Title: Where have they all gone?: classroom attention
patterns after Acquired Brain Injury
Author: Siân A. Rees
Affiliation:
The SHIPS Project,
Contact details:
43/45 Stanley Road
Warmley
Bristol
BS15 4NX
Email: sian@shipsproject.org.uk
Abstract
Certain groups of pupils who have sustained an Acquired Brain Injury (ABI)
have a different pattern of attention within the classroom which interferes
with learning and social interactions. The delineation of these groups is
suggested. By looking in detail at the classroom behaviour of eight pupils, a
common account for classroom behaviour post-ABI is questioned, and an
alternative explanation put forward. Practical ways to promote learning for
this group are explored.
Key Words: attention, concentration, acquired brain injury, classroom interaction, instruction
Introduction
A growing number of pupils are returning to our mainstream classrooms having sustained an
Acquired Brain Injury (ABI) (Sharples et al 1990, Royal College of Surgeons 1999, Hawley
et al 2002, Hawley et al 2003, Petit-Zeman 2001). In the classroom young people are
required to give attention to tasks and teachers in different ways. They may be asked to
switch attention from one task to another quickly, divide attention between concurrent tasks,
focus attention on particular aspects of a task and sustain attention to complete a task (Walker
& Wicks 2005). Most importantly, pupils are expected to move into and out of the different
kinds of attention rapidly and efficiently, as the lesson demands. For those who have
sustained an ABI this may be difficult (paper in preparation).
Sustaining a brain injury is a major event in any life, but if it occurs while the brain is
developing, recovery becomes intertwined with the normal process of development can take
many years and may not be complete (Hawley et al. 2004). A rapid physical recovery can
mask underlying cognitive difficulties (Lord-Maes & Obrzut 1996, Johnson 1992). Older
1
children with ABI may act like younger ones (Dennis et al. 1996, 1998) and further
development of the brain after injury may not proceed as expected (Johnson 1992).
ABI and attention
Attention is the process of admitting and holding information in consciousness (Ylvisaker &
Szekeres 1998), but the term tends to have a wider definition in the educational world.
Concentration is the selecting and maintaining aspects of attention. It is affected by
motivation and deliberate control of attention is necessary under less than ideal conditions,
such as a classroom. In a classroom, and life in general, it is also necessary to divide
attention between two or more tasks while focussed attention refers to the ability to ignore
distraction while focussing on an activity. However in the classroom it will always be
necessary to be aware of distractions and to judge whether they are important or not; a
teacher providing additional information about a talk is important, while a peer wanting to
talk about social matters is more likely not to be important for the task.
It is suggested that speed of processing is a limiting function of attentional capacity and poor
working memory could also be an impairment of attentional control (Mateer et al. 1996),
leading to impulsivity and poor judgement. Attention problems could arise from the over
processing of redundant stimuli. The ability to divide or change the focus of attention allows
flexibility in thinking, ability to appreciate different points of view and reasoning (Mateer et
al. 1996).
Difficulties with attention after an ABI are well documented in the literature (Begali 1992,
Ewing-Cobbs et al. 1998, Kehle et al. 1996, Semrud-Clikeman 2001, Mateer et al. 1996,
Ylvisaker & Szekeres 1998, Walker & Wicks 2005). People, things and their own thoughts
will distract learners after an ABI and a programme of gradual re-entry to school is usually
advised to avoid attentional overload (Telzrow 1987). Dennis et al. (1995) found that young
people with an ABI process both the distractor and the target. Such pupils are more easily
distracted in lessons which they find difficult, where many ideas are new and much
information is provided. New learning is then adversely affected. Often these children can
concentrate on activities of their own choosing but have problems when the activity is chosen
for them (Baldwin et al. 1998). They experience difficulties when asked to switch from one
activity to another or to maintain attention on a particular task (sustained attention). The
effect of difficulties with attentional control in the classroom has not been considered widely,
although it has been found that good attention skills are a prerequisite for the successful
return to schools in the USA (Semrud-Clikeman 2001, Telzrow 1987).
