Purpose
To compare the prevalence of attention deficit/hyperactivity disorder (ADHD) in children with normal vision and with vision problems not correctable with glasses or contact lenses (vision problems) as determined by parent report in a nationwide telephone survey.
Methods
This cross-sectional study included 75,171 children without intellectual impairment ages 4 to 17 participating in the 2011-12 National Survey of Children's Health (NSCH), conducted by the United States Centers for Disease Control and Prevention. Demographic information and information regarding vision and ADHD status was obtained by parent interview. Questions asked whether they had ever been told by a doctor or health care provider that the child had a vision problem not correctable with glasses or contact lenses, ADHD, intellectual impairment or one of 13 other common chronic conditions of childhood. A follow-up question asked about condition severity. The main outcome measure was current ADHD.
Results
The prevalence of current ADHD was greater (p<0.0001) among children with vision problems (15.6%) compared to those with normal vision (8.3%). The odds of ADHD compared to that of children with normal vision was greatest for those with moderate vision problems (odds ratio (OR) 2.6 (95% CI 1.7, 4.4)) and mild vision problems (OR 1.8, 95% CI1.1, 2.9). Children with severe vision problems had similar odds of ADHD to that of children with normal vision, perhaps owing to the small numbers in this group (OR 1.6, 95% CI 0.8, 3.1). In multivariable analysis adjusting for confounding variables, vision problems remained independently associated with current ADHD (OR 1.8, 95% CI 1.2, 2.7).
Conclusions
In this large nationally representative sample, the prevalence of ADHD was greater among children with vision problems not correctable with glasses or contacts. The association between vision problems and ADHD remains even after adjusting for other factors known to be associated with ADHD.