Building a House With Dr. Amorita Treganza

Amorita Treganza as “Miss Lemon Grove”

Dr. Amorita Treganza received the Skeffington Award  in 1986 .  She was another GIANT in developmental optometry.  She was instrumental in the birth of COVD as the national (and now international) organization of developmental optometry.  In fact she served as COVD’s first president, in 1971.   When I typed her name into Google, I was delighted to find this story about the celebration in Lemon Gove, CA, honoring her life and legacy , 100 years after her birth.  Dr. Treganza continues to be  an inspiration and role model for women pursuing optometry, especially those of us specializing in developmental vision.  Dr. Treganza is the co-author of Optometric Evaluation of Children with Academic Dysfunction, published by the Optometric Extension Program, from 1977-78. 

In her case presentation to parents, Dr. Treganza would often begin by separating the vision problem and the reading problem.  She would use the analogy of building a house.

Vision is the foundation.  Vision provides the platform, the stability and the strong beginning on which the remainder of the house will be built.  Reading is the structure of the house; the framing, walls, ceiling and finishing work.  The visual dysfunction affects reading efficiency.  It eliminates or puts crack in that foundation that is supposed to provide stability and strength.  Learning to read and reading to learn are both more difficult.  Attempts to teach that child to read may add a few boards to the walls of the house, but what might we expect if the foundation is unstable and weak?  The pieces won’t fit together and won’t function properly.  At best it will be disorganized, and at worst, it will be unusable!  In order to treat the academic dysfunction, it is necessary to start at the beginning, by rebuilding the foundation.  This can be accomplished with optometric vision therapy.  Then, it is possible to address the reading problem with the appropriate educational intervention.  The framing, walls, ceiling and finishing touches can be built.  Just as building a house requires a team effort (contractor, plumber, electrician, carpenter, etc) so does treatment of the academic dysfunction.  Optometrists, parents and educators must work together.

–August is National Children’s Vision and Learning Month–

So let’s build some houses, from the ground up.   If your child has academic problems, please schedule a vision examination today! 

Find a developmental optometrist in your area.

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The Science – Visual Factors a Primary Cause of Beginning Reader Failure

August is National Children’s Vision and Learning Month!

As promised I wanted to take the next few Science entries to highlight great research showing the correlation between vision and academic performance.

One thing that always amazes me is how just about every mom in America knows that their child needs to get their child’s teeth checked by a dentist before they enter school.  Yet, very few know that they they should get their child’s eyes checked by their eye doctor before those very first days learning how to read.  To which I always think, “How much learning do you do with your teeth.”

A great study named “Visual Factors – A Primary Cause of Failure in Beginning Reading” published in Optometry and Vision Development* looked to see if vision was something that impacted children’s ability to learn to read.  I think all of us can imagine that visual acuity or the ability to see clearly would impact a child’s ability to learn to read, which the study affirmed, but the study also found something else important.  Binocular function, or the ability to use the eyes together in tandem, was also a significant factor in impeding beginning reading.  And doesn’t that make sense?  If we cannot get the two eyes to point to the same place on a book, then a child will see doubling or overlapping of letters on the page.  Obviously, that could make an already difficult task of learning to read much more challenging.

So let’s think about the school screening or the vision check that pediatricians do.  We stand the child 20 ft from the letters on a wall and ask the child to cover an eye.  How much does that check how well the child can use both eyes up close for 5 hours a day at school?  Unfortunately, not very much.  Now, this is not to fault the dedicated school nurses and pediatricians.  Vision is not their specialty.

It does tell us however, that every child needs to have their vision checked before they enter school by their family eye doctor and every one to two years thereafter.  And it also tells us that every parent needs to know the warning signs of a vision problem that may need to be addressed by a developmental optometrist.

• Headaches, eye strain, or tired eyes with school work
• Slow or hesitant reading
• Skipping words or lines on a page when reading
• Words moving, doubling, or floating on the page
• Taking hours to do 20 minutes of schoolwork

August is National Children’s Vision and Learning Month!

