部分ADHD /ADD的徵狀可能由於視力問題引致

睡覺

我小時候老師評語話我inattentive 及 restless...我常忘記帶東西，記性差...不愛閱讀 (因為好易頭痛暈嗜睡疲倦)，而加先知道係由遠視引致...但我看東西係好清楚架....

好普通的視力檢查係驗唔到遠視的，因為小孩子本身能自動調節..
所以，在你懷疑小朋友係adhd及add前，記緊俾佢地先做詳細的視力檢查...以下是一些參考資料，如想知多一點視力與add/adhd或學習障礙有關資料，可以去各搜尋線到打下 vision , (如遠視hyperopia (farsightedness), ...)及learning disability / add adhd等，你便會發現好多li方面的資料架喇。...
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Vision, Learning and ADD/ADHD
Attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD), are frequently diagnosed conditions among school age children, now more than ever. In fact, it is one of the most common behavioral disorders diagnosed in children living in the U.S.

It is estimated that 3%-5% of school age children have ADHD, or about 3 1/2 million American children. Boys outnumber girls 3 to 1 and are more often diagnosed with ADHD. Since girls tend not to have the hyperactivity component, it is suspected that girls are underidentified.

Once thought that symptoms fade with the onset of adulthood, it is now estimated that 1/3 to 2/3 of all ADHD children become ADHD adults.

Did you know that almost all of the symptoms associated with both ADD and ADHD are also symptoms found in vision related learning problems? If these symptoms are due to vision, the vision problem can be fixed and the symptoms will stop.

Definitions of ADD and ADHD
ADD is characterized by poor attention span and difficulty controlling impulses. According to the Diagnostics an Statistical Manual of Mental Disorders IV (DSM-IV) which sets the criteria for diagnosis, six or more symptoms listed for inattention must be observed for six months in a manner that is considered inconsistent with that child's developmental level before ADD can be diagnosed.

ADHD also includes hyperactivity. Six or more symptoms listed in hyperactivity or impulsivity must be observed for six months in a manner inconsistent with that child's developmental level in order to be diagnosed with ADHD.

Many children truly do suffer from ADD and ADHD, but certain visual and learning problems may appear as ADD and ADHD type symptoms.
Many symptoms seen in ADD and ADHD are similar to vision related learning difficulties. Visual dysfunctions will not respond to most ADD/ADHD treatments, especially pharmaceutical treatments. It is possible that a child can be medicated unnecessarily, therefore it is important to know if the correct problems are being treated.

Children with vision problems, even those such as hyperopia (farsightedness), accommodative (focusing), or binocular dysfunctions (how their eyes work together), may exhibit the same signs as ADD/ADHD in the classroom. Their visual systems cannot tolerate the demands within the classroom for very long, so avoidance behaviors are common. A thorough vision exam will rule out any possible vision problems that may be part of the reason for a child's behavior.



General habits that may be observed in children with vision problems, but can also be ADD/ADHD symptoms include:
Careless mistakes in homework and class work
Poor ability to sustain attention and stay on task
Poor listening skills
Difficulty following directions
Loses and misplaces things often
Talks excessively and interrupts others
Fidgety
Difficult time organizing, prioritizing work and activities
Shifts from one activity to another
Difficulty playing quietly


Remember, vision is important, but it can be only ONE part of a bigger problem. It is even possible to have ADD or ADHD, as well as a vision problem. Fixing the vision problem may not be all that is needed to help your child. This is why a multidisciplinary approach is ideal.

Who diagnoses ADD/ADHD?
Any physician is actually able to diagnose these disorders. However, many general practitioners do not take the time to make sure their patient fits all the criteria for diagnosis, before they determine it is the only cause of the symptoms. Often their first treatment is to prescribe medication.

Psychiatrists are specialty medical doctors. Child and adolescent psychiatric training requires 4 years of medical school, at least 3 years of approved residency training in medicine, neurology, and general psychiatry with adults, and 2 years of training in psychiatric work with children, adolescents, and their families in an accredited residency in child and adolescent psychiatry. They are trained to look at biological and physiological problems, but also psychological and social factors in working with patients.

Psychologists obtain their doctorate in clinical psychology (though their our masters programs available in counseling) and pass board tests in order to practice. They also look at psychological and social factors when working with patients, as well as the physiological and biological factors, since mind and body are closely linked. At this time are not able to prescribe medication themselves, but do take more time to observe the child to make a proper diagnosis. If medication is deemed necessary, they will refer to the appropriate professional.

Other professionals, such as teachers, school counselors, optometrists, etc., can recognize the signs and symptoms of ADD/ADHD and may refer you to one of the above professionals for appropriate testing to rule out these disorders.

Unfortunately, many children are being diagnosed hastily by primary care physicians, pediatricians, etc. based on parent or teacher recommendations. This often leads to medication prescriptions to handle the problem. It is our opinion that a person that specializes in behavioral conditions, such as a psychiatrist or psychologist, will be able to test and observe a child more thoroughly to diagnose individuals with ADD/ADHD and decide if medication is absolutely necessary. They are also trained to rule out other possible behavioral issues. This is not meant to undermine the family doctors and pediatricians. It is meant to illustrate that their our specialists specifically trained in behavioral problems. If you were having a baby, would you want your family physician taking care of you, or would you want to go to an obstetrician that is specially trained to deliver babies? Your family physician may know how to deliver a baby, but the obstetrician does it all the time and will be more trained to handle problems along the way. The same goes for a diagnosis of a behavioral problem that will be there for the rest of a child's life.

Psychostimulant Medications - Ritalin, Dexedrine, Cylert
A huge number of children diagnosed with ADD or ADHD are treated with psychostimulant medications. In 1995 it was estimated that more than 1.5 million American children aged 5 to 18 were taking Ritalin. This number has about doubled by now.

These medications have been found to improve easier manageability of children and increased time on tasks, but it has not been proven that these medications actually affect academic achievement. One double blind study shows no cognitive, academic or behavior improvement over time between children diagnosed with ADHD that have taken medication compared to those who have not.

Psychostimulant Medications and their Visual Side Effects
Paradoxically, these drugs can also cause visual side effects that can actually make it more difficult for a child with ADD/ADHD to concentrate on learning related tasks. Ritalin (methylphenidate) and Dexedrine (dextroamphetamine) may include decreased focusing power, dilated pupils (also related to focusing) and blurry vision. Cylert (pemoline) can cause double vision, eye turns and nystagmus ("jumpy" eyes). If a child has already been experiencing some of these visual problems, these medications may actually enhance their problem.

Careful diagnosis of ADD/ADHD is important
To make a careful diagnosis of ADD/ADHD, it is important to rule out all other explanations for the symptoms manifesting, including health reasons, allergies, other behavioral problems such as depression, hearing problems and vision problems. This means that it is wise to see different professionals that specialize in the mentioned areas, along with seeing a psychologist. This can get expensive, but if you want to really know what your child is struggling with, it may be worth the cost to find the most appropriate treatment(s) for your child.