“My son has a hard time paying attention to instructions, and tells me he feels nervous all the time. Should he be in counseling?”

Yes, please consult with a child psychologist and/or child psychiatrist--he/she will evaluate your son and prescribe a course of treatment for him. This may or may not include medications along with play therapy on a regular basis. There are many hopeful options. I wish you both well!

Thank you for emailing your question. From just what you've told me, I would suggest you take him to see a professional for evaluation. I might also ask that professional whether he/she recommends your son also be tested for ADD/ADHD, just based on the issues around listening to instructions and paying attention. I would first start with the consultation with a child psychologist. Hope that is helpful.

Your child is bringing his concern to you. Acknowledge it. Speak to his teacher about his performance and behavior. Ask her to monitor. Do the same at home. Decide if the teacher and your own observations confirm his report. Discuss options with his teacher including whether a consult with a professional would help.

I want you to know I don't think inside the box about these things. I have found that children with those symptoms have insecure attachments and are distracted by their own thoughts and feelings of inadequacy. Just curious: Did he go to daycare or other care when he was very young, as in the first three years of his life? If so, you may want to talk to him about it and tell him you think he feels that way, because he learned to worry that he is not enough. If you can say that to him, he might feel relief, that his feelings come from something real and are not inborn. You can tell him you are sorry and give him some extra love and attention, and he may work his way out of it. There are lots of kids in his boat. They call it ADHD and prescribe uppers. I find that what I suggested is a better alternative to medication which can become addictive over time. It's OK, if you disagree. I can't really meet you and hear you out, so I'm winging it.

It would be helpful to have your son evaluated by a child psychologist to explore the possibility of attention deficit disorder as well as an anxiety disorder. Following the evaluation the psychologist will make recommendations for further treatment.

Dr. Martin Keller

Counseling is a very good option to help your son with his anxiety. I’m curious if he has a diagnosis of ADD or if he has been evaluated for a learning disorder.

Dear Madam/Sir:

Thanks for your concern regarding your son's difficulties in listening and his feeling nervous all the time. Have you asked him what he is nervous about? And what he is doing when not listening to your given instructions? That is what is he instead focusing on? It seems like a good idea, to have him be checked out by a licensed psychologist. Finding out what is troubling him and what needs to be done about it so he can start paying attention will be the first step. Teaching him meditation and relaxation will also be very beneficial as he will then learn to be mindfully present in any given moment without being nervous all the time.

Take care,

Dr. Lata Sonpal

Yes, a therapist can provide support, foster needed communication, and help him learn how to cope with symptoms of anxiety as well as circumstances or internal conflicts that are contributing to it. 

I think that your son is telling you that he's unhappy if he's saying that he's feeling nervous all the time. As a mom, all you can do is to try to explore what is making him feel nervous. If it was a specific thing, then you could try to correct his perception or intervene in some way. Often children can't tell you what is making them nervous so it is helpful to bring them to a child psychologist who has special training in helping children to talk and play out their internal concerns. In terms of his attentional difficulties, it could help you to consult with a psychologist to determine the nature of his difficulty paying attention and following directions. I would not assume that he necessarily needs counseling, but I would suggest that you bring him for a consultation so that a psychologist could determine the nature of his difficulties. A well trained child therapist will be able to tell you whether your son needs individual therapy or whether he could be best helped just by providing you with some support and guidance about how to help your son.

You are a concerned and alert mother – he would best be seen by a person specializing in testing, to evaluate if he has a form of Attention Deficit Disorder. If so, special approaches to learning will help him to succeed where, without such, he might flounder. If there is a guidance counselor at his school, she or he will be able to refer you to a qualified person, usually a psychologist or psychometrist.

Peace,

Marian K. Shapiro, Ed.D.

This answer is for informational purposes and does not constitute treatment.

A few possible reasons for your son's difficulty with instructions comes to mind: 1. are the verbal instructions too complex for his age or general language level; 2. does he seem nervous another other stuff, but instructions are places where if you mess up, the consequences are drastic; 3. does he seem to have problems paying attention in other situations.

Situation 1 - some kids have language delays or processing problems that make instructions very difficult for them. If your child is in school, you can talk to his teacher about whether they notice this also. If yes, then it may be a good idea to ask the school to do an evaluation of his language abilities. BUT, sometimes parent (and less often, teachers) give instructions in ways that are too complex or too long. This makes anyone nervous. See if you can cut instructions down to a max of 1-3 steps and see how your kid does.

Situation 2 - directions/instructions are the key to success for tasks. If you child is anxious by nature, this might be the area where that come out the most. Think about whether they seem worried and easily fixated on stuff. When a person is anxious, it often affects their attention.

Situation 3 - some kids have ADHD that makes it hard for them to pay attention to directions that go on for too long. After getting yelled at, they can see the train wrecking coming and can get anxious simply because they almost never get this right. If you see other situations with lots of issues with hyperactivity, a hard time paying attention, then getting an evaluation to check for ADHD might be appropriate.

He might be a little ADHD or something similar. The issue is that they will put him on medication, even if he is not so bad or not adhd. It could be a learning or focusing disability. He is only 8 and you can wait till he is around 12.

Consider him taking Dr. Amen's screening assessment for ADD. Check out the following link to assess the possibility:
https://addtypetest.com/
You will get a report with a series of recommendations....