The Purpose of Psychotherapy
Learn how to recognize inattention in kids, what it can mean, and when parents should seek extra support for school, home, and daily life.
Most parents have had the same thought at some point: “Why does my child seem to hear me one minute and completely drift off the next?” A child forgets directions halfway through getting ready for school. Homework that should take twenty minutes somehow stretches into an hour. A teacher mentions that your child seems bright and capable, but often misses details, zones out, or needs repeated reminders to stay on task. At first, it may feel like a phase. Maybe your child is tired, bored, distracted, or simply acting their age. Sometimes that is true. Sometimes, though, inattention in kids and teenagers deserves a closer look.
That is where many parents start to feel uncertain. Children and teenagers are not supposed to have perfect focus. They are still developing self-control, emotional regulation, and the ability to manage tasks that are not especially interesting. A second grader will not approach work the same way an adult does. A middle schooler may be scattered in ways that are frustrating but not unusual. Yet there is also a point where everyday distractibility begins to interfere with school, routines, relationships, and confidence. When that happens, parents are right to pause and ask deeper questions.
For families in Bethesda, Chevy Chase, Gaithersburg and Rockville, MD, understanding inattention in kids and teens is not about overreacting or putting a label on every moment of distraction. It is about knowing when a child’s pattern of attention difficulty is persistent enough, broad enough, and disruptive enough to deserve support. At Helping Families, many parents come in not because they are looking for a quick diagnosis, but because they want clarity. They want to understand whether what they are seeing is typical development, stress, a learning issue, ADHD, anxiety, or some combination of factors affecting their child’s ability to function well.
This article is designed to help parents think through that question in a practical and grounded way. We will look at what inattention in kids and teenagers can look like, what it may mean, how it can affect daily life, and when it makes sense to seek professional guidance.
When people hear the word “inattention,” they often picture a child or teen who is daydreaming at a desk or staring out the classroom window. That can certainly be part of it, but inattention is often broader and more complex than it first appears. It can show up as forgetfulness, poor follow-through, trouble listening, difficulty finishing tasks, missing details, losing materials, making careless mistakes, and seeming mentally “elsewhere” even during important moments.
Many kids and teens with attention difficulties are not disruptive. They are not the ones bouncing off the walls or blurting out answers every few seconds. Instead, they may seem quiet, slow to start, easily overwhelmed, inconsistent, or disconnected from what is going on around them. Because these children are not always drawing obvious negative attention, their struggles can be missed longer than parents expect, especially if that child or teen is a girl or a person of color.
That is one reason inattention in kids and teens can be tricky to interpret. A child may look calm on the outside while internally struggling to stay organized, process directions, or hold information in mind long enough to complete a task. Parents may hear, “She’s sweet, but she drifts,” or “He understands the material, but he doesn’t always turn things in,” or “Your teenager seems capable, but focus is becoming a problem.” Those kinds of comments often reflect something deeper than ordinary distractibility.
Parents are usually the first to sense that something is not quite right, but it can still take time to recognize a consistent pattern. Part of the reason is that childhood itself includes a lot of uneven attention. Children get tired. They become absorbed in their own thoughts. They lose interest quickly in boring tasks. They have periods of acute stress. They need redirection. None of that automatically equates with a diagnosable problem.
Another reason is that inattention does not always look dramatic. A child or teen who is impulsive or highly active often gets noticed faster because the behavior is visible and disruptive. Youth who are inattentive may instead be described as dreamy, forgetful, slow-moving, messy, or easily sidetracked. Those qualities can be brushed off as personality traits rather than signs that the child is working harder than expected just to keep up. Moreover, the quickest referral trigger for a youth evaluation is annoying an adult, and many of these kids and teens do not bother adults.
Parents also adapt. They remind their child every step of the morning routine. They sit through homework to keep things moving. They pack backpacks, track assignments, repeat directions, and provide continuous structure. Over time, that level of support can start to feel normal. It may not become obvious how much help the child needs until demands increase or a teacher points out that peers are handling the same expectations much more effectively.
At home, inattention in kids and teenagers often shows up in ways that can be frustrating because they seem so simple on the surface. A parent asks for shoes to be put on and ten minutes later the child is playing with a toy on the floor. A child starts cleaning a room and somehow ends up sorting trading cards instead. You may give a two-step direction and discover that only half of it was completed. You may feel like you are repeating yourself all day long. That can be exhausting for a parent.