Schedule a vision examination for your child TODAY!

To find a developmental optometrist near you, follow this link .

For more information on vision problems that affect school performance, learning, and reading please visit the COVD website at www.covd.org.

*Young B, Collier-Gary K, Schwing S. Visual factors – a primary cause of failure in beginning reading. J Optom Vis Devel 1994;25(Winter):276–88.

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Parents speak out about their children’s struggle with undetected vision problems

August is National Children’s Vision and Learning Month! This marks an important time of the year for public awareness of a critically important set of visual problems that can have serious impact on a child’s ability to apply him or herself in reading or other classroom activities in learning.  Parents are stepping up to tell their stories, like the one below by Kathleen Hayford who posted her child’s story on Pinterest.

“Our son struggled in school starting in second grade, once reading was required. He was frustrated, anxious, complained of frequent dizziness and headaches and was withdrawn socially. Over the years, he was diagnosed with various disorders, including ADD, Processing Disorders, Sensory Integration Dysfunction, anxiety, OCD. He had Occupational Therapy, Psycho Therapy, medication, and EEGs. Every year his vision was tested and he was 20/20. Clarity was fine.”

“Davis would scream out, ‘I’m stupid!’ more times than I’d like to remember,” Hayford continues. “He thought so little of himself.  Constantly frustrated, he developed anxiety that interfered with every aspect of his young life. It was heartbreaking for us as parents knowing he was a remarkable and intelligent boy, trying everything we could think of to help him, and not finding the appropriate help.

“Based on a tutor’s suspicion he had Dyslexia, Davis was referred to a Developmental Optometrist who tested and diagnosed him with Convergence Insufficiency, an eye tracking problem, and accommodation disorders to compensate. Basically, he had suffered with double vision because his eyes did not track together.”

After completing optometric vision therapy, Hayford shares, “He’s a new boy!!! He’s off the variety of medications he was on and is now an A/B student with increased confidence, less anxiety, and has better relationships. He is happier and has hope for his future. I wish we could have spared him the years of struggling and pain.”

A common theme within these parents stories of their children who have struggled, is a relatively common condition known as Convergence Insufficiency (CI). There are many reasons why obstacles block public awareness for this condition that affects over 20 million.  One reason could be its unusual name…Convergence Insufficiency. What is Convergence Insufficiency?  Take a look at this video produced by vision advocacy group, The VisionHelp and see if you have a better insight. Then please let us know your thoughts with a comment. We would especially like to hear from parents. Please speak out if you have a child who has struggled. Let’s all help make the 2012 August National Children’s Vision and Learning Month an event that will truly help more children struggle less due to an undetected vision problem…like Convergence Insufficiency!

 

Dan L. Fortenbacher, O.D., FCOVD

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Dr. Harold Solan — Visual Attention and Reading

Dr. Harold Solan received the Skeffington Award in 1990.  At that point, his body of work was quite impressive.  But he was only getting started!  He continued his research, writing and scholarship for many more years.  In many ways, his post-Skeffington Award work was even more influential.  It is very difficult to choose one “topic” or article to highlight his contributions to developmental optometry.  I suppose I shall have to write more about Dr. Solan’s work. 

Dr. Harold Solan

Attention is often defined as the ability to focus on relevant stimuli as well as a decrease in responsiveness to irrelevant information.  In reading, visual attention increases the ability to read efficiently across a line of text.  Readers must learn to use the oculo-motor system to move their eyes accurately.  First they must focus on the first word on the line, then they must shift their attention to the right as they prepare to move their eyes to the next fixation point, then they must sustain their attention in order to allow for processing of the text.  These three principal elements of attention–focus, shift and sustain—are the link between perception and cognition.  Perception makes the visual information available but not necessarily recognizable.  Cognitive processes allow the reader to use the visual information in order to gain meaning.  In other words, reading comprehension is dependent upon visual attention as expressed by accurate oculo-motor control.  Therefore, vision therapy that is directed at improving focus on relevant stimuli, shifting attentional focus within a complex visual environment, and sustaining attention for an appreciable interval might be expected to improve reading comprehension.

