Q: What is ADHD?
Attention deficit hyperactivity disorder (ADHD) is one of the most common behavioral disorders that affects children.
- Approximately 5% of children have ADHD, worldwide.
- Around four million American children— up to 11% of school age children have ADHD.
- ADHD affects males more than females, with a 3 to 1 ratio.
ADHD is usually suspected and diagnosed during the early school years when problems within the classroom, such as concentration and attention begin to appear.
ADHD affects both children and adults, but the symptoms always begin in childhood— generally interfering with academic performance and social success.
Q: Does my child have ADHD?
A: The primary behaviors associated with ADHD are inattention, hyperactivity, and impulsivity. While most children do exhibit these types of behaviors from time to time, with ADHD, these behaviors are the rule, not the exception.
Inattention: Difficulties concentrating on a task, knowing where to start, or getting lost along the way, easily distracted, disorganized, and forgetful.
Hyperactivity: The most visible sign of ADHD— in which the child appears to always be fidgety or “on the go”.
Impulsivity: Acting without thinking— such as speaking out of turn, interrupting others, and engaging in risky behavior.
Q: What causes ADHD?
Unfortunately, the cause of ADHD is still unknown. However, studies suggest that in many cases, ADHD occurs from a chemical imbalance or deficiency in certain neurotransmitters that help the brain regulate behavior.
ADHD tends to be genetic, so if one of the parents has it, there is a 50 percent chance that their child will have it.
Children are at a higher risk of ADHD if they were born prematurely, had a low birth weight, or the mother had a difficult pregnancy.
Studies show that pregnant women who smoke or drink alcohol, or were exposed for lead, PCBs, or pesticides, may have a higher risk of having a child with ADHD.
The brain chemical dopamine may also cause ADHD symptoms. Dopamine is responsible for carrying signals between nerves in the brain, and is linked to movement, sleep, mood, attention, and learning.
Q: How is ADHD related to vision?
A: Difficulty focusing in school, fidgeting in their seat, and making careless mistakes can be signs of ADHD, but may also be signs of a functional vision problem.
Moreover, visual problems can make reading a challenge, which may lead to avoidance behaviors and even behavioral problems in school.
Convergence insufficiency (CI) is the most common vision condition that affects reading performance, and is known to mimic the symptoms of ADHD.
Q: What is functional vision?
A: Functional vision is how your entire visual system— your eyes, brain, and visual pathways, work together to accurately interpret visual information, and help you to interact with your environment.
Your functional vision includes all of the essential visual skills.
ADHD typically affects the following visual skills:
- Eye teaming
- Hand-eye coordination
- Visual perception
- Visual tracking
Q: What is convergence insufficiency?
A: The eyes converge, or work as a team to come together, as they focus on an image, to enable clear vision. Convergence insufficiency means that the eyes do not work well as a team, resulting in blurry vision, and other visual distortions. When a child has CI, the eyes need to work harder to accurately process visual information for clear vision of the object.
Convergence insufficiency can directly impact your child’s success in reading, learning, sports performance, and more.
A child can have CI, even with perfect 20/20 eyesight. Therefore, if your child is showing signs of ADHD, it is important to have an eye exam to first rule out a vision problem, such as CI, before treating the ADHD.
Q: How do I know if my child has convergence insufficiency or reduced visual skills?
A: Studies show that children with vision problems are twice as likely to be diagnosed with ADHD when compared to their peers.
If your child is showing any of the following behaviors or symptoms, schedule a functional vision evaluation as soon as possible— your child may have a problem with their visual skills.
- Difficulty paying attention in class may lead to frustration, tiredness, or an inability to sit still.
- Reading below grade level or avoiding the task altogether.
- Loss of concentration may result in ‘daydreaming’ or distracting their classmates.
- Rushing through school work and making careless mistakes.
- Difficulties playing sports and following a ball as it flies through the air, or assessing the physical distance between players.
- Excessive squinting
- Frequent eye rubbing
- Disinterest in reading
Q: How is ADHD diagnosed?
Unfortunately, diagnosing ADHD is complicated, and usually requires a thorough assessment conducted by a developmental pediatrician, child psychologist, child psychiatrist, or pediatric neurologist.
A diagnosis of ADHD is made using multiple sources that can attest to certain behavioral symptoms, in multiple settings.
A proper ADHD diagnostic evaluation includes the following elements:
- A thorough medical and family history
- A physical examination
- Interviews with the parents, the child, and the child’s teacher(s)
- Behavior rating scales completed by parents and teacher(s)
- Observation of the child
- A variety of psychological tests to measure I.Q., social and emotional adjustment, and detect any learning disabilities.
Q: How do I know if my child was misdiagnosed with ADHD?
A: Schedule a functional vision assessment to determine whether your child is truly presenting with signs of ADHD, or suffering from reduced visual skills. A proper diagnosis can facilitate your child’s academic and personal success.
An incorrect diagnosis of ADHD can result in serious consequences, including prescriptions of strong medications that could permanently alter the dopamine levels in the brain.
While these medications increase focusing ability and concentration levels, they may cause uncomfortable side effects such as:
- Sleep disruptions
- Loss or increase of appetite
- Mood swings
ADHD can also affect the child socially— resulting in stigmas and negative behaviors from peers, and possibly leading to reduced self-esteem and confidence levels.
Q: Why is ADHD associated with social challenges?
A: Many children with ADHD have difficulties making friends and suffer from social and communication difficulties. This is typically because they are unable to intuitively recognize the rules of social interactions, such as when joining a group of peers, responding to a greeting, or listening to a joke. As a result, a child with ADHD may exhibit inappropriate behavior in certain social situations.
Common social challenges associated ADHD:
- Missing social cues
- Misinterpreting body language and tone of voice
- Talking too much, or at the wrong time
- Responding inappropriately in social situations
- Misinterpreting jokes
- Difficulty participating in group interactions
If you think your child may be showing signs of ADHD, discuss all of your concerns with your eye doctor to first rule out a vision problem such as convergence insufficiency.
A proper diagnosis of a vision problem and/or ADHD, is crucial for the most appropriate and effective treatment plan.