Some children seem to lose their place in everyday routines constantly. They get distracted while brushing teeth, forget what they were supposed to bring downstairs, or wander off in the middle of getting ready for bed. Others can begin tasks but do not finish them unless an adult is nearby to keep them moving. Families sometimes describe this as a child who “can’t stay with it” or who seems mentally gone the moment a task becomes less interesting.
These patterns can lead to frequent conflict. Parents may interpret the behavior as laziness, defiance, or lack of effort. The child may genuinely want to comply but still struggle to stay mentally engaged long enough to follow through. That gap between intention and execution is one of the hardest things to understand for parents. It can create a cycle where everyone becomes frustrated, but no one feels truly understood.
School often makes attention concerns more visible because the environment places regular demands on focus, memory, organization, and task completion. A child may miss instructions, lose track of multi-step assignments, make careless mistakes, forget to turn in completed work, or need frequent prompts to stay on task. Teachers may notice that the child seems to understand the material during discussion but struggles to show that understanding consistently in written work or daily performance.
Sometimes parents are surprised because the child or teenager is intelligent, verbal, or clearly capable. That can make inattention more confusing, not less. A child or teen who seems bright may still have a hard time with the practical demands of classroom life. They may start work late, rush through details, overlook directions, or drift mentally when tasks feel repetitive or effortful. High intelligence does not always protect a child or teen from the impact of weak attention and executive functioning.
It is also common for youth with attention difficulties to become discouraged in subtle ways. They may begin to think of themselves as careless, lazy, or “bad at school,” even when the real issue is that they are struggling with consistency rather than ability. Over time, that can affect confidence, willingness to try, and overall emotional wellbeing.
There is a difference between a child who is occasionally distracted and a child whose inattention is affecting daily life in meaningful ways. The question parents often need to ask is not whether their child can pay attention sometimes. Most children can, especially when something is highly interesting, rewarding, or exciting. The better question is whether the child can regulate attention well enough to manage ordinary demands with reasonable consistency for their age.
When inattention in kids and teens becomes more concerning, the pattern is usually persistent and shows up across time rather than only during a stressful week or a rough transition. When diagnosable, it also appears across settings, such as home and school, even if it looks slightly different in each place. Most importantly, it begins to interfere with functioning.
Parents may start to notice patterns like these:
Any one of these can happen in childhood and adolescence from time to time. What matters is the overall pattern, its intensity, and the degree to which it is disrupting the youth’s ability to function and feel competent.
One of the most important things for parents to understand is that inattention in kids and teens does not point to only one explanation. ADHD is one possible reason, especially when inattention is persistent and linked with problems in organization, task completion, time management, or restlessness. But ADHD is not the only possibility, and it should not be assumed too quickly. Consistent inattention in a psychologist’s practice is like a fever in a pediatric practice: you know there’s a problem in there somewhere, but it could be any number of things causing it.
Inattention can also be connected to anxiety. A child or teen who is worried may appear distracted because their mind is occupied with internal concerns. It can be related to depression, low motivation, or being emotionally overwhelmed. It may be influenced by poor sleep, poor nutrition, sensory overload, stress at home, microaggressions, racism, excessive pressure at school, or a learning disorder that makes academic tasks feel confusing or exhausting. Sometimes a child is not inattentive because they cannot focus, but because they are struggling with something else that is consuming their mental energy. Most adults can relate to this: when something important is bothering us, attention is one of the first cognitive skills to fly out the window.
This is why thoughtful evaluation matters. Parents do not need to guess whether the problem is ADHD, anxiety, trauma, depression, a learning issue, or something else. But it helps to know that attention problems deserve a careful look rather than adopting quick assumptions or unfortunate cultural truisms. The child who seems distracted may not be unmotivated at all. They may be overwhelmed, discouraged, tired, or quietly struggling in a way that is easy to miss from the outside.
Parents often first notice attention concerns through schoolwork, but the effects of inattention in kids and teens usually extend beyond grades. A child who misses social cues, forgets plans, tunes out during conversations, or struggles to stay mentally organized can also have difficulty in friendships and family relationships. Siblings may become annoyed. Parents may feel exhausted by the level of repetition required. Teachers may become frustrated when a child appears not to listen.
There can also be a strong emotional impact. Children who are frequently corrected may start to believe they are always getting things wrong. They may hear that they need to try harder, pay more attention, be more careful, or get more organized, yet still feel unable to do those things consistently. That can lead to shame, frustration, avoidance, poor self-esteem, depression, substance abuse, and hanging out with other youth who feel disenfranchised.
Some children become anxious because they know they are missing things and cannot keep up reliably. Others become oppositional or defensive because they are tired of being corrected. Some begin to shut down. When attention problems are not understood well, the emotional fallout can become just as significant as the practical difficulties.