Although it is suggested that difficulties with attention in general may be secondary to other
cognitive disabilities (Ylvisaker & Szekeres 1998), many commentators (e.g. Walker &
Wicks 2005) note that after an ABI, young people experience difficulties with focussed
attention. It is possible for pupils who have sustained an ABI to switch, divide, sustain and
focus attention under ideal conditions (paper in preparation). But the ability to become
absorbed in a task is essential for learning.
Method
Pupils were recruited to this study as they were referred to The SHIPS Project (Supporting
Head Injured Pupils in Schools), a charity which helps schools and families to manage the
education of young people who have sustained an Acquired Brain Injury and who are
educated in mainstream or MLD schools. The young people had all sustained severe
traumatic injuries, or were in intensive care for a significant amount of time where the injury
2
was non-traumatic. Full consent was obtained from pupils, parents and teachers, and names
have been anonymised. Because of the paucity of existing evidence about the performance of
ABI students following re-integration into the school setting, and the opportunistic nature of
recruitment to the project, a qualitative, naturalistic case study strategy was adopted, seeking
to illuminate the difficulties experienced by this group of pupils. Participant observation
within the pupils' normal classrooms was undertaken, recording observations as fieldnotes in
a range of classes, over several years for some pupils, while on a single session for others.
Data from 92 pupils was collected with aetiologies as in Table 1
Aetiology
Anoxic injury
Encephalitis
Traumatic brain injury
Tumour
Stroke/haemorrhage
Meningitis
Epilepsy
Congenital Heart Defect
Table 1
Number of pupils in study
2
6
48
11
11
4
8
2
Table 2 provides further details about Louise, Nasser, William, Joanne, Ruth, Julie, Vicky
and Simon whose observations are used as examples
Name (Alias)
William
Ruth
Simon
Vicky
Joanne
Nasser
Louise
Julie
Aetiology
encephalitis
tbi
tbi
tbi
tbi
tbi
tbi
tbi
Stage at injury
KS4
Infant
Lower KS2
Upper KS2
KS4
Early Years
KS3
KS3
Stage at observation
KS4
Upper KS2
KS3
KS3
KS4
KS3
KS3
KS4
Table 2
Data from observations were subjected to analysis within NVivo (www.qsinternational.com).
3
Classroom Attention Requirements
Typically developing pupils seem to be able to move in and out of the different kinds of
attention required in the classroom, graphically represented in Figure 1:
Sustained
attention
Into lesson
Switching
attention
Focused
attention
=
absorbed
Divided
attention
Figure 1: typical classroom attention pattern
This study was provoked as William’s Maths teacher commented that he was continually
disrupted and distracted in class, but could become absorbed when the researcher (SR) was
there. William did not have a teaching assistant (TA), he was considered too able to qualify
for personal assistance, but the maths class does have TA help once a week. It was not the
presence of more adults in the room that made William settle more quickly. This TA is
unaware of the needs of ABI pupils, but as a specialist teacher SR is aware of his difficulties.
SR seemed to be doing something specific. On examination it appeared that SR was pushing
William through his distractions into a period of focussed attention, by gently, and
wordlessly, keeping his attention on his work touching the task and bringing his attention to
bear on it long enough for him to be able to focus and do it for himself. This could be classed
as an aspect of scaffolding, namely direction maintenance where 'The tutor has the role of
keeping [learners] in pursuit of a particular objective.' (Wood et al. 1976 p98)
Classroom Observations
Through the way that they time their instruction, classroom teachers can help pupils with ABI
to focus, and in time pupils do learn that they need to focus and not allow themselves to be
distracted by others. Simon was four years post injury at this point, in a science lesson about
electromagnets. The class are standing or sitting around the front bench with the teacher.
Previously they have been working from a text book.
The teacher conducted a quick revision of the
exercise with questions and answers, accepting
some together.
There followed a didactic
electromagnetic bell works. Simon looked at the
4
answers of the previous
lots of ideas and linking
explanation of how an
teacher and the board as
appropriate. The teacher asked them to copy the diagram into their exercise
books and annotate it. They were sent back to their seats.
