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Low concentration and attention
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Low concentration and attention

My son is almost 5 and over the past 12 months has struggled to concentrate when being spoken to and consistently forgets what he is told. Instructions generally have to be given 4 or 5 times and we have tried a wide range of positive behaviour strategies from sticker charts to small treats. They work for short periods of time. I have been worried for a while but now he seems to be getting aggressive for no apparent reason. Please could you give me some advice on my next steps.
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Hello,
   first I would check in with your pediatrician to make sure there is nothing physical going on (such as a hearing loss or blood sugar issue). Let the pediatrician know how your son is eating, sleeping, and how he's doing in school/daycare. Children his age are often distractable and forgetful, so it can be difficult as a parent to determine how unusual he is as compared to his peers. I would let the pediatrician know about the aggressive behavior and ask for a referral to a psychologist who specializes in young children.

   When you meet with the psychologist, you and he/she will determine if your son should be tested to see if he has conditions such as ADHD, an auditory processing disorder or a receptive language delay. You can read my Medhelp article on developmental testing and the one on ADHD as well. If the psychologist determines that this is largely a behavioral issue, then you will want to work on learning effective ways of managing your son's undesirable behavior.

Sticker charts and such seem very easy to do, but they can be difficult to get just right. Changing behavior can be complex, especially when you are emotionally involved. A psychologist can help you identify what behaviors to target, how to set appropriate goals, and how to avoid unwittingly reinforcing behaviors you want to eliminate (which is often the hardest part for parents to identify without help). Seek a psychologist who will first focus therapy on helping you manage the behavior and improve your communication, and gradually build in individual work with your son as needed.

Here are two books that you will find useful before you get started with the psychologist:  The Kazdin Method by Alan Kazdin
How to Talk so Kids Will Listen and Listen so Kids will Talk by Adele Faber and Elaine Mazlish

Best Wishes
Rebecca Resnik

Disclaimer: These posts in response to Medhelp.com questions are intended to be informational only. They should never be considered a substitute for face-to-face medical and mental health care by a qualified practitioner. Answering Medhelp questions is not intended to create or imply a patient-clinician relationship. Information presented in posts is not intended to give or to rule-out a diagnosis.
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