Associations Between Pediatric Mental Health and Vision From the 2022 National Health Interview Survey

To further explore the specific cognitive and behavioral challenges that may be associated with visual difficulties by examining demographic, health, and behavioral data from the 2022 National Health Interview Survey (NHIS).

Pediatric data from the 2022 NHIS were analyzed using the JMP Pro 16 software. Univariate and multivariate analyses were performed to identify associations among variables including visual difficulties, demographics, overall health, life satisfaction, learning disabilities, and behavioral subscale scores as assessed by caregivers.

Children between 2 and 17 years of age with difficulty seeing according to their caretakers were less satisfied with life and had a higher prevalence of attention-deficit/hyperactivity disorder, intellectual disability, autism, developmental delay, and learning disabilities. Controlling for these conditions, children with visual difficulties received higher scores on all behavioral subscales, suggesting an association with more behavioral challenges, as perceived by caregivers. These subscales included peer problems, hyperactivity, conduct problems, and emotional problems.

There was a correlation between difficulty seeing and emotional, cognitive, and behavioral challenges as reported by caregivers. Although these findings must be interpreted with caution due to their reliance on caregiver perception, pediatricians may consider ophthalmologic evaluation as part of a comprehensive assessment for children presenting with mental health or behavioral concerns, given the observed associations between visual difficulties and behavioral challenges.