Simon immediately gets out his book and starts. The rest of the group chatter
and fiddle with equipment. Simon draws in pen. The rest keep mucking around.
The teacher admonishes them, but Simon takes no notice. When I checked later,
even though there had not been a break in the chatter all had done the work to
the teacher's specification. At times Simon was clearly distracted by the
mucking about but did not speak or join in.
The teacher arrives with the apparatus for them to have a closer look. She
explains the process (third time through at least) and others make comments, but
again nothing from Simon, though he looks very closely.
On completion of the lesson, he had explained what had happened in his book
clearly and succinctly, including the vital role of the spring which the teacher
had not mentioned. It was in the book.
Most pupils can manage to move in and out of being absorbed as in figure 1, getting on with
the task while chattering but pupils with ABI do not appear able to do so. This excludes them
from the group and makes them appear different. Simon, who was several years post injury
at this point, seems to know that he must not join in, but must focus on his work. The arrival
of the teacher was at just the right time for Simon to remind him of the explanation she had
given and although he again said nothing he looked intently. Notably the teacher did not
disrupt his train o f thought by requiring an oral/verbal response. The exercise involved a
diagram and annotation, a more iconic representation of the concept rather than the symbolic
exercise of writing about it. He had managed to link the teacher’s explanation with that in the
textbook.
Deep focusing after ABI
Further from injury, some pupils are able to move themselves into a deeply focussed state.
Once these pupils with an ABI settle there is a period of deeply focussed attention, during
which they ignore all around them, including the teacher’s indications that they are moving
onto the next part of the lesson. Where the teacher makes the transition less obvious the ABI
pupil remains engrossed.
Maths Y11 class. Louise and the rest of the class had been working at
exercises 'finding the mean'
Suddenly the teacher asks the class to give him some numbers. Louise was
concentrating on her graph. Everyone else stops their task and provides a
number without prompting - this seemed to be a regular feature of lessons. The
teacher had to ask her specifically to give a number and had to repeat her name
before she was aware.
Louise was very deeply engrossed in the task before her and did not respond to her name on
the first occasion. Once the teacher had collected the numbers offered and asked the class to
multiply them by 10 and 100, they were expected to return to the initial task. Louise did not
settle well to this, having been disturbed, and was unable to regain her focussed state. The
teacher commented to me that Louise likes her routine and did not come with the ‘starter’
5
activity being moved to the middle of the session. However it could equally have been a
difficulty with the attention cycle having been broken. This seems to be a pattern which
occurs in many lessons with several different pupils.
Non-injured pupils seem to be able become absorbed in a task much more quickly and then
not to focus their attention quite so exclusively and are able to notice the teacher’s indication
that the lesson is moving on, or a new task is being set, but this seems rather more difficult
for some pupils with ABI, as in this excerpt from a Geography lesson.
Louise read the task from the board, the TA read the relevant passage from
the book. The teacher then started to read a different passage from the
book, but Louise ignored the teacher. She had not reached that part of the
task.
P2: Where are the atlases?
T: There
TA: Shall I get you one?
Louise nodded
(Key for extracts: T is teacher, TA teaching assistant, pupils are identified by their initial, P1, 2, 3 are other pupils,
SR is the researcher)
Louise was so engrossed in her current task, that she did not attend to the teacher’s next set of
instructions or assistance or was not able to divide her attention as the task was so
complicated. It may be that she made a decision that she did not need this information as she
had not yet reached that part of the task. If so then this is evidence of poor planning! In this
class this is overcome by the prompting of the TA to fetch an atlas, and subsequently the TA
showed Louise what to do, but not why. That part of the lesson has been lost.
This deep focusing can mean pupils get a lot done, but there are also disadvantages to being
lost in the task.
Disadvantages of deep focusing
Pupils may be left behind in previous classes and try to catch up, their focus being on that
activity, missing even the beginning of the session
Previously in tutor time the class had been asked to make sure their
timetables were stuck into their planners. Nasser had not finished but
arrived in his Maths class before the teacher so he carried on.
