The Key to Children's Behavior Problems May Be Within 'Sight'
Metro Services
(TF) - The challenges posed by Attention Deficit Hyperactivity Disorder (ADHD) have by now been well-documented by medical and education experts, as well as government agencies like the U.S. Centers for Disease Control (CDC) and the U.S. Department of Education.
Characterized chiefly by poor attention span and difficulties with organization and impulse-control, the disorder affects an estimated 3 to 5 percent of children, according to the American Academy of Child and Adolescent Psychiatry. It is one of the most commonly diagnosed psychiatric conditions in children living in the United States.
However, what may be less well-known is that almost all the symptoms associated with ADHD are also symptoms of vision-related learning problems. According to Mary McMains, O.D. M.Ed., an optometrist who specializes in vision-related learning problems, many children may be misdiagnosed with ADHD by primary care physicians or pediatricians, based mostly on parent or teacher recommendations.
How Vision Works
Though it may seem as simple and natural as opening your eyes, vision is a complicated and dynamic process. Far more than seeing objects clearly, vision also involves how your eyes work together, how they focus, how you perceive depth as well as process, store and recall information. It requires more than 65 percent of all pathways to your brain to work - more than any other single activity - according to the American Foundation for Vision Awareness (AFVA).
The most complex of the five senses, vision actually develops over time based on your experiences and how you react and solve problems - much like walking and talking.
"When you're born, you don't have all the skills you need to see and to interpret what you see," says McMains, who practices at the Insight Vision Center in San Diego, the first nonprofit vision center dedicated to providing comprehensive eye examinations and vision therapy through interaction with the schools and community. "As you creep and crawl, your eyes learn focusing, depth perception and eye-teaming. These are just the input skills; then you have to learn the processing skills that allow you to understand what you're seeing."
According to McMains, 85 percent of classroom learning happens through the visual system, which means that beyond all the paper, pens and nifty gadgets, good visual skills are your child's most important school supply.
Vision and Learning
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), a diagnosis of ADHD is largely based on extended observation by parents, educators, doctors and psychiatrists. However, an optometrist is often missing from this diagnostic mix, McMains says.
Children with vision problems like farsightedness, difficulty focusing or binocular dysfunctions (how the eyes work together) may exhibit the same symptoms as ADHD children, including "careless" mistakes in schoolwork, poor listening skills, difficulty following directions or completing tasks, frequent loss or misplacement of items, fidgeting, excessive talking or interrupting, and poor organizational skills.
Their visual system is unable to handle the rigors of classwork, a situation that can lead not only to frustration for the child, but also avoidance - trying to find a way around the task - or acting out, McMains says.
In fact, vision disorders are the fourth most common disability in the U.S., according to the AFVA, which estimates between 8 and 12 million children are affected each year, a fact that may be directly related to the burgeoning numbers of students requiring special education services and the cost to community school systems nationwide.
It is important to note, however, that a child can have both vision-related learning difficulties and ADHD, and other factors may influence a child's performance in school. Only a thorough vision exam will rule out any sight problems as the cause of a child's "misbehavior" or poor performance in school. The American Optometric Association recommends that children visit an optometrist at least once every two years, or more frequently, if specific problems or risk factors exist.
"Vision is not the only reason why children are having trouble [in school] or diagnosed with ADHD," McMains says. "But it needs to be addressed so that it is not a problem."
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Last modified: 08/23/03
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