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| Vision & Autism |
The following article was published in The Newsletter of Achievers Unlimited, Inc., Fields of Vision, Volume 1, Number 6 (March 1996). Permission to post on the ASW homepage was obtained. The information contained in this article is for your information and does not constitute endorsement by the Autism Society of Wisconsin.
If an eye care professional can do the testing, we find most individuals with autism have 20/20 eyesight. Eyesight is the ability to see a certain size at a certain distance, momentarily. Vision, or the way our eyes function, is the ability to understand what we see, store the information, and retrieve what we know at a later time.
Vision is actually a set of skills and abilities including 20/20 eyesight, focusing, eye movement, two-eyed coordination and tracking. Vision skills can be taught.
Normal Vision Development
At birth, babies don’t see the world beyond their grasp. If you brush a newborn’s hand with your finger, the baby will grasp the finger. Eventually, the baby will begin to look at your finger after he grasps it. At this stage of development the tactile sense is directing the baby’s vision. This is the first step in training the visual system.
There are many steps in developing the visual system automatically. Soon, the baby can locate an object visually, reach for it and pick it up. By six months, the baby manipulates a toy with his hands, turning it around and around to allow his visual system to examine the toy from all angles. By 12 months, the child can glance at that toy from any direction and know that it is his toy.
As the visual system continues to develop it begins its lifelong task of directing the body and brain. The child learns to visualize his toy, making it possible to learn the word for that toy: “truck.” Language begins to develop, directed by the visual system. By 10 years of age, the goal of the visual system is integration: the ability to see an object, such as ice cream and know that it is cold without having to touch it.
Vision Development and Autism
Visual development is erratic in a child with autism. Eric, age 12, does not know that ice cream is cold without touching it. In Eric’s case, his tactile sense is still directing his body, brain and visual system. Eric’s world is confined to the objects he can see within his grasp. Eric does not see anything that he is not touching. Eric’s visual system is at the level of a newborn infant.
The goal of a developed visual system is to direct the body. Since Eric’s tactile sense is still directing his body, he does not move out in space very well. Yes, he can sit and walk and run, but Eric’s body never stops. He is constantly in motion, constantly running. Like a newborn, whose body moves without direction, Eric has not yet learned to stop and start his body. He doesn’t have body awareness. If we want Eric to stop running, we have to touch him on the shoulder. If we want Eric to sit in a chair, we have to direct him to the chair and press down on his shoulders. Jessica, age 8, has a visual system that has not learned from constancy. She can spend hours holding and looking at a plastic cup. We know that Jessica can say the word “cup.” However, if we give her a styrofoam cup, she cannot use the word “cup” to describe it. She has not visually integrated the information. We don’t know how much information she is receiving through her tactile sense.
Jessica’s visual system is in place, but it is on idle. Her vision is reflexive, rather than directive. Her visual system doesn’t help her survive in the real world.
Like some individuals with autism, Jessica has a photographic memory to compensate for the lack of visual development. As long as her environment remains the same, Jessica can function. If, however, the family sofa is moved to another part of the room, Jessica becomes agitated. She does not know this is the same sofa, because she is now seeing it from a different angle. Her ability to function in the family room setting is threatened. She cannot rely on her photographic memory. Jessica’s visual system is functioning at the level of a six month old infant.
Typical Visual Patterns Associated With Autism
Both Eric and Jessica have 20/20 eyesight, but they also have visual patterns that interfere with their ability to react and interact with their surrounding. These patterns include poor eye contact, looking through rather than at objects, using peripheral or central vision, and visually sweeping the room rather than looking at specific items in the room.
Splitting peripheral vision and central vision
Peripheral vision is using side vision. You can get the feeling of peripheral vision by putting your hand in front of your face and looking around your hand. Some individuals with autism shift from the extreme right to the extreme left, moving the head as the eyes shift. This results in picking up fragments of visual information, instead of the full picture.
Some individuals with autism switch from peripheral to central vision. Put your hand, once again, in front of your face. Separate your fingers in the center of your hand. Now switch from side to side or look at a detail in the center. The visual information is still fragmented.
Scanning
Scanning or darting is that constant shifting or sweeping motion. Again, put your hand in front of your face and continue to shift your eyes from one position to another. You may notice objects in the room jump at you, swim, blur, or double. The act of constantly scanning can lead to dizziness, headaches, nausea and disorientation.
Binocular problems
Seventy percent or more of individuals with autism do not automatically develop an efficient binocular (two-eyed) pattern. Think of the eyes as being two cameras. They need to point, focus, move exactly to avoid blur or double vision. When the two do not work exactly as a team, the individual experiences blur or double vision, or the brain conveniently suppresses vision partially or totally. Total suppression of an eye eliminates some visual confusion but does not allow information to get to both sides of the brain. Partial suppression leads to much confusion and visual stress making all visual tasks exhausting.