T: Nasser
He looks up and then down again. He is cutting out his timetable and sticking it
in his planner. The teacher has started writing on the board and the class are just
settling down
T: So if you could write a little grid and a little diagram to help you understand.
If you call it Place Value.....
Nasser continues his cutting and sticking
T: What are you doing? You need to write this down. You need to stop. Put
today’s date like this (she writes on the board). I’ll sort that out later.
He carried on with it.
P1: Do you have to write this?
T: Yes please. (reading from the board) The value of a digit depends on its
place in the number.
N: Shall I write that?
6
T: Yes please. I’ll put units, tens, hundreds, thousands. What shall I put after
the line?
Other pupils answer but not Nasser. She continues teaching and Nasser
continues copying. He copies one letter at a time, which means the copying is
very slow.
Nasser was so engrossed in the task from tutor-time that he missed the start of the maths
lesson. The teacher tried twice to get his attention, but not successfully, perhaps because she
use the conditional tense (Rees 2007) and he was only alerted by the question from another
pupil, who had arrived at the lesson rather late.
Pupils with ABI frequently miss homework being given and there is a constant cry from
parents for this group of pupils to be given assistance with writing tasks in their planners.
However in the example below the difficulty is seen to be deeper than just the amount of time
given in class for the homework task to be recorded.
Maths lesson, Nasser is well into his work
T: I’m trying to decide whether to make you work on this for homework or give
you something else.... Get your planners out
Nasser does nothing
T: Keep this pink sheet you have now. You can work on this sheet. I want you
to do question 3.
She writes it on the board. Nasser does not respond. He is deeply into his
work. The teacher explains what question 3 is asking them to do and writes it
all on the board. Then a few boys who have been very disruptive all lesson
decide to run around the class, hitting and throwing things, they run in and
out of the door. Nasser does not take any notice whatsoever.
T: I want my counters back.
The class starts packing up.
T: You can stay sitting down to the end of the lesson
Nasser is still working on the classwork. The bell went and there was a rush for
the door. Nasser looked at me.
N: Where have they all gone?
Nasser is so deeply focussed on his work that he does not notice the embedded instruction to
get out planners, the teacher writing on the board or her explanation of the homework.
Certainly her indication that the lesson was over, ‘I want my counters back’ was rather
elliptical, but others understood it, particularly in the context of homework being set. Nasser
did not even notice the boys running around the room, however they had been rather
disruptive and Nasser may have chosen to block out their behaviour. In the general literature
several authors hold that ABI students are unable to block out distractions (Ylvisaker &
Szekeres 1998, Semrud-Clikemann 2001, Walker & Wicks 2005), but it seems to be that
pupils in this study completely block both useful and unhelpful interruptions once they are
deeply focused, unlike typically developing pupils.
Some pupils do not seem to be aware of transitions at all, which probably contributes to the
air of elusiveness they have in the classroom. If pupils have hearing difficulties as a result of
their ABI this is frequently given as the reason that they do not follow lesson patterns. But
what is more striking is that once focused none of the pupils seem aware of transitions. What
7
eventually arouses Nasser is the strident school bell and it is then a rush to clear away and
move to the next class.
Vicky's class were offered Sudoku or reading as a fill in activity before the session
started. Vicky chose reading poetry
V: I’ll get a poem book
SR: You like poems?
V: Yes they rhyme
She read a couple, we discussed them. She read more, silently.
T: It’s time for Mrs H’s group to go
She did not hear. I touched her arm and pointed at the other pupils. We went
to literacy.
Like Nasser, Vicky was deeply focused on her task and did not hear the transition to a new
lesson. Without a TA, she would have been left in the wrong class, possibly missing the start
of the next lesson and having to catch up. Most of these pupils, including Vicky, want to feel
'normal' and anything which points out that they react differently from their peers tends to
provoke an outburst. My presence in this class prevented this.
