April is National Autism Awareness Month

April is National Autism Awareness Month, and there has been a lot of information in the news about the rising rates of autism spectrum disorders. The CDC now estimates that as many as 1 in 68 children are now being diagnosed with ASD. This is particularly frightening as it’s not well understood what  is behind this abrupt rise.

While such research is ongoing, it’s important to consider what we as parents and providers can do right now to improve the quality of life of those with ASD. The College of Optometrists in Vision Development (COVD) has issued a press release discussing the impact of vision in ASD:

“While the search to find the exact cause for ASD is ongoing, the visual link to autistic behaviors provides some answers and help to improve quality of life,” states COVD President, Dr. Ida Chung, O.D., FCOVD.

 

There has recently been a lot of research involving the role of vision in autism spectrum and other disorders, which you can read about here and here. There’s also a piece about eye movements in ASD in the Huffington Post.
autism
In our practice, every day we see children with ASD who exhibit visual processing deficits that interfere with school, play, and social interactions. Fortunately, most of these visual anomalies can be improved through vision therapy.
“Visual processing problems are common in individuals with autism spectrum disorders. They can result in lack of eye contact, staring at objects, or using side vision… Suspect a visual processing problem if you see an autistic child tilt his head and look out of the corner of his eye… a child with poor vision processing may fear the escalator.”– Temple Grandin in The Way I See it: A Personal Look at Autism & Asperger’s
One of the most promising autism therapies available is DIR/Floortime, an approach which influences the style of the vision therapy we offer at the Vision & Conceptual Development Center. In fact, my colleague Dr. Mehrnaz Azimi Green holds an Intermediate Certificate as a DIR/Floortime provider. We first engage the child based on his individual interests, and adapt our therapy techniques based on those interests. We find this tailored approach to be successful with both neurotypical children and those with ASD or other special needs.
We also provide education to other professionals regarding the role of vision in autism spectrum disorders. To keep up-to-date with our speaking schedule, please join our mailing list (we send an e-newsletter about once a month), or visit our Facebook page.
The slides from our most recent lecture, prepared for Parent University, can be accessed here.

More Reasons Your Child Needs an Eye Exam, Not a Vision Screening

The most recent Review of Optometry has three news items emphasizing the importance of infant and child eye and vision evaluation– not just a screening done by the pediatrician or school nurse.

The first describes how retinoblastoma, a rare but potentially fatal eye cancer found in children, can be detected by the appearance of a white pupil in baby photos. It used to be thought that early stage eye cancer couldn’t be detected this way, but a recent study found that early disease in a child as young as 12 days can be visible as a white pupil.

When treated early, retinoblastoma is often curable.

Next, a new study shows that in children with autism, changes in visual behavior can be

Using eye-tracking technology, researchers found that infants later diagnosed with autism showed a decline in attention to others’ eyes by two to six months of age.

detected in the first few months of life. The children that were later diagnosed with autism started out showing normal eye contact with caregivers, but over the next several months their eye contact decreased. Decrease in eye contact began somewhere between two and six months of age. Since the social interaction (eye contact) started out intact, it suggests that there may be another opportunity for early intervention in autism.

Finally, researchers in Sweden discovered that children born before 32 weeks gestational age had a much higher– up to 19 times– risk for retinal detachment by adolescence or young adulthood. The risk for retinal detachment increased with age. So for children born prematurely, it’s very important to have annual dilated eye examinations. It’s also critical to know the signs and symptoms of a retinal detachment: sudden onset or sudden increase of floating spots in the vision, which may look like hairs, cobwebs, or debris in the visual field; flashes of light in the affected eye; and what may look like a curtain or shadow over part of the visual field. If a person notices any of these symptoms, it’s critical to contact an eye care provider immediately. A retinal detachment is an emergency, and the sooner it can be repaired, the more likely the person’s sight can be saved.

If you have any concerns about your child’s developing vision, the first step is a comprehensive eye and vision evaluation. The American Optometric Association sponsors a public health initiative called InfantSEE, which provides no-cost examinations to children between 6 and 12 months of age. Infantsee.org can help you find a participating provider in your area. Yearly eye examinations are also now covered by all insurances as an essential benefit for children under 19 as a part of the Affordable Care Act.DSC_0294

At the Vision & Conceptual Development Center, we provide evaluation and non-invasive, non-surgical treatment for a variety of vision disorders, including Convergence Insufficiency, Strabismus (eye turn), Amblyopia (lazy eye), problems with tracking, Visual Perceptual disorders, and visual anomalies secondary to developmental delay, autism, concussion, stroke, or brain injury. We are also InfantSEE providers.

