Autism and Vision
The prevalence of Autism Spectrum Disorder (ASD) diagnoses in children is on the rise. A considerable number of individuals with autism also contend with visual challenges, significantly impacting their daily lives. While autism primarily affects social communication and behavior, it can also have an impact on visual perception and processing.
Eye movement disorders and crossed eyes are common. Here are some ways in which vision may be influenced by autism:
1. Sensory Processing Differences: Many individuals with autism experience sensory processing differences, including visual sensitivities. They may be hypersensitive to certain visual stimuli, such as bright lights, intense colors, or specific patterns. On the other hand, some individuals may be hyposensitive and show reduced responsiveness to visual stimuli.
2. Eye Contact and Social Gaze: People with autism may have challenges with making eye contact and engaging in social gaze. This can affect their ability to interpret and respond to facial expressions and social cues, which are often conveyed through eye contact. Autistic people may also struggle with coordinating their central and peripheral vision. For instance, if you ask someone to follow an object, instead of using their eyes to look directly at the object, they will look to the side of the object.
3. Visual Processing Speed: Some individuals with autism may exhibit differences in visual processing speed. This can impact their ability to quickly interpret and respond to visual information in the environment.
4. Attention to Detail: Individuals with autism may demonstrate a heightened attention to detail. While this can be a strength in certain situations, it may also lead to difficulties in seeing the “big picture” or understanding context.
5. Repetitive Behaviors and Visual Stimuli: Some individuals with autism engage in repetitive behaviors that involve visual stimuli, such as hand-flapping or staring at moving objects. These behaviors may serve as a way to self-regulate or cope with sensory experiences.
It’s important to note that the impact of vision in autism can vary widely among individuals. Some may have heightened visual abilities, while others may experience challenges. A vision problem’s signs and symptoms are often masked by behaviors that autistic individuals use to cope with the sensory overload of the world around them.
The behaviors that are attributable to both autism and vision problems can include lack of eye contact, staring at spinning objects or light, fleeting peripheral glances, side viewing, and difficulty attending visually. They might also struggle with poor posture or toe-walking due to the interruption in organizing the spatial visual process.
Several studies have been done that show an association between Autism Spectrum Disorder (ASD) and vision problems. One recent study at Sankara Eye Hospital found that 83 of 100 children with Autism also had vision problems, such as refractive errors and convergence and accommodation issues. One of the doctors who participated on the study, Dr. Vidhya. C said,
“In some cases, parents and caregivers may initially seek help from behavioral therapists, assuming that the issue lies solely within the realm of behavior. However, it is crucial to recognize that refractive errors, such as near-sightedness or astigmatism, can also cause a child to adopt this visual behavior. It is important to address any potential visual impairments before assuming it is solely behavioural. Refractive errors can significantly affect an autistic child’s visual perception and behavior. Prescribing appropriate glasses based on comprehensive eye evaluation can correct these errors allowing the child to see clearly. Addressing refractive errors can have positive effects on a child’s visual experience, potentially reducing sensory overload and improving their overall engagement and communication skills.”
Your child may have a vision problem if you notice the following:
- Extreme reactions to bright lights
- Viewing things from the side of the eyes, such as when watching TV
- Fleeting glances or rolling eyes
- Language difficulties
- Toe walking
- Poor posture
- Crossed eyes
- Inability to maintain eye contact with others
- Looking past or through objects rather than directly at them
- Avoid contact with specific visual input
- Hypersensitive vision.
- Difficulty with visually holding still
- Rely on a constant scanning of visual information in an attempt to gain meaning
Addressing visual considerations, such as providing visual supports or accommodations, can be beneficial in supporting individuals with autism in various environments. Dr. Willingham is able to do a deeper dive into your child’s vision, and can examine and treat individuals who are nonverbal or have other developmental delays. We are able to accommodate you, please let us know what your needs are. Collaborative care involving professionals from different disciplines, including optometrists and educators, can contribute to a comprehensive approach in addressing the visual aspects of autism.