Part of the issue for these pupils is that the transitions are frequently in the wrong place. This
can be difficult for other groups of pupils too, but in these examples teachers took their
timing from the rest of the class, those without an ABI, becoming restless. My presence,
specifically looking at the pupil who had sustained an ABI, may have meant that they gave
more time than normal. But taking longer to settle, pupils after ABI frequently have not
completed one part of the task before the teacher wants to move them on.
Vicky was in the literacy class
The class had been told to work through a two sided A3 sheet planning and
developing their superhero. Vicky was distracted by others mucking around,
but gradually settled with the help of SR. Every now and then the teacher
read out the next bit, moving the class to the next part of the task as she
noticed that they were ready. But Vicky was still completing the section she
was on and carried on with the work she was doing. SR had to touch Vicky’s
arm and point at the teacher. Vicky looked up and listened.
The teacher's timings, taken from those of the rest of the class, did not coincide with Vicky’s
timings. Teachers commented that Vicky did not get much work done and was easily
distracted, but it was clear from this dynamic assessment session that Vicky was able to focus
on work when helped to settle, but that her timings were not the same as those of her peers.
Some pupils do notice when the class has moved on, but after the teacher has started talking,
as happened to Joanne.
Joanne was in a Maths lesson where the class was working through a GCSE practice
paper, working on their own, but with guidance from the teacher.
T: Now the bearings question.
He drew on the board. Suddenly Joanne looked up and asked
J: What are we doing?
TA: (quietly) Next page.
Joanne turned over and carried on.
8
Joanne missed the start of the guidance having to try to make sense of the explanation
without the introduction. This then becomes doubly difficult for these pupils. The rest of
the class were working at a similar pace, but Joanne took longer on each question to settle
and then become focused missing the transition to the next question. This issue of timing is
of significant concern to those who teach pupils after an ABI.
Having concentrated hard for some time in a period of focussed attention, a pupil who has an
ABI is often overcome with fatigue, and finds it difficult to follow the next part of the lesson.
During a History lesson, comparing the way of life of the Native Americans
and settlers, William listened attentively to the lesson and knew what to do
when the activity arrived.
P1 made a very loud and persistent comment about gay priests in the Church of
England. William smiled and made a brief comment. He then got back to work.
A little while later
T: OK, look the sheets.
A class question and answer session followed which led to the setting of
homework. William did not look up.
T: Write it in your planner
P2: I haven’t got mine
T: Those without planners, write it in the front of your books
William continued working
SR: Where’s your planner?
William looked in his bag and looked at me
SR: Oh dear! Where will you write it then?
W: Don’t know
He looked at the back and then the next page of his book
SR: In the front?
He could not see where to write it. The teacher meant on the cover
This is an example of the very subtle difficulties of the ABI pupil. At the beginning of the
lesson William was able to divide his attention between his work and the comments of
another pupil, but when focussed on the task in hand he completely missed the teaching for
the homework task. During the lesson he had produced some good work and by this time he
was quite tired. He was then very confused by the instruction to write it in the front of his
book. This may have been because he would not usually write the homework in the front,
preferring to write it on his hand, and to him writing it in the front of his exercise book was
my suggestion, as he had completely missed the teacher’s instructions. His teacher’s
comment was that William was doing well in class, but homework was completely
disorganised. This excerpt may indicate a possible reason, if intense focus on the classwork
task means he misses the teaching for the homework and then is too disorganised to write
down the homework clearly.
Thus in classroom observations an unexpected attention pattern has been seen. This causes
several difficulties for some pupils with ABI. Firstly they do not get as much work done as
others as they are unable to settle as quickly. This means they do not get the practice or that
they do not have as many notes in their books for revision purposes. Later they miss the
transition to a different task or to homework being set. If this is not understood, or not
written down, they are then unable to reinforce the learning while studying on their own.
9
Thus much of the lesson has been lost to the pupil. Deep focusing is a significant barrier to
understanding what the teacher is trying to communicate to the class.
