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Vision Therapy and ADD/ADHD

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They say it’s ADD or ADHD...It Could be a Vision Problem

boy covering his eyes in schoolOur Miami Vision Therapy office sees many children who have been diagnosed with ADD or ADHD. All too often, a child who is unable to stay still, hyper, and or overwhelmed by the thought of school work is quickly diagnosed with either of these conditions. However, behaviour patterns such as these might actually be indicative of a vision condition. It’s important to understand the difference, and how to get your child the appropriate care without unnecessary intervention with pharmaceuticals.

Vision problems can often manifest with the same symptoms as ADD or ADHD. Very often, a child might be started on a course of medication even though problems such as a convergence insufficiency (e.g. exophoria) is actually to blame. Recent research has found that children with a vision problem were in fact twice as likely to develop ADD or ADHD as compared to their peers. However, as the study suggests, it’s hard for a child with a vision problem to pay attention. This results in poor behaviour school performance.

Signs of a Functional Vision Problem

Here are some clear indications that your child has a functional vision problem. Many of these are similar to the symptoms associated with ADD/ADHD:

  • Child covers an eye when reading;
  • Problems with reading or writing (e.g. losing place, seeing double, skipping lines or words);
  • Negative classroom behaviour (disruptions, talking, acting out);
  • Hyperactivity and inability to focus;
  • Poor test results despite familiarity with the topic;
  • Poor attention to detail;
  • Strong beginnings to tasks followed by rapid degeneration and failure to finish;


Learning is, by and large, accomplished visually. There is even research suggesting that vision problems can affect the very cognitive processes required to maximally process the information necessary to focus and interpret spatial and temporal information.

Let’s take reading for an example. When we read, both eyes need to converge, that is, focus on a specific point on the board, screen, or page. Otherwise, the words, symbols, or numbers will appear blurry. When the eyes are unable to converge properly, the brain is simply unable to maintain concentration or retain information.

It’s precisely due to the eyestrain resulting from vision problems that children don’t like to read. Continued inability to focus is naturally going to cause agitation and fidgeting when a child is asked to read or engage with visual information. This, in turn, is often the cause of poor behaviour both in the classroom and while attempting to do homework. What’s more, the child’s mounting frustration and negative reinforcement can lead to feelings of inadequacy, stress, and even depression.

Such vision problems are often not caught by schools. This is because vision is much more than acuity. While your child’s school or pediatrician may test vision, this is usually restricted to basic acuity. The child is asked to read the various symbols or letters on the chart. If there is a lack of acuity, then prescription corrective lenses are recommended. However, this doesn’t solve underlying vision problems such as a convergence issue. The eyes need to be retrained to work together in order to accomplish basic visual tasks such as:

  • Focusing  on a stationary object;
  • Tracking an object in motion;
  • Locating or an object by visually scanning for it;

Reading Becomes Impossible...

A child with a vision problem is probably going to try and avoid reading and will likely develop negative behaviour problems. When asked to perform visually demanding tasks require extraordinary effort on behalf of the child in order to focus on and accurately interpret the visual inputs. The effort itself will lead to eyestrain, headaches, fatigue, etc. Such a child can hardly be blamed for preferring to tune out and look elsewhere. Switching focus constantly in order to take notes becomes a monumental task. Because of all this, children with a vision problem will try and rush through tasks and homework in order to avoid the negative symptoms they experience. This results in multiple mistakes and careless work, with little attention to detail.

Vision Therapy and Learning

little girl wearing rainbow shirt putting bright colored blocks over her eyes If your child has been diagnosed with ADD or ADHD, or is suspected of having these conditions, he or she should absolutely be evaluated for functional vision problems by a Vision Therapy specialist. Vision Therapy, or, Developmental Optometry, is a customized series of non-invasive exercises which effectively retrain the brain to interpret visual inputs properly. Vision Therapy is proven to effectively teach a child’s eyes to interact together properly, without blurriness, soreness, or fatigue.

Vision therapy is a process, which is effective only over time. The exercises are geared to challenge the visual system as whole, which can include physical vision challenges such as interacting with objects while in motion, and with virtual reality or other physically interactive computerized activities.

What Can Parents and Schools Do?

Understanding vision problems is an important step. Referring children to a developmental optometrist, and not just a psychologist will go a long way to identifying children who can benefit immensely from Vision Therapy, regardless of whether or not the child has ADD/ADHD or not. When a vision problem has been identified, schools can help accommodate the child with changes such as highlighting alternating lines of text and by using specialized fonts designed to improve eye tracking ability.

Beyond making sure that a child is assesessed for a functional vision problem, there are also various things parents can do to build up their child’s visual perception skills. This includes using differently colored worksheets based on the child’s preference since typical bright white can be difficult to look at. Parents can also draw incomplete objects and have the child complete the drawing. Referred to as “visual shape constancy”, these activities also help train the eyes for better focus.

Whether or not ADHD or ADHD is present is a complicated issue. However, the undeniable fact here is that a functional vision test is strongly recommended in no uncertain terms. It could be that a vision problem is underlying the diagnosis. Or, it could be, as is often the case, that a genuine diagnosis of ADD/ADHD comes along with various vision problems. Only with a proper vision therapy assessment with a qualified developmental optometrist, such as our own Dr. Pino, can it be determined if some or all of the learning problems are due to a vision condition.

Call for a Vision Therapy Assessment 305-363-1414
Request an Appointment