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    • Contact Us
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  • Our Practice
    • Meet the Staff
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    • Office Hours, Special Schedules & Holidays
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      • Marlo Contact lens ordering
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Its never too early to know how your child sees, but it can be TOO late
to know what they're missing... in school and in life!  

by Dr. Hank Makini

   There are approximately seven to ten million children between the ages of three to five being treated for ADHD. At the same time statistics also indicate that one out of every four children may possibly have an undetected visual characteristic that leads them to poor concentration, poor academic performance and negative behavioral changes.  What does this mean?  It means that a child with an undetected visual characteristic could tragically be misdiagnosed and unnecessarily medicated for an ADHD condition that does not exist.  

     I wish this was only a speculation but it's not, it's a reality!  Can you imagine a mom sitting by herself before three educators and three health professionals being told that she has to medicate her 8 year old son and if she chooses not to, her son would not be allowed to return to school and her name would be given to CPS?  I've seen first hand what this can do to good and responsible parents! I've seen other parents with their hearts broken because their children were forced to take ADHD medication that made them feel awful and gave no significant improvements academically.  An undetected visual problem left untreated ultimately means that a child's potential bright future is now simply thrown away!

     Therefore, without the knowledge of vision and it's critical importance in learning and concentration, students are too easily and conveniently considered for learning disabilities and ADHD which treatments with either special education or strong psychiatric medications are destructive. And believe me there are consequences. I've seen a parent in tears because their child couldn't be taught to read not by one but two separate special education programs.

     In schools today, visual problems are no longer ruled out as a possible cause for poor academics and behavior in students.  Decades ago they were considered, but unfortunately, those times have gone.  Psychology has unintentionally overshadowed the importance of the basic fundamentals of seeing and hearing.  It began in the 1990's when the Federal government had implemented a modified medical program to address ADD and ADHD in schools and allowed a different definition of the term 'Diagnosis' to exist.  Unlike medicine, where a diagnosis is arrived at through a differential process involving the ruling out of other possible causes.  School systems were given the authority to identify (diagnose) ADHD in children when 7 out of a list of 9 behaviors are agreed upon to exist in that child by a group usually consisting of educators and assigned health advisors including state-hired pediatricians, psychologists and psychiatrists.  Without proper differential testing including an effective visual evaluation by an specially trained optometrist, this medically modified program is a mis-identification (misdiagnosis) just waiting to happen!

     Project S.A.V.E. is a public awareness project founded by Dr. Makini that stands for 'Supporting Academic & Visual Excellence.'  Its purpose is to protect our children from this life-altering misfortune!  Dr. Makini has created a children's visual care approach called Academic Vision Care that can determine if a child is being misidentified.  

     Dr. Makini - "It should never be just about the behavior only, but should include the successful academic development of the child.  In reality, there aren't many health professionals best suited for this kind of problem.  The behavioral optometrist, like myself, would be the closest in helping parents to find a solution for their child. This type of problem, although still relatively new, is unfortunately becoming more and more common place.  We need more optometrists and pediatricians to be made aware of this devastating problem, how to identify them and how to get them the care they truly need!"


If you've any questions, need to acquire more information or would like to have Dr. Makini speak at your next gathering, please call 808-674-0744. You may also reach Dr. Makini at drhankmakini@gmail.com.

The Problem With Vision Screenings
     
​     Keep in mind that a vision screening performed by your pediatrician or the school nurse is not a comprehensive eye exam. These screenings are designed to alert parents to the possibility of a visual problem, but not take the place of a visit to an eye care practitioner.

Vision screenings are helpful, but they can miss serious vision problems that your eye care practitioner would catch. A child who can see the 20/20 line on a visual acuity chart can still have vision problems, and the visual skills needed for reading and learning are much more complex than identifying letters on a wall chart.
​

Also, children who fail vision screenings often don't get the vision care they need. Two studies published by the American Academy of Ophthalmology found that 40 to 67 percent of children who fail a vision screening do not receive the recommended follow-up care by an eye doctor.

      One reason for this lack of compliance is poor communication with parents who may or may not be present at the screening. One study found that two months later, 50 percent of parents were unaware their child had failed a vision screening.
The best way to make sure your child has the visual skills he needs to excel in and outside the classroom is to schedule routine comprehensive eye exams with an eye doctor who specializes in children's vision.

ADHD, Vision & Misdiagnosis
by Dr. Hank Makini

       Attention Deficit Hyperactivity Disorder or ADHD as it is more commonly referred to as, has become the most notorious behavior disorder ever diagnosed in children and teens. According to the psychiatric community, this disorder is supported by the argument that ADHD is a psychiatric condition that can be best managed by using a CNS (central nervous system) stimulating oral medication. Since the 1990’s, federally funded programs within our state public schools were implemented to handle what many physicians and ADHD support groups were calling an epidemic. With teachers and parents along with physicians believing this disorder was just that, an epidemic, the suspicions of ADHD with children that ‘couldn’t sit still or focus’ sky rocketed. What has not been officially recognized as of yet are the dangers of misdiagnosing this disorder. The misdiagnosis of this disorder, confusing it with something else, can literally mean the destruction of a child’s hope-filled future. It is this program’s lack of accuracy in the process of selection that has become problematic. Because Vision’s incredibly significant role in a human’s ability to mentally concentrate is far too overlooked, it is not factored into the equation used by these programs to determine which children have ADHD. Therefore, children with concentration problems due to visual deficiencies are being dangerously misdiagnosed.