Each individual is unique, so each program of care is specialized to them, their needs, and their goals. Treatment may include specialty lenses, vision therapy, or another program of care and aims to help the patient to:
- organize visual space
- gain peripheral stability
- attend to and appreciate central vision
- gain more efficient eye coordination
- improve visual information processing
Achieving these goals can help the autistic person to feel less overwhelmed by visual stimuli and to interact with the world more comfortably.
In Thinking in Pictures: My Life with Autism, Dr. Temple Grandin shares about vision issues in children with autism, saying, “the eye itself is normal but faulty wiring in the brain is causing the problem.” Thanks to neuroplasticity, vision therapy helps rewire the brain by teaching and guiding people how to more effectively use their eyes, letting it work more efficiently with the brain.
Connect with us for a call or join us at a workshop if you have questions or suspect you or your loved one have a vision problem. Dr. Jesse Willingham is a development optometrist (also known as a binocular vision specialist, neuro-optometrist or behavioral optometrist) who cares about you and your family. We can work with your current providers to help find solutions and answers. We want to help you live your best life, unimpeded by vision problems!
The following article is from COVD, the College of Optometrists in Vision Development.
VISION AND AUTISM
Autism is a neurobiological disorder that is described as a behavioral syndrome. Individuals with autism have difficulty with processing and responding to information from their senses, and with communication and social interaction. Vision problems are very common in individuals with autism. Symptoms of autism may include visual components such as lack of eye contact, starring at light or spinning objects, fleeting peripheral glances, side viewing and difficulty attending visually. Other symptoms of autism include lack of reciprocal social interaction, delays in development and a hypo or hyper-response to sensory information. Symptoms appear over time as the child shows a pattern of developmental problems.
Some persons with autism use visual information inefficiently. They have problems coordinating their central and side vision. When asked to follow an object with their eyes, they usually do not look at it directly. They scan or look off to the side at the object. These individuals may have difficulty maintaining visual attention. Eye movement disorders and strabismus are also common.
Many persons with autism are tactually or visually defensive. Tactually defensive persons are over stimulated by input through touch. They are always moving and wiggling. They avoid contact with texture. Visually defensive persons avoid contact with specific visual input and may have hypersensitive vision. They have difficulty with visually “holding still” and frequently rely on a constant scanning of visual information in an attempt to gain meaning.
As a result of poor integration of central and peripheral visual input, individuals with autism may have difficulty processing information. Once central focus is gained, they ignore side vision and remain fixated on a task for excessive periods. Since the visual system relates to motor, cognitive, speech, and perceptual abilities, these areas may also be affected when the visual processing is interrupted.
The vision evaluation of persons with autism varies depending on their developmental, emotional and physical level. After a thorough patient history, a comprehensive vision examination is attempted. The examination includes but is not limited to, an evaluation of: visual acuity, eye tracking and fixations, depth perception, color vision, eye teaming and focusing, the presence of nearsightedness, farsightedness and /or astigmatism, eye health and visual fields.
Testing may also be performed using lenses and/or yoked prisms while the patient does specific activities such as walking, ball catching and throwing. Observation of postural adaptations and compensations while the patient is sitting, walking and standing with and without the lenses and prisms is often conducted.
Depending on the results of testing, lenses to compensate for nearsightedness, farsightedness and astigmatism, with or without yoked prism may be prescribed. A progress examination may be scheduled in three to five weeks to evaluate subjective changes and to repeat portions of the vision examination as needed. A consultation may also be scheduled to discuss the benefits of vision therapy. Vision therapy activities are used to stimulate general visual arousal, eye movement and the central visual system. The goals of the treatment program using lenses, prisms and vision therapy are to help the individual organize visual space and gain peripheral stability so that he or she can better attend to and appreciate central vision. In addition, treatment is directed at gaining efficient eye teaming and visual information processing.
Treatment programs are coordinated with the patient’s primary care physician and others who may be participating in the multidisciplinary management of the patient.
Members of the College of Optometrists in Vision Development (COVD) are optometrists who specialize in examining children and adults with developmental disabilities, including autism. Fellows of the College are certified in the diagnosis and treatment of learning related vision problems. For further information, contact COVD or consult with a COVD member optometrist.
This informational paper was produced by the College of Optometrists in Vision Development, which board certifies qualified optometric physicians in vision therapy.
