take the context of behavior into account, and just focuses on specific details.

  • A visual intuitive or visual kinesthetic thinker. S/he does not make sense just of what s/he sees and hears. S/he needs to feel a reality to perceive or remember it.

  • Unable to comprehend or deal with change in his environment. S/he needs "sameness."

  • Incapable (as a small child) of using language to get social and emotional needs met. S/he uses language "instrumentally." The child may say words like "Give me the toy" but would not say "I love you Mommy. I need a hug."

Asperger’s Syndrome (AS).

"Odd but active" (Dr. Lorna Wing)

The DSM V has removed the distinction between autism and Asperger’s syndrome and no longer contains the AS diagnosis.   In my practice I continue to make the distinction because I believe that the challenges for people with a primary correct diagnosis of autism are different from those with a diagnosis of AS.  The more severe the level of challenge in the above factors, the more likely the person carries a frank Autistic Spectrum Disorder as opposed to Asperger’s syndrome.

  • The AS child is not mind-blind (he has a rudimentary understanding of the role emotions play in his life and how certain thoughts lead to certain feelings).

  • The AS child may be capable of rehearsed "shared attention" though he usually feels compelled to talk about his special interest.

  • The AS child may think in words as well as images.

  • The AS child has a need for sameness but much less so than the HFA child.

  • The AS child will not use language to get social needs met (either) but is rarely mute as is the case for some autistic children.

  • The AS child is the "little professor." The child with HFA is much more "in a world of his own."

Anxiety Disorder

Excessive worry which is difficult to control associated with:

  • Fatigue

  • Restlessness

  • Difficulty concentrating

  • Irritability

  • Muscle tension

  • Sleep disturbance

  • stomach and head ache

Anxiety may be sensed as a disturbed, apprehensive feeling state—"waiting for the ax to drop," as much as a state of specific worry. Anxious adults and children typically ascribe "negative attribution" toward life stressors—they tend to see the glass as half-empty, never half-full. Younger kids are prone to frequent meltdown. Many show performance anxiety, are fearful of humiliation and rejection, are perfectionist, and have separation anxiety from parents.

Bipolar Disorder (BD)

A condition involving dysinhibition of the emotional centers of the brain. Adults will experience depression and mania, in the form of inappropriately elevated mood or aggressive irritability ("mixed state"). They will be very impulsive. Pre-pubescent children will demonstrate rage, depression, dangerous hyperactivity, and extreme impulsivity. 

Cognitive-Behavioral Therapy (CBT)

A type of counseling approach based on the idea that our thoughts and perceptions precede our feelings. To change the way we feel and act, we must change the way we think about the challenges that we face. Though CBT is not a universal panacea, it can be very helpful when dealing with anxiety, depression, and impulsivity. Using this approach, I help clients rethinkthe way the reactso as to behave more resourcefully.


A mental and physical pain disorder with the following major symptoms:

  • Changes in appetite

  • Changes in sleep patterns

  • Irritability

  • Feelings of sadness, worthlessness, and guilt

  • Lack of energy

  • Recurrent thoughts of death

  • Cognitive impairment

  • Diminished interest in pleasure

  • Psychomotor agitation or slowness

In teens depression is often seen as a state of chronic irritability and oppositionality.  Treating physicians now look for the possibility that a depressed teen is manifesting the first phase of a bipolar mood disorder that will eventually emerge as mania or hypomania.  The Selective Serotonin Reuptake Inhibitor (SSRI) medication used to treat depression may make a bipolar condition much worse.

Post-Traumatic Stress disorder

A set of behaviors that are seen in persons who have experienced traumatic stress. Criteria for this disorder include:

  • The traumatic event was terrifying and the person felt helpless to protect himself

  • The person experiences recurrent recollections of the event. In children, these themes are seen in play behavior

  • Nightmares and flashbacks (reliving the experience) are present

  • The person experiences intense stress when reminded of the event

  • The person avoids thoughts, feelings or conversations associated with the event

  • The person cannot recall parts of the event

  • The person has a feeling of detachment from others

  • He has difficulty falling or staying asleep

  • Rage, hypervigilance, and an exaggerated startle response may be present

  • HA person has difficulty concentrating

When working with clients with PTSD, I try to balance attending to the trauma itself and all the ways it has changed my client’s life to treating the syndrome so that the visceral pain of it can be put where it belongs, in the past.


The term first seen in the book Breaking the Trance:  A Practical Guide for Parenting the Screen-Dependent Child (CRP, 2016) is used by Cynthia Johnson (my co-author) and I to denote a mental state characterized by excessive reliance on screen media (video games and social media) to the degree that significant distress is experienced if deprived of access to media.

Stress Psychology

The stress response is the mind/body’s response to events perceived as novel or overwhelming. Stress psychology is the study of how the mind reacts to stress and what attitudes push for either distress (a self-destructive reaction) or "eustress," (a pro-health, pro-hardiness, strengthening reaction). In my practice I teach people cognitive-behavioral skills so that they are able to control their reaction to stress and be proactive in their lives so as to reduce its potentially destructive impact.

Tourette’s syndrome (TS)

A condition in which a child experiences both semi-voluntary motor movements ("motor tics") and vocalizations ("vocal tics) for over a year. Oftentimes the child will also experience obsessions, compulsions, and depression. Some children will repeat what others have said ("echolalia"), or repeat objectionable words ("coprolalia"). Many, not all children with TS are also diagnosed with ADHD.

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