Shriver Center studies visual attention in children, adolescents with intellectual disabilities

Aug 18, 2015
Three children at desks in school

By Ellen Moran

Children who overfocus on one small part of a picture, word or face may have difficulty with such life skills as reading or recognizing people. UMass Medical School’s Eunice Kennedy Shriver Center has been studying visual attention in children and adolescents with intellectual or developmental disabilities to develop teaching methods to reduce the problem.

The Focus of Attention project, funded by grants from the National Institutes of Child Health and Human Development, studied stimulus overselectivity, or overfocused attention, to try to improve teaching methods for children with intellectual or developmental disabilities. Overselectivity is characteristic of children with intellectual disabilities with or without autism, said William V. Dube, PhD, principal investigator at the Shriver Center and a professor of psychiatry at UMass Medical School.

“In one of our early studies we found that the problem with most children who could do matching tasks with individual items but not with arrays of two or more items, wasn’t that they couldn’t attend to more than one thing at a time, it was that they weren’t moving their eyes effectively,” Dube said. “Once we got them moving their eyes, the accuracy went up. What they had was poorly organized observing behavior.”

Overselectivity is the tendency to overfocus attention on one part of a person, the environment, or the initial letter in a word and not process it as a whole. An example of overselectivity is a child who apparently learns the name Sam, but then can’t differentiate between the words Sam and Sue because the child learned the name by the letter S. A child at summer camp doesn’t recognize a camp counselor who is wearing new glasses because the child overfocused on the counselor’s first pair of glasses.

“It’s the developmental level of the individual and the visual complexity of the stimuli that determines overselectivity,” Dube said.

The project involved two parts: assessment and intervention. For the assessment part, the children were recruited and given preliminary training to make sure they could do the tests. Some of the nonverbal children with autism could communicate with symbols on computer tablets.

One objective of the study was to determine whether overselectivity is more severe or prevalent in children with an autism spectrum disorder and an intellectual disability, than in those who have a comparable intellectual disability but without autism. The study included three groups that had comparable developmental levels: children with autism spectrum disorder, children with Down syndrome (with the same IQ level as the children with autism), and a group of typically developing children. Each included 12 to 22 children, which varied depending on which of seven tests was being given.

The tests were developed so that accuracy was high if there was no overselectivity. As the tests became more complex, accuracy dropped in all three groups, but at the same rate. The results showed that overselectivity wasn’t more severe or prevalent in autism on these types of tests, Dube said.

The intervention part of the project examined the effectiveness of interventions and remedial training and ways remedial interventions could be incorporated into special education teaching. The researchers were trying to find the instructional support a child needs to avoid overselectivity.

“Children with severe intellectual disabilities are probably not going to learn by the methods you’d use in typical education,” Dube said.

One approach to reduce or eliminate overselectivity is known as differential observing responses. This approach requires the child to respond to a task to make sure all the important stimuli have been observed. The child, for example, might be asked to spell the printed word DOG aloud before being asked to match a picture of a dog to that printed word.

Dube had this advice for special education teachers: “If the accuracy is poor with complex stimuli, be suspicious of overselective attending. Use differential observing responses to address that problem.”

For example, if overselectivity is suspected when teaching a child to identify clothing items of different colors, one way to test it is to have blue socks, red socks and a blue T-shirt available, and ask the child to pick out the various items. A child who gets it right 100 percent of the time is paying attention to both the color and the item, Dube said.

Focus of Attention is a five-year project in which the research is wrapping up. The testing was done in schools in Central and Eastern Massachusetts, and as far north as New Hampshire.

© 2015 University of Massachusetts Medical School