Many of the behavioral characteristics of the autism spectrum involve vision. For instance poor eye contact may be the result of poor vision. Wall hugging may indicate struggle with spacial relationships or poor eyesight. Trouble with eyesight can also effect gross and fine motor skills. Even the age at which Autism is first diagnosed, 18 months old, is also a critical time period for visual development. A very high percentage of children with ASD show eye movement disorders. It is important to get your Autistic loved one involved with an eye doctor and ask your child be tested by a psychologist if you suspect any kind of impairment. To read more about the importance of Optometry in ASD please read this article.
So how do we cope with all these issues? First you must understand that visual impairments are rare in occurrence. Approximately 285 million people worldwide are visually impaired. The World Health Organization, WHO, estimates that 80% of all visual impairment can be avoided or cured. The WHO Visual Impairment Fact Sheet can provide you with more facts about visual impairment. If you have an Autistic child with diagnosed blindness there are ways to cope. This article is from a mother and medical professional of a blind ASD child. She herself states that these two conditions together are extremely rare, but do happen. The Texas School for the Blind and Visually Impaired has published a series of articles related to autism and visual impairment. I strongly suggest you take a look at these articles to help you further your understanding of these conditions.
According to the Texas School for the Blind there are six visual impairments (blindness) that have been documented with Autism:
- Anophthalmia: This is a condition in which one or both eyes are missing at birth. The cause of this condition is relatively unknown, but may include genetic mutations or abnormal chromosomes. There is no cure for Anophthalmia, but its sister condition Microphthalmia (in which the eyes are too small) has responded well to surgery and other treatments. To learn more about Anophthalmia and Microphthalmia please read this article. Here is a blog, Adele's Eyes, from a parent who's daughter has Anophthalmia.
Anophthalmia Microphthalmia
- Leber's Congenital Amaurosis: This is an inherited retinal disease in which severe loss of vision begins at birth. The cause is genetic and it is impossible to determine who is a carrier of the LCA gene. It only shows itself when a child is born, both parents must be carriers for this event to occur. Scientists are not trying to find a cure through gene therapy. To learn more about Leber's Congenital Amaurosis or LCA, please read this article. The little boy pictured is Ivan. Ivan has a blog post about him, Wonder Baby, for you to read from his parents.
- Peter's Anomaly: This condition is caused by a thinning and clouding of the cornea and effect the attachment of the cornea to the iris, causing blurred vision. Premature infants are at risk for developing this condition. This disorder has also been linked to Fetal Alcohol Syndrome. Genetics may also be a factor. Interestingly some chromosomes involved in this disorder are also linked to Autism Spectrum Disorder. Treatment involves management of cataracts that develop on the eye and monitoring glaucoma. To read more about Peter's Anomaly please see this article. The child pictured is Emily. Her mother keeps a blog, Her Eyes, That's Where Hope Lies.
- Retinopathy of Prematurity: This condition effects prematurely born infants. The smaller the infant is at birth the more likely they are to develop ROP. This condition is caused by the abnormal development of blood vessels in the eye. The most effective treatment is laser therapy or cryotherapy. To learn more about ROP see this article. It was difficult to find pictures of this disorder. There are multiple stages and most pictures involve internal photo's of the blood vessels in the eye.
- Septo-optic Dysplasia: This condition is rare. It involves abnormal development of the optic disc, pituitary deficiencies, and the absence of part of the brain which contributes to vision called the septum pellucidum. Treatment for the optical problems in this disorder is not possible. Symptomatic treatments are available with hormone therapy. To learn more please see this article. This adorable picture is of a Septo-Optic baby and can be found on this blog, Septo Optic Dysplasia.
- Congenital Rubella Syndrome: For this condition to develop the mother must be infected with the rubella virus, during the first trimester of her pregnancy. Prevention through the Rubella vaccination of the mother is critical for preventing this type of visual impairment. There is no treatment for Congenital Rubella Syndrome, symptoms are managed according to each individual's specific needs. To read more about this disorder please read this article. It is difficult to find a blog about this disorder since it is so rare now, thanks to vaccination.
Visual Processing Disorders are not blindness. The way the brain processes information varies by person. Every person has certain strengths and weaknesses. Certain activities may expose difficulties in kinds of visual processing. There are seven types of Visual Processing Disorders:
Visual Discrimination- This skill uses sight to notice features of different items, separating one item from the other. Where will you notice difficulties? Determining differences between similar letters, shapes, colors, patterns, etc. How do you help? Provide clear, distinct spacing between words. Point out direct examples and show differences between items.
Visual Figure- Ground Discrimination- This skill uses sight to separate a shape or character from its background. Where will you notice difficulties? Finding specific information on a printed page full of words and numbers or seeing an image on a competing background. How do you help? Practice find items books, like Where's Waldo, use reading guides to block out other input, and use a highlighter to highlight important information.
Visual Sequencing- This skill uses sight to distinguish the order of symbols, words, and images. Where will you notice difficulties? Using a separate sheet of paper for answering questions, staying in the right place while reading, misreading/reversing letters/numbers/words, understanding math problems. How do you help? Have the individual orally present what they read and color code instructions.
Visual Motor Processing- This skill uses sight to coordinate body movement. Where will you notice difficulties? Writing within lines or margins, copying information, bumping into things, sports participation. How do you help? Allow for computer use, use a tape recorder for lectures, allow written reports instead of oral presentations, and have a "note buddy".
Visual Memory- This skill uses sight to remember things. There are two kinds of visual memory, long term and short. Long term memory is the ability to recall something the individual saw a long time ago. Short term is something seen recently. Where will you notice difficulties? Remembering how to spell words, reading comprehension, using a calculator or keyboard, remembering phone numbers. How can you help? Provide written handouts and directions.
Visual Closure- This skill uses sight to determine what an object is when only parts of it are visible. Where will you notice difficulties? Recognizing an object from a partial image, identifying words with missing letters, recognizing a face with a missing feature. How can you help? Puzzles and like games.
Spatial Relationships- This skill uses sight to understand how objects are positioned in relation to each other, such as near vs far, as well as relationship of characters described in a narrative. Where will you notice difficulties? Getting around places, spacing of written words on paper, judging time, and reading maps. How can you help? Practice distance with ball games, create maps and travel logs, and practice social skills that focus on physical proximity.
Here is a great website for worksheets to improve visual processing disorder: http://www.abcjesuslovesme.com/visual-perception/350-worksheets
Other articles of interest in relation to Autism and Visual Impairments:
I hope this has helped you with a basic understanding of visual impairments and visual processing disorder and how it relates to Autism. Be sure to stop on our Facebook page for updated information and other interesting topics.
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