Ophthalmology
23-11-2023
ADHD in children: when the orthotist can come to help
Publication date: 19-04-2024
Updated on: 19-04-2024
Topic: Ophthalmology
Estimated reading time: 1 min
ADHD stands for Attention-Deficit/Hyperactivity Disorder and consists in an attention deficit disorder that manifests from childhood onward. With the right framing, this condition can be experienced as a “non-problem” for those affected and by those around them. An orthoptic evaluation, for example, is useful if ADHD is diagnosed: having a vergence-efficient visual system (eye movements) for attention orientation in children is critical. Moreover, children diagnosed with ADHD are known to have visual motor system alterations.
We discuss this with Dr. Chiara Urbano, orthoptist at the Istituto di Cura Città di Pavia.
Orthoptic evaluation in children with ADHD
Thorough orthoptic evaluation is very important in children who:
- have received or are awaiting diagnosis of attention disorders;
- manifest difficulties in school.
In fact, the orthoptist is able to study and evaluate the following abilities:
- fusion;
- binocular;
- accommodative;
- oculomotor;
- convergence;
- visuo-spatial;
- of visuo-motor integration;
- attention;
- visual memory.
If impaired, these abilities can interfere with reading and writing activities causing symptoms such as:
- headache in reading and writing activities and marked fatigability;
- bringing the head closer to the paper;
- assumption of abnormal head positions;
- presence of eye redness and burning;
- reading difficulties (reversal of some letters/syllables, perception of moving letters, loss of line);
- difficulty in adhering to the spatiality of the paper (going out of lines/squares);
- presence of motor impediment (could be a consequence of incorrect use of the peripheral visual field).
Orthoptic examination for adults
Symptoms/disorders requiring orthoptic/visuo-postural evaluation and rehabilitation can also be found in adults, including:
- dizziness;
- diplopia;
- oculomotor paralysis;
- blurred vision;
- fatigability during reading;
- assumption of abnormal head positions (CAP);
- cervicalgia;
- headache.
"In these and many other cases, the eye receptor may be involved. It is for this reason," Dr. Urbano explains, "that an orthoptic evaluation is necessary, so that areas of difficulty can be identified and a rehabilitation pathway aimed at making life easier for patients, large and small, can be developed. The ultimate goal is to provide the patient with the tools to enable them to better assimilate visual information that will then be transformed into processing or motor skills."
Visual rehabilitation in children with ADHD
In children diagnosed with ADHD, the visual motor system may be impaired, sometimes hidden by excellent compensatory skills. This may lead to:
- greater complexity in learning information;
- need on the part of the subject for significant effort in terms of cognitive engagement in filling these gaps.
"It is in fact thanks to the visual system, particularly the saccades, movements of binocular vision, that we quickly acquire all the information that is sent to us from outside," the specialist explains.
Visual rehabilitation work aids the full development of eye movements, making the patient aware of how the eyes should move in certain stimulus situations and in various viewing spaces.
Importance of prevention
The visual system in the first 6 years of life is extremely plastic, sensitive to external perturbations: if causes that prevent vision in 1 or both eyes (congenital cataracts, uncorrected refractive defects, presence of strabismus...) are present, it will be possible to treat them with excellent margins of improvement or resolution.
"Hence the importance of prevention: if these defects or pathologies are detected and treated in time, it is possible, again thanks to the plasticity typical of the pediatric age, to restore normal function and allow the child to develop visual function optimally," concludes the specialist.