Visual Management of Autistic Spectrum Disorders
Most autistic individuals suffer from visual perceptual dysfunction. This is not to suggest that autistic people can not “see” in the traditional sense of the word; many autistic patients can demonstrate normal visual acuity, as measured by a standard eye chart test. Visual perception, however, involved far more than visual acuity; it is a process for receiving, integrating, and interpreting visual stimuli. A lack of integration between the visual and vestibular systems, or an inability to orient ones self in space and adapt to changes in the visual environment are examples of visual perceptual dysfunction. Visual perceptual dysfunction can produce symptoms of physiological and emotional disorders, as well autism.
It has been my clinical experience that visual management can reduce or eliminate visual perceptual dysfunction and improve the patient’s ability to function at school, work and play. The first step in the process is identification of the problem. This necessitates treating the individual as a whole, rather than focusing on the eyes as merely organs for sight. This entails measuring the patients visual performance not only while sitting looking at a stationary object, but also while the patient is standing and moving and while the object is moving measuring peripheral vision and depth perception, and assessing the patients posture, mood and response to various visual tasks. This approach will reveal the patients true perceptual style; some patients fight to process visual information but others, including many autistic individuals, flee from processing visual stimuli and withdraw into themselves.
Our office has great success in treating such cases through the use of lenses, which transform light, in combination with visual management exercises designed to enable the patient to process visual stimuli in an organized, integrated fashion. Such therapy can allow the patient to achieve harmony with their environment and reduce the panic responses to visual information, which are symptomatic of autism.
Common Visual Symptoms Associated Functional Vision Deficits
With Autistic Spectrum Disorders
Double Vision Visual Field Loss
Side Viewing Strabismus (Eye turn)
Toe Walking Oculomotor Dysfunction (Eye tracking deficit)
Dizziness Convergence (aiming) deficit
Light Sensitivity Accommodative (focusing) deficit
Bumping into Objects Visual Perceptual Difficulties
Spatial Disorientation Visual Memory Loss
Poor Visual Attention Depth Perception Deficiency
Hand Flapping Abnormal Blink Rate
Finger Flicking Balance and Posture Difficulties
Saccadic Eye Movements
Lacking Eye Contact
Visual Management of Learning Disabilities and Cognitive Skills
Visual development, if developing normally should follow a sequential and/or orderly maturation, beginning with perception and taking us into cognition. Perception is unconscious and cognition is conscious knowledge. Binocular rivalry and alternation or compression of vision interferes with the unconscious movement and organization of the ‘where’ system of visual processing. When binocular rivalry interferes with the interaction of the visual system, a child will exhibit delays in motor performance and learning abilities.
Visual processing is tightly linked to perceptual decision making. Visual processing delays will create difficulties in constructing and organizing a representation of the visual world, thus, interfering with decision making and cognitive retrieval and eventually, creativity.
The role of visual management is to first identify the level of visual processing dysfunction and second to design a program utilizing lenses and procedures to reorganize visual efficiency. The goal is a return to a sequential and orderly maturation of learning and cognition.
Visual Management of Affective, Emotional Behaviors
What’s vision got to do with it?
Dr. Joseph LeDoux, a prominent neuroscientist, believes that emotions and cognition are best thought of as separate but interacting mental functions mediated by separate but interactive brain systems. This model best explains the visual management of affective, emotional behaviors.
The histories of patients suffering from severe anxiety reveal childhood symptoms which evolved. Developmental delays in our visual time/space interactions can trigger emotional reactions before the brains perceptual systems have fully processed the stimulus, thus affecting the perceptual representation and the evaluation of the object. These delays in representational processing in turn affect the storing and retrieval of memories, creating a significant emotional response at all levels of visual processing of a stimulus.
A childhood symptom, such as motion sickness, evolves slowly into full-blown panic or anxiety disorder, many times around the age of 30. This pattern, very commonly seen in our center, stems from correctable vision deficits. Markers for such disorders commonly include convergence insufficiency, convergence excess, and abnormal saccades. A mild visual impairment may cause a young child to have difficulty in sports, for instance, catching a ball. The child's delayed reflexes may cause him or her to flinch, because they are working so hard at figuring out "Where is the ball?" but this delay may surely trail into the very same individual's experiences as an adult. The anxiety at this stage now surfaces as "Where am I?" "Why are the walls closing in on me?" "Why can I no longer walk through a department store?" or even "Why am I so anxious when I drive?"
The role of visual management is to change the manifestation of these emotional behaviors through a series of growth and movement, creating conscious awareness to a level of relaxed attention and finally reflective performance a position in which the model works best and thus eliminating the physiological aspect of emotional behavior.
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