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Posted on 09-25-2013

Confusing ADD/ADHD With Visual Issues

Originally posted on April 24th, 2013

The number of children with developmental and/or learning challenges just keeps growing. And not just the number, but the percentage. Whether it is ADD, ADHD, Dyslexia or some unnamed learning difficulty, the percentage of children so labeled seems to increase as time goes by. As I have mentioned at other times, the vast majority of those diagnosed with autism spectrum disorder, developmental delays of any kind or with any kind of learning “disability” would be found to have visual developmental delays and/or visual skills deficits if they were properly evaluated. Briefly, this means that they are not performing up to the expected levels with eye movements, eye teaming, focusing, eye-hand coordination, etc. These visual development issues are more likely near the root of the problem than elsewhere. That is, they are contributing factors rather than results of the other, more well-known developmental diagnoses. Visual developmental deficits generally result in a lack of reliable or consistent input from the visual system. These visual issues respond well to vision therapy and developmental lenses. There is often a significant improvement in behavior, performance and overall development once this foundational issue - the visual process - is properly addressed.

“If a child sees ‘distorted,’ he reproduces ‘distorted’ and he therefore learns ‘distorted.’”

                        G.N. Getman, O.D., early advocate of the importance of visual development

Children with developmental delays commonly have difficulty aiming their eyes accurately and/or consistently. The ability to accurately, effortlessly and consistently aim the eyes is the most basic and likely the most important visual skill there is. It is a skill that, under optimal circumstances is fairly well established in the first several years of life. It is also a skill that is commonly undeveloped or under-developed in the vast majority of children diagnosed with developmental and/or learning challenges - and one that, if properly treated, can have tremendous positive impact from that point forward.

Reduced fluency in aiming the eyes often shows up as an inability or dislike of making eye contact. This in itself makes for awkward social interaction and often contributes to delayed or stunted social development. This of course occurs below the level of our normal awareness. A young person cannot be expected to realize there is an eye movement problem. It's not likely they would associate this with other problems they may be having even if they did notice. This is not surprising when you consider that most adults, including the majority of eye care professionals, wouldn't make the connection either. The medical community made a point of insisting that the visual process has no relationship to reading for years. Only behavioral optometrists and those who have come to understand the concepts of behavioral optometry recognize the importance visual development and how it affects behavior.

“A child reproduces what he sees and he learns what he reproduces.”

                   D.B. Harmon, PhD, pioneer in ergonomics

Processing visual information becomes much more cumbersome when the eyes are not pointing precisely where they need to aim. We must figure out how to function the best we can by compensating in some way, unless the visual issue is resolved properly. There are many ways to compensate for visual deficits, but these compensations are rarely, if ever, as good as getting these issues resolved with the help of a behavioral optometrist.

People with visual systems that are constantly compensating are likely to perform below the level one would expect given their overall intelligence or other abilities. This happens because the visual input is inconsistent in quality and in the effort it takes to obtain, absorb and process that input. This can result in avoidance behaviors and/or behaviors that resemble ADD or ADHD. Some manage to push past their visual deficits, but most do not.

Many of these children are diagnosed with ADD, ADHD or something similar. And then they are subjected to medication, which is the preferred approach for many education and health professionals. The medication can be severe, including anti-depressants in many cases. Not surprisingly, there are often side effects from such harsh medication. The most obvious result of these medications is the child becomes subdued, and not necessarily in the best sense of the word. A July 8, 2013 article in the Wall Street Journal entitled “ADHD Drugs Don’t Boost Kids’ Grades: Studies of Children With Attention-Deficit Hyperactivity Disorder Find Little Change” revealed that whatever else these drugs are doing to our children, they are NOT resulting in improved learning.

Perhaps the most important answer for these children is proper diagnosis and treatment of the underlying visual issues. Vision therapy has a proven track record for developmental and functional vision problems, including those discussed here. Be sure to have your child evaluated by a behavioral optometrist if he or she has been labeled with attention deficit disorder or any other learning or developmental classification. Everybody else’s job is made easier when behavioral optometry and vision therapy become part of the equation for children struggling with developmental and learning related challenges.

Next time: Working for the Department of Defense

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