Counsellors perceptions of the phenomenon of concentration difficulties

Pupils’ lack of concentration is a concern in everyday classrooms in Norway as in many other countries. Whereas research has defined different behaviour issues in classroom contexts, there has been less focus on how the counsellors, working at the Educational and Psychological Counselling Service (EPCS), describe different behaviour issues. This article is based on a study that aims to develop a deeper understanding of how the counsellors perceive the term ‘concentration difficulties’. Even though the term is widely used in templates and in national strategic documents to describe pupils’ disruptive behaviour, few other studies emphasise this perspective. The study has a phenomenological-hermeneutic inspired approach and is based on individual in-depth interviews with counsellors working at the EPCS. The key findings suggest that the counsellors understanding of the term are influenced by their personal perceptions of the term, their education and the way they facilitate adapted learning.


Introduction
Pupils' ability to concentrate in classroom contexts is vital for their academic progress (Rabiner et al., 2016;Gochenour and Poskey, 2017) and important for their emotional adjustment and relationship with others (Wang and Dix, 2017). Nevertheless, research show that pupils lack of concentration on learning tasks is a concern in Norwegian schools as well as in schools in other Western societies (Bru, 2009;Münchhausen, 2016;Nagashibaevna, 2019;Skaalvik and Skaalvik, 2019). As many as 33% of Norwegian adolescent students say they have been disturbed by interrupting behaviour in class (Wendelborg, 2012). Previous research indicates that disruptive behaviour is contagious among pupils in many classrooms (Ødegård, 2017). Disruptive behaviour is also a trigger for teachers to leave their teaching profession within 5 years after post-qualification (Greene, 2014). The difficulties are often perceived to be pupil-related (Casin, 2019;Hvidsten and Wilhelmsen, 2019), and teachers also understand pupils with 'concentration difficulties' differently Wilhelmsen, 2018, 2019).
Counsellors in Norway working at the Educational and Psychological Counselling Service (EPCS) are mandated to perform assessments through testing, mapping and observations. They also give the advice to help schools develop inclusive environments (Mjelve et al., 2018). The counsellors often use the term 'concentration difficulties' to describe disruptive behaviour but there has been less focus on investigating how the counsellors describe this term (Stray, 2013;Münchhausen, 2016). The aim of the study is to develop a deeper understanding of how this term is perceived by counsellors in the EPCS. The research question is: Seven in-depth interviews with counsellors working at the EPCS in Norway have been conducted. The study highlights three questions: First, how do the counsellors perceive what falls within the concept of concentration difficulties? Second, how do counsellors perceive the concept of concentration difficulties used in reports from teachers? And third, what actions do the counsellors recommend, based on their perceptions of the concept as described in templates?

Describing the term concentration difficulties
The term 'concentration difficulties' is often used when describing any type of behavioural deviation, from learning problems to child maltreatment (Elkit et al., 2016;Selvik, 2018). The majority of children exposed to maltreatment struggle with concentration difficulties (Selvik, 2018).
The expert assessments and strategic documents, like pedagogical templates, often use the term in an explanatory way (Knudsmoen et al., 2011;Stray, 2013). Concentration difficulties is less established as a concept used in educational research (Stray et al., 2012). In 1990, German school researchers used the term when describing pupils in learning environments. They found that pupils with concentration difficulties can struggle to listen to someone speaking, learn texts or carry out a specific task; that is, they lack the skills needed to acquire knowledge (Westhoff et al., 1990). Concentration requires a certain effort, which often decreases as one works on an activity in a focused way (Münchhausen, 2016). The concept 'concentration difficulties' is also used when describing attention in the ADHD diagnosis in the diagnostic manual APA (American Psychiatric Association, 2019). Westhoff and Hagemeister (2005) suggest a distinction between the terms concentration and attention. The term attention is linked to 'warnehmen' -that is, to apprehend or notice -while 'konzentration' refers to that which one has chosen to focus on, something in particular. Domsch (2014) and Kreinbucher (2015) find that the explanation for the mixing together of these two terms are influenced by English-language literature, in which attention and concentration are both largely referred to as attention. Brünken and Seufert (2006) prefer the term concentration because it has a level of intention and is more targeted. While psychiatrists often diagnose using the terms 'disorder' and 'disturbance', educationalists often use the term 'difficulties' when describing the same phenomenon (Pihl, 2010). Data from GSI (2016-17) show that 45% of EPCS staff are teachers with upper secondary education in special needs, and 13% are psychologists. The rest of the EPCS staff (42%) are teachers with master's degrees in pedagogy or professionals with different educational backgrounds. Despite of this, all counsellors may assess pupils with all kinds of special needs.

