Vision Care for Autism

Children diagnosed with autism commonly demonstrate visual patterns that interfere with their ability to react and interact with their surroundings. These patterns include poor eye contact, looking through or flapping their hands, flicking objects in front of their eyes, or looking at objects sideways or with quick glances.

Children with autism are also commonly light sensitive though many are fascinated by lights and shadows. They are also more prone to bump into objects and they will often touch walls or tables while moving through space.

These common visual patterns are caused by a lack of visual development skills, such as eye-hand coordination, eye movement control, eye teaming and visual-spatial knowledge. Thus, any individual with a diagnosis of autism, PDD, or Asperger’s syndrome as well as those diagnosed with learning disabilities, sensory integration dysfunction, or non-verbal learning disabilities should undergo a thorough examination by a developmental optometrist.

Vision skills impact a child’s ability to eat without spilling, walk without falling, and be aware of their surroundings. Poorly developed vision skills will affect a child’s penmanship, reading, attention span, and socialization skills. Because vision development is erratic in an individual with autism, the visual system interferes with learning life skills and academics. An inefficient visual system may cause one or more of the following:

  • Inability to pay attention (child doesn’t work at near for long because of blur or double vision)
  • Lack of form constancy (cannot recognize an object from another angle, resulting in rigid behavior)
  • Language delays (lack of visualization)
  • Lack of integration (knowing ice cream is cold without touching it)
  • Inability to move out into space (can’t see beyond his/her grasp)

The Importance of Motor Development

Visual development is erratic in children with autism because the motor system is compromised. Unfortunately, motor development, the most essential area in dealing with autism, is often neglected in pursuit of developing the child’s intellect.

Understanding the visual components that accompany each stage of healthy motor development is the key to teaching vision skills that have not sufficiently developed in a child with autism. Because motor, visual, language, and cognitive development are all interrelated in a child with autism, vision therapy can be an important component of a multidisciplinary therapeutic approach.

The time period from age 18 months to four years of age, when autism is usually diagnosed, is an extremely important window of development for vision, as well as language, socialization, and other crucial areas. During this very critical time frame, vision should begin to dominate the movement system as well as begin to coordinate the proprioceptive, vestibular, and tactile systems.

As vision combines with the other senses, central or focal vision should emerge. If there is faulty information processing in any of the primitive sensory systems, visual dysfunctions are inevitable. These children are the ones who still need to touch and move to experience their environment because their visual systems are so inefficient. Some of their stimulatory behaviors, such as flapping and side looking, may actually serve the purpose of allowing them to interact with their world and tell the brain where their body is in space.

In order to address these types of behaviors, the child needs to learn how to use their visual systems more accurately so that they can internally identify where they are in space. Improving a child’s depth perception and binocular vision can have significant impacts on their everyday behaviors as they deal with their visual world.

Most individuals on the less severe end of the spectrum generally show more subtle, but very significant visual processing problems. Patients with attention deficits and learning disabilities are often very attracted to external, highly charged visual stimulation. They love to play video games and are generally highly skilled with computers.

These traits lead to the misunderstanding that vision is an area of strength. Often it is these kids who are then labeled “visual learners” because they learn best when they can touch and see the materials. The problem with this misunderstanding about vision is that it often prevents them from seeing a vision specialist who can help identify the various visual deficiencies that may be present.

Parents and educators need to understand that acquiring good visual skills is a developmental process that must work together with other systems in a coordinated manner. Just because the visual system is “strong” does not necessarily mean that it is operating in an efficient manner.

Parents, teachers, and other professionals assume that most behaviors seen in autism spectrum disorders are simply a result of the disorder, not a by-product of vision problems. This falsehood must be made known. Symptoms such as poor eye contact, repetitive stimulatory behaviors, and practically every other behavioral symptom could be caused by poor fixation, accommodation, or eye teaming abilities. Furthermore, these types of vision problems are very treatable, and once rectified, can result in significant improvements in everyday function.

The earlier families of children with autism undergo a visual examination and begin visual intervention, the faster the improvement and the longer lasting the gains and overall chances for success.

For those with autism spectrum diagnoses, an immediate developmental exam is essential. After age four, a child may make adaptations which further embed the visual problems and make treatment more time consuming and less successful.

Recommended Reading:

  • “Envisioning a Bright Future” – Patricia Lemer
  • “Seeing Through New Eyes” – Mel Kaplan
  • “Thinking Goes to School” – Furth and Wachs
  • “The Kid-Friendly ADHD & Autism Cookbook” – Compart and Laake

​​​​​​​You can find these books available for purchase here.