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CNN TONIGHT
Vision Problems Sometimes Misdiagnosed as ADD
Aired August 13, 2001 - 22:11 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
KATE SNOW, CNN ANCHOR: It's back-to-school time here in the Atlanta area, already, as it will be for kids all around the country all over the next few weeks. Children returned to class sporting the latest backpacks, lunch boxes and sometimes even a bit of nervous excitement.
Before you know it, some parents will be getting those dreaded notes from schools, saying your son or daughter is having trouble paying attention and perhaps needs a test for attention deficit disorder. But before you pick up the phone to make that call, you need to watch tonight's eye-opening cover story.
Here's CNN's Thelma Gutierrez.
(BEGIN VIDEOTAPE)
THELMA GUTIERREZ, CNN CORRESPONDENT (voice-over): Does your child have trouble reading?
SALLY OLAS, PETER'S MOTHER: It broke my heart that he had so much trouble.
GUTIERREZ: How about daydreaming or getting antsy in school?
S. OLAS: He would be looking everywhere but at the teacher.
GUTIERREZ: Does your child have a short attention span and trouble following directions?
S. OLAS: The doctor recommended that we put him on Ritalin.
GUTIERREZ: Meet Peter Olas. He's 7 years old. When he was 5, his parents, his teacher, even his doctor knew something was wrong. The diagnosis? Attention deficit disorder, or ADD.
S. OLAS: I, you know, broke into tears. I was heartbroken.
GUTIERREZ: And Peter was medicated. For one month, he took Ritalin, but his concentration did not improve. In fact, his mother says she noticed a frightening change.
S. OLAS: He started developing twitches, and so my husband and I at this point just said, you know: That's it, this is not -- this is just not the right -- the right diagnosis. GUTIERREZ: Peter's teacher suspected his problem could be something as simple as his vision, but his parents thought it had already been ruled out. After all, Peter's eyesight was 20/20.
DR. DONALD GETZ, BEHAVIORAL OPTOMETRIST: All 20/20 means is that a child can see clearly 20 feet away, and unfortunately, how well a child sees at 20 feet bears absolutely zero relationship to how well they function at this distance.
GARY ETTING, BEHAVIORAL OPTOMETRIST: Do you skip and leave out words anymore? How about copying from the blackboard? Are you not getting any headaches or any eyestrain?
GUTIERREZ: Doctors Donald Getz and Gary Etting are optometrists who've seen hundreds of cases like Peter's. They believe eye chart screening, by itself, is woefully inadequate.
(on camera): It's hard to believe, but this eye chart that we've all come to rely on was actually developed in the 1800s. Experts say it only screens for distance vision, not reading vision, and it only catches 5 percent of all vision problems.
GETZ: It would be a great test if we wanted to train a generation of buffalo hunters, but if want to find those children who'd be doing better in school if it weren't for an undetected vision problem, we're going to have to go well beyond that particular test.
(voice-over): Vision therapy runs about $125 a session. Insurance doesn't always cover it. Dr. Etting diagnosed Peter with a condition called convergence insufficiency, which means he can't follow a moving target or get his eyes to work together.
ETTING: It's like he's driving a wagon pulled by two horses that really don't like each other.
GUTIERREZ: Sometimes the words on a page pull apart like this, so children try to cope by turning one eye off.
ETTING: The way you can tell someone's doing that is that they get into distorted postures when they read or write, they cover an eye, rotate their head.
GUTIERREZ (on camera): Was it hard for the other kids to read?
PETER OLAS: No.
GUTIERREZ: How'd that make you feel?
P. OLAS: It made me feel bad, real bad.
GUTIERREZ: Real bad?
P. OLAS: Super bad.
GUTIERREZ: Super bad? Yeah.
P. OLAS: Enormous bad!
GUTIERREZ (voice-over): With 18 weeks of vision therapy, Peter learned to control his eye muscles. Did it make a difference?
(CROSSTALK)
P. OLAS: Over 158.
GUTIERREZ: In fact, Peter is now reading at grade level.
(on camera): Do you think you're doing better in school, too?
P. OLAS: Yeah, of course.
GUTIERREZ (voice-over): Thelma Gutierrez, CNN, Los Angeles.
(END VIDEOTAPE)
SNOW: So what steps can parents take to be sure that if their kids have problems, the parents know what those problems really are?
Behavioral optometrist Gary Etting, who you just saw in Thelma's report, and his partner have written on vision problems being diagnosed as ADD or other disorders. He joins us now live from Los Angeles.
Doctor, thanks for being with us.
ETTING: Thank you.
SNOW: Let's start with the numbers. Do we know how many children we're talking about, how many kids are being misdiagnosed with ADD and really have a vision problem?
ETTING: No. I think it's really difficult for us to know that, because many times there are many underlying causes, vision being one of the primary ones.
SNOW: But in the story that we just saw, the young boy had what you call convergence insufficiency. Is that problem that's most associated with ADD?
ETTING: Well, yeah, as far as visual problems go, it is one of the more common ones. We see a lot of focusing problems and other eye-teaming problems that are associated with it as well.
SNOW: And how do you know? How do you judge that it is a vision problem as opposed to -- to ADD, attention deficit disorder?
ETTING: Well, we do a comprehensive visual evaluation, and all the tests that we put the child through are standardized and we can find out whether or not they have the visual abilities that are appropriate for their chronological age.
SNOW: You're an optometrist, so I'm going to be a devil's advocate for a minute. Cynics might say, look, of course this guy is going to say it's a vision problem. That's your business. You would want children to be treated for vision problems rather than something else -- it might be more lucrative for you. How do you respond to that?
ETTING: Well, my response is, is that I don't believe that all attention problems are due to vision problems. I think many of them are due to undetected auditory processing problems or sensory integration problems, nutritional reasons, emotional reasons, and even more importantly, educational reasons.
We just remove a visual roadblock that's interfering with the child's ability to respond to the educational process, and just like Peter, while he seemed calmer with the medication, still was not interested in doing reading and writing -- many times these children do not respond to the medication and/or only show problems with attention when they're having to do reading or writing, but otherwise can concentrate for long periods of time. That's a real tipoff that it may very well be a visual problem.
SNOW: So if you're a parent, do you wait until you're prescribed -- your child is prescribed Ritalin and then see how they respond, or is there a way beforehand of knowing that maybe it's a vision problem instead of an attention problem?
ETTING: Well, we're, you know, real strong advocates of a child having really a comprehensive examination way before they begin school, because we can pick these problems up very early, and many times tell a parent that maybe a child should wait a year before they go on to enter kindergarten.
SNOW: Is that something that's common, having an eye exam at a young age?
ETTING: Unfortunately, it's not, and when you consider that 70 to 90 percent of what we learn comes to us through the process of vision, it's a real tragedy.
SNOW: Dr. Gary Etting, a behavioral optometrist out in Los Angeles. Appreciate you joining us, clarifying some of that for us tonight.
ETTING: Thank you.
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