Dr. Solan and colleagues investigated this relationship in a group of 6^th graders with moderate reading disabilities.  These students attended public school in New York City.  On a standardized reading test, their reading comprehension scores averaged 2.2 years below their grade level.  The students’ attention skills were assessed using a standardized testing battery.  Then they received 12 one-hour sessions of vision therapy.  The therapy consisted of specific procedures which were aimed at improving or enhancing focusing, shifting and sustaining visual attention during oculo-motor (eye movement) activities.  After completing the 12 hour therapy program, the students were retested with both the standardized reading and attention tests.  Their scores improved significantly on both measures.  After 12 hours of vision therapy over 5 months, their average reading scores jumped an entire grade level, from the 4^th to 5^th grade level.  This is in sharp contrast to the first 5 years of schooling, when their reading scores improved from a 1^st grade to a 4^th grade level.

Dr. Solan’s research supports the notion “that a link exists between visual attention, oculomotor readiness, and reading comprehension…”  He acknowledged that uncertainties still exist.  For example, the therapy also incorporated memory, speed of processing and executive functions.  How does the engagement of this triad influence cognitive performance and reading comprehension?  Dr. Solan’s research always answered BIG questions but at the same time, left more questions to consider.  That way, he never ran out of ideas for his next research project.  Now, he has left these unanswered questions for others to consider.

Read more about eye movements here.

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The Science and Splash are Back

So today, let’s talk science.  I recently had a conversation with a well-known pediatric neuropsychologist in my area. She is a very caring and competent practitioner by all counts.  She expressed some concerns about referring patients to me.  She said while she felt the science would validate vision therapy in the future, she did not feel that there was enough scientific evidence currently demonstrating the relationship between the vision problems we treat, such as Convergence Insufficiency, and academic performance.  She felt that the science certainly shows that functional vision problems exist and that vision therapy would help alleviate discomfort associated with these vision problems, but that the science did not yet show that treating these vision problems would impact school performance.

I was happy to report to her that the future is here.  In fact, I would like to dedicate the next several “Science” posts to the great research being done showing the correlation between vision and academic performance.

The article I would like to focus on today was written by the same authors of the Convergence Insufficiency Treatment Trial.  In this original research article sponsored by the National Institute of Health these scientists validated what so many of us have known for a long time.  Convergence Insufficiency and many other functional vision problems not only exist but cause a host of problems such as double vision, headaches, eye fatigue, slow reading and poor reading comprehension.   The treatment trial found that in-office Optometric vision therapy is by far the best treatment to alleviate these symptoms.  After completing this research, I am sure they must have encountered some of the same skepticism elicited by my colleague.

Their latest research article found in the journal of Optometry and Vision Science demonstrated that children with symptomatic Convergence Insufficiency showed significant improvements in reading comprehension after being treated with vision therapy. To see  the article click here.  Sounds like an academic performance link to me.   However, their research is by no means the only research out there.  I am happy to report I was able to send many other research articles as well to the practitioner in my area and have to say that she responded very favorably.  I am excited to share more of these research articles with you in the coming weeks.  Stay tuned…

For more information on vision problems that affect school performance, learning, and reading please visit the COVD website at www.covd.org.  To find a developmental optometrist near follow this link.

I hope to be blogging here more often.  I want to give a shout out to all of the COVD blog authors who put in so much time to getting the word out about how vision can impact the lives of so many.  Especially a thank you to Dr. Rochelle Mozlin whose dedication to this blog has helped the lives of many seeking to learn more about these critical and often silent vision problems.

