Attention can be compromised by various factors, including ADHD, emotional trouble, learning disability, language disorder, and executive function problems. When these factors are present they interact, each influencing the other. Therapists also have trouble maintaining a consistent, even focus because of selective inattention, countertransference, and pressure from parents and school. To illustrate, this article presents the background of a case of a seventh grade boy with attention problems. Neuropsychological and psychoanalytic concepts relevant to attention are then reviewed, before returning to a description of the treatment of that case. A summary uses the case to demonstrate a contextual, psychodynamic approach to the children with attention problems.