Attention Disorders and Dumb Mistakes

Most people think of Attention Disorder as a deficit in one’s ability to listen, to concentrate on the details of what is going on. These symptoms refer to an individual’s failures to follow directions and focus on what is being said to them. Of course other symptoms are observed (restlessness, impulsivity). But listening problems are frequently cited as major features of an attention disorder. In fact, however, these problems characterize only half the pitfalls engendered by an attention disorder; they describe only the “input”or “receptive” impairments of this disorder.

But an Attention Disorder also compromises the functions of a rather different set of mental actions. These functions control output behavior, what one DOES in response to some stimulus. Defects in this “output regulation ” system occasion repeated experiences of defeat and self-contempt as I will explain next.

Imagine that I ask you  how you to spell the word “RECEIVE”.

What you have to do is generate some sort of VISUAL image ( mental representation) of this target word. We will call this your “intended spelling”.  Let’s say your image is correct, that you  generate the image “RECEIVE“.

Now, to spell this, you convert this mental image to a series of strokes on paper that correspond to the series of image segments in your mind. It is crucial for you to recognize that you must “hold” these image segments in your “mind’s eye” until you have  executed them on paper because you want to ensure that what you intended to write and what you actually write correspond exactly. Provided all goes as planned, you will find that you have written R-E-C-E-I-V-E correctly.

We can also say that your intended action and your actualization of that intention are congruent; you did what you intended to do.  Simple enough if you’re a good speller. **

But now, imagine that you have to spell the word ORALLY.  This is quite a different matter. First, of course, you generate the VISUAL image of “RECEIVE”.  But unlike writing it, you now must hold all the segments of that image in some temporary storage system UNTIL you’ve named all  the letters of “RECEIVE”.  The reason you have to do this is that you have to have a way of confirming the fact that what you INTENDED to spell (the image) and what you actually spelled (the names of the letters in that image) are the same. For example, if you SAY ” are – ee -see – ay – ee – vee -ee” (receive), you may spontaneously CORRECT your oral version because you detect a mismatch between your intended  utterances (naming the letters in your mental image) and your actual utterances (naming the letters aloud).

Now these intended utterances are registered and maintained in a memory system designed to hold representations of things you INTEND to do. So, this system is called PROSPECTIVE MEMORY.  This memory system is responsible for storing actions we are going to take in the FUTURE.  And people vary in the extent to which they can hold intentions reliably in this system.

Folks with lousy prospective memories are constantly forgetting bits and pieces of what they WANT to do.  Or they’ll get the pieces out of order.  Or they’ll substitute one segment with another unintended segment.  Quite involuntarily and below the level of conscious awareness, they execute all sorts of DUMB mistakes that they neither intend nor notice. These glitches occur in fractions of seconds.  Many’s the person I’ve asked to spell words out loud that they had just finished spelling correctly on paper.  But if they have Attention Disorders, they’ll invariably produce an incorrect ORAL spelling of a word they just spelled correctly on paper!  And not even know it!  They’ll leave segments out, duplicate them, even add letters that aren’t even in the correct spelling. The reason?  Because even as they’re spelling the word out loud, this or that letter in prospective memories is, in a few milliseconds, corrupted in some way.  But since the only “record” they have of their intended spelling exists in Prospective Memory and since that record is already being rapidly compromised, their attempts to compare their intention (the image in prospective memory) with what they’re actually saying meet with failure because that intended image or its parts have too quickly decayed.

Notice that in written spelling, the letters are made concrete, tangible, permanent and so the segments of the intention and actual representation can be compared and confirmed (or disconfirmed).  No such luxury exists for the oral speller.  He or she is left with nothing but a very fragile, rapidly deteriorating  mental image to go on.  And a set of equally evanescent spoken words that come and go in milliseconds. . . as soon as each is pronounced, it disappears. Without a reliable way of confirming that what you intend to do and what you subsequently do are perfect matches, you open yourself to all sorts of dumb mistakes.

We all have had moments when we say, “Oh, I forgot what I was going to say!”. We’ve all gone into a room to fetch something and “forgotten” what we went there for. We’ve all dialed wrong numbers and don’t know that we’ve done so until the WRONG person picks up. Then we mumble an apology and check and redial. These all are manifestations of Prospective Memory failures. They are inconveniences for most of us..  But for those with Attentions Disorders, these failures become ever-humiliating and embarrassing, relentlessly recurring indices of incompetence, “carelessness” and a poor attitude.  And they engender peculiar, sometimes scary feelings of helplessness.


**It is of interest to note that spelling a word “backward” makes you quite conscious of this “output memory” system by becoming more aware of the stress on this system and your need to maintain deliberately in this system your intended spelling, intact for a much longer period.








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