Understanding Attention and Regulation

When we think of “paying attention,” it is often seen as something a person either has or doesn’t have. In reality, attention is not a fixed trait, it is a dynamic state that is deeply connected to regulation.

What is attention?

Attention is the ability to focus on specific information, whether it comes from the outside world—like your child alerting you to a dog walking by, or from inside your body, such as feeling a tag from your shirt on your skin all day.

For attention to work effectively, the brain needs to be in an optimal state of regulation.

Attention is always present, but where it is directed depends on our regulation state.

For example, imagine you are walking in a new city late at night. You may become highly aware of footsteps behind you or other environmental sounds. Your attention is pulled toward safety cues.

Now imagine the same walk at home, in the middle of the day, feeling rested and safe. In that state, you may easily listen to a podcast or talk with a friend instead.

When the nervous system experiences felt safety, we have more flexibility and choice in where our attention goes.

What is regulation?

Regulation is the foundation that allows us to participate in everyday life. When a child is regulated, they are in a physical and emotional state that matches the demands of their environment.

Regulation is not just about being calm, it is about being in the right state for what is happening around you.

For example:You are at your favorite sports game, but you didn’t sleep well and had a difficult day. From the outside, you may look calm and content. But internally, you feel low energy and unmotivated, even though you want to be engaged. You miss key moments and feel disconnected from the experience.

Now imagine the same game after a good night’s sleep. You feel alert, energized, and excited to participate. You cheer, react, and fully engage with the environment.

Both versions of you are “at the game,” but only one is truly regulated for participation.

Regulation is a skill that develops over time and often begins with co-regulation—being supported by others before we can do it independently.

How does sensory processing impact attention?

Children who struggle with attention are often responding exactly as their nervous system is designed to respond.

We are constantly taking in sensory information including sounds, textures, movement, light, and more. For some children (and adults), the nervous system responds more strongly to certain inputs, such as loud noises, clothing textures, or movement in the environment.

When this happens, sensory input can compete for attention and pull focus away from the task at hand.

Our nervous system also prioritizes what it pays attention to. In general, it shifts attention in this order:

first to safety-related cues

then to discomfort or negative sensations

then to positive or enjoyable experiences

and finally to learning and higher-level thinking

This means that if the nervous system is occupied with feeling unsafe, overwhelmed, or uncomfortable, attention will naturally shift away from learning or participation.

Supporting sensory integration and regulation can therefore be a powerful starting point for improving attention. This begins with careful observation and understanding of each child’s unique sensory profile, so their needs can be met proactively.

This is a core goal of occupational therapy: supporting regulation so that attention is freed up for learning, play, and social connection.

So what is the goal?

When a child is struggling to pay attention, it can feel frustrating and confusing. But attention is not something we can simply demand, it is something we support through regulation.

Occupational therapy helps children develop the skills to regulate their bodies and nervous systems so they can more flexibly direct their attention.

We are all always paying attention to something—whether it is external instructions, internal thoughts, background noise, or body signals like hunger or fatigue.

The key question is:

Are we regulated in a way that allows us to direct our attention toward what matters most at this moment?

References

Lazarus, J. A., & Todor, J. I. (1991). The role of attention in the regulation of associated movement in children. Developmental Medicine and Child Neurology, 33(1), 32–39. https://doi.org/10.1111/j.1469-8749.1991.tb14783.x

Posner, M. I., & Rothbart, M. K. (2009). Toward a physical basis of attention and self regulation. Physics of Life Reviews, 6(2), 103–120. https://doi.org/10.1016/j.plrev.2009.02.001

Rueda, M. R., Moyano, S., & Rico-Picó, J. (2023). Attention: The grounds of self-regulated cognition. WIREs Cognitive Science, 14(1), e1582. https://doi.org/10.1002/wcs.1582