Vision Therapy and
						ADD/ADHD 
								  | 
								
						 
												Attention Deficit Hyperactivity Disorder or AD(H)D is 
						being diagnosed with increasing frequency in both 
						children and adults. Many of these individuals were 
						previously labeled hyperactive or minimally brain 
						damaged. It is estimated that 10 to 15% of school-age 
						children presently have this disorder.  
						
						 
						
												The fourth edition of the Diagnostic and Statistical 
						Manual of Mental Disorders, published by the American 
						Psychiatric Association, classifies three types of 
						Attention Deficit/Hyperactivity Disorders: predominately 
						inattentive, predominantly hyperactive, and combined. 
						Six of nine symptoms of inattention, and six of nine of 
						hyperactivity and impulsivity are necessary. 
								 | 
							 
						 
						 
						
												In each case, the symptoms must be present for at least 
						six months to a degree that is maladaptive and 
						inconsistent with developmental level. In addition, some 
						symptoms must be present prior to age seven, and in two 
						or more settings (e.g. at school, work and home). There 
						must be clear evidence of clinically significant 
						impairment in social, academic, or occupational 
						functioning, and the impairment cannot be caused by 
						other disorders such as anxiety, psychosis or a 
						pervasive developmental disorder.  
						
												
						
												Even though it is generally assumed that people 
						diagnosed as having AD(H)D present a common set of 
						characteristics emanating from a common etiology, little 
						agreement is found among researchers regarding these 
						symptoms. Some symptoms seen in children diagnosed as 
						having attention deficits include: 
						
							- 
														Making careless mistakes in schoolwork
 
							- 
														Not listening to what is being said
 
							- 
														Difficulty organizing tasks and activities
 
							- 
														Losing and misplacing belongings
 
							- 
														Fidgeting and squirming in seat
 
							- 
														Talking excessively
 
							- 
														Interrupting or intruding on others
 
						 
						
												
						
												These symptoms are also seen in both children and adults 
						with learning-related visual problems, sensory 
						integration dysfunction as well as with undiagnosed 
						allergies or sensitivities to something they eat, drink 
						or breathe. The chart that follows illustrates this 
						graphically.  
							
								| 
								 
								
								Symptoms  | 
								
								 
								
								AD(H)D 
								
								
								(DSM-IV)  | 
								
								 
								
								Sensory Integration Dysfunction 
								
								
								(Kranowitz, OEP)  | 
								
								 
								
								Learning-related Visual Problems 
								
								
								(Berne, Getz)  | 
								
								 
								
								Nutrition Allergies 
								
								
								(Rapp, Sahky, Zimmerman)  | 
								
								 
								
								Normal Child Under 7 
								
								
								(Kranowitz)  | 
							 
							
								| 
								
								
								Inattention
								(at least 6 necessary) | 
								
								 
								
								   | 
								
								 
								
								   | 
								
								 
								
								   | 
								
								 
								
								   | 
								
								 
								
								   | 
							 
							
								| 
								 
								
  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  | 
								
								 
								   | 
								
								 
								   | 
								
								 
								   | 
								
								 
								   | 
								
								 
								   | 
							 
							
								| 
								 
								
								
								Hyperactivity and Impulsivity
								 
								
								
								
								(at least 6 necessary)  | 
								
								 
								
								   | 
								
								 
								   | 
								
								 
								
								   | 
								
								 
								   | 
								
								 
								
								   | 
							 
							
								| 
								 
								
  Often fidgets with hands 
								or feet or squirms in seat  | 
								
								 
								   | 
								
								 
								   | 
								
								 
								   | 
								
								 
								   | 
								
								 
								   | 
							 
							
								| 
								 
								
  Often has difficulty 
								remaining seated when required to do so  | 
								
								 
								   | 
								
								 
								   | 
								
								 
								   | 
								
								 
								   | 
								
								 
								   | 
							 
							
								| 
								 
								
  Often runs or climbs 
								excessively  | 
								
								 
								   | 
								
								 
								   | 
								
								 
								
								   | 
								
								 
								   | 
								
								 
								   | 
							 
							
								| 
								 
								
  Often has difficulty 
								playing quietly  | 
								
								 
								   | 
								
								 
								   | 
								
								 
								
								   | 
								
								 
								   | 
								
								 
								
								   | 
							 
							
								| 
								 
								
  Often 'on the go'  | 
								
								 
								   | 
								
								 
								   | 
								
								 
								
								   | 
								
								 
								   | 
								
								 
								   | 
							 
							
								| 
								 
								
  Often talks excessively  | 
								
								 
								   | 
								
								 
								   | 
								
								 
								   | 
								
								 
								   | 
								
								 
								