The use of specific terms in templates
As stated, the templates called pedagogical reports make frequent use of the term 'concentration difficulties' when describing disrupted behaviour. Stenberg (2006) found that using this term in headings restricted comprehensive description of the pupil's difficulties. He interpreted the weak descriptions from teachers as a result of using inadequate categories in the templates. The use of specific terms to describe difficulties, may restrict the way in which the problems are understood. The forms also tend to exclude descriptions of the teacher-pupil relationship, and relations among the pupils (Stenberg, 2006). The heading in one local pedagogical report from 2019 is, for example: 'Working strategy', followed by; concentration, attention, distractibility, perseverance, ability to plan, ability to 86 Support for Learning • Volume 36 • Number 1 • 2021 © 2021 NASEN complete tasks and organisation. The term 'concentration' is frequently used as a sub-category or as a leading word, and this can make teachers feel obligated to use this term when describing the pupils. Knudsmoen et al. (2011) found that the decision to grant support often is based on general terms like concentration and attention difficulties. The researchers also found a lack of system-focused work within EPCS in the time between referral and provisions being made. When investigations indicate that forms emphasise terms that focus on the pupils, this is a paradox when other studies shows that teacher's competence has an impact on classrooms interactions (Hattie, 2009;Valle, 2014).

Different cultures, different views in EPCS
The principal task of the counsellors is to carry out expert assessments based on medical and psychological knowledge (Pihl, 2010;Mjelve et al., 2018;Nordahl et al., 2018;Tveitnes, 2018). Stenberg (2006) argues that the work methods in different EPCS centres will lead to differing educational-psychological cultures, even though the EPCS itself has largely retained its psychological/therapeutic character (Tveitnes, 2018). The professional debates within special education in Norway have been characterised by two different views; between a diagnostictherapeutic orientation, on the one hand, and education welfare and teachingfocused orientation, on the other hand (Befring and Saebø, 1993;Tveitnes, 2018). These contradictions also appear in Stray's (2013) research on assessments. He argues that counsellors increasingly carry out their assessments through evaluation of cognitive and special educational elements, however, without integrating these with the social and emotional aspects of learning. Stray (2013) points out that there is greater concern regarding discipline problems in those schools, where EPCS has a supervisory role via system-focused work. Herlofsen (2014) argues that, in many expert assessments, the extent of the special needs provisions given in teaching per hours per year is not earmarked in any way. The increasing number of individual decisions is based on the need for more structured teaching of the class, and refers to the Education Act paragraph 1.3, stipulating adapted education ahead of specific measures aimed at the pupils.

Methodological approach
The study is inspired by a phenomenological-hermeneutic tradition, seeking to understand the subjective reality of experiences, thoughts and understanding (Creswell, 2012). In line with this the purpose of this study is to investigate in-depth experiences (Befring, 2015). Moustakas (1994) explains that the shared experiences and individual perceptions gathered from personal interviews help contribute knowledge and wonder, adding depth to the study. These shared stories convey the essence of the phenomena. It is a process that helps unveil wonderings about an idea, which drives curiosities and creates unity between past and present.

