Responding helpfully to children or young people who are overactive, inattentive or unable to concentrate

Things to think about
Think about yourself
What you can do
When to contact a mental health specialist

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About overactivity and inattention                                                                      printable pdf

Some children are naturally energetic, restless and excitable. They may not do as they are told and they may be noisy and argumentative.  Many children have difficulty sitting still, for example, children are often unable to sit through a meal without fidgeting or attempting to leave the table and allowing their food to go cold.  Although this can be exhausting to deal with, it is nothing to worry about.  Children like this are often described as being 'hyper' but this over-used term can be misleading.  It is merely used to describe overactive behaviour which is often nothing more than being in high spirits.

Children who have marked difficulty with concentration/attention/overactivity and who do not receive help at a young age often continue to have difficulties when they grow up.  This can affect their working life, for example, they may find it difficult to hold down a job for any length of time and instead they flit from job to job.  These difficulties also often lead to major stress within the family.

Providing the child with help at a young age can often increase their chance of achieving their full potential, for example, feeling able to contribute or raising their sense of self-worth or confidence.  As they mature, young people learn to live with their difficulties and to cope better with them, but providing help at a younger age is important in helping them to have happier experiences in their childhood.

Some children who struggle at home may do extremely well within the structure of the school setting.  Having a structure, clear boundaries and routine in their daily life is helpful.

Things to think about                                                                                           top of page

In trying to understand why a child or young person may have poor concentration, poor attention or overactivity, think about the following:

  • Some children are naturally lively and boisterous; this is perfectly natural and nothing to worry about.
  • If parents/carers are unhappy, worried or stressed, they may spend less time with the children in their care and give them less attention.  In order to get some attention, children may respond by becoming noisy or naughty.  Any attention is better than none so sometimes even getting a row is better than being ignored!
  • Some children with learning difficulties will show frustration by being inattentive and distractible when they struggle to understand things.
  • Some parents/carers report that their children react to certain food stuffs/additives by becoming more active or restless and less able to concentrate.  It may be helpful to monitor this by keeping a food diary.  This might identify a pattern of behaviour that can be linked to eating certain foods.

Think about yourself                                                                                             top of page

It is important that, as a worker, you are aware of the impact that your feelings will have on your response to a situation as this will increase your ability to help the child or young person.  If a child is being extremely boisterous, not listening to you or not doing as he/she is told, it may make you angry.  Shouting at the child in a confrontational way might make you feel better, but it is unlikely to be the best way of defusing the situation.

For more information, see section on being aware of yourself and your own response.

What you can do                                                                                                   top of page

  • Have a positive approach, for example show affection and give praise.  Children need to know they are loved and appreciated.  A positive approach promotes confidence, a good sense of self-worth and a feeling of being valued, which can help to reduce attention-seeking behaviours.
  • It is important that clear boundaries are set for the child and for parents/carers to ensure that the child is aware of these 'house rules'.  Parents/carers have to agree on how and when to enforce the rules and they should apply them consistently.  By doing this, the child will learn just how far they can go.
  • Spend time doing activities the child or young person enjoys, both on a one-to-one basis and in groups.  Spending more time with the child or young person will help them feel appreciated and calmer.
  • Try for the most part to have a daily routine.  Plan ahead and let the child know what is going to happen during the day.
  • Ensure the child participates in energetic activities.  This puts their energy to a positive use and can help in tiring them out.  You can build in times for physical activity on a daily basis, as well as times for quiet reading or watching television.
  • Keep an eye on patterns of behaviour that emerge following the intake of certain drinks or food by keeping a diary.  If a pattern emerges, cut these drinks or food out of the diet for a period of time and note any changes in behaviour.
  • Find out if there are occasions when the child’s attention and concentration are better. See
    if there are things that you and others are doing at these times that you could repeat to increase the chances of success at other times. For more information, see section on solution-focused techniques.
  • Introduce rewards for positive behaviour.  It is extremely encouraging for a child to hear that he has done well so give praise when this is the case.  Remember this will encourage positive follow-up behaviour. Fore more information, see section on behavioural techniques.
  • Introduce consequences for negative behaviour.  The child must be aware that there will be penalties if they choose to overstep the mark.  For more information, see section on behavioural techniques.
  • Young people need guidance and it is important to provide this guidance within a positive framework, for example, it’s better to say "I would like you to do this", rather than "Don’t do that".
  • Look the child in the eye when communicating with them.  Make sure they have heard and understood what you have said.
  • Try to give only one instruction or piece of information at a time.  Once the child has completed one task they can then be given the next and so on.
  • You may find that you have to repeat instructions several times for the child.  It is unlikely that the child will be doing this on purpose, i.e. to wind you up.  It is important to respond calmly and methodically to their requests for repetitions.

When to contact a mental health specialist                                                    top of page

  • If the child is persistently, extremely impulsive and frequently engages in dangerous activities with no awareness of the consequences.

  • If the child is extremely restless to the point that it interferes with or prevents normal daily activities from taking place, for example, if the child is unable to sit still for any length of time, is continually fidgeting or getting up and wandering around.

  • If the child’s attention and overactivity occurs over a prolonged period of time and is interfering with their ability to sustain friendships or seriously interrupting their school work.

How to contact a mental health specialist

You should get in touch with your local health centre or hospital to obtain a contact number for the appropriate children and young people's mental health specialists.

Remember - you can contact your local mental health specialists for a number of reasons, for example:

  • For advice on how to make a referral about a named child.

  • For advice about whether or not to make a referral (it is normal practice to seek this advice without naming the child in the first instance).

  • For advice about what to do (once again there should be no necessity to name the child).

By not naming the child you are protecting their right to confidentiality. This method of seeking advice also has the advantage that you do not need to get anyone’s consent in advance of your contact phone call.