1. 1. What is Autism?
Autism is a brain development disorder that impairs social interaction and
communication and causes restricted and repetitive behavior, all starting before a child is
three years old. This set of signs distinguishes autism from milder autism spectrum
disorders (ASD) such as Asperger syndrome.
2. What is Autistic Spectrum Disorder? Name & describe syndromes under this
category.
The autism spectrum, also called autism spectrum disorders (ASD) or autism spectrum
conditions (ASC), with the word autistic sometimes replacing autism, is a spectrum of
psychological conditions characterized by widespread abnormalities of social interactions
and communication, as well as severely restricted interests and highly repetitive behavior.
Of the various forms of ASD:
• Pervasive developmental disorder not otherwise specified (PDD-NOS) was
the vast majority. It refers to a group of developmental conditions that affect
children and involve delays or impairments in communication and social skills.
Typically, PDDs are first diagnosed during infancy, toddlerhood, or early
childhood.
• Autism was at least 1.3 per 1000.
• Asperger syndrome was about 0.3 per 1000. It is characterized by difficulties in
social interaction and by restricted, stereotyped patterns of behavior, interests and
activities. AS is distinguished from the other ASDs in having no general delay in
language or cognitive development. Although not mentioned in standard
diagnostic criteria, motor clumsiness and atypical use of language are frequently
reported.
• Atypical forms childhood disintegrative disorder was rare.
• Rett syndrome (also called Rett disorder) was much rarer. It is a
neurodevelopmental disorder that is classified as a pervasive developmental
disorder by the DSM-IV. The clinical features include a deceleration of the rate of
head growth (including microcephaly in some) and small hands and feet.
Stereotypic, repetitive hand movements such as mouthing or wringing are also
noted. Symptoms of the disorder include cognitive impairment and problems with
socialization, the latter during the regression period.
3. Do you think their sign & symptoms are visually related?
Yes, because most autistic children seem to see perfectly well. However, we see not just
with our eyes, but with our brains-and children with autism spectrum disorders frequently
2. have neurological problems that prevent them from correctly interpreting what their eyes
are seeing.
Signs and Symptoms of Autism and Autism Spectrum Disorders
Impaired social skills/social interaction
• Child may not make eye contact or use other nonverbal forms of
communication.
• Child does not make friends & has difficulty relating with peers.
• Child does not show empathy or cannot understand how someone else feels.
• Child does not play with others or prefers to be by himself.
• Child does not have imaginary play or play with toys.
• Child does not respond to his name.
Impaired language and communication
• Child is delayed in spoken language or does not talk at all. (About 40% of
children with ASD do not talk at all).
• Child has difficulty starting conversations or sustaining a conversation.
Other symptoms
• Child is repetitive. He may repeat the same things over and over or may
develop rituals or routines.
• Child may parrot what is said to him. This condition is known as echolalia.
• Child may line up toys or objects excessively.
• Child may have repetitive body movements such as hand flapping.
• Child may have sensory issues. Certain textures, tastes or sounds may bother
him.
• Child may have seizures. One in four children with ASD has seizures.
Most autistic children have a preference for focal vision, which is why many display a
fetish for numbers, letters, and objects. Their lack of attention to ambient vision-which
has neural feedback loops to other sensory modalities-limits their ability to process
information in areas involving posture, movement, speech, and thought. The brains of
many autistic children, however, do not process information from the ambient visual
system correctly. In patients with autism or related disabilities, we typically see two types
of altered vision. One is "tunnel vision" or compressed vision, in which they view the
world in two dimensions, and cannot accurately judge distance or motion. The other is
"alternating" vision (hypoconvergence or visual disparity), in which the eyes see two
different images with no overlap. In these cases, the person is basically seeing two
dissimilar and competing views of the world.
Many of autistic children exhibited strabismus, both at distance and near; only 14.7% of
the children exhibited normal voluntary eye pursuit movements; and mostly did not
exhibit a normal nystagmus response. Children with autism have extreme difficulty in
disengaging their attention from one visual stimulus in order to focus on another; the
3. children's responses, the researchers noted, were comparable to those of two-month-olds.
All of these findings are consistent with severe disruption of ambient visual processes.
4. Name the symptoms that are visually related & the theory / reasoning of visual
disorder behind those symptoms.
Rocking, hand-flapping, toe-walking, poor eye contact, and odd postures are solutions to
their visual problems, because they reveal the adaptations that children make in order to
compensate for their visual disabilities. Hand-flapping and front-to-back rocking, for
instance, can be a child's way of achieving depth perception in a world that appears two-
dimensional. Viewing people sideways rather than face-on also is a survival instinct,
because it limits vision to one eye-a smart solution, when the brain can't coordinate the
input from both eyes.
5. What type of visual treatment / therapy would you propose to help these ASD
syndromes?
Ambient vision is largely learned, and we can correct it by retraining the brain. This task
starts by identifying the clues that autistic children give us about their visual deficits.
Once we identify children's visual problems through careful observation, we can
intervene with yoked prism lenses and vision training. The yoked prism lenses used alter
the visual field, stimulating an unconscious, active reorganization of a child's visual
processing. Often, the effect is instantaneous.
6. A baby who exhibits ASD syndromes is brought to your clinic, and doesn’t seem to
respond to visual stimulus. How would you handle this case?
Prescribed a pair of yoked prism lenses and arrange months of training to transform
temporary changes into permanent neural alteration. These transformations lead not just
to better vision, but also to better physical, emotional, and cognitive ability. The amount
of improvement each patient experiences depend, of course, on the individual's innate
ability to change, as well as the degree of motivation.
Vision training is just one part of a comprehensive treatment program, including
educational and biomedical interventions. Autism is a multi-faceted condition, and only
by addressing each aspect of the problem-including vision impairments and other sensory
issues-can we successfully battle it.
7. An ASD child has these symptoms: “the room seems so crowded, overwhelming or
bombarding. The background noise always heard before was apparent & disturbing.”
How would you handle this case?
'Irlen Colored Filters' or Irlen Lenses are coloured overlay filters or tinted lenses that are
intended to help people with learning disabilities to improve their ability to read.
Standardized diagnostic procedures have been developed to individualize the colour
selection.
4. 8. An ASD child comes to your clinic with these symptoms: seems to parents and
lookers to avoid eye contact, has “social gaze-looking”. How would you handle this
case?
Prescribe a spectacle correction or the use of low amounts of yoked prism and make sure
he or she could interact with the environment. Try five prism diopters of yoked prism in
several different directions to elicit an improvement in walking, sitting down and even
playing catch. If one direction works best, introduce a lower amount into the spectacle
prescription. Yoked prism alters the oculomotor state, affecting sensory function.
Training must be given as well to help adapt to new sensory function.