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 andinvolve 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 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 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 doesnt 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.

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.