Pediatric Annals

Attention and Memory: Progression and Variation During the Elementary School Years

Melvin D Levine, MD, FAAP

Abstract

A 10-year-old girl has trouble remembering what she needs to know when she takes a test and she also has difficulty paying attention while she studies. It is unclear whether she fails to remember because she does not concentrate or whether she fails to concentrate because she has trouble remembering.

Attention and memory are frequent cognitive collaborators in problem solving, in the acquisition of new knowledge, and in the activation of relevant prior learning. As such, the appropriate development of these dual functions is critical for successful learning and skill acquisition during the elementary school years, interactions between attention and memory can pose complex clinical questions relating to school performance. In addition, attention and memory play a significant role in behavior and social interaction. This article will describe the developmental evolution of each of these functions separately and then examine some of the common clinical disorders mediated by weaknesses of attention or memory.

THE DEVELOPMENT OF ATTENTION

The psychologist William James wrote: "Everyone knows what attention is."1 Nevertheless, it can be helpful to clarify the concept before surveying the development of attention during the school years. Most commonly, attention is thought to consist of three fundamental components: mental effort, selective focus, and intentionality.2 Attention as mental effort entails the mobilization of structural and functional resources to process adequate amounts of information or to create substantial enough products to meet demands. There are clear limitations on mental effort and the resources available for concentration and output. Selective focus entails an individual's ability to make use of only those stimuli or memory traces that are most relevant to a current need or context.3 This selection process necessitates the filtering out of irrelevant data or resistance to distraction. Intentionality involves the ability to act purposefully, reflect consciously, operate at an optimal pace, and monitor the quality of one's thoughts and productions.

Mental Effort

Mental effort is composed largely of two components: concurrent processing or production capacity and the sustained deployment of attention. As growing children are confronted with increasingly complex tasks, there is a steadily expanding need for concurrent cognitive operations so that by secondary school a student is expected to be able to think, spell, punctuate, and remember grammatical rules while writing. That student must also be able to maintain that mental effort, delaying closure or gratification long enough to complete a lengthy assignment. Such maintenance of mental effort depends in part on sufficient levels of arousal and the stamina to thwart mental fatigue.

There is now substantial evidence to indicate that during their school years children exhibit a progressively expanding capacity for mental effort. They are able to engage in tasks that call for more concurrent cognitive processes as they become more efficient learners, but also there are indications that students simply gain more working capacity as they mature.4

Selective Focus

Selective focus, the second major component of attention, allows for the differential processing of simultaneously presented stimuli or information. An individual is constantly confronted with data that include sights, sounds, memories, sensations, and thoughts about the future. One must be highly selective in sorting and selecting one or more relevant stimuli for processing. This selection process is dynamic and flexible. As Simon notes: "A crucial function of the attentional mechanisms is to allow a shift in focus and context: to break off the continuity of thought in order to respond to real-time requirements of the organism in adapting to its environments. "5

Selectivity of attention also evolves during school years. As Flavell notes: "As children develop they generally become more capable of deliberately directing and controlling the deployment of their…

A 10-year-old girl has trouble remembering what she needs to know when she takes a test and she also has difficulty paying attention while she studies. It is unclear whether she fails to remember because she does not concentrate or whether she fails to concentrate because she has trouble remembering.

Attention and memory are frequent cognitive collaborators in problem solving, in the acquisition of new knowledge, and in the activation of relevant prior learning. As such, the appropriate development of these dual functions is critical for successful learning and skill acquisition during the elementary school years, interactions between attention and memory can pose complex clinical questions relating to school performance. In addition, attention and memory play a significant role in behavior and social interaction. This article will describe the developmental evolution of each of these functions separately and then examine some of the common clinical disorders mediated by weaknesses of attention or memory.

THE DEVELOPMENT OF ATTENTION

The psychologist William James wrote: "Everyone knows what attention is."1 Nevertheless, it can be helpful to clarify the concept before surveying the development of attention during the school years. Most commonly, attention is thought to consist of three fundamental components: mental effort, selective focus, and intentionality.2 Attention as mental effort entails the mobilization of structural and functional resources to process adequate amounts of information or to create substantial enough products to meet demands. There are clear limitations on mental effort and the resources available for concentration and output. Selective focus entails an individual's ability to make use of only those stimuli or memory traces that are most relevant to a current need or context.3 This selection process necessitates the filtering out of irrelevant data or resistance to distraction. Intentionality involves the ability to act purposefully, reflect consciously, operate at an optimal pace, and monitor the quality of one's thoughts and productions.

Mental Effort

Mental effort is composed largely of two components: concurrent processing or production capacity and the sustained deployment of attention. As growing children are confronted with increasingly complex tasks, there is a steadily expanding need for concurrent cognitive operations so that by secondary school a student is expected to be able to think, spell, punctuate, and remember grammatical rules while writing. That student must also be able to maintain that mental effort, delaying closure or gratification long enough to complete a lengthy assignment. Such maintenance of mental effort depends in part on sufficient levels of arousal and the stamina to thwart mental fatigue.