You’ll shoot your eye out!

Blue laser toys have burned holes in the retinas of 30 boys, recently reported Saudi Arabia’s King Khaled Eye Specialist Hospital and Johns Hopkins Medicine. These toys, available on the internet, may seem harmless but in fact can cause serious eye damage. So if your child received such a toy over the holidays, you may want it to become “lost”. Just tell Uncle Bob that UPS never delivered.

You'll shoot your eye out!

Lasers? No way!

Is it a Behavior Problem? Or a Vision Problem?

I recently had a discussion with a parent about behavior and vision problems. A mom of

photo from Newsbusters.org

one of our patients told me that the biggest change she has noticed is that,

“It’s not nuclear war anymore,”

when she tells her daughter it’s homework time. This makes perfect sense to me, and we hear similar stories all the time. If you, as an adult, were asked to do something frustrating,

arduous and painful, on a daily basis, you would eventually refuse. You might even throw a temper tantrum.

Maud at AwfullyChipper wrote to me that

“I really want to make others aware of vision therapy because I know there must be many children out there who’ve just been labelled slow readers (or disruptive, ADD, etc.) when in fact they have vision difficulties. I hope I can help spread the word.”

In fact, studies have been published showing that, indeed, “adverse academic behaviors” decrease following successful treatment for Convergence Insufficiency, one of the more common binocular vision problems we see. The behavior questions used in the study were:

  • How often does your child have difficulty completing assignments at school?
  • How often does your child have difficulty completing homework?
  • How often does your child avoid or say he/she does not want to do tasks that require reading or close work?
  • How often does your child fail to give attention to details or make careless mistakes in schoolwork or homework?
  • How often does your child appear inattentive or easily distracted during reading or close work?
  • How often do you worry about your child’s school performance?
weighted symptom checklist

weighted symptom checklist

It’s important to note that there are other symptoms that may point you to a vision problem. For a more comprehensive list, see our Weighted symptom checklist.

Scientific Basis for an Accommodation Already in Use in VT Practices

books

Image courtesy of adamr/ FreeDigitalPhotos.net.

Amanda Zeller Manley, O.D., F.C.O.V.D.

It’s always nice when research proves the benefit of what we’ve already been doing in clinic.

For the last several years, as e-readers have become more prevalent, I have been recommending them to many of my patients. In our clinic, we have found that by increasing the font size (which also increases letter/word spacing and decreases the number of words per line), many of our vision therapy patients report that they can read more quickly, with better comprehension and less fatigue.

So I was quite pleased to hear an NPR story a few days ago about a study described in the journal PLOS ONE.  Researchers had dyslexic students read on specially formatted iPods or printed text. For many of the students, reading on the iPods (limited to about 3 words per line) greatly improved their reading speed and fluency.

The lead researcher, Matthew Schneps, director of the Laboratory for Visual Learning at the Harvard-Smithsonian Center for Astrophysics, postulates that the mechanisms involved include visual attention span; saccades (the small word-to-word eye movements we make when reading); and visual crowding. By limiting the amount of text per line, deficiencies in those areas don’t have the same effect as when a person reads a normally printed page.

What I find interesting is that in the article, there was no mention of whether these students had had a comprehensive vision examination to look for oculomotor dysfunction, convergence problems (excess or insufficiency), or other binocular vision disorders. In numerous other publications, there have been links between dyslexia and eye movement disorders and binocular vision problems. In many studies of learning disabilities and vision disorders, it has been found that up to 70% of students who have been diagnosed with a learning disability have a vision problem that may be causing or exacerbating that learning difficulty. It would be interesting to see whether the population described in Dr. Schneps’s study has a similar incidence of vision problems.

Fortunately, vision therapy has shown to be a very effective tool in eliminating the underlying visual problems that interfere with reading and learning. And in the meantime, an iPod fits neatly in your pocket.

Top 5 Signs of Back to School Vision Problems

The September issue of Vision & Learning News has news you can use, just in time for back to school. Are your kids having vision issues that keep them from learning as well as they should? Are they working too hard to get their homework done?

The 5 most common signs that a vision problem may be interfering with your student’s ability to read and learn are:

  • Skips lines, rereads lines
  • Poor reading comprehension
  • Homework takes longer than it should
  • Reverses letters like “b” into “d” when reading
  • Short attention span with reading & schoolwork

Just one of these symptoms could mean that your child is struggling with a vision problem.Call today to schedule a developmental vision evaluation: (301) 951-0320

Visit our website for a complete symptom checklist.

Find our previous newsletters on our website.