- by Dr Gowher Pebbles n Pearl Pediatrics and Child Care
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- Feb 09 2017
Vision problems can make classroom attention impossible
ADD and ADHD are psychiatric disorders characterized by inattentiveness or hyperactivity and compulsiveness which hinder a child's academic or social performance. Because there is not yet an objective clinical test to confirm ADD or ADHD, the diagnosis is based on a set of subjective symptoms. If children exhibit any six of nine characteristics in either category, they are labelled ADD or ADHD. In an effort to help children who are struggling at school because of their short attention spans, many parents, teachers, and health care providers make the assumption that these children have ADD and start them on medications. Unfortunately, they are often treating the symptoms and not the real cause. High distractibility and difficulty remaining on task are not the sole domain of ADD. These can be symptoms of other problems.
Children with undetected vision problems can exhibit symptoms similar to ADD. Studies show that approximately 20% of school-aged children suffer from eye teaming or focusing deficits which make remaining on task for long periods of time difficult. Like those with ADD, children with vision-based learning problems are highly distractible, have short attention spans, make careless errors, fail to complete assignments, and are often fidgety and off task. However, their inability to remain on task is caused by the discomfort of using their eyes for long periods of time at close ranges, not true deficits in attention. Unfortunately, parents and teachers are not trained to recognize the difference and these children are often misdiagnosed.
For example, children with eye teaming disorders called convergence insufficiency and convergence excess often appear to have ADD or ADHD. These children have difficulty using their two eyes together at the close-up distances required for reading and writing. After a short period of time, they can no longer control their eye movements, and the print on the page begins to jump and move as they struggle to aim their eyes at the same point on the page. The result is a great deal of eyestrain as they fight to coordinate their eyes. Soon these children are forced to exercise their only relief--avoidance of the close-up tasks which are making them uncomfortable. These children are often looking around the room, getting a drink, going to the bathroom, staring out the window, or talking to their neighbours. They're taking "vision breaks," although they don't realize that's what they're doing. Children with eye teaming problems have always seen this way, and most are not aware that their close-up vision is not normal. Few report eye strain or blurred or double print; all they know is that they cannot continue with their seat work one more moment. As the day progresses, they become increasingly fatigued and frustrated.
The connection between eye teaming problems and attention deficit disorders was recently documented in medical journals. The latest research study found children diagnosed with ADHD were three times more likely to have a convergence insufficiency than children in the rest of the population. Dr. David B. Granet, director of the Ratner Children's Eye Center of the University of California in San Diego and a nationally known paediatric ophthalmologist, explains that because this kind of eye teaming problem causes children to have difficulty keeping both eyes focused on a close target, it becomes more difficult for them to concentrate on reading, one of the ways doctors diagnose ADHD.
Dr. Granet recommends that no child be diagnosed with ADD or ADHD until their visual system has been checked because the chance of a misdiagnosis is just too great.
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