Fragment from Cognitive Vision Therapy (Master in Clinical Optometry and Vision Therapy).

Joaquín Vidal López, OD, Psych, PhD and Director of SAERA.

          The most widely used diagnosis to describe the patients with attention-deficit is the Attention-Deficit Disorder with or without Hyperactivity. Thousands of children and adults are diagnosed with this deficit every year through the use of a diagnostic manual called DSM-5 (Diagnostic and Statistical Manual of Mental Disorder, 2013) that allows the psychiatrists, psychologist and neurologists evaluate most of the Attention Deficits based in the patient´s symptomatology. The symptoms that help to determine whether a patient has an Attention Deficit are:

  • Difficulty paying attention to the details and making frequent mistakes in the task performed.
  • Difficulty maintaining attention while performing tasks.
  • The patient seems not to hear what he is being told.
  • Difficulty to follow instructions correctly.
  • Difficulty to organize their daily life
  • Avoiding of tasks or discomfort when performing activities that require thinking.
  • Frequent loss of objects
  • Frequent distractions when performing any task.
  • Forgetting to perform everyday activities.

Patients who have hyperactivity have the following symptoms:

  • Nervous agitation of arms or legs when sitting on a chair.
  • Difficulty staying seated.
  • In children: Running or moving too much. In adults: Lack of need for rest.
  • Difficulty starting activities quietly.
  • The actions performed appear to be driven by an engine.
  • Excessive speech.
  • Responding to questions impulsively before the question is finished.
  • Difficulty waiting for their turn.
  • Frequent interruption or intrusion in the activities of others.

          The ADHD is carried out by the doctors and psychologists. Medical treatment may be helpful to increase the attention or reduce hyperactivity. Some of the medicines provoke benefits due to a paradoxical effect, as in the case of amphetamines. Amphetamines are stimulant of the central nervous system, and in principle, cause greater excitement and therefore less attention and more hyperactivity.

          Psychological treatment is based on cognitive – behavioral therapy in which the patient is aware of the difficulties they present and develops strategies to try to solve problems.

          There are tasks and questionnaires to quickly evaluate if a patient may have a visual attention deficit. In this topic we present one of these questionnaires as an example: The AFT (Attentional Flexibility Tasks, 1992). The following table shows the tasks that the patient should be develope correctly.

          Since this questionnaire do not have standardized scales for the population of every country, we recommend to all vision professionals who wish to use it with patients suspected of having Attention deficit, that they should do the test to patients without the disorder, family members o acquaintances, with different ages and cultural levels, to familiarize themselves with its usage. When any anomalous results are obtained, it is advisable to refer the patient to a medical professional or psychologist for a more detailed assessment.

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