Hidden Challenges Negatively Affect Attention (ADD, ADHD)
According to the American Psychiatric Association, behavioral characteristics of Attention Deficit Hyperactivity Disorder occur before age five and is “a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, as characterized” by lack of attention that occurs in multiple environments; lasting longer than six months without traumatic episode; and consisting of both hyperactivity and impulsivity. (DSM V)
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Auditory Difficulties Associated With ADHD
All information below is retrieved from:
The American Speech and Hearing Association, 2011 Conference,
(Neurobiology, Differential Diagnosis, and Treatment of Co-morbid CAPD & ADHD. Presenters: Gail Chermack, PhD., Washington State University; Frank Musiek, PhD.,Univ. of Connecticut; Terri Bellis, PhD., Univ. of South Dakota)
Bellis et al., (2011), found that auditory processing deficits are found in individuals with ADHD. Research introducing a sound (hum) resulted in the following findings:
- Norm group had equal auditory and visual attention
- ADHD’s auditory attention was weaker than norm group, but visual attention was almost the same as the norm group.
- CAPD’s auditory attention was weakest of three groups and visual response was also weak, although slightly stronger than auditory attention
Under-activity occurs in the hearing system when there are ear infections, enlarged adenoids, or lack of strong sound stimulation along auditory neural pathways.
Ciccia et al., (2009), found some evidence that a deficit (under-activity due to hearing loss) in the auditory processing system may negatively impact “neural organization and plasticity of multiple brain systems responsible for efficient auditory and auditory-language processing.”
Attention Deficit with Hyperactivity can coexist with a diagnosis of Central Auditory Processing Deficits (CAPD), a hidden hearing loss. Only an audiologist specializing in CAPD evaluates individuals for CAPD; audiometric equipment must be used during testing.
Shared Behavioral Characteristic | ADHD | Hearing Loss |
---|---|---|
Fidgets, squirms | yes | yes |
Needs to be busy, move | yes | yes |
Thinks out loud, talks | yes | yes |
Interrupts | yes | yes |
Difficulty listening in noise | yes | yes |
Inappropriate impulsive actions | yes | no |
Suddenly gets out of chair | yes | no |
Evidence of Visual Processing Difficulties Found in Those Diagnosed with ADHD
Convergence Insufficiency is difficulty sustaining the ability to use both eyes together needed for single vision while reading and writing, often despite normal 20/20 vision. The picture below is an example of what happens when each eye works separately, independent form each other.
Are visual processing difficulties contributing to poor development of attention skills?
Researchers found that 10% of 266 children with a diagnosis of convergence insufficiency also had a diagnosis of ADHD. Researchers found that 106 children out of 1,700 children with a diagnosis of ADHD were being affected by convergence insufficiency. (Granet, D.B., Gomi, C.F., Ventura, R., Miller-Scholte, A. (2005). The relationship between convergence insufficiency and ADHD. Strabismus 13(4); 163-8)
ADHD Without Intervention Increases Risks
- Mild language, motor, or social delays during childhood
- Emotional distress, behavioral problems, social acceptance during the teen years
- Substance abuse (self-medicating), and suicide attempts during the teen years
According to the American Optometric Association, relying on vision screenings that only test for how well one sees, 20/20 vision, fails to provide accurate information concerning visual difficulties 63% to 73% of the time.
“The American Optometric Association (AOA) recommends that all children have a comprehensive eye exam (eye alignment, eyesight, eye health) by an eye doctor (optometrist) as opposed to a vision screening, before beginning first grade.“
“Undiagnosed and untreated vision disorders increase the potential for misdiagnosis of special needs and Attention Deficit Hyperactivity Disorder (ADHD), placing unnecessary stress on families and classrooms.” (https://www.aoa.org/patients-and-public/resources-for-teachers)
Cheri Moore's Findings Resulted in Improved Responses to AIT and Vision Therapy
Cheri Moore's desire to improve clients' emotional response during auditory integration training resulted in the discovery of a high rate of co-existing visual processing difficulties with sound intolerance, with or without a hearing loss. After some clients experienced increased visual processing difficulties during AIT, like chronic double vision, Cheri Moore collaborated with optometrists specializing in vision therapy to track client's progress. Auditory-visual protocols have resulted in improved responses to auditory integration training and vision therapy.

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FDA Statement On AIT
"Auditory Integration Training remediates impairments in auditory discrimination (sound sensitivity and auditory distortion) associated with Autism, Learning Disabilities, and related disorders - ADD, ADHD, CAPD (Central Auditory Processing Deficits), SPD (Sensory Processing Disorder), Dyslexia."
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Cheri Moore, B.S. Spec. Educ. Teacher, MSW, Certified Berard Practitioner since 2011