Academic behaviors in children with convergence insufficiency with and without parent-reported ADHD

Abstract

Purpose: To determine if children with symptomatic Convergence Insufficiency without the presence of parent-reported Attention Deficit Hyperactivity Disorder (ADHD) have higher scores on the academic behavior survey (ABS).

Methods: The ABS is a 6-item survey that evaluates parent concern about school performance and the parents' perceptions of the frequency of problem behaviors that their child may exhibit when reading or performing schoolwork (such as difficulty completing work, avoidance, and inattention). Each item is scored on an ordinal scale from 0 (Never) to 4 (Always) with a total score ranging from 0 to 24. The survey was administered to the parents of 212 children 9- to 17-year old (mean age 11.8 years.) with symptomatic convergence insufficiency before enrolling into the Convergence Insufficiency Treatment Trial and to 49 children with normal binocular vision (NBV) (mean age 12.5 years). The parents reported whether the child had ADHD, and this information was used to divide the symptomatic convergence insufficiency group into the convergence insufficiency with parent report of ADHD or convergence insufficiency with parent report of no ADHD groups.

Results: Sixteen percent of the convergence insufficiency group and 6% of the NBV group were classified as ADHD by parental report. An analysis of covariance showed that the total ABS score for the symptomatic convergence insufficiency with parent report of ADHD group (15.6) was significantly higher than the symptomatic convergence insufficiency with parent report of no ADHD group (11.7, p = 0.001) and the NBV group (8.7, p < 0.0001). Children with convergence insufficiency with parent report of no ADHD scored significantly higher on the ABS than the NBV group (p = 0.036).

Conclusions: Children with symptomatic convergence insufficiency with parent report of no ADHD scored higher on the ABS, when compared to children with NBV. Children with parent report of ADHD or related learning problems may benefit from comprehensive vision evaluation to assess for the presence of convergence insufficiency.

Trial registration: ClinicalTrials.gov NCT00338611.

Figure 1

The Academic Behavior Survey.

Figure 2

The percentage of parents responding to each category on the ABS for the CI children with parent-report ADHD, CI with parent-report of no ADHD, and NBV groups for question 1: How often does your child have difficulty completing assignments at school?

Figure 3

The percentage of parents responding to each category on the ABS for the CI children with parent-report ADHD, CI with parent-report of no ADHD, and NBV groups for question 2: How often does your child have difficulty completing homework?

Figure 4

The percentage of parents responding to each category on the ABS for the CI children with parent-report ADHD, CI with parent-report of no ADHD, and NBV groups for question 3: How often does your child avoid or say he/she does not want to do tasks that require reading or close work?

Figure 5

The percentage of parents responding to each category on the ABS for the CI children with parent-report ADHD, CI with parent-report of no ADHD, and NBV groups for question 4: How often does your child fail to give attention to details or make careless mistakes in schoolwork or homework?

Figure 6

The percentage of parents responding to each category on the ABS for the CI children with parent-report ADHD, CI with parent-report of no ADHD, and NBV groups for question 5: How often does your child appear inattentive or easily distracted during reading or close work?

Figure 7

The percentage of parents responding to each category on the ABS for the CI children with parent-report ADHD, CI with parent-report of no ADHD, and NBV groups for question 6: How often do you worry about your child's school performance?