Delineation of the Attention Cycle
While for most children attention is under ‘automatic control’ (Walker & Wicks 2005 p36),
after an ABI pupils have to work hard to maintain their interest in a task. Under suitable
conditions, pupils with an ABI are able to focus, switch, sustain and divide their attention, but
some pupils find this a much harder task than others. The findings of our study indicate that,
in the classroom, the pattern of attention for young people with an ABI seems to be different
from that of other classmates.
At the start of an activity pupils with ABI are easily distracted and take a long time to settle.
Some pupils with ABI notice everything and seem unable to choose where to focus, as they
process all stimuli (Dennis et al. 1995). There follows a period when they are able to dual
task, answering other pupils or the teacher while writing. If an adult then helps identify a
target for attention, the young person enters a period of deeply focussed attention, when they
seem unable to hear anything else in the classroom, including the teacher calling the class to
attention for the next part of the task. As one of the TAs in Ruth’s school pointed out:
SR: What about in class?
TA: She is always good in class. She concentrates really well, in fact
sometimes she concentrates so much that she misses things. You see the rest
of the class lift their heads when the teacher wants to say something and she
carries on with what she’s doing.
Later after injury, the young people are able to identify targets for attention and choose where
to focus; they seem to need to consciously choose what will engage their attention. However
if the teacher breaks their concentration, an unsettled period follows before being able to
focus again, graphically represented in Figure 2
distracted
Into lesson
divided attention
disrupted
deeply
focussed
miss next
instruction
Figure 2: attention pattern of a pupil with ABI
10
Typically developing pupils seem to be able to enter and leave a state of focussed attention
which is not as deep, at will; they become absorbed in a task rather than deeply focussed.
The cycle followed by the pupil after an ABI takes longer, and hence these pupils frequently
achieve less than they would have done had they not sustained their injury, as illustrated in
Figure 3
distracted
divided attention
absorbed
disrupted
deeply
focussed
Key
Pupils with ABI
Other pupils
miss next
instruction
Figure 3: comparison of the attention patterns of a typical pupil and a pupil with ABI
Which ABI groups do this?
An examination of the data from all the young people in the study has shown that not all
pupils with an ABI are subject to the tyranny of deep focusing (Table 3).
Aetiology
Number
of pupils
in study
Unable
to focus
Over
focus
No
opportunity
to observe
Anoxic injury
Encephalitis
Traumatic
brain injury
Tumour
Stroke/
haemorrhage
Meningitis
Epilepsy
Congenital
Heart Defects
Table 3
2
6
48
0
0
6
2
5
29
0
1
8
11
11
6
0
4
2
4
8
2
0
0
0
0
0
0
11
No
difficulties
in this area
Percentage
observed
with
overfocus
Percentage
observed
with no
focus
100
100
73
0
0
15
1
0
40
18
60
0
0
0
0
0
4
100
100
100
While all the pupils in this small sample with anoxic injuries and encephalitis have this
changed attention pattern, only 73% , 40% and 18% of pupils who had sustained injuries
traumatically, via a brain tumour or a stroke showed this attention cycle. What is notable is
that there are also pupils within these three groups who could not control their focus of
attention at all. Perhaps William had been in this group when SR was not present and this is
what the Maths teacher had noticed. However there were 4 pupils with a traumatic brain
injury who were able to manage their attention, becoming absorbed in tasks and noticing
transitions without assistance. Three of these four sustained moderate injuries and the fourth
was a non-accidental injury after which she was adopted. There is little documentation
available for her.
Pupils with an ABI through meningitis, epilepsy or congenital heart defects, at least in this
study, did not show this pattern at all. As deep-focussing has been shown above to be helpful
in some circumstances, further work could ascertain whether these skills could be taught to
those whose do not show this tendency and whether young people could develop control to
ameliorate the disadvantages.
What can teachers do to help
This cluster of pupils who have sustained a brain injury due to trauma, tumour, encephalitis
or anoxia does not have a typical learning pattern. Most of these pupils are able to achieve a
state of focussed attention in the classroom when they are further in time from their injury,
but this may be assisted by other adults in the classroom for those who have just returned to
school, in fact this may be the most important task for a TA supporting a pupil with an ABI.