The data
Seven in-depth interviews with ECPS counsellors were conducted. The counsellors were selected on the basis of their experience as counsellors in the EPCS. The managers at three different EPCS services in a Norwegian city were asked to give permission to contact counsellors with more than 3 years of experience. Participating ECPS centres are located in the east (E), west (W) and north (N) of a Norwegian city and the counsellors were contacted by email. The counsellors are educated as special needs teachers and psychologists, and therefore, represent different traditions. They displayed, in their understanding and reflections, a depth of knowledge that made it possible to identify different perspectives of the counsellors' work. Table 1 shows the overview of seven participants, their gender, profession, education and expert field as well as their EPCS-place of work: The interview guide operationalises the research question: how do counsellors from The Educational and Psychological Counselling Service perceive the term 'concentration difficulties?' and explores three limited main questions: How do the counsellors perceive what falls within the concept of concentration difficulties? Second, how do they experience the teachers' perceiving of concentration difficulties as a concept? And third, what actions do the counsellors recommend, based on their understanding of the concept as described in templates?

Data analysis
The data material from the in-depth interviews was analysed using phenomenological-hermeneutic content analysis. The data material has been coded and categorised. The transcribed in-depth interviews were conceptualised in an analytic framework and the underlying structure of the participants' experiences helped identify new categories and formed new concepts and sub-categories (Creswell, 2012). This is an qualitative inductive analysis strategy where the interchange between theory and the narratives can develop new knowledge (Blaikie, 2000). The developed categories are accounted for in the next section.

Ethical considerations
Research ethics guidelines (NESH, 2016) have been followed and approved by NSD (Norwegian Centre for Research Data). The participants were informed about the use of the data material, their anonymity, confidentiality and also their right to drop out at any time without explanation. Their anonymity was ensured using a pseudonym comprised of numbers and letters for each informant, and all sound recordings were deleted. In line with Lincoln and Guba (1985), that named this method 'member-checking' because it helps to make the study valid and trustworthy, the participants were given the opportunity to comment on the transcribed text. Since this is a phenomenological-hermeneutic study, based on in-depth interviews the purpose has not been to generalise the findings.

Findings
The participants displayed, in their reflections, a depth of knowledge that made it possible to differentiate between the various informants' understanding of the term 'concentration difficulties' (Creswell, 2012). All seven participants stated that the concept is a widely used term in notifications from the school, and that 'concentration difficulties' arise as a consequence of diagnosis or an identified problem.

The counsellors' understanding of the concept of concentration difficulties
Three of four counsellors educated as teachers in special needs (participants 1WE, 5MN and 7WN) claim that concentration difficulties are a problem area related to learning difficulties. One of them said that: 'There could be a lot of children with language difficulties, learning disability issues'! (WE1).
The counsellors who brought this up all agreed that disruptive behaviour in many cases also relates to other learning difficulties.
Two participants (1WE and 7WN) also claim that this may be connected to home circumstances, something which the counsellor with psychologist background does not mention. The counsellors educated as special needs teachers use the word 'problems' to describe the concept of 'concentration difficulties', while the counsellors with a psychologist background are more preoccupied with physiological deficiencies. They were unanimous, and largely unhesitant, in their explanations of the concept, whereas the special needs teachers were more enquiring in their approach to the concept. In terms of offering explanations as to possible causes of these difficulties, they were more wag, and also raised a number of possibilities, while the psychologists were briefer and more concise in their answers. The psychologists spoke of coping, physiological deficiencies, ADHD and boredom, while the special needs teachers included home circumstances, different aspects of learning difficulties, neurological conditions as well as ADHD. They In this study, most of the descriptions from counsellors with a background as special needs teachers come from classroom contexts. The psychologists were more concerned with describing the pupil. Educational-psychological offices have different professional priorities (Table 1) and the participants from different parts of Norway focus on different themes. Participants from the EPCS in East include difficulties with reading and writing, language and learning to a greater extent in their descriptions of causation. Those in the West describe pupils with concentration difficulties from the perspective of social and emotional problems. Participants from North refer to the training they receive in the DAt-Kon (Differentiation of Behavioural and Concentration difficulties) mapping tool, which includes consideration of the different aspects of concentration difficulties.

