The Centers for Disease Control and Prevention state on their website that to determine when a child has ADHD:
- “One step of the process involves having a medical exam, including hearing and vision tests, to rule out other problems with symptoms like ADHD. …”
- “The health professional should also determine whether the child has another condition that can … explain the symptoms better…”
Before a child is diagnosed with ADHD it is vital to rule out a Binocular Vision Disorder due to the similarity in symptoms to ADHD; in addition:
- According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), the symptoms must be present in 2 or more settings for 6 months or longer. When a student has a Binocular Vision Disorder, the symptoms will be present in multiple settings because they occur whenever the student is trying to read.
- The key point here is that when children struggle to pay attention in school, “visual acuity” is often checked and vision is incorrectly ruled out as a possible cause. “Visual acuity” is strictly a measure of how clearly one can see the letters on the eye chart which is 20 feet away. Reading takes place within arm’s distance, around 18 inches.
There are 17 visual skills required for academic performance and being able to see the letters on the eye chart (visual acuity) is just one of these skills. It is important to understand that vision screenings are not designed to test all of these visual skills; yet if a child is missing even one of these skills academic performance could be negatively impacted.
The majority of children who struggle with binocular vision disorders have excellent visual acuity. Binocular vision disorders include eye coordination, eye tracking and eye focusing disorders which can make print look blurry, double, and often appear to move. Children can lose their place when reading, and often have difficulty remembering or comprehending what they have read. Reading fluency often suffers as well.
Before you assume that it’s ADD or ADHD:
It is vital that you rule out the possibility that a binocular vision problem may be contributing to the child’s difficulties.