Parents sometimes hope a child will simply mature out of attention difficulties. And sometimes increased development, routine, stress management, and support do help. But when the pattern is persistent and impairing, waiting too long can allow frustration to build. School becomes more demanding over time, not less. Children are expected to manage more independently, track more information, and juggle more responsibilities as they get older, especially when an involved extracurricular life kicks in. What looked manageable in first or second grade can become much more concerning by fourth, fifth, or middle school. When a child consistently indicates that they hate school, parents should view this as smoke that tracks back to a fire.
Early support does not mean rushing to conclusions. It means being responsive when the signs are consistent enough to suggest that a child needs more than reminders and patience alone. When children get support earlier, it can reduce conflict, protect self-esteem, and improve functioning before the child develops a deeper sense of failure around school or daily routines.
That support may involve a thorough evaluation, science-based psychotherapy, parent guidance, or school consultation depending on what is going on. The key point is that parents do not have to wait until a child is in full crisis to seek help. It is reasonable to reach out when concern becomes persistent, even if the picture is not completely clear yet. Mental health challenges are like physical challenges: the sooner they are recognized and treated, the better the prognosis.
So, when should parents pay closer attention to inattention in kids and teens? Usually, it is time to consider professional guidance when the issue is no longer occasional or limited but has become a repeating pattern that affects day-to-day life. If teachers are noticing it, if home routines are constantly breaking down, if your child seems increasingly discouraged, or if you find yourself repeatedly wondering why ordinary expectations feel so hard for them, it may be worth having the situation assessed more carefully.
It can also be wise to seek support when you sense that something more than “not trying” is going on. Parents are often told their child or teen just needs to be more responsible, more motivated, or more disciplined. Sometimes that feedback is misguided. A child who is struggling with attention often does not need more criticism. They need adults to understand what is getting in the way and to respond with strategies that effectively address the real problem.
At Helping Families in Bethesda, MD, parents often seek support because they want that deeper understanding. They want to know whether their child’s or teen’s inattention is within a typical range, whether anxiety, mood, stress, or other problems may be involved, whether ADHD should be considered, or whether school-related challenges are playing a role. That kind of thoughtful process can make a meaningful difference for the whole family.
A good evaluation is not about labeling a child quickly. It is about understanding the child accurately. That usually means looking at developmental history, school patterns, emotional functioning, routines at home, family history, social life, health habits, and extracurricular engagements, as well as the specific situations where inattention shows up most strongly and the child or teen’s top strengths. Common elements in a science-based evaluation are as follows: a family interview, an individual interview with the child or teen, use of teacher, parent, and child or teen behavior rating scales, and a review of school and treatment records. Such an evaluation is trying to answer two primary questions: what is causing the problems of concern and what is the best science-informed intervention plan for resolving those problems as soon as possible?
The value of a careful assessment is that it helps parents move from confusion to direction. Instead of wondering endlessly whether the child is lazy, immature, anxious, overwhelmed, or inattentive in a more clinical sense, families begin to understand what support is needed. Sometimes the next step is therapy. Sometimes it is parent coaching. Sometimes it is school-based support or further psychological evaluation. Clarity itself is often a relief.
Inattention in kids and teens is easy to dismiss when it looks mild, inconsistent, or familiar. But when it becomes a repeated source of stress at school, at home, or in everyday routines, it deserves examination. Children and teenagers do not need to be perfectly focused to be doing well. They do need enough attention, organization, and follow-through to function with reasonable confidence and effectiveness for their age.
If your child or teen is forgetting directions, losing track of tasks, missing details, zoning out often, or needing far more support than expected to manage daily demands, it may be time to look more closely. That does not mean assuming the worst. It means being willing to understand what your child may be communicating through their struggles.
For families in Bethesda, Chevy Chase, Gaithersburg and Rockville, MD, support is available. Helping Families provides a safe and caring space for children, adolescents, individuals, couples, and families to explore challenges, build insight, and move toward healthier and happier functioning. When attention concerns are creating stress or uncertainty, thoughtful evaluation and science-based interventions can usually help parents make sense of what they are seeing and decide on a better path forward.
Sometimes paying attention to inattention is exactly what helps a child or teenager to feel more understood, more supported, and more capable.
Psychotherapy is a place to deeply reflect on how life is going. We are all so busy and overscheduled that creating this kind of space can be transformative. We are expert at using the truth of our clients’ lives to create understanding, to alleviate suffering, and to expand on experiences of meaning and joy.