However once in this state all the pupils seem to find it hard to return to a normal level of
attention and to notice what is happening around them, which means that they may miss vital
learning and teaching. TAs will require additional training when supporting a pupil in this
group to emphasise the importance of intervening to assist the young person when shifts in
attention are called for.
Pupils who are affected by an a-typical attention cycle need to learn to become focused on a
task. Within the project it has been found that the most successful way to do this is to touch
the work without uttering a word, drawing the pupil back to the task time and again until they
are focused. This does take more time, and teachers will need to be aware of this when
considering the tasks to be undertaken by different pupils. This presumes a differentiated
class which is essential for the inclusion of pupils with an ABI. Teachers also need to signal
transition points explicitly between lesson activities, forewarning the pupil with the ABI who
will probably be in a state of deep focus. Pupils may be alerted to new instructions verbally
when they are not in deep focus but they will need to be explicit, along the lines of ‘stop what
you are doing and pay attention to my instructions’. However if TAs do too much for the
pupil they may not allow the pupil to develop strategies to focus, as they interrupt the
process.
In many schools homework is recorded by the TA rather than the pupil with an ABI, but
frequently this is not enough information when the pupil has not focused on the instructions
from the teacher. Teachers or TAs could be aware of this difficulty with homework. His
teacher’s comment was that William was doing well in class, but homework is completely
disorganised. If pupils focus too intently on the classwork task, miss the teaching for the
homework and then lacks the organisational skills to write down the homework clearly, it is
no wonder that homework is not done, done inadequately and causes family rows.
12
Homework instructions would be better provided as written handouts or by email for ABI
students. While the young person with ABI does not need minute-by-minute assistance in the
classroom, they do need transitions to be signalled, as well as ensuring that the homework
task is in their planner in sufficient detail. With the general help of the parents/carers, pupils
may then find homework a less onerous task.
When pupils have been focusing deeply they often complain of a headache or fatigue; this
may contribute the need for extra rest periods, or a partial time-table for pupils with ABI. All
the pupils I observed had hour-long lessons. Some schools have shorter lessons and the
problems of fatigue may be different.
Moving around the cycle
It seems that most of these pupils can achieve a deeply focused state, sometimes on their
own, and sometimes with assistance. At times this deep focusing can be helpful, in that
young people may then be able to complete tasks. However, it does not happen all the time
and it is not always beneficial in the classroom if the pupils then miss out on learning
opportunities.
It is clear that on return to school, and for a few years after, pupils with ABI do not manage to
move into this cycle without help. They then remain distractible for the whole lesson and
achieve very little. Where a teaching assistant is in the class, they could be instructed to assist
the pupil with ABI to settle and then watch as they become focussed. When the teacher
wants to introduce the next task it will be necessary for the assistant to bring the pupil out of
their focussed state in order to be ready to learn with the rest of the class.
This rigid attention cycle causes several difficulties for these pupils. Firstly they do not get
as much work done as others as they are unable to settle as quickly. This means they do not
get the practice or that they do not have as many notes in their books for revision purposes.
The rigid pattern of attention also robs the ABI pupil of the ability to follow when a teacher
moves the next activity, and poor monitoring skills mean they do not complete tasks. Later
they miss the transition to a different task or to homework being set. If this is not understood,
or not written down, they are then unable to reinforce the learning while studying on their
own. Thus much of the lesson has been lost to the pupil. This is a significant barrier to
understanding what the teacher is trying to communicate to the class.
This paper has drawn on the observations of a few pupils, but they are in line with the others
in the study. As pupils develop after the point of injury, it seems that some, like Simon and
Nasser, are able to learn to focus their attention, but earlier on in recovery, like William, they
need assistance. Frequently lack of concentration in the classroom is seen by teachers as the
pupil engaging in ‘attention-seeking behaviour’ (Hawley 2005). From this study it may be
seen that the issue is more complex than this may suggest.
13
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