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ADHD: The Patchy Attention System



Welcome to the first edition of our bimonthly newsletter, The Developing Child.

The vast amount of research into ADHD and brain function has resulted in ever greater insight into the intricacies and complexities of this condition. Our current understanding of ADHD is that it stems from a malfunction of the brain’s attention system, a complicated network that affects arousal levels, motivation, the reward system, executive function and movement. This dysfunction creates a patchy attention system, which presents as both hyperfocus and inattention – essentially an inability to direct attention on command.* Motivation and the reward system do not respond in the typical way in an ADHD brain due in part to dysfunction with the neurotransmitters norepinephrine and dopamine, which jointly regulate the attention circuits. Intense pressure is often necessary to focus.

In Spark, Dr John J. Ratey explains the benefits of exercise on this patchy attention system, particularly exercise that is highly structured and requires complex movements during high exertion, such as martial arts, ballet, figure skating, gymnastics, rock climbing, white water paddling, skateboarding and mountain biking. Regular exercise increases dopamine and norepinephrine by spurring the growth of new receptors in certain brain areas with the effect of balancing neurotransmitters and improving the quality of these signals. But even more importantly, the technical movements required by complex physical activities activate a vast array of brain areas that control balance, timing, sequencing, evaluating consequences, switching, error correction, fine motor adjustments, inhibition and intense focus and concentration.* A consistent exercise program also addresses hyperactivity.

*Ratey, John J., and Eric Hagerman. Spark: the Revolutionary New Science of Exercise and the Brain. Little, Brown, 2013.

An effective occupational therapy treatment plan for kids with ADHD symptoms needs to address all the levels of the attention system compromised in an ADHD brain.

1) To help regulate arousal levels and sleep patterns, auditory interventions such as the Safe & Sound ProtocolDreampad and iLs to help calm the autonomic nervous system.

2) Improve organization, sustained attention, coordination and academic achievement through iLsBal-a-Vis-XReflex Integration and Yoga.

3) To help with delayed Social Emotional Development, provide parent coaching on co-regulation strategies. Help the child to develop self-regulation abilities and introduce “Mindsight” skills (Dr Dan Siegel).

4) A home program of guided visualization and breathing exercises and complex physical exercise.


Based on Dr Stephen Porges’ Polyvagal Theory, the Safe and Sound Protocol (SSP) is a five-day auditory intervention designed to calm the physiological and emotional state,  reducing stress and auditory sensitivity while enhancing social engagement and resilience.


iLs: a listening and movement based program that activates the cerebellar function with input from the visual, auditory and vestibular system. Parts of the cerebellum are smaller in volume and do not function properly in the ADHD brain.

The multi-sensory input of iLs increases activation of the Reticular Activating System (RAS). The RAS contributes to emotional regulation by providing a sufficient arousal level to inhibit impulses and to control strong emotions, thereby increasing the arousal of the entire brain to function optimally and effortlessly.


Series of Balance / Auditory / Vision exercises that increases in complexity and employs rhythm, full-body coordination and focused attention. This program greatly helps improve ocular motor control, improves attention and helps with reading and learning difficulties.

We hope you’ve enjoyed our newsletter on ADHD. Let us know what you think in the comments below or suggest another topic for our next newsletter. You can also initiate services through our website or by giving our office a call.

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