      For over half a century, the profession of optometry has been addressing concentration behaviors such as inattention, impulsiveness and hyperactivity in children with natural, non- invasive treatments designed to manage certain sight and vision performance characteristics that were cause related. Most professionals that support the psychiatric diagnosis and treatment of ADHD are unable to tell the difference between visual and psychiatric causes.

      Thus, the risk is very high today for children exhibiting similar symptoms caused by their vision to be misdiagnosed with ADHD. With approximately seven to ten million children between the ages of three to five being treated for ADHD and at the same time statistics also indicating that one out of every four children may possibly have an undetected visual problem that can lead to poor concentration, poor academic performance and negative behavioral changes, the risk is very great.

      A closer look at ADHD medication gives us a closer look at the disorder and how it may be very possible for other causes of inattention to exist. The first medication that was ever used to treat ADHD was called Ritalin.

      Over the years, much of what has been presented to the public in support of ADHD by the medical community has been seemingly concise. However, information that is publicly available in the 2003, 57th edition of the Thomson Physician’s Desk Reference (pg. 2305) states a not-so concise description of Ritalin’s clinical pharmacology as it relates to the condition. It states, “The mode of action in man is not completely understood, but Ritalin presumably activates the brain stem arousal system and cortex to produce its stimulant effect. There is neither specific evidence which clearly establishes the mechanism whereby Ritalin produces its mental and behavioral effects in children, nor conclusive evidence regarding how these effects relate to the condition of the central nervous system.” Without valid proof that all deficiencies in attention are entirely a neurological disorder, it is reasonable to speculate that other causes of deficiencies in attention such as insufficient concentration in children besides psychiatry’s ADHD can and do exist.

      Both psychiatrists and pediatricians generally accept the idea that glasses cannot and will not help a child with ADHD. I’m in total agreement with them as long as the disorder truly exists. On the other hand, I’m in total disagreement when the disorder has been misdiagnosed and a visual condition is the true cause. I have been able to successfully treat ADHD children with the use of glasses and without the use of any medication. How could I have used visual treatment instead of medications to bring about a successful solution for these children? The answer is easy. These children were misdiagnosed. With all that you’ve learned from reading this book regarding the impact that vision has on learning and concentration, you might better understand why it concerns me so when psychiatrists or pediatricians are not seriously ruling out vision as a valid cause.

      In no way am I trying to disprove ADHD as a psychiatric disorder. Instead, I am trying to make the point that unfavorable sight and vision performance characteristics can also cause behaviors that are very similar to ADHD. And if a psychiatrist or pediatrician are incapable of determining the difference, a misdiagnosis is only to easy to occur.

      Listen to this story, it literally changed the way I examine and visually assess children. At a time when ADHD was never a concern in my office, a struggling eight year old boy was brought to me by his Mom for an exam. I found out early during the exam that he had been diagnosed with ADHD by a public elementary school in a near by community. She continued to explain that she has been meeting with the school many times due to her refusing to medicate her son. Even after the school had a psychiatrist, psychologist and pediatrician test him confirming that he had ADHD she still refused to medicate him. The last meeting she had with the school she had her hired private attorney attend to halt their threats to refuse her child from attending the school any longer and to refer her name to Child Protective Services if she still continued to refuse medication for her son. Her reason for the lawyer was to give her time to have her own choice of doctors test him. This is where I came in the picture.

      I found that her child had mild Astigmatism in both eyes, the same eye characteristic that was described in Chapter 3. It’s very important to note that although his measured visual acuities in my office were 20/30 in each eye (a failed test in my office), his visual acuities were considered passing by the pediatrician hired by the school. Since Astigmatism can be very distracting to mental concentration, I guaranteed his Mom that I could without a doubt improve his classroom concentration with the use of glasses. Unfortunately, I couldn’t guarantee that his so called, by the school, ADHD behaviors would be affected since ADHD is from a psychiatric cause not a visual one. Low and behold the Mom came back to my office with a report that was to forever change my view of children’s eye care in public school. His teacher had noticed a significant difference in his overall classroom performance when he used his glasses. The teacher’s words were,“He’s a totally different student when he wears his glasses!”

      After observing him for over a month, the school dropped the ADHD diagnosis from his school file. I had the hardest time to keep from wondering how in the world could a teacher, a vice-principal, a psychiatrist, a psychologist and a pediatrician all have come to same conclusion with such conviction and all be completely wrong. This mother was a definite hero to her son. She had the strength to withstand the intimidation of so many educational degrees including the threat of having her child taken away from her. Now she is a hero to so many other children because of how it had inspired me to reach out and educate as many parents and help as many children as possible regarding this problem of misdiagnosed ADHD. Besides her son, I too am truly grateful for her courage.
​

      Who will determine the truth for the sake of these children whose futures lie in the balance? Years later when their vision condition is discovered and a solution for their eyes is given, who will help the child to overcome their poor self-esteem and lack of self-confidence and ambition? The misdiagnosis of ADHD is a problem that can grow into personal challenges that become much greater difficulties down the road and without a doubt are much more difficult to treat than with a pair of glasses. As I many times have said to parents regarding their children, it’s much faster to change the way they see than the way they think about themselves when they are older. That’s why I stress starting visual care for children at age 3 or 4 when they start school.

      The more a parent knows about their child’s vision, the more they are able to help their child grow and develop academically as well as athletically. It’s that simple!

​"UNLEASH THE POWER OF THE STUDENT WITHIN YOUR CHILD!"
Author: Dr. Hank Makini, O.D.
$15.00

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                           EYES PLUS, INC.
                           Dr. Hank Makini
                           Optometrist
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                           Manawa at Mehana
                           1049 Kakala St. #102
                           Kapolei, HI 96707
                           Phone: 808-674-0744
                           ​Fax: 808-333-3744
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