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SUNY Student Changes a Life

Yesterday I was examining young patients in the Pediatric Service at SUNY’s University Eye Center, along with 3rd and 4th year students.  One of our patients was an 8 year old boy with complaints of blurred vision, difficulty focusing, and words moving around the page when reading.  Although he was reading “on grade level,”  he was struggling to keep up with his peers.  Mom felt like he was always swimming upstream.  Now in 3rd grade, it was becoming more difficult for him to maintain that effort.  This child never had an eye examination.  He passed every vision screening because his visual acuity was never worse than 20/40.

The examination revealed 5 diopters of uncorrected hyperopia.  In order to see clearly, especially for reading, he had to make an extraordinary effort to focus his eyes and then sustain that effort.  My student described this to mom with a wonderful analogy.  Imagine running a marathon while carrying an extra 20 pounds on your back.  By prescribing lenses, we are getting rid of the extra 20 pounds.  Can you imagine how much better he is going to perform in that marathon (of schoolwork)?  Can you imagine how much better he will perform in his LIFE if the simple act of seeing clearly no longer wears him down day after day?

I looked at my student and told him, “You are going to change a life today.”  His response: “Yeah, I like that.”

Me too!  I like that….. changing a child’s life by simply prescribing lenses.  When I thought about it, I realized that optometrists all around the world are doing this every single day.  It might not be as simple as prescribing lenses, but we are changing lives.  But then I looked at it from another perspective.  Can you also imagine how this child’s life might have been different if he had a comprehensive vision examination before entering kindergarten?

If your child is struggling in school, do not feel secure that it is NOT a vision problem because he/she passed a vision screening.  Give that child the gift of a comprehensive vision examination.  Do it today.

Read more about vision screenings here.

Read more about learning related vision problems here.

 

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Optometry & Vision Development Volume 43 Number 1 Now Online

Editorials

     Single Malt Scotch and Developmental Optometry

by Dominick M. Maino, OD, MEd, FAAO, FCOVD-A, Editor

     Lost in Space

Sidney Groffman, OD, MA, FCOVD

    Articles

     Evidence Based Medicine and CAM: A Review

by Dominick M. Maino, OD, MEd, FAAO, FCOVD-A

Reverse-Engineering of Hyperopic Anisometropic Refractive Amblyopia

by Leonard J. Press, OD, FAAO, FCOVD; Daniel J. Press, OD, FAAO, FCOVD

Dyslexia: An overview

SO Wajuihian,a BSc(Hons)Optom OD(Benin) MOptom(UKZN) PGCertMod L/ Vision(City Univ London) and KS Naidoo,a,b BSc BOptom(UDW) MPH(Temple) OD(PCO) PhD(UNSW)

Literature Review

Current Eye & Vision Science Literature

Review by David A. Goss, OD, PhD, FAAO, FCOVD-A

Book Review

Ocular Therapeutics Handbook, A Clinical Manual, 3rd Edition

Review by Christine L. Allison, OD, FAAO, FCOVD

Practice Management

Computer Tips and Tricks

by Christopher Grant

NewsMakers

Optometry & Vision Development (OVD) is the official journal of the

College of Optometrists in Vision Development.   Read OVD 43-1 Online

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What is Dyslexia?

The following editorial appeared in Visions, which is COVD’s newsletter.  It was written by Dr. David Damari who is presently serving as COVD’s President. 

There has been some interest in the Kelley King Heyworth article in the December article in Parents magazine, “Outsmarting Dyslexia.” Your patients or their parents may be asking some hard questions based on this statement in the article—“Because dyslexia is a language disorder and not a visual problem, experts say there is no evidence that doing vision exercises or wearing special training lenses with colored lenses can benefit kids – even though there are companies that sell them.”  This statement is fraught with errors (I discuss them one by one below), as is the American Academy of Pediatrics political statement on “Dyslexia and Vision” from 2009, but it may raise questions. Here are my suggestions for a reasoned, literature-based response. These suggestions are based on my opinions formed from keeping up on the extensive literature in vision disorders and learning problems; they are not to be taken as official COVD policy.

