Skip to content
Moving and Sensing — Central Coherence

Central Coherence Issues in Childhood

Two girls with long blond hair holding hands running on a path into a forest.

Marcy Willard


Last modified 19 Oct 2023

Published 21 Apr 2022

What Is Central Coherence in Childhood?

Central coherence in childhood is the ability to grasp the main idea of a concept, dialogue, movie, story, or picture. The central theme of a grouping of information may be called ‘the gestalt’. The gestalt is the main thread that ties a whole story together.

A good way to think about central coherence is, ‘it’s the gist’ of what a person is saying. People who are good at understanding the world in this way may be described as  ‘big picture thinkers.’ 

Central coherence requires shifting attention away from the details, keeping sustained attention on the main idea, and staying flexible enough to see the big picture unfold.

Symptoms of Central Coherence Issues in Children

  • Gets stuck on the details: your child has a harder time seeing the big picture and instead is focused on the details
  • Tells stories that make no sense: your child includes so many details in their story you have a hard time following along
  • Misses the forest through the trees: your child is  so focused on a single tree (aspect or detail) that they miss the ‘big idea’ or the ‘central idea’ which is the whole forest
  • Disregards the main point: your child tells all the details and never gets to the main point in a story or dialogue
  • Tells a story with no main character or plot: your child gets stuck in telling you all kinds of irrelevant detailed information but fails to share the context by providing the main character or a logical sequence of events
  • Reads beautifully but is unable to tell you about what they read: your child can read the words on a page but has little memory or comprehension for these reading materials
  • Notices tiny details while forgetting important information: your child is doing jigsaw puzzles, and they study the patterns and individual shapes, without even noticing the picture they are attempting to construct
  • Works slowly: your child is distracted by tiny details causing tasks to take longer
  • Noticing very little items: your child walks into a room full of toys and games. Instead of gravitating toward those objects, they run over to find a piece of fuzz on the floor

Causes of Central Coherence Issues in Children

Central coherence difficulties could be related to attention, visual processing, or rigidity.

Shifting attention: your child may have difficulty shifting attention and is unable to shift focus back and forth between multiple types of inputs.

Sustained attention: your child may struggle to maintain attention to a task in the absence of immediate reinforcement. Your child may not see the big picture because he is struggling to focus on the big picture and to maintain attention to it. Instead, your child may be easily distracted by irrelevant details.

Visual processing: your child may have challenges seeing objects and pictures accurately. Within the area of visual processing is the skill of visual planning

Visual planning is visualizing what something will look like when pieces have been added or removed. For example, a child would look at a pie with several pieces missing and understand that if those pieces were filled in, the pie would be a whole circle shape.

Rigidity: your child may struggle with rigidity. Rigidity refers to considerable perfectionism, attention to detail, and resistance to change. 

Kids who are rigid may miss the big picture because they are doggedly determined to focus on one piece of the puzzle or one part of the story. This issue can come up more when your child is frustrated or emotional. Your child may find it harder to imagine the big picture and they may become increasingly upset until that one little problem is sufficiently addressed.

Restricted interests: your child may have challenges with expanding attention and interests broadly instead of focusing attention around a single interest or aspect. A restricted interest could be as detailed as Carrier air conditioning units or more general like horses or dogs. Restricted interests can draw attention away from the main idea of a situation or concept.

What to Do About Central Coherence Issues in Children

If you are concerned that your child may have trouble getting lost in the details, help your child with answering questions, reading comprehension, and story-telling.

Practice answering questions about a picture

To help your child with central coherence issues, help them practice answering questions about a picture. Have your child sit with their back to you and describe an image that you cannot see. The child may be looking at a magazine or a photograph. Don’t peek. Let your child describe the picture to you as best they can.

Ask your child questions like:

  • ‘Are there any people in the picture?’
  • ‘Are there any animals or shapes in the picture?’
  • ‘How many objects are in the picture?’ 
  • Then, most importantly, ask the child, ‘What is the main idea of this picture?”

Practice this exercise with your child. Have them describe a picture, then you try. Practice finding the main idea and a few supporting details. 