There is now substantial evidence to indicate that during their school years children exhibit a progressively expanding capacity for mental effort. They are able to engage in tasks that call for more concurrent cognitive processes as they become more efficient learners, but also there are indications that students simply gain more working capacity as they mature.4

Selective Focus

Selective focus, the second major component of attention, allows for the differential processing of simultaneously presented stimuli or information. An individual is constantly confronted with data that include sights, sounds, memories, sensations, and thoughts about the future. One must be highly selective in sorting and selecting one or more relevant stimuli for processing. This selection process is dynamic and flexible. As Simon notes: "A crucial function of the attentional mechanisms is to allow a shift in focus and context: to break off the continuity of thought in order to respond to real-time requirements of the organism in adapting to its environments. "5

Selectivity of attention also evolves during school years. As Flavell notes: "As children develop they generally become more capable of deliberately directing and controlling the deployment of their own attention. They become better able to focus their attention in an active, controlled fashion on just those external data which are relevant to their task objectives, while disregarding task-irrelevant data that are also present and equally perceptible .... An overall developmental trend exists toward greater voluntary control over one's perceptual-attentional processes."4 It is fortunate that the capacity for selectivity becomes refined since the school curriculum places a growing emphasis on selectivity. In particular, school children must be able to make keen determinations of saliency as they learn to take notes, predict what will be on a test, and summarize texts.

Intentionality

The third component of attention, intentionality, enables one to reflect, make decisions regarding appropriate strategies or methods of accomplishing tasks, and monitor one's efforts before, during, and after a purposeful activity. Once again, this capacity appears to grow during the school years.6 Older children are better able to analyze the demands of a task and to deploy ongoing quality control. They allocate time with growing effectiveness and pace themselves appropriately as they pursue a cognitive challenge.

MEMORY

All students must endure the mnemonic strain imposed by school work. Day to day performance and the long term acquisition of skills demand efficiency and accuracy of remembering. During the elementary school years there is a notable acceleration in children's mnemonic skills.7 Although there are many developing aspects of memory function, the following six aspects have been particularly well documented and are known to be most relevant to the learning process.

Immediate Memory

It has been amply demonstrated that 12- and 13year-old children are able to hold larger chunks of information in short term stores than can 5 and 6 year olds. Most often this growth has been demonstrated through the use of digit spans. A 5 or 6 year old is usually able to repeat four numbers in the correct sequence immediately after hearing them. A 12 or 13 year old on average can repeat six or seven numbers.8 Such an expansion of immediate memory facilitates the processing of directions and explanations. By holding larger chunks of information in immediate memory, children can be more effective at copying from the chalkboard, remembering what they are reading, and performing complex operations in mathematics.

Searching Skill and Persistence

It has been shown that 7- and 8-year-old children respond to a memory challenge by offering an immediate associative response, whereas older youngsters are more likely to search through memory while trying out various responses until they come up with the perfect answer.9 The persistence of older children is associated with more effective methods for conducting memory searches. As Kail notes: "Young children respond to cues associati vely, and they are likely to generate only a single item: Older children use a cue as the starting point for an extensive search of memory. "7

Strategy Development

Older elementary and junior high students make use of a repertoire of mnemonic strategies. They have learned to be adept at registering new information in memory through various rehearsal techniques, including whispering under their breath (subvocalizing), conjuring up visual imagery, or deploying other devices to make sure that data have been firmly entered. I0 They also consolidate data in their memory with increased skill by making good use of categories of knowledge, paired stimuli, and other mnemonic devices. The persistent search processes mentioned above call for the use of strategies as well. In one study, Keniston and Flavell presented children at various ages with 20 letters in succession and asked them to write each letter on a separate card. n The cards were then removed and the subjects asked to recall all of the letters that had been presented. The most efficient way to accomplish this task is to recite the alphabet to oneself; as one arrives at each letter, one decides whether that particular letter had been presented in the initial list. This technique was used by a large percentage of 13 year olds and by very few of the 7 and 8 year olds, thereby demonstrating the acquisition of strategic approaches to recall in the older cohort.

Automaticity

When children reach early adolescence, it is assumed that a large proportion of their previously acquired skill and knowledge can be recalled with only minimal expenditure of effort.12 By seventh grade, students should be able to recall the multiplication tables automatically. A substantial number of words should be recognizable instantly on paper. Older children should be able to form letters and spell many words with only a parsimonious allocation of attention. Automaticity of memory grows rapidly during the elementary school years.13 Automaticity spares attentional resources, enabling a student to expend mental effort on sophisticated problem solving, strategy use, or creative thinking, rather than having to concentrate on such banal components of work as letter formation during writing or the recall of basic mathematic facts while solving a word problem.

