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Zebra Stripes for ADHD

A monthly newsletter of stories tips and news for those concerned with ADHD, Attention Deficit and Hyperactivity Disorder, No. 31

Sarah Jane Keyser : ADHD Coach

ADHD and Convergence Insufficiency

The brain is an amazing organ. We are born with billions of neurons with basic connections for sucking, breathing, sleeping and eliminating, but all the other skills that we need to survive in the world are learned. As parents we see our children learning to walk and talk, but they are also learning to see and hear.

From day one, the brain gathers perceptions from seeing, hearing, touching, tasting, feeling, kicking and screaming to build a data base for a future life. It links neurons into chains to execute a complex repertoire of skills like walking and talking.

For some babies the process is not as smooth as for others. ADHD, for example, occurs when the dopamine which should link neurons in a chain is not functioning properly so the prefrontal cortex does not develop the skill to keep other systems in line the visible result is hyperactivity and not-paying-attention.

As research advances the knowledge of the brain, specialists are finding that hyperactivity has more and more causes.

I learned about another ADHD look-alike from an article in the International Herald Tribune, "Sometimes 'hyperactive' kids are just seeing double" by Laura Novak. It was about "convergence insufficiency". I had never heard of it.

It related the story of a girl, Raea 9 years old, who did anything she could to avoid reading and writing (just imagine how many times she was told to try harder.) The diagnoses considered had been autism, ADHD, neurofibromatosis, or anxiety, and she was given medications for ADHD and depression with no success.

Although she had had two eye tests which showed that her vision was 20-20, a school reading specialist recommended another eye exam. This time the ophthalmologist put his finger on her nose and moved it back and forth. Her eyes jumped all over the place a sure sign of convergence insufficiency.

Seeing with two eyes or binocular vision gives human beings a valuable capabilties including depth perception. Poor binocular vision can have a negative effect on coordination, sports, driving a car, making eye contact, motion sickness and more.

When you look at an object your brain receives two slightly different perceptions; the brain learns how to combine and interpret these different views so that you are conscious of a single three dimensional object. But first your eye muscles must move the eye balls to point at the chosen object. For near work both eyes need to point slightly inward towards the nose and for reading they must be able to move smoothly together along the line.

With convergence insufficiency the eyes may point straight ahead or slide outward. The result is blurred vision, eye strain, headaches, inability to concentrate, short attention span, trouble remembering,(sounds a bit like ADHD) motion sickness or vertigo. The person, adults can have the problem too, may close or cover one eye to reduce the stress, or the brain may just ignore one eye making it functionally useless.

Experts estimate that 5% of children have convergence insufficiency and yet Raea's pediatrician had never heard of it. One report suggests that 92% of children with a reading dysfunction may have a convergence problem.The standard eye exam on the wall chart tests that both eyes function properly but does not test how well they work together.

There is an overlap between ADHD and convergence insufficiency; a higher percentage of children with ADHD have convergence insufficiency and vice versa than in the general population.

A child before the age of 9 or 10 probably cannot tell you what's wrong. Children don't know that what they see is not what others see or don't have the words to express it. Raea "felt that she had been telling us all along that she couldn't see, but nobody listened."

If you have a child who is having difficulty reading or if you yourself have problems you need to see an eye specialist who can do appropriate tests for convergence. The problem can be treated successfully with vision therapy.

Here are two sites for more information or type "convergence insufficiency" into your favorite search engine. http://www.children-special-needs.org/vision_therapy/esophoria_reading.html http://www.convergenceinsufficiency.org

A zebra joke to help you get into happy mode:

From the old Abbott and Costello radio show:

Bud Abbott: You trained wild zebras? Now don't make me laugh. You don't even know what a zebra is.

Lou Costello: Oh, I don't! A Zebra is a black horse with venetian blinds.

For more About Sarah Jane

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