You will instantly notice if this is an issue for your child if you choose a picture with a big main idea. For example, one child that I was working with as a psychologist, described a picture of a squirrel to me while my back was turned. I heard all about the grass, the sun, the pebbles on the ground, and the little bird in the distance. The child never mentioned the squirrel! That is a major sign of a problem with central coherence. The good news is that these skills can be taught to kids and it will dramatically improve their comprehension. 

Next, practice answering questions about a story

Now that you have practiced with a picture, you are ready to move on to a short story. Tell your child a story with a main idea and a few supporting points. Have them do the same. Once you have both told a very short story, it is time to do a storyboard. 

The monkey story: An excellent example of a story to practice is, “There was a monkey holding a red, shiny balloon. The monkey accidentally let go of the balloon. The balloon flew away and the monkey was mad.”  Use a visual storyboard where you start with the main idea and draw out 3 detailed points. The main idea, in that case, was the monkey who lost his balloon. Decide what details are helpful and what details are distracting. For example, the color of the balloon is just a detail. The story can be retold sufficiently with that detail removed.

Practice reading a story together and identifying the main idea

Now that you have done a couple of simple stories together, you are ready to read a short story. Stick with a story that has a clear main idea and is relatively short. The book does not have to include pictures. In fact, it is ideal if there are no pictures and the child is making visuals in their own heads.

Help your child recognize what details are important and which ones add to a story but are not central to the main idea. Have fun and make this a game. Fortunately, this skill is readily amenable to intervention, and your efforts are likely to pay off over the long run.

When to Seek Help for Central Coherence Issues in Children

If problems are still noted and having an impact, this concern probably requires further support or an evaluation.

A good rule of thumb is to see if this focus on detail has social or academic implications. If you have tried strategies to work on this skill with your child to no avail and grades and friendships are suffering further evaluation is needed. For resources on an evaluation, see the list of resources below. In addition to considering an evaluation, a shorter and simpler path is to engage with a reading tutor.

A reading tutor: If all of these exercises feel like too much, it may be helpful to get a tutor to work on this with your child. Some tutors are trained in what is called the Visualizing and Verbalizing method by Lindamood-Bell. This method is an excellent option for a child who is struggling with central coherence, particularly if it is having an impact on either oral or reading comprehension. Having a tutor if you can, gives you a break and your child may be more cooperative. The tutor can help your child pick out the main idea, work on reading comprehension and learn to get better at recognizing the ‘gestalt’ of stories, books, and dialogues. 

Further Resources on Central Coherence in Children

  • Speech and language therapist: to practice storytelling, determining the main idea, social conversation skills, and general pragmatic language skills
  • Occupational therapist: to assess and treat fine motor skills and sensory integration needs that may occur in children who have this area of difficulty
  • Psychologist or neuropsychologist: to consider symptoms in context via comprehensive diagnostic evaluation, may be related to visual-spatial problems, attention, social deficits, or learning
  • Therapist: to work on emotional challenges and rigid thinking patterns that may be causing frustration or unhappiness. Therapy could be a helpful support in emotional awareness, flexible thinking patterns, emotion regulation, and coping strategies
  • Optometrist or ophthalmologist: to evaluate your child’s vision or visual tracking if concerns are present

Similar Conditions to Central Coherence Issues in Children

  • Body space awareness: standing too close or failing to read social cues could be related to central coherence; self-awareness could also be related (recognizing self, body part identification, and figuring out where objects are in relation to you)
  • Attention: problems shifting or sustaining attention could be related to central coherence challenges
  • Learning problems: challenges with reading or writing could be related to central coherence problems
  • Spatial reasoning: difficulties with visual-spatial processing may be related to central coherence issues

References on Central Coherence

Kroncke, Willard, & Huckabee (2016). Assessment of autism spectrum disorder: Critical issues in clinical forensic and school settings. Springer, San Francisco.

Barton, Erin. Educating Young Children with Autism Spectrum Disorders.

Fein, Deborah (2011).  “The Neuropsychology of Autism”

Koegel, Lynn Kern & LaZebnik, Claire (2010). Growing up on the spectrum: A guide to life, love and learning for teens and young adults with autism and Asperger’s.

Giler, Janet Z. (2000). Socially ADDept: A manual for parents of children with ADHD and / or learning disabilities.

Giler, Janet Z. (2011). Socially ADDept: Teaching social skills to children with ADHD, LD, and Asperger’s.