How counsellors understand the concept of concentration difficulties used in reports from teachers
According to the counsellors, the concept 'concentration difficulties' were used as a descriptor of pupils in 50-80% of written referrals from teachers.
1WE said: «This is big. I think in around half of all the requests, that is the explanation … Yes. I'm not sure I can give an exact number, but it is very commonly used.» 2ME: said: «Yes. Over 80% -yes, definitely.» None of them stated that this might be related to the reporting templates used by teachers. In this template, 'concentration difficulties' form their own subheading under the main heading. All of the participants stated that the reports refer to school subjects regarded as core subjects or academic subjects, namely, Norwegian, Mathematics and English. The counsellors point out that arts subjects are not included in the reports, and that the teachers also seek assessments that focus on specific diagnoses, or at least focus on the areas of difficulty that they assume the pupil is having. One example from WM7: «Teachers want to have a diagnosis, and over half of them emphasise concentration difficulties. Thinking of ADHD! Worrying».
Whether or not teachers and parents share this opinion is not clear, as that question was not asked in the interviews. The psychologist counsellors reported that teachers use observations as a basis for the preparation of their report. The counsellors who had previous experience in schools as special needs teachers (1WE, 5 SMN and 7WN) did mention observations, and also stated that teachers use reporting tools such as ADDES (Attention Deficit Disorders Evaluation Scale), Logos (a diagnostic test for reading difficulties), 5-15 (a diagnostic test of the child's development) and 6-16 (a language screening test) in their referrals. The participants claimed that they were able to remain objective in their reading of the referrals received from teachers and that referrals only supplied certain pointers in the conduction of their expert assessments.
The counsellors felt that teachers had become more proficient at writing, even though most referrals had to be sent back to the school for expansion and clarification. An example of this is when psychologist counsellor 4MW said: «They are better -at school! They are more descriptive than interpretive. Maybe this is just fine?» Counsellors state that when they need to conduct investigations, it is common that the pupils visit the EPCS. Additional information about the pupils comes from speaking to parents/caregivers and teachers. Five participants stated that they seldom have time to visit schools in order to see the pupils under tuition. One example of this is: «Sometimes the parents follow them, but I'm never in class to see the pupil» (WW2). This is perceived as having too little time for observations before finishing the proposed measures.

The counsellors' recommendations of measures and recommendations proposal after a pupil is identified as having concentration difficulties
Adaptation at a system level is something that all the participants talk about. They refer to different packages of measures such as PMTO (Parent Management Training -Oregon), guidance material on ADHD and the anti-bullying programme (Olweus). These programmes are made for classroom teaching and suitable for all pupils in line with the Education Act paragraph 1.3. The participants made the point that packages of measures require time in order to become operational and implemented in each school. When it comes to measures aimed at the individual pupil seen as having concentration difficulties, the data shows a few such.
The special needs teacher 1WE said: «The school must do its best. This means for all of the children. We have a long way to go in working with the schools. System-based work is important.» All seven participants said that they have insufficient time to offer guidance and counselling to schools, as the pressure of work and expert assessments dominate their working day. Their expertise is clear in the work they do. The discussion concerning expert assessment and provision of appropriate measures hinges rather on the question of measures for the individual pupil. There, the expert language takes on a more general tone and they do not specify what measures they would recommend.
Examples of this are when two of the special need teachers said:

7WN: «When I come into the classroom, then I take a look at … -or, when I do studies, then I take a look at the pupil, and then I take a look at the teachers, and then I take a look at the learning environment so that they are warned about what … -about what I am looking at.»
Though the special needs teachers describe a pupil with concentration difficulties in the classroom, and the psychologists are more focused on individual difficulties, they generally have similar proposals with regard to provisions.

