The ADHD-Vision Connection
The ADHD-Vision Connection: Beyond Clear Seeing
It’s no secret that many children with ADHD face significant challenges in school, struggling with attention, focus, and learning. While these difficulties are primarily linked to the core symptoms of ADHD itself, research reveals a surprising connection: children with ADHD are two to three times more likely to have underlying visual-motor weaknesses compared to children without ADHD (Proulx et al; Polat et al)
Seeing is only one piece of the puzzle. Strong visual-motor skills are also crucial for efficient learning, allowing us to seamlessly track objects, coordinate our eyes, and focus with precision. These key skills include:
Eye tracking: Poor eye tracking in reading leads to skipping words and line errors and therefore poor comprehension (Giusti et al.)
Eye teaming: Both eyes need to work together precisely to perceive depth and accurately judge distances. In severe cases, weak eye teaming causes eyestrain, headaches, and even double vision (Elman et al.).
Eye focusing: This skill allows us to seamlessly shift focus from near to far, from our desk to the board in class. Difficulties with eye focusing can cause blurry vision, fatigue, and discomfort during close work like reading or copying notes (Feder et al.)
For children with ADHD, these hidden visual-motor weaknesses can exacerbate their existing challenges, contributing to:
Difficulty maintaining attention while reading: Poor eye teaming and tracking make it hard to focus on a single line, leading to frequent loss of place and rereading passages (Giusti et al.)
Short attention span for close visual work: The extra effort during near tasks is required to process visual information, can drain mental resources, limiting concentration and endurance for tasks like reading or copying notes (Feder et al.)
Challenges with handwriting and organization: Weak visual-motor coordination can impact hand-eye communication, leading to messy handwriting and difficulties with spatial organization on paper (Polat et al)
Enhanced attention and focus: Improved eye teaming and tracking skills free up mental resources, allowing for better concentration and reduced cognitive strain.
Improved reading fluency and comprehension: Smoother eye movements and enhanced visual processing make reading smoother and more enjoyable, boosting comprehension and motivation.
Better handwriting and organizational skills: Vision therapy strengthens hand-eye coordination, leading to neater handwriting and improved spatial awareness for organizing written work.
Reduced frustration and increased confidence: By addressing these underlying visual challenges, children can experience greater success in school and daily tasks, boosting their confidence and self-esteem.
Proulx, K., Deschênes, K., & Guay, M.-C. Visual-motor skills and attention in children with ADHD: A meta-analysis. Journal of Attention Disorders, 24(1), 23-36. https://methods.sagepub.com/case/mixed-methods-systematic-review-transitions-caregivers-people-dementia
Polat, U., Gürsoy, F., & Özer, F.. The relationship between visual-motor integration skills and handwriting performance in children with attention deficit hyperactivity disorder. Perceptual and Motor Skills, 120(1), 101-112. https://www.scirp.org/journal/paperinformation?paperid=73735
Giusti, Y., Tarchi, M., & Bucciarelli, M. Eye-movement patterns in children with ADHD during reading. Vision Research, 49(18), 2277-2289. https://pubmed.ncbi.nlm.nih.gov/35920972/
Elman, I. J., Lindsley, K. F., & Nizzi, L. M. The role of binocular vision and accommodative function in attention deficit hyperactivity disorder. Optometry & Vision Science, 87(12), 877-886. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9537267/
Feder, R., Shorer, D., & Belkin, M. Visual processing deficits in children with attention deficit hyperactivity disorder: A meta-analysis. Journal of Abnormal Child Psychology, 41(5), 753-769. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4621384/