Helping Families is a psychotherapy practice dedicated to providing a safe and caring space for individuals, children, adolescents, families and couples to explore, heal and self-actualize. Our practice is built on over 50 years of experience offering specialized and science-based mental health care tailored to the unique needs of each person and family. We are committed to helping families and individuals break free from emotional distress and lead enriching lives. Our approach is rooted in empathy, understanding, DEIB awareness, and evidence-based techniques to support transformative change.
ADHD is a highly misunderstood neurodiversity. Our approach is to use evidence-based methods for diagnosing, treating and actualizing the unique potential of every person who either has ADHD or who lives with a loved one with ADHD.
Anxiety can be overwhelming, but a science-based treatment can often keep it from interfering with the quality of a person’s life. Our therapy sessions provide a safe environment for individuals to explore the root causes of anxiety and to develop coping strategies for living a calmer, more balanced life.
Depression can feel crushing and isolating, but you or your child can often find significant relief. Our science-based and tailored approach to treating mood disorders offers people a collection of practical tools to regain hope, find purpose, and develop the skills to navigate through life's challenges with resilience.
Nothing gets a kid referred faster for mental health care than annoying an adult. Oppositional Defiant Disorder and Conduct Disorder can dramatically unsettle a classroom and a home life, making it a top stress for all involved. We use science-based treatments to eliminate ODD, in a child 12 years or younger, in the large majority of instances, in 8 or less sessions. The transformation can be so quick and dramatic that many parents have asked us things like, "why isn't this information taught on maternity units in hospitals?!"
Experiences of isms–racism, sexism, ageism, religionism, heterosexism and others–are ubiquitous in our culture, as are more subtle micro aggressions and systemic bias towards power down groups. In our practice we keep these issues in focus when a client has been hurt by them and help each person to grow in their advocacy skills while making tactical decisions about how they wish to proceed.
Just about all of our clients present with a primary and acute concern (e.g., ADHD, mood, anxiety). However, our clients have greater ambitions than only to stop feeling badly. They want more and deeper experiences of meaning and joy. This is where the science of positive psychology comes into play. We routinely weave these interventions, of which we are very familiar, into the evidence-based structures that we offer.
Childhood and adolescence can be a challenging time. Our therapies for kids and teens provide a supportive space to navigate complex emotions, build self-esteem, manage challenging family and school dynamics, and develop healthy coping mechanisms for a brighter future, both individually and within the family.
Couples therapy provides a safe space for partners to explore challenges, enhance communication, and rebuild trust. Our goal is to help couples deepen their understanding of each other and create a more fulfilling and harmonious relationship that is well equipped to solve problems and to have difficult conversations.
One of our favorite things to do is to work with adults who are sick-and-tired of being sick-and-tired. As Thoreau put it, many adults lead “…lives of silent and go to the grave with the song still in them.” We have a long track record of helping adults to use their top strengths, and the evidence-based skills we teach, to access the lavish banquet that surrounds us all and to live lives lavish with meaning and rich with purpose.
Psychotherapy is a place to deeply reflect on how life is going. We are all so busy and overscheduled that creating this kind of space can be transformative. We are expert at using the truth of our clients’ lives to create understanding, to alleviate suffering, and to expand on experiences of meaning and joy.
Talk with a trusted therapist and take the next step forward with confidence.
We work with kids, teens and adults, starting at age 4.
We have the most experience with ADHD, Oppositional Defiant Disorder, Generalized Anxiety Disorder, Post-Traumatic Stress Disorder, OCD, Depression, Autism and helping kids overcome experiences of bullying, racism and microaggressions. However, we also have experience treating less common conditions such as Juvenile Onset Bipolar Disorder and Reactive Attachment Disorder.
This is a strength of our practice. When he was President of the Pennsylvania Psychological Association, Dr. Dave co-chaired a collaboration between the state’s child psychologists and pediatricians. The principal goal of this work was to develop a standard of care for outpatient mental health evaluations of youth. We use this protocol in our practice. It includes the following elements:
• A 90-minute interview with the child/teen of concern and their parents (in instances when there are two households, we collaborate on which adults to include).
• A 50-minute interview with the child/teen. For kids this often includes observations of drawing and play.
• The completion of a battery of parent, teacher and child/teen rating scales.
• Review of academic records
• Review of relevant clinical or forensic records
• The creation of a slide show that includes the following elements: sources of information, strengths, charts of behavior rating scales, a list of problems, a diagnostic impression and a list of interventions for the identified problems.