Discussion
In line with previous research, teacherstudents (N = 80) (Hvidsten and Wilhelmsen, 2018) and the teachers (N = 13) (Hvidsten and Wilhelmsen, 2019), as well as the counsellors in this study, use words such as restlessness, walking around and noisiness when describing the concept concentration difficulties. All participants assert that concentration difficulties may be related to ADHD. The number of ADHD medicine recipients has risen from 13,000 in 2006 to 18,000 in 2016 (Norwegian Institute of Public Health, 2017). The counsellors with a background as psychologists say they refer pupils to BUP (Children's and Young Person's Psychiatric Outpatient Clinic) if the pupil falls within the criteria for ADHD. By identifying and delimiting behavioural deficiencies using medical terminology, this may affect teachers' and parents' way of perceiving a pupil's behaviour (Honkasilta et al., 2016). Researchers (Paju et al., 2018) argue that one reason why knowledge and awareness of the contradictions within the field may be inadequate is that special needs education includes many professional specialities. 'Concentration difficulties' is not a primary diagnosis but is considered one among several symptoms of a disability. Koziol et al. (2015) suggest that it is an element of a neurological process within a neurological network for the coordination of activity and that the concept is so unwieldy that it might be of no use in practical situations. Domsch (2014) points out that in order to concentrate one must have the capacity to maintain unwavering attention. Moreover, there should be a balance between challenge and capability if a pleasurable and voluntary level of concentration is to be achieved (Csikszentmihalyi, 2014).
In this study, the participants relate differently to the concept of 'concentration difficulties'. The counsellors educated as special needs teachers speak about the role of the pupils in the classroom, whereas the psychologists speak about children from a physiological viewpoint. The psychologists do employ descriptions of the child in class but mostly based on descriptions of what is evident; what the child displays. The special needs teachers describe the interplay in class and are somewhat more subjective, more enquiring and pragmatic, giving fuller descriptions of the ways in which the concept of 'concentration difficulties' can be understood. The psychologists are more conclusive in their reflections and this might be related to their strong profession.
Although this is a small study based on seven in-depth interviews, the data material indicates that the counsellors understand the term 'concentration difficulties' © 2021 NASEN differently. While the psychologists have a diagnostic-therapeutic approach, the counsellors educated as a special needs teacher have a social pedagogical and learning-focused approach. In line with previous research (Befring and Saebø, 1993;Tveitnes, 2018), the results from this study suggest that both professional background and the focus area of the individual EPCS centres may affect the understanding of the term concentration difficulties. Sfard (2008) criticises the traditional cognitive psychologists and their view of what some researchers (Honkasilta et al., 2016) calls 'explanation by attribution' or 'reification', and argues the need for developing a better way of understanding the aspects of learning by using the observable discourse to avoid misattribution. He also gives an example of this when changing the sentence from; 'Magnus is unable to concentrate' to 'Magnus has concentration difficulties'. That which is fundamentally a description of an event or process is changed into a static object, which can be described as a 'frozen picture' (Sfard and Prusak, 2005). Reporting templates in Norway could also be understood as a 'frozen picture' or a static object. The templates may affect counsellors understanding of teachers descriptions of the term concentration difficulties. As Table 2 shows, the content of the templates varies by the different local authorities and cities.
The EPCS templates used in several local communities in Norway may also affect a teacher's or a counsellor's description of what the pupil's difficulties are (Hvidsten and Wilhelmsen, 2019). As stated Knudsmoen et al. (2011) found a lack of system focus work at EPCS. The way the expert assessments and the referral forms are formulated may also affect the assessment, and the referrals often have to be improved when they contain too general information (Stenberg, 2006) -the counsellors refer to this as 'A4 referrals'. When the templates focus on the individual, they indicate that the pupil 'owns' the problem (Fasting, 2015). Counsellors can also feel pressure from teachers wishing to receive the maximum possible resources in class (Skaalvik and Skaalvik, 2019). More focus on classroom contexts could lead to better teaching and adequate organisations making it easier for the pupils to learn (Valle, 2017). If teachers interaction competence are well developed this could lead to more children not being classified as having special educational needs. Bachmann and Haug (2006) make a point of this, stating that the consequence of this may, in the extreme, be that if the teaching is inadequate, the solution is to give pupils special education. EPCS may thereby feel pressured to recommend resources to the individual pupil (Smeets and Roeleveld, 2016), rather than focusing on the quality of teaching and the interaction between pupils and teachers. However, it would not be fruitful to exclude the individual perspective. Both perspectives are of importance to meet the pupil's needs (Mjøs and Flaten, 2018).
The participants describe different tools used to investigate the pupil's difficulties, but when interviewed they did not talk about the context and how the pupil's story could affect the assessments. In line with Tveitnes (2018), the results from the study suggest that the participants seem to create a sort of distance from classroom practice, from the pupils' learning arena that is under evaluation. However, this does not mean that the counsellors are not concerned with what is going on in the classroom. The counsellors state that they should spend more time out of office, being present to make observations, something that Nordahl et al. (2018) pointed out is essential when delivering correct measures in school.
The study shows that the preparation of expert assessments is individual-focused while the recommended measures and provision are system-focused (Stenseth, 2019). Fylling (2016) argues that a considerable difficulty for many EPCS centres is that educators do not want them to work with their pupils in a system-facing way, preferring them to focus on the individual. Their proposals concern systemic counselling work with different large packages of measures requiring careful introduction over time. The results from Mjelve (2017) indicate that ECPS counsellors emphasised process competence more strongly than expert knowledge. Mjøs and Flaten (2018) argue that individual and systemic perspectives should be perceived as a unit when making appropriate provision. The counsellors' twofold role in schools increases the need to be engaged in both special needs counselling and system-focused work counselling (Stray, 2013;Nordahl et al., 2018). Nordahl et al. (2018) claim that pupils receiving special education work less hard than other pupils. It is largely the teacher's ability to foster teaching and to create a learning environment that leads to improved learning outcomes (Hattie, 2009). In line with this, it is important to record background information for referrals, gained from observations or other appropriate measures, and then, use the competence of a special needs teacher in order to provide tutoring for pupils (Herlofsen, 2014).