As is my wont, I will start with my most controversial suggestion.  Our profession should stop using the term dyslexia: I would strongly recommend that we stopusing this term immediately. Why? Because here is how Shaywitz defines the word dyslexia in the December article in Parents: “the learning disability that prevents children from reading and spelling with ease and accuracy.” As everyone (and I do mean everyone) knows, there are a host of disabilities and disorders – learning, visual, auditory, mental, or emotional – that could cause difficulties with reading. The term therefore has no useful meaning; that is, labeling a child as dyslexic does nothingtoward improving that child’s life. For evidence, look no further than the article’s suggestions for treatment of children labeled as dyslexic.  None of the recommended “treatments” have been shown to improve reading to average levels in well-designed, long-term studies, and the remaining suggestions are accommodations, not solutions. Note that the article describes these measures as “methods that have been scientifically studied,” NOT as scientifically proven effective.  As an added irony, the Rave-O and Orton-Gillingham systems mentioned as possible management have elements of vision therapy included to improve the orthographic processing aspects of reading acquisition.

Dyslexia is a word that has been used against our profession time after time. It can be used this way because almost every writer who uses the term uses it broadly to meanany problem with reading but then conflates “dyslexia” with phonological processing disorder.  The logic of their argument then runs like this — dyslexia is any problemwith reading, the reading problems we have studied are phonological processing disorders, phonological processing disorders are language disorders, therefore vision has nothing to do with reading problems. When we use the term dyslexia, we only aid this flawed syllogism. Let’s not. But if you do use the word dyslexia, please be very clear about what you mean by it, and contrast your definition with how others misuse that term.

Continue to aid patients toward a useful diagnosis: If the patient has a binocular, accommodative, or other ocular motor dysfunction, find it and call it what it is. If he has a visual information processing disorder, find it and call it what it is. If she has a fine- or gross-motor delay, find it and call it what it is. If it becomes apparent that the problem is more of an auditory information processing or emotional or psychological disorder, refer appropriately.  The management suggested by the Parents article and most other allopathic medicine-based articles on reading problems are usually just variations on the “try harder and take longer” theme. We offer so much more, including good multidisciplinary approaches to care of complex developmental challenges. Don’t be afraid to demonstrate our capabilities. Educate, and provide references: One of my favorite resources on reading is Beginning to Read: Thinking and Learning about Print by Marilyn Jager Adams. This classic book clearly demonstrates the complexity of the reading process, including how visual the act of reading actually is, and how the interplay between visual and verbal abilities is critical to reading acquisition and reading fluency. This is demonstrated in study after study described in the book.

In fact, there is some good in the Heyworth article. As I mentioned, some of the approaches suggested actually include visual interventions, once you investigate them. What I have found in my review of these suggestions, though, is that they are all far less efficient than vision therapy. The study on Rave-O included 70 hours of interventional instruction! And ophthalmology says that our interventions are expensive! My suggestion would be to review the article point by point with your patients, or train your staff to do this.  Use what is good to reinforce the education you have already given your patient, and point out the flaws in the other aspects of the article. During the review, start with the offensive sentence quoted above, which is made easy by these major mistakes: Heyworth uses the term dyslexia to mean phonological processing disorder, she therefore implies that there is no visual process involved in reading even though every study indicates that is incorrect; she does not offer any references or state which experts make the contention that visual exercises don’t help, she ignores the myriad of studies – some of which were funded by the National Eye Institute – that demonstrate that vision therapy does help reading in certain people with reading problems, and she expands the population supposedly not helped to all kids.

The best places to look for good resources on vision and reading are the COVD andOEP websites. These sites offer a host of good, scientific articles on the subject of reading and the impact visual and other disorders can have on the process. Have your patients write to the magazine: If your patients or their parents would like to respond to the article they can do so at mailbag@parents.com.  Please ask them to send a cc to our Executive Director, Pam Happ at phapp@covd.org.