Summarization Skill

Summarizing is a vital memory task, one that is tapped frequently in secondary school curricula. Students progressively develop effective study strategies for summarization as they acquire the techniques to become more efficient at finding main ideas, condensing information, and restating facts or concepts in their own words. In one study, a group of children at varying ages were given passages to read and then asked to recall the most important parts. They were told they could do anything they wanted to improve recall. It was found that only 6% of the sixth graders took notes or underlined, whereas 50% of the junior high school students did so. The latter were also far more effective summarizers.

Metamemory

Not only do older students use memory more effectively, but they are also more conscious of it, more able to think about it, to talk about it, and to understand their own memory habits and patterns. This insight, called metamemory, allows children to become more competent memorizers. 14 Insight into one's own memory is likely to enhance study skills and to make it far easier for students to prepare for examinations. A child who has developed good metamemory may consciously predict the material that is most likely to appear on an examination. That student can then decide what has to be memorized and what will be able to be figured out during the examination. That student can then allocate the appropriate amount of time for memorization and select strategies to register the condensed information in memory. Finally, a student with good metamemory is more likely to apply sophisticated self-testing techniques. A student with well developed metamemory knows how and when to study to maximize mnemonic assets, estimating the mnemonic difficulty of a task while being aware of personal strengths and weaknesses in various aspects of memory. Such metamemory should begin to be evident as children proceed through the late elementary school years. By high school it is assumed that students have highly developed metamemory insights.7

ATTENTION DEFICITS

Attention deficits are probably the most common causes of underachievement in children. Affected youngsters harbor various deficiencies in the three major components of attentional development: mental effort, selective focus, and intentionality. These deficiencies manifest themselves in task impersistence, a tendency to experience inordinate fatigue when trying to concentrate on relevant detail, and difficulty coordinating the multiple aspects of a task. I5 Affected students require inordinately high motivational impetus or exciting stimuli to mobilize and sustain mental effort. As a result of their poor selective focus, children with attention deficits are apt to have difficulty making determinations of saliency (ie, focusing on most relevant details). Closely related to this phenomenon is a distractability that may take many forms, including a tendency to be inappropriately distracted by visual or auditory noise, irrelevant memories, somatic sensations, appetites, or the future. A failure of intentionality is commonly encountered; instead of planning before attempting a task, such youngsters often proceed impulsively (and carelessly). In addition, they seem to have problems allocating time, devoting either too much or too little to specific tasks or task components. The tendency to be impulsive may have a significant impact on behavior as well as learning. An affected child may act without a plan, failing to foresee or predict consequences, thereby committing unpremeditated transgressions. The lack of planning is often accompanied by diminished self-monitoring; many children with attention deficits have difficulty watching what they are doing as they pursue tasks and interact socially. They often proceed unaware of their own errors or misguided efforts.

Children with attention deficits may or may not show signs of overactivity and behavioral maladaptation. In many instances attentional dysfunction manifests exclusively or nearly exclusively as a cognitive deficit and not a behavior problem. Students who combine behavioral maladaptation with cognitive attentional dysfunction may be more conspicuous and more likely to be diagnosed properly; however, those whose attentional dysfunction is not accompanied by disruptive or hyperkinetic behavior may elude early detection. It has been observed that many girls with attention deficits fail to exhibit behavioral manifestations or overactivity. 16

Children with attention deficits tend not to manifest their symptoms all of the time. Instead, they exhibit inconsistent patterns of attention.17 Consequently, they are likely to go through periods during which they exert sufficient mental effort, are selective in their attention, and exhibit truly intentional behaviors, only to be followed by intervals of attentional decompensation. Such performance inconsistency is often puzzling to parents, teachers, and the children themselves.

MEMORY DISORDERS

School age children are susceptible to a wide range of specific memory disorders that impede skill acquisition and thwart academic productivity. Such memory disorders can cause substantial underachievement in an apparently intelligent child.

Some students have limitations of immediate memory. They perform poorly on tests of short term registration in memory. They may exhibit poor digit span scores on intelligence tests. iH They experience trouble acquiring new knowledge, following multistep directions, and meeting other demands that require effective immediate memory. Many develop secondary attentional difficulties; they tend to "tune out" because they are unable to stabilize and retain the rapid flow of information around them. When attention fails to yield durable data there is a natural proclivity to tune out.

Some children struggle with recall. They are inefficient at locating know ledge and skill previously stored in memory. They may show prolonged latencies of response time when asked a question. They may exhibit impersistent searching of memory stores, characteristically offering instant (generally inaccurate) responses or instantly asserting that they do not know an answer; some have problems with concurrent recall and seem unable to bring forth multiple skills or facts simultaneously. The latter is commonly manifest in serious problems with written output. Many students who have difficulty with recall require excessive time to complete work. Such task prolongation may exceed their capacities for mental effort, resulting in a depletion of attentional resources (Figure 1). This phenomenon is amplified in children with pre-existing attention weaknesses.