								   | 
							 
							
								| 
								 
								
  Often blurts out answers 
								to questions before they have been completed  | 
								
								 
								   | 
								
								 
								   | 
								
								 
								   | 
								
								 
								   | 
								
								 
								
								   | 
							 
							
								| 
								 
								
  Often has difficulty 
								awaiting turn  | 
								
								 
								   | 
								
								 
								   | 
								
								 
								   | 
								
								 
								   | 
								
								 
								   | 
							 
							
								| 
								 
								
  Often interrupts or 
								intrudes on others  | 
								
								 
								
								   | 
								
								 
								
								   | 
								
								 
								   | 
								
								 
								   | 
								
								 
								   | 
							 
						 
						
												  Physicians often recommend that AD(H)D be treated 
						symptomatically with stimulant medication, particular 
						education and counseling. Although these approaches 
						sometimes yield positive benefits, they often (may) mask 
						the problems rather than get to their underlying causes. 
						
												Many common drugs for AD(H)D, which have the same Class 
						2 classification as cocaine and morphine, can have 
						negative side affects that relate to appetite, sleep, 
						and growth. These drugs must thus be withdrawn only 
						under medical supervision. Placing a normal student who 
						has difficulty paying attention in a particular class and 
						counseling could undermine, not boost, his self esteem. 
						
						
												If you have a child who enjoys being read to, who will 
						sit and 
						
						listen for long periods of time, but who 
						demonstrates attention problems when using eyes for 
						reading, deskwork, or homework, there is an excellent 
						chance that the child's attention problem is caused by 
						an inability to use his eyes. There is no biochemical 
						imbalance which allows children to attend when 
						information comes in through the 
						
						ears, but distracts children when 
						information comes in through the 
						
						eyes.  
						
						Similarly, if a child can pay attention for math, but 
						not pay attention for reading, there is no biochemical 
						imbalance which occurs when the child looks at numbers 
						but disappears when the child looks at words. In math, 
						other than story problems, there is less visual 
						information to cope with. The child looks at individual 
						numbers and, as often as not, copies them one at a time, 
						getting the hands into the act. In reading, the letters 
						are crowded together so visual problems can more easily 
						cause the letters to run together. Children who can 
						pay attention for math but lose attention for reading, 
						frequently have a visual problem masquerading as an 
						attention problem.  
						 
						However, if when you read to your child, his attention 
						is better, but still a problem, then any number of 
						causes, along with vision, could be contributing to the 
						attention problem. For instance, your child might not 
						understand the words, or there could be some other 
						health problem making attention difficult. 
						 
						Whatever the reason for your child's struggle with 
						attention, or behavior, untreated vision problems will 
						only increase frustration, trigger behavior problems, 
						and make things worse.  
  
						
												Undiagnosed vision disorders can often 
						be misdiagnosed as learning disabilities or even AD(H)D. 
						That's why we strongly recommend that before a child is 
						classified as learning disabled or ADD and treated 
						with potent prescription drugs, a full vision screening 
						and evaluation be performed. 
						
												Vision Therapy improves many skills that allow a person 
						to pay attention. Anyone diagnosed with AD(H)D should 
						have a complete evaluation by an optometrist trained in 
						Developmental Vision Therapy. Testing should be done at 
						distance and near point to assure that both eyes are 
						working together as a team. Vision is more than clarity 
						and is a complex combination of learned skills, 
						including tracking, fixation, focus change, binocular 
						fusion, and visualization. When all of these are well 
						developed, children and adults can sustain attention, 
						read and write without careless errors, give meaning to 
						what they hear and see, and rely less on movement to 
						stay alert. 
						
						
												Occupational Therapy for children with sensory 
						integration dysfunction enhances their ability to 
						process lower level senses related to alertness, 
						understanding movement, body position and touch. They 
						can then pay attention using their hearing and vision. 
						
												Biological and Nutritional Therapy for food and chemical 
						sensitivities and metal toxicity have also been shown to 
						eliminate many symptoms of AD(H)D. since biological 
						problems can cause secondary visual symptoms, heavy 
						metal detoxification is one of the most important 
						treatments someone with an AD(H)D diagnosis should 
						consider.  
						
												The public needs to understand that some optometrists, 
						physicians, educators, mental health professionals, 
						occupational therapists and allergists are all 
						addressing the same symptoms and behaviors. The 
						difference in that medication, particular education and 
						counseling (can) mask these symptoms and behaviors, 
						while vision therapy, occupational therapy and treatment 
						of allergies can (may) alleviate the underlying causes 
						and thus eliminate the symptoms long-term. 
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