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Ellen L. Bowman, Lynne Stevens, Gerald McGwin, Jr., Cynthia Owsley, Dawn K. DeCarlo; Prevalence of Attention Deficit Disorder Among Children with Vision Impairment. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4230.
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To determine the prevalence of attention deficit disorder (ADD) among children with vision impairment.
All charts of children aged 4 to 17 seen at the University of Alabama at Birmingham Center for Low Vision Rehabilitation between 2006 and 2010 were retrospectively reviewed to determine: age, race, gender, primary ocular diagnosis, presence or absence of nystagmus, best-corrected acuity in the better eye, whether or not the child had an Individualized Education Plan (IEP) at school and whether or not the child had ever had a diagnosis of ADD. Exclusion criteria included multiple disabilities and incomplete history forms.
The prevalence of ADD in this group of children with vision impairment (n=149) was 20.1%. The mean age was 10.6 ± 3.8 years. The participants were primarily male (59%) and white (77%). Mean best-corrected visual acuity in the better eye was 0.77 logMAR (20/118) for those without ADD and 0.74 logMAR (20/110) for those with ADD. The prevalence of ADD was greater in children who were white than non-white (23% vs. 9%) and in males compared to females (24% vs. 13%). Children with an IEP were also more likely to be diagnosed with ADD than those without an IEP (25% vs. 12%). Eight children were homeschooled or enrolled in private school and none had a diagnosis of ADD. Interestingly, children with nystagmus were less likely to be diagnosed with ADD (15% vs. 29%). None of these differences was statistically significant.
The CDC estimates that the national prevalence of ADD is 9.5% among children 4 to 17 years of age. The prevalence of ADD in this patient population is more than twice the national average. It is possible that ADD is associated with vision impairment; however, it is also possible that the symptoms of decreased vision mimic those of ADD leading to over-diagnosis.
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