The CITT and brain injury literature have already had a great impact on reducing these types of articles, but as long as optometry remains an independent profession organized medicine will continue to distort what we do, or distort the science on reading, in order to attack vision therapy. A reasoned, patient-centered response will always serve us well when these attacks occur. Count on COVD  to help you with useful resources when discussing these issues with your patients and referral sources.

References:

1. 
http://tinyurl.com/8xh7vk5

2. www.covd.org

3. www.oepf.org

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Perceptual Malnutrition

Dr. Tole Greenstein received the Skeffington Award in 1973.  This discussion is based on his writings for the Optometric Extension Program from 1967-8.  The resultant monograph is entitled Optometric Child Vision Care and Guidance. 

When young children learn how to manipulate objects with their hands, they must learn how to REACH for the object, and then GRASP onto the object.  This allows the child to MANIPULATE the object and learn what it feels like and perhaps decide if it is familiar or not.  Then the child must RELEASE the object in order to be ready to reach for something else and initiate this cycle once again.  REACH-GRASP-MANIPULATE-RELEASE.

As children progress developmentally, they learn this same process utilizing the visual system.  The child will reach for an object with the eyes instead of the hands; then grasp the object with the eyes in order to explore the object and determine what it is and what it means; then release the visual “lock” on this object in order to get ready to reach and grasp the next object worthy of “seeing.”

Many children with vision problems have great difficulty with this cycle of VISUAL Reach-Grasp-Manipulate-Release, especially the “grasp” part.  They may be able to find an object with their eyes, but they have significant difficulty keeping their eyes on the target long enough to manipulate the object and figure out what the object is, what it means and how they might want to interact with it.  Without grasping and manipulating, their visual processing is reduced to Reach-Release-Reach-Release.

This visual problem will be evident during very simple procedures to evaluate the quality of eye movements.  The child will be asked to perform saccadic eye movements, which are jump eye movements from one object to another.  These children cannot wait until they are instructed to jump to the other target; they cannot grasp the object.  As soon as they reach the first target, they release and grasp on the 2^nd target; then they release again and jump back to the 1^st target; all this despite instructions to try to keep looking at the 1^st target until told to look at the 2^nd target.  These children will make several round trips without ever visually grasping long enough to manipulate the object.  When asked to fixate a small object, such as a small bell, and keep the eyes on the bell as it is moved into different positions, they have similar deficits.  These children cannot maintain their grasp on the bell; they will release their grasp and look at something else: Reach-Release-Reach-Release.

What is the result of this inability to visually grasp and manipulate?  Dr. Tole Greenstein described this as PERCEPTUAL MALNUTRITION.  These children do a good amount of “looking,” but very little “seeing.” Without the grasp and manipulation, these children have very little useful information; very little visual “food” to feed their visual processing and thinking.  How would a child with PERCEPTUAL MALNUTRITION behave in a classroom?  When reading across a line of words in a book, they may never learn to identify the words.  Every time they see words that are repeated on the same page, they are unable to use past experiences.  Words strung together in a sentence have no meaning.  Pieces have no relationship to a whole.  Maps, graphs and diagrams are incomprehensible.  What about the playground? How can these children react to a moving target if they can’t keep their eyes on the ball?

These children are often diagnosed with an oculomotor dysfunction, which describes their inability to perform age appropriately on the eye movement tests.  Dr. Greenstein wrote, “it is important to talk about what the findings indicate that his life-world response in a given task would be.”  The diagnosis of oculomotor dysfunction is meaningless unless you discuss the consequences.  The resultant perceptual malnutrition and the inability to perform in and out of a classroom are of great consequence.  Dr. Greenstein described vision therapy as a program of learning, teaching these children how to control their environment instead of allowing the environment to control them.  The benefits of vision therapy will be different for every child.  If you think your child may be suffering from PERCEPTUAL MALNUTRITION, find a developmental optometrist and start writing your child’s success story.

 

Read more about eye movements here and here.