Poor visual attention
When the visual system is working correctly, the individual can see, understand what is seen, and remember what is seen with speed, accuracy, at any time and with little energy. An inefficient system makes controlling the eyes difficult. Shifting with exactness, and maintaining clear eyesight becomes exhausting. The physical effort is extensive, leaving little energy to understand, remember or use what was seen.
The Effects of Erratic Vision Development
These visual patterns are caused by the lack of vision development skills, such as eye-hand coordination, eye-foot coordination, eye movement control, convergence, difficulty with eye contact and eye-hand-foot-brain coordination. Vision skills impact a child’s ability to eat without spilling, walk without falling, and to be aware of their surrounding. 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 causes the following:
Motor Development
Our visual system develops along with the body, not separate from the body. A child with autism has a visual system that develops erratically. This erratic development is caused by a compromised motor system.
Motor development is the sequential development of the body, brain and eyes as a coordinated unit. For example, a child needs to
This sequential development occurs on many levels. In order for a child to learn to write, he must learn the following tasks:
A properly developed motor system allows the child to explore and inspect the world with his sense of touch, smell, taste, sight and hearing. Ideally, the child gradually becomes aware of his body and begins working to control the body’s action. As the child plays, his body’s movement becomes more relaxed and fluid, causing his mind, body and vision to develop.
Let’s say each of us is given 100 units of energy to use at birth. As a newborn, we use 100 units of energy to control our body. We learn how to such out fingers, roll over, grasp a rattle, eat finger foods. As we grow over the first few years, more and more units of energy are needed for developing our brains and visual system. By the time we are seven years old, we need 75 units of energy to control our visual system and allow our brains to function efficiently. Only 25 units of energy should be needed to control our body.
Healthy motor development allows a child to become aware of his body. A newborn’s first motor development stage a newborn involves fighting gravity. The sequential development is
Between crawling and walking, a child learns to stop and start his body. When a child like Eric is unable to start and stop his body, we know something went wrong in his fight against gravity.
The goal of the motor system in fighting gravity is to develop posture. Correct posture allows our body to balance with a minimum of effort, so we don’t have to use the majority of our 100 units of energy to sit, stand or walk.
An additional bonus of good posture is the efficient use of addition energy we need for vision and fine motor activities. The muscles of the neck and trunk constantly adjust and hold the body in balanced relationship with gravitational forces. Many of these same muscles are also used in maintaining the body’s center of visual attention and for manual activities, such as writing.
We have all experienced situation in which we had to sit through a lecture, speech or church sermon when we needed to go to the bathroom. For a short period of time, our motor system is compromised. We need all our energy to control our body. We are unable to focus on that portion of the sermon, lecture or speech. Eric and Jessica have motor systems that are permanently compromised. They have poor vision skills, trouble paying attention, poor language skills, and learning difficulties because all of their energy is used up in an effort to control their bodies.
The Hazards of Ignoring Motor Development
Visual development is erratic in children with autism, because their 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.
Remember, motor development is the sequential development of the body, brain and eyes as a coordinated unit. A child’s intellectual development is often limited by an inefficient body and visual system.
Eric, who is constantly in motion, lacks body awareness. He has to be constantly watched to keep him from running into the street or any hazardous situation. He lacks the attention needed to learn the life skills needed for independence. His visual patterns prevent him from integrating what he sees, making a classroom setting out of the question.
Before we can teach Eric the vision skills he needs to pay attention, visualize, integrate information and move freely about, we must teach Eric’s body to start and stop. In Eric’s case it took six sessions.
Next, we try to get Eric’s eyes involved in some way with an activity. We’ll start by slowly rolling balls to him to see if his eyes can follow the ball. If that doesn’t work, we might try getting him to kick a ball or balloon. Our goal is to try to get Eric to use his eyes instead of his body.
If we cannot find a way to get Eric’s eyes to participate in an activity, we’ll look for another of his senses that is most adaptable to change. We start with the tactile sense. We’ll stand next to him and move his body for him. If we want him to kick a ball, we’ll move his leg when it’s time to kick, hoping that his eyes will eventually begin to participate.
We don’t know how much of a change we can make with Eric and Jessica. We don’t know how long it will take to make the changes. We do know, however, that any change improves the child’s quality of life. Once Eric could start and stop his body, the entire family benefited. The amount of stress involved with safeguarding Eric decreased. Dad and Eric now play catch for hours each week and have fun doing it.
Understand the visual components that accompany each stage of healthy motor development is the key to teaching vision skills that have not automatically developed in a child with autism. The next six issues of Fields of Vision will cover vision development by age groups: 0-3 years; preschool years; elementary school years; high school years; adulthood; mature adult years. Each issue will provide an overview of vision development for the particular age group and activities to teach skills your child may be lacking. Adults and senior will learn activities to ensure their vision is not limiting them in jobs, hobbies, sports, driving and independent living.
Fields of Vision is published six times per year by Achievers Unlimited
of WI, Inc., 104 S. Main St., Suite 420 Fond du Lac, WI 54935,
Phone: 1-920-924-9898, toll-free: 1-866-924-9897