Concluding observations
The findings in this study indicate that ECPS counsellors understand the concept 'concentration difficulties' as one among several symptoms of a disability and that they act based on their competence and preconceptions. This could mean that the consultant who processes the case can give different conclusions according to these findings. Moreover, the concept is mainly used in the headings of the pedagogical templates. There is a chance that this type of headings can contribute to turning a description of a pupil into a static object. The preparation of expert assessments is individual-focused while the recommended measures and provision are system-focused. Because of this, the templates should be more open and written by the teachers who have first-hand experiences from classroom teaching.
Special needs education arising from individual assessments is nearly three times as common in year 10 of school as in year 1 (GSI, 2016-17;NOU, 2016:17). A political aim is to lower the quantity receiving special needs education in Norwegian schools, but perhaps it would be fruitful to also take more account of the complexities in the field of special needs, within which there are various specialities relating to different difficulties and diagnoses. The current conceptualising of inclusive pedagogy and arguments against a deficits-based focus on the needs of individual pupils have been on the political agenda for several decades. This may not always give the pupil the help they need in order to master their studies. Public policy guidelines emphasise language, reading and writing difficulties, together with behavioural problems, in nurseries and schools. The counsellors in this study focus on different aspects; the EPCS in North focuses on the DAt-Kon mapping tool, in West, they focus on behaviour and relational issues and in East language, reading and writing difficulties are the main perspectives (Table 1). It is possible that the focus areas of the EPCS centres may influence the counsellors' competence area development and perception of pupils with concentration difficulties. The counsellors in North provided richer and more complex descriptions of the concept of concentration difficulties, probably because of their knowledge of DAt-Kon (Stray, 2013). Schütz argued, as early as 1942, that the way in which the counsellor acts, based on their competence and preconceptions, shapes the way the pupil is understood. We need to understand the 'rules of the game' (Wittgenstein, 1993) -in this case, the political, economic and structural regulations the counsellors must adhere to while carrying out their work. The outcome of their assessment affects the pupils and may change the course of their school life. This change becomes evident in how the pupils experience themselves at school, and how they are experienced by others there (Valle, 2014).
Future research should take into account the various influences when a pupil is described with concentration difficulties Wilhelmsen, 2018, 2019). The measures taken should be correctly targeted in order to be as accurate as possible in order to make a difference and be assessed through follow-up counselling by the EPCD (Fasting, 2015;Nordahl et al., 2018). When head teachers use 50% of staff without professional competence, the results may be poor (Nordahl et al., 2018). System-wide measures and individual provision should be seen in conjunction with each other. The discussion should focus both on inclusions as well as an individual-focused discourse based on equity and social justice in educational systems (Mjøs and Flaten, 2018). Future research could address the pupil voice, also stated by Casin (2019) who say; the most important is not to forget to ask the pupils themselves.