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Vision, Inner-Ear, Auditory Integration, and Sensory Integration Problems

An entire class of theories about the causes of ADHD and effective treatments for it centers on the workings of the senses. Problems relating to sight, hearing, balance controlled by the inner ear, sensory integration, and so on have been proposed as underlying conditions that lead to ADHD and accompanying problems and disorders. Each theory is linked to a treatment approach, and each form of treatment is supported by a large number of vocal enthusiasts. Again, none of these theories or methods has yet been proven valid in diminishing or eliminating the behaviors related to ADHD.

Optometric Training

Optometric training, a kind of eye training for children with learning disabilities, is based on the theory that faulty eye movements and problems in visual perception can cause dyslexia, language disorders, and other learning problems that frequently accompany ADHD. Named behavioral optometry by the optometrists who developed and support this form of therapy, the treatment consists of teaching children specific visual skills as a way of improving learning. These skills include tracking moving objects, fixating on or locating objects quickly and accurately, encouraging both eyes to work together successfully, and changing focus efficiently. The skills are taught through the use of eye exercises and special colored or prismatic lenses. Optometric training is often supplemented with training in academic skills, nutrition, and personal relationships. This treatment is frequently quite expensive.

However, little research has supported the theory that dyslexia or other learning disabilities are caused by vision defects or problems, and thus vision training is an ineffective approach to reading and learning disabilities. In 1984 the American Academy of Pediatrics (AAP), along with the American Association for Pediatric Ophthalmology and Strabismus and the American Academy of Ophthalmology, issued a policy statement affirming that no known scientific evidence “supports the claims for improving the academic abilities of dyslexic or learning-disabled children with treatment based on visual training, including muscle exercises, ocular pursuit or tracking exercises, or glasses (with or without bifocals or prisms).” Because vision training is not only ineffective but may delay more effective treatment for coexisting learning disabilities, it is not recommended.

Motion-Sickness Medication

Dr Harold Levinson, a New York physician, is responsible for the popular theory that inner-ear problems can cause problems with balance, coordination, and energy regulation, which in turn can lead to ADHD and learning disabilities—as well as dyslexia, obsessive-compulsive disorder, panic disorder, and many other difficulties. In his book, Total Concentration, Levinson states that ADHD symptoms are often related to a kind of dizziness or motion sickness resulting from inner-ear problems. He recommends treatment with anti–motion-sickness medications, often in combination with antihistamines, tricyclic antidepressants, the antipsychotic drug thioridazine (Mellaril), vitamin B complex, gingerroot, or stimulants.

To date no studies have revealed a link between ADHD and inner-ear deficiencies, and Levinson’s theory conflicts with much that is currently known about ADHD. His claims rest almost entirely on anecdotal information, and the published reports of his work consist of individual case studies rather than scientific research. Because insufficient research has been conducted to prove this treatment effective, and because it contradicts many of the known facts about the causes of ADHD, it is not recommended as a treatment option.

Sound Treatment

Difficulties with auditory integration—that is, organizing, attending to, and making sense out of information while listening—have also been suspected as a cause of ADHD. The Tomatis Method, devised by the French physician Alfred Tomatis, is perhaps the best-known treatment approach aimed at this proposed deficiency. A large number of individual accounts testify to the effectiveness of Tomatis’ auditory-stimulation sessions—in which children listen to high-frequency modifications of the human voice, classical music, and Gregorian chant through special headphones called “electronic ears,” and are given listening training to improve focus and attention. The effects of music and sound on brain function have been insufficiently studied to date, however. While one study did show that boys with ADHD were better able to solve arithmetic problems when listening to their favorite music—implying that auditory stimulation may help to improve performance on specific tasks—no scientifically controlled studies have yet supported the claim that the Tomatis Method improves ADHD. Any improvement that has been reported by individuals may be due to the treatment’s emphasis on individual attention for each child, with at least 75 specially designed listening sessions and targeted training in social and academic skills.

Sensory Integration Training

Dr Jean Ayres, an occupational therapist, developed the theory that much of the hyperactivity in today’s children is the result of poor sensory integration—that is, the failure of the brain to organize and make use of information derived from such senses as vision, hearing, smell, taste, touch, motion, and temperature. According to this theory, sensory integration dysfunction makes it difficult to concentrate and sit still, and puts children at risk for learning disabilities, problems with coordination, social difficulties, and touch sensitivity. Ayres claimed that sensory integration dysfunction is usually genetically inherited or acquired prenatally, during birth, or from environmental toxins. Recommended treatment includes exercises or experiences that provide the child with extrasensory stimulation and feedback—such as brushing and rubbing of the skin, deeppressure exercises, vibration, stretching, and so on.

While this approach has some intuitive appeal, feels good to children, can be calming, and is said to address the poor coordination and social difficulties that many children with ADHD experience, no convincing evidence has surfaced to prove that deficits in sensory integration are a cause of related disorders. Studies have not shown that sensory integrative training succeeds as a treatment for children with ADHD or learning or behavior problems. While not known to be harmful in any way, the expense and time demands are such that this approach cannot be recommended as a treatment for ADHD.

Last Updated
ADHD: A Complete and Authoritative Guide (Copyright © 2004 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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