In preparing for the feedback we typically invest 3-4 hours of our time.
There are three ways we’d like to address this question.
First, we find that our field is replete with clinicians who are less aligned with the available science than our practice; this is also a finding in psychotherapy outcome studies. For this comparison the contrast is stark. We do a thorough evaluation, explain our goals and methods at each juncture, set measurable treatment goals, and empower our clients to verify for themselves how the science supports what we have concluded and what we are recommending.
Most of the treatments we offer are also structured, focused on skill building and involve between session practice (exceptions are when clients could benefit from psychodynamic therapy or play therapy, which we also offer). While a non-science-based practice can feel nice it may not yield transformational change (sort of like a psychological massage) and may be harder to differentiate from what an intelligent, life-experienced and warm-hearted friend might offer at no cost.
Second, another evidence-based practice will look more similar than different to ours.
However, a few things we offer that are less common is the thoroughness of the initial evaluation, our focus on strengths, our inclusion of biofeedback to treat anxiety, anger and stress management, the use of magic to engage kids and teens, our common practice of going into schools to collaborate on helping our child/teen clients, and an acute focus on how to effectively identify and manage experiences of isms and micro aggressions when that is relevant to the care.
Third, we are highly experienced and credentialed clinicians, published authors, media consultants and leaders in our fields. Bios ( Dr. Dave's BIO ) - ( Dr. Lia's BIO )
Our approach can best be described as a blending of behavioral (e.g., Gottman Institute) and emotionally focused (e.g., EFT) methods. (Dr. Dave can be found on the Gottman Institute’s therapist directory which only includes those clinicians that have completed at least two levels of their training).
Our initial evaluation includes a 90-minute couple interview, the completion of the Gottman Institute’s battery for couples (at no additional charge), the completion of a battery supplemental measures, a 50-minute feedback session and the preparation of a slide show that includes sources of information, strengths, results of the rating scales, a list of problems and a list of recommended interventions. It is common for us to spend 3-4 hours preparing for the feedback session.
Our treatment approach involves skill building, is structured and usually time limited. We say “usually” as the work can take longer when there are significant resentments that need to be resolved. In our opinion, the skills we teach are ones that all couples would do well to know before formalizing a long-term commitment. They are also practices that promote resilience in a couple’s life.
Yes, we do. The evaluation consists of a 90-minute interview, the use of behavior rating scales, a review of relevant records, and a feedback session that incorporates a slideshow that includes sources of information, strengths, results of rating scales, a problem list, a diagnostic formulation and a list of recommended interventions. We usually spend about two hours preparing the feedback for a standard adult evaluation.
We also specialize in ADHD adult evaluations; these include the additional elements of collaterals filling out rating scales, a review of academic records and any other records that might be helpful (e.g., performance evaluations at work). (Dr. Dave is formerly the Clinical Director of a nationally recognized ADHD specialty clinic and currently serves on the national Board of Directors for CHADD.)
The areas in which we have the most experience are ADHD, anxiety disorders (including OCD and PTSD), mood disorders, self-esteem, self-compassion, existential crises and self-actualization. We also focus on identifying and overcoming the effects of isms and micro aggressions when that is relevant. (Dr. Lia is on the faculty of an HBCU and has offered countless training on DEI issues for schools, employers, corporations and non-profits)
There are four things we’d like to say in response to this question.
First, our services are based on $280/hour, which we find is a little bit under what clinicians at our level of experience and credentials tend to charge in the DMV.
Second, while we are out-of-network providers, we arrange for our clients–at no cost–to use the services of Reimbursify.com to submit our statements to health insurance companies for reimbursement.
Third, please consider our bios and/or CVs ( Dr. Dave's BIO ) - ( Dr. Lia's BIO ). It’s difficult to summarize them here as we have 50+ years of cumulative experiencing doing clinical work, serving as professors, holding leadership positions, publishing (i.e., books, chapters and articles) and being media consultants.
Fourth, when thinking about costs, consider the costs that can be associated with not getting needed mental health treatment. For example, the cost of a contested divorce in the DMV ranges between $15,000 and $30,000+ per person, suicide is the second leading cause of death among people aged 10-24, unresolved mental health challenges increase the odds of substance dependence, academic underachievement, school dropout, vocational underdevelopment, relationship dissatisfaction, compromised physical health and overall lower quality of life. Also, consider what it would be like to be free of that which is troubling you, your child or your partner the most.
Compassionate, evidence-based therapy for children, teens, and couples—supporting healing from trauma, anxiety, depression, and ADHD while building resilience, connection, and lasting change.