Vision and Attention

We are seeing an increase in parents who are concerned about their children’s academic performance as well as the possibility that ADHD could be a contributing factor. In addition, many of these children have underlying visual deficits contributing to their difficulties that were not identified until recently. 


There is a tremendous amount of information on how to diagnose ADHD, but there is a sentence in the DSM-V, as well as in the CDC and AAP Guidelines that is often overlooked or not fully understood.  It is located in the section on Neurodevelopmental Disorders (p.65), under the Introduction Risk and Prognostic Factors:


Genetic and physiological. ... Visual and hearing impairments, metabolic abnormalities, sleep disorders, nutritional deficiencies, and epilepsy should be considered as possible influences on ADHD symptoms. ...


While visual impairments typically refer to visual acuity, there are a wide variety of visual deficits that can also influence ADHD symptoms.  Most people don’t realize you need 17 visual skills to succeed in reading, learning, sports, and in life. Good visual acuity is just one of those skills.  The majority of children who have deficits in the other visual skills typically have 20/20 visual acuity with or without glasses. Attached is a chart  to help explain the different visual skills that can impact reading and learning. 



The other point to keep in mind is that typically the visual skills deficits will not manifest until the child has been reading for at least 5 to 10 minutes.  Which also helps to explain why these visual deficits are usually not caught in most eye exams. 


Children who struggle with self-esteem issues, attention (ADHD) and behavioral problems can often have underlying eye coordination and eye movement problems (which are just a couple of the 17 visual skills), also known as Binocular Vision Disorders. 

Over the years we have helped numerous children resolve the vision disorder that was contributing to their difficulties with reading and attention.  This includes children that started having issues with reading after a concussion, children with special needs who struggled with reading, as well as kids who appeared to be bright underachievers that had poor reading comprehension and trouble remembering what they read. 

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