ADHD and Vision

Recently it was suggested that my daughter was having trouble with her focus. She would rather socialize than work. She was caught staring off in the distance when she was supposed to be doing work. In a classroom of a team of 4 adults that is 2 teachers and 2 intervention specialists my wife and I were told that one of them is often reminding her to stay on task.

To us this sounded like the teacher was suggesting she has issues with her attention. Now, there are some signs of attention deficit that may be worth looking into, however no one asked or maybe knew to ask “what happens when or before you lose attention? What stops you from being able to pay attention?”

Having an unfair advantage of being a developmental optometrist and myself being my daughter’s optometrist I knew the correct questions to ask. So I asked her “what happens to make you stop paying attention and what causes you to lose your focus?”

Unprovoked my daughter raised her hands, one on each side of her head and started shaking them left and right. I asked her what does that mean? She said “my eyes get tired and then the words start moving all over the place and I cant focus!” So I asked do you feel like you’re able to keep your place easily when reading or doing school work? She replied “no, I lose my place all of the time”. None of this was overly surprising to me as I had previously performed an evaluation 6 weeks prior to this discussion noting deficits in her teaming (ability to coordinate the eye to go in and out together), tracking (the ability to follow a moving target or move the eyes from one word to the next) and her focusing (ability to make letters and words clear at near or distance and then able to allow them to quickly transition back and forth from far to near). These issues often cause someone to appear as if they have attention issues or can exacerbate known attentional issues.

Below is a list of symptoms of Attention Deficit/Hyperactivity Disorder taken from the DSM-V, the Diagnostic and Statistical Manual for Psychiatric Disorders 5th edition. Below is specifically the symptoms of inattention. According to the DSM-V it is says 6 or more symptoms must be present in 2 or more setting I.e home and school for greater than 6 months:

•  Often fails to give close attention to details or makes careless mistakes
• Often has difficulty sustaining attention in tasks or play activities
• Often does not listen when spoken to directly
• Often does not follow through on instructions or fails to finish work
• Often has difficulty organizing tasks and activities
• Often avoids, dislikes or is reluctant to engage in tasks requiring sustained mental effort
• Often loses things
• Often distracted by extraneous stimuli
• Often forgetful in daily activities

Now below is shown symptoms of Learning-Related Vision problems similar to what was discussed above. This was taken from a study done by Berne and Getz. There should something glaringly obvious here:

• Often fails to give close attention to details or makes careless mistakes
• Often has difficulty sustaining attention in tasks or play activities
• Often does not listen when spoken to directly
• Often does not follow through on instructions or fails to finish work
• Often has difficulty organizing tasks and activities
• Often avoids, dislikes or is reluctant to engage in tasks requiring sustained mental effort
• Often loses things
• Often distracted by extraneous stimuli
• Often forgetful in daily activities

These symptoms are exactly the same!

What does this mean if the symptoms are both the same? This suggest that you cannot determine a diagnosis of an attention issue unless you have ruled out a Learning-Related Vision Problem. This also suggests that a Learning-Related Vision problem may look like attention issue or the Vision problem may be making these issues worse.

If you are thinking your child may be having an attention issue, give us a call to rule out a Learning-Related Vision Problem. This may save you lots of time and struggle down the road!