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The Science – Vision problem or ADHD?

I have just spent sometime venturing through the blogosphere of mothers with children with ADHD.  I was so impressed with these brave women that write about their experiences, triumphs, and challenges in raising their children with ADHD.  Many of their accounts truly broke my heart.  This is an excerpt from Penny Williams blog “A Mom’s View of ADHD” where she describes her experience of trying to find a good fit for educating her son with ADHD:

“I live in search mode these days, ever since my son Luke, age nine, was diagnosed with ADHD in 2008. I am searching for the medication, therapy, classroom accommodation, product that will make his life with learning disabilities a little easier. I guess you could say I’m searching for the magic bullet, but I don’t think that’s really accurate anymore. It was true the first year or two — I was looking for an “answer,” something to erase his ADHD symptoms. Then I realized that that “something” doesn’t exist. I didn’t think I was looking for a cure for ADHD because I knew that’s not possible, but that’s exactly what I was searching for nonetheless.

My focus in my search now is different, more refined. I am searching for tools to help him compensate for his differences, for environments where he can learn and prosper, parenting methods best suited to his needs, treatments that teach him the skills necessary to have a happy, successful life despite ADHD (and dysgraphia, SPD, Executive Functioning Deficits, and a gifted intelligence). This search is intense and stressful for me, his parent. There’s a lot of {self-inflicted} pressure to be diligent to find all opportunities and to make choices that will only have positive outcomes. In the area of making appropriate choices that lead to positive outcomes, I have failed miserably this year.Luke has struggled in school since the day he walked into kindergarten. Yes, the very first day. While it should improve each year with treatment, maturity, growing self-awareness and a diligent advocacy for accommodations and resources in school, it has not improved for Luke. I feel like we have been standing in the same place for three years, paralyzed, while the world continues to move on all around us. In our minds, we’re moving and working, but we’re getting nowhere.

That feeling of helplessness became overwhelming to me earlier this year. I fought hard with the school but mostly we just received lip service. I watched Luke struggle to fit in an environment that was clearly the opposite of what he needed. I knew he needed more help. I had to find that for him. ”

I think Penny encapsulates the very real struggle that many parents go through that have children with ADHD.  As a developmental optometrist I work everyday with children that have been diagnosed with ADHD.  I see in their parents’ eyes the same sentiments shared by Penny.  While I do not claim to have a magic bullet, I do have tools that have helped many of of my patients that have vision problems that can often mimic or complicate ADHD.

Dr. David Damari, Developmental Optometrist and Fellow of the College of Optometrists in Vision Development wrote a great research article, “Visual Disorders Misdiagnosed as ADHD,” that gives several great case studies of patients with ADHD  who had developmental vision problems. He speaks in the article of how similar the symptoms are for children with common developmental vision problems and those of children with ADHD.  He also describes in detail case studies of children that were misdiagnosed with ADHD and instead suffered from vision problems that affected their ability to perform well in school, learn, read, and maintain their attention.  He also references other research that shows the correlation between ADHD and Convergence Insufficiency, one of the leading developmental vision problems in children.

Probably, though most compelling are the stories from parents whose children were misdiagnosed with ADHD.  Here is a story from the parent of a child from the website, “Vision Therapy Success Stories”:

“Recently, “Sarah” came into the office just to talk to Dr. X. She was so excited .she was no longer struggling with reading and schoolwork and couldn’t wait to thank him. She is no longer taking Ritalin and is doing well in school.

Prior to seeing Dr. X, Sarah struggled to do the work required of her in high school. She found reading burdensome, was unable to finish her homework in a reasonable amount of time, and was unable to keep up with all her assignments. She was feeling frustrated and discouraged. Sarah had been put on Ritalin in order to help her focus on her work, but she continued to struggle.”

Bottom line, if your child is stuggling with attention in school, check to be sure there is not a vision problem.  To find a Developmental Optometrist near you that can diagnose and treat these types of vision problems, please follow this link.

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