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BY: LD Resources Foundation Action

Vision therapy is an eye training regimen used to improve vision skills such as eye movement control and eye coordination.  Vision therapy is comprised of a couple of different therapies. In this article we will be mainly discussing a condition known as Convergence Insufficiency, which is a disorder of binocular vision and is characterized by eye fatigue, discomfort and double vision.  It can contribute to reading inefficiency.  Convergence Insufficiency can be treated with Orthoptic Visual Therapy.  

There are other disorders such as difficulties of visual attention and concentration that are classified as visual processing weaknesses.  The point being that there are many visual processing disorders that may mimic to some degree ADHD and Dyslexia.  This article will also point out that there may be a link between ADHD and Convergence Insufficiency.  Therefore, if a child is having problems reading and if a learning disability is suspected, a full COMPREHENSIVE eye exam should be performed.

A new study from the University of Alabama, 2016, sheds some light on a link between vision conditions that are not corrected by typical glasses such as Convergence Insufficiency (and other visual processing issues) and ADHD in children. Results from a large survey of 75,000 children suggest an increased risk of ADHD among children with vision problems that are not correctable with glasses or contacts, such as lazy eye, as relative to other children. This finding suggests that children who have vision impairments not corrected by glasses such as problems with the eyes not working as a team and focusing issues should be monitored for signs and symptoms of ADHD so that this dual impairment of vision and reduced attention can best be addressed.

recent study by researchers at the Children’s Eye Center, University of San Diego, uncovered a relationship between a common vision disorder, convergence insufficiency, and ADHD.

According to the Mayo Clinic, Convergence Insufficiency is a condition in which your eyes do not work as a team when looking at nearby objects.  One eye will turn outward instead of inward with the other eye, creating a double vision or blurred vision.  In and of itself, CI is not classified as a Learning Disability, but it can affect the process of learning for the following reasons listed below:  

  1. Eye Strain
  2. Headaches
  3. Difficulty in reading, where words appear to float on the page causing you to lose your place and to read more slowly – this may cause you to avoid reading and cause lack of completion of schoolwork.
  4. Double or blurred vision
  5. Difficulty concentrating and loss of comprehension
  6. Short Attention Span
“Children with convergence insufficiency are three times more likely to be diagnosed with ADHD than children without the disorder. Patients diagnosed with ADHD should also be evaluated for convergence insufficiency and treated accordingly” – Dr. Granet of the Children’s Eye Center

The study included children ages 4 to 17 with data from the National Survey of Children’s Health.  The study found that more than 15 percent of children with vision impairment also had an ADHD diagnosis, compared with 8.3 percent of children with normal vision.

Basic Findings of the Study:

BACKGROUND:  

“Children being evaluated for attention deficit hyperactivity disorder (ADHD) often have an eye exam as part of their evaluation. The symptoms of convergence insufficiency (CI) can make it difficult for a student to concentrate on extended reading and overlap with those of ADHD”.

RESULTS:

“They reviewed 266 charts of patients with CI. Twenty-six patients (9.8%) were diagnosed with ADHD at some time in their clinical course.  The review of computer records showed a 15.9% incidence of CI in the ADHD population”.  This study reveals a “relationship” between ADHD and vision impairments in children.

CONCLUSION OF STUDY:

The researchers found an apparent three-fold greater incidence of ADHD among patients with CI when compared with the incidence of ADHD in the general US population (1.8-3.3%). They also noted a seeming three-fold greater incidence of CI in the ADHD population. This may simply represent an association and not be a causative relationship.  Until further studies are performed, patients diagnosed with ADHD should be evaluated to identify the small subset that may have CI,- a condition that responds well to treatment at home”Science Daily

It has been known for awhile that there is a link between certain vision issues and conditions that involve attention problems, i.e. ADHD and Dyslexia.  ADHD and Dyslexia are not the same, though individuals with ADHD and Dyslexia can share common symptoms.  Children with dyslexia or ADHD find reading very demanding (though for different reasons) and they tend to fatigue easily which in both cases leads to losing their place on the page and comprehension issues.

 According to the International Dyslexia Association, “Dyslexia is a specific learning disability that is neurological in origin and typically results from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities.  ADHD is characterized by distractibility and difficulty in sustaining attention.  Fidgeting of hands and feet is sometimes seen with the hyperactive impulsive version of the condition.   

A child presenting with Reading issues must be evaluated by a team of specialists to determine the exact cause.  However, as noted above, many conditions have overlapping symptoms.  The goal of treatment is to allow the child to meet their full potential.  Therefore, it is critical to have the child carefully evaluated because the treatment of the above disorders differs from one another.  

Not only can dyslexic children and children with ADHD have some similar characteristics, but other visual processing conditions can present with similar symptoms as well.  As noted above, “Children with convergence insufficiency are three times more likely to be diagnosed with ADHD than children without the disorder.  Symptoms of ADHD overlap with Convergence Insufficiency.  All these conditions can lead to low self-esteem, the inability to concentrate and under performance at school.

Conclusion:

A child presenting with reading problems and a suspected learning disability needs to be carefully evaluated by a team of professionals.  Dyslexia, ADHD, vision conditions of eye movement control and eye coordination can present symptoms that overlap.  In addition, some studies have shown that there is a link between ADHD and the eye teaming binocular vision disorder called Convergence Insufficiency.

Though symptoms of the above conditions may be similar at times, the treatments are different.

Dyslexic children will receive specialized instruction in reading.  The gold standard for teaching children with dyslexia is MultiSensory structured language education (MSLE).  Children with Dyslexia will also receive the help that will aid in phonological awareness.

Many children with dyslexia also have ADHD.  ADHD is treated with medications and cognitive behavioral therapy.  Dyslexia may be indirectly helped by these treatments.  Children with ADHD or dyslexia may suffer from low self-esteem and anxiety and therefore adjunctive therapies such as CBT may prove helpful.

Vision Therapy is a controversial topic.  In the past, some practitioners of vision therapy believed that these therapies may help children with dyslexia or ADHD.  The general consensus now is that vision therapy will not help these conditions.  However, since there seems to be a three-fold greater incidence of CI in the ADHD population, and vision therapy is accepted as a therapy for convergence insufficiency, then vision therapy could be evaluated as a useful treatment in this case.

Parents and teachers when confronted with a reading issue caused by convergence insufficiency which is an eye disorder, may initially think that the child has a learning disability.

Therefore, it is very important to have a comprehensive eye exam to rule out visual processing issues and to have your child evaluated by a team of specialists since many symptoms of ADHD, Dyslexia and visual processing conditions can overlap with one another and appear similar.

References: https://www.sciencedaily.com/releases/2016/02/160225101557.htm

Photo by lalesh aldarwish from Pexels

 

If you are struggling with Dyslexia of Learning disabilities, LDRFA is offering an AWARD PROGRAM for ASSISTIVE TECHNOLOGY.