Vision and Autism: Part 1

Editor: Dr. Russel Lazarus, Published April 13, 2021

Author: Randy Schulman, MS, OD, FCOVD

This year marks my 30th year as an optometrist and during all of those years I have seen thousands of children and adults on the spectrum from autism to learning disabilities.

I owe much of my early knowledge to Patty Lemer who introduced me to the Developmental Delay Registry, now reinvented as Epidemic Answers. I learned about the DAN! Network, Kelly Dorfman, Bernard Rimland, and Mel Kaplan’s work in the beginning of my career, even working for Mel primarily in the vision therapy room in the early 90’s.

Autism by numbers

It is hard to believe that the rates of children diagnosed with autism in this country have grown from 1 in 2500 to almost 1 in 60!

We are looking at an epidemic that has dire consequences for our society.

We are guaranteed to come in contact with someone on the spectrum and Patty’s newest book, ‘Outsmarting Autism’, gives detailed and cutting edge ways to address factors associated with the exponential rise in autism rates and concrete treatment methods. Maria Rickert Hong’s book, ‘Almost Autism’, is also a good read for parents.

Autism and vision

Once a child has the appropriate support, I look at vision within the context of a multisensory model.

Vision is the dominant sense and much of the brain is dedicated to visual learning.

An individual learns most efficiently in a multimodal fashion. That means that learning occurs best when inputs from different parts of the brain match.

Learning occurs best when visual inputs match perspective inputs, for example, when we see an object and reach out to touch and feel it in the same place as where we saw it.

The same synchronicity of auditory and visual inputs occur when we see and hear something that matches. Think of the mismatch and confusion that happens when the soundtrack of a movie does not match the lip movements of the actors.

This sensory motor integration is critical for the proper development of a child.

In children with developmental delays, there is often a lack of cohesion between visual, auditory and other inputs leading to the unusual behaviors, language, and socialization difficulties such as:

 

  • Repetitive movements
  • Echolalia or repeating words
  • Lack of eye contact

Accurate assessment of a child in a vision examination includes looking at posture, balance, physical health, receptive and expressive speech patterns, cognitive understanding of the tasks given, motor coordination, attention, and awareness.

The functional vision examination gives essential information so that the appropriate intervention can be recommended. 

The eye itself and how a child uses their vision can give clues on how to best treat the entire system.

Vision therapy for autism

Because vision is key to so many other systems, vision intervention, such as vision therapy, can have a profound effect on a child.

Specific optical lenses, prisms, tints, and vision therapy are highly effective in treating patients on the autism spectrum.

The most commonly observed signs indicating that vision therapy could benefit a child include:

  • Poor eye contact
  • Repetitive hand movements
  • Staring
  • Side looking
  • Light sensitivity
  • Poor coordination
  • Learning challenges

A customized program of vision therapy provides the opportunity to develop these visual skills in a guided and therapeutic manner.

Examination of visual skills is essential

Determining the strength of the visual skills is a vital component of an eye examination for all children on the autism spectrum.

Children, especially, may be exposed to various stressors including biochemical, environmental, physical, social, educational and emotional challenges that impact development and learning.

Referral to health care practitioners can provide patients with the essential nutrition and recommendations to strengthen the immune system, balance hormones, and detoxify the body, from more traditional treatments to the latest ones which use more alternative medicine methodology.

It is essential to assess a child’s functional visual skills, as well as nutrition, physical health, development, environmental and genetic factors, cognitive ability, motor, speech and language, and their educational demands.

I am grateful for those who came before me and those colleagues that understand the importance of vision intervention in those on the spectrum.