The symptoms of Attention Deficit Hyperactivity Disorder (ADHD) include inattentiveness and impulsivity. Being inattentive means that you cannot pay attention to a topic or task for very long unless it is very stimulating (e.g., video games). Impulsivity is doing whatever comes to the mind without thinking about the consequences. Eyes have an important role in attention skills.

Some scientist have observed that when the eyes are focused on a task, the person is able to concentrate. When the eyes shift their gaze, the mind automatically processes another thought. At this point the child may lose attention and get off task. This shift or movement of the eyes in some ADHD individuals is automatic and seemingly not under the person's control.

An observed characteristic of some ADHD individuals is their inability to follow simple instructions related to focusing visually on two objects in succession. When asked to look at a red pencil and then at a green pencil and back to a red pencil, they often look at the other pencil before instructed to do so. This behavior is called visual impulsivity. It is simple to measure and easily observed. Improvements in this behavior are easily monitored as well. The goal in this paper is to describe two exercises that improve visual attention skills and decrease visual impulsivity. The long range goal of these exercises is to improved productivity in completing homework and listening to instruction. To our knowledge, these exercises have yet to be tested in scientific research. They have been used in practice with favorable results being described by parents, teachers and children.

Impulsive eyes.

Many impulsive children have impulsive eyes. This means that it is difficult for them to hold their eyes on a fixed point until told to shift their gaze to another point. It is simple to test if a child has this ability or not.

Test.

To test if a child has this ability, simply take two pencils and place them 16 inches in front of the child's face. The pencils should be placed about shoulder length apart. Each pencil should look different (e.g., one green the other red). Instruct the child to first look at the red pencil. After a second or two, instruct the child to look at the green pencil. Repeat this process several times using variable timing patterns. Most impulsive individuals will look atthe other pencil before being told. It will be difficult for them to follow your instructions.

Treatment.

Treatment is simply making a game out of this test. The child scores points if he/she can follow exact directions for eight trials (a trial is one instruction to look at a pencil). If the person holding the pencils spots the child moving his/her eyes too soon to the other pencil, a point goes to the person holding the pencils. The game can become more difficult by telling the child to look at the green pencil while he/she is already looking at the green pencil. This helps the child to pay careful attention to verbal instructions. At first, try to play the game for five minutes. When the child gets good, play the game for ten minutes. Count up the points and verbally reward the child for playing the game. The next time the child plays, he/she tries to earn more points than the time before.

Play this game often at home. Do this exercise four or five times a week to increase attention skills. Over time your child will become good at keeping his/her eyes on the correct pencil until instructed to move them. This exercise is designed to decrease impulsivity of the eyes, to increase focus and attention, and to improve listening skills.

Theoretical explanation.

How does working with the eyes help decrease impulsivity? To answer this question, we will take a developmental approach. The brain is constantly developing. The older a child gets, the more cognitive skills he/she will develop. The symptoms of ADHD often change with time as well. Many ADHD children will loose their hyperactivity and become fidgety as adolescents. A few ADHD children even outgrow most of their symptoms. Training the eyes to stay on task should stimulate brain cells to grow dendrites connecting to other brain cells. This process strengthens pathways so the child has the ability to perform the desired skill.

This is a natural process. It happens with athletes, musicians, students in school, and every healthy person. When you daily practice something, you usually improve in ability. When you improve it is because you have altered your brain structure. Our goal is to alter brain structure to the point that children have abilities to attend and be less impulsive. In these exercises, we focused on the eyes. Some scientists believe that the visual pathways involve 85% of the brain. Thus training visual attention skills will stimulate a large number of brain cells to grow or develop in ways that contribute to attention skills and reduced impulsivity. The more practice, the more benefit will be obtained from these exercises.

Visual tracking exercise to increase attention skills.

Another exercise is to have children follow a moving target with their eyes. One way to accomplish this is to sit in front of a child(but towards the side of the child) and move an object (e.g., hand,marker, puppet) about 16 inches in front of the eyes. Usually, the younger the child the bigger the object has to be in order to get good tracking. Move the object horizontally for a period of time. Do it at a speed that is comfortable for the child. Tell the child to follow the object and do not get ahead or behind of the object. Some children will move their head while they track with their eyes. This may be acceptable at first, but it is better to have the child keep their head still and only move the eyes.

Many children with ADHD will have trouble following the object. Let them know when they are doing it correctly. You may need to stop to let them refocus on the object. Over time, they should getbetter and better at following the object. This exercise also tends tohave a relaxing effect on some children.

The next step is to have the child follow the object moving in frontof the eyes in a the pattern of a windshield wiper. Move the object in an arc from side to side, having the child follow the object. Again, if the child loses the object, let the child catch up or get refocused. Do this exercise for a period of time. The length of the time period will become longer as the child practices this exercise. Do the exercise until the child gets tired or seems to lose motivation. Always push your children to go as long as possible, but never push them to the point that they hate doing the exercise.

The third part of this exercise is like the second, except the object is moved in an arc at the lower part of the visual field. Again, move the object in an arc going from one side to the other and then back again. Make sure the child follows the object with his/her eyes. After a period of time, let the child rest. Again encourage the child to follow the object without moving his/her head. Sometimes you may need to hold the head still with one hand and move the target with the other. Over time, your child will not need this assistance.

The object of this exercise is to increase the amount of time that the eyes can comfortably track an object. A total time of 20 minutes for all three parts of this exercise is a good goal to work up to. Most tasks in school require 20 minutes or less of good concentration to complete.

One must be careful not to think that if a child is able to do this exercise for twenty minutes, he/she should be able to pay attention in school. While some children are able to generalize what they learn behaviorally at home to the school environment, research suggests that behavioral exercises learned at home do not always generalize to the school setting. Some children may need to practice this exercise at school and then try to use the same level of energy to focus on what is being presented in the classroom.

Summary

Impulsivity and not paying attention are two characteristics of children with Attention DeficitHyperactivity Disorder (ADHD). Often these characteristics are also seen in visual abilities. Impulsive children usually have impulsive eyes. The first exercise is designed to help children overcome their impulsive vision and improve listening skills.

Attention abilities is also developed through visual exercises. Children try to sit still for up totwenty minutes following an object. They are instructed to keep their head from moving and only follow with their eyes. Since most school learning only require twenty minutes of intense focus, being able to attend for twenty minutes on a single task will help ADHD children succeed in school.

For more information, check out our section on Neuro-Development We have sections on Attention Skills, Memory and Vision.

The top photograph was by Paolo Nicolello on Unsplash. We are grateful.

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