Many students with learning problems exhibit delayed automatization: an insufficient proportion of what they have learned in the past is instantly and effortlessly retrievable now. Such failures of automatic recall can render academic work output exceedingly laborious.

There are many children who underachieve academically partly because they have underdeveloped mnemonic strategies.19 Many recent studies have demonstrated that students with learning disorders are often inefficient strategists, passive learners who do everything the hard way. They seldom deploy active techniques for registering data in memory, searching memory stores, and designing and implementing appropriate study methods. They may experience tremendous difficulties taking tests and writing summaries. They may also reveal a lack of metamemory, a failure to reflect upon and understand the workings of their own memory systems.

Figure 1. Children with inefficiencies and excessive slowness of recall can exhaust their capacities for mental effort which, in turn, leads to attentional dysfunction. The resultant weakness of concentration makes it less likely that an affected child will search memory efficiently. Inefficient concentration further contributes to inefficiencies of recall. The problem is exacerbated when a child has some pre-existing attentional weakness, thereby having less mental effort available for tasks. This diagram offers one conceptual model accounting for the frequent association between weaknesses of attention and weaknesses of memory among school children.

Figure 1. Children with inefficiencies and excessive slowness of recall can exhaust their capacities for mental effort which, in turn, leads to attentional dysfunction. The resultant weakness of concentration makes it less likely that an affected child will search memory efficiently. Inefficient concentration further contributes to inefficiencies of recall. The problem is exacerbated when a child has some pre-existing attentional weakness, thereby having less mental effort available for tasks. This diagram offers one conceptual model accounting for the frequent association between weaknesses of attention and weaknesses of memory among school children.

THE ATTENTION* RETENTION DIMENSION

Dysfunctions of memory commonly coexist with attentional disorders. Deficits along the attentionretention dimension are so common that a clinician caring for a young child with attention deficits should anticipate the emergence of academic problems relating specifically to memory. Such memory shortcomings are apt to become especially conspicuous in late elementary and junior high school when there is a surge in the requirement for rapid, precise, and concurrent uses of memory.

The diminished mental effort capacity of a child with attention deficits can greatly interfere with the recall of facts or procedures needed to write effectively; consequently writing inhibition and failure commonly ensue. During mathematics problem solving, a lack o( mental effort can lead to an inability to maintain in memory one part of a problem while working on another aspect of that problem. Moreover, an impulsive approach may make it unlikely that a child with attention deficits will have the planning time to deploy mnemonic strategies (Figure 2). In addition, many children with attention deficits have trouble consolidating information systematically in long term memory, persisting in their searches of memory, and building cumulative memory (ie, recalling in April what they learned in September)/' The latter is essential for proficiency in mathematics and foreign languages.

The intimate connections between attention and memory have significant diagnostic and therapeutic implications. Underachieving students should have their patterns of attention evaluated systematically to determine the nature and extent of impairments of mental effort, selective focus, and intentionality. At the same time, the memory toll of attentional dysfunction must be assayed and described well. Many of these children need to be taught mnemonic strategies. They need to develop greater insights into their personal patterns of attention and memory. In many instances, the memory load needs to be lessened and temporary accommodations made to reduce the demand for sustained and multiply allocated mental effort. Affected children need to have their memory problems managed along with their attentional weaknesses. To deal with attentional dysfunction without considering its mnemonic manifestations is likely to lead to frustration and continuing academic disappointment. In addition, if students themselves come to understand the nature of their dysfunction, it is likely that there will be fewer feelings of hopelessness and less of a negative impact on self-esteem. Furthermore, if their parents and teachers are aware of their dysfunctions along the attention-retention dimension, these students will be encouraged and supported rather than criticized for their seemingly willful lack of effort.

Figure 2. The impulsivity commonly encountered in children with attentional dysfunction is shown to have a significant impact upon the effectiveness of memory. Impulsivity reduces the length and depth of exposure to new data while making it less likely that a child will take the time to deploy appropriate memory techniques and search memory thoroughly during recall. Over time such an unplanned and hurried use of memory results in academic underachievement. This diagram provides a conceptual model for the close association of memory and attentional difficulties in some school children.

Figure 2. The impulsivity commonly encountered in children with attentional dysfunction is shown to have a significant impact upon the effectiveness of memory. Impulsivity reduces the length and depth of exposure to new data while making it less likely that a child will take the time to deploy appropriate memory techniques and search memory thoroughly during recall. Over time such an unplanned and hurried use of memory results in academic underachievement. This diagram provides a conceptual model for the close association of memory and attentional difficulties in some school children.

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10.3928/0090-4481-19890601-07

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