Vision Assessment and Autism

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In my last blog post I discussed the practical aspects of performing an eye test for someone who is Autistic, and also highlighted the ocular (eye-based) conditions that are more common among those on the autism spectrum. In addition to eye issues, Autistic people commonly experience the world differently due to brain-based differences. In some, there can be significant overlap with a condition called Cerebral Visual Impairment (CVI); you can read more about CVI in my previous blog post: What is Cerebral Visual Impairment?

What do brain-based differences look like?

Vision differences that are brain-based look quite different from ocular (eye) based conditions. They tend to be much less specific and their presentation can vary significantly depending on the environment. The variability can make things extremely confusing for the person themselves, as well as for those who care for and support them. Below is a list of ways in which vision can differ for those on the autism spectrum:

Visual field

Autistic people can struggle to attend to the entire of their visual field: this can result in them entirely neglecting their peripheral vision because they are so focused on something of interest in their central vision. Functionally, these individuals will collide with or bump into large objects in their path. They may also struggle to find a parent/carer/friend in a crowd, a possession from within a cluttered drawer, or a favoured toy from a toybox.

Conversely, some Autistic people will attend to their peripheral vision more than their central vision. From a sensory perspective, peripheral vision is less intense. Our peripheral vision is sensitive to movement, so these individuals may be constantly on the move, pacing the room, or swinging, or rocking, since this improves their vision.

Motion perception

Some autistic people struggle to interpret vision when things are moving. They may struggle to accurately judge their body position within their surroundings, and to ‘map’ spaces. On entering a new room they will explore the space by walking around, touching objects and trailing their hands on walls and surfaces. They may struggle to interpret facial expressions, copy gestures and body movements and experience challenges with fine motor tasks.

Dual sensory processing

Dual sensory processing refers to processing sensory input from more than one sense at a time, this can be challenging for some Autistic people and sometimes input from one sense will override others. Often, if there is something visually interesting to them, this will override their auditory input - they appear to ignore spoken directions. They may also need to look away from a person’s face in order to fully process what is being said to them. Sometimes they may try to block out their vision in order to attend to another sense - this can be through rocking, or turning away.

Recognising things

Some Autistic individuals struggle with object recognition because they don’t have a reliable visual memory. For most of us, we can recognise an item, such as a water bottle, even if we haven’t encountered that particular type of water bottle before. We can use our visual memory to reference the object in front of us, interpret that it has features in common with other water bottles we have encountered before, and therefore conclude that the object being viewed is a water bottle. If you cannot reference other items this gets much more difficult. An Autistic child or adult who has always used a particular water bottle may become upset when presented with a different style or colour of water bottle, because they don’t recognise it as a water bottle.

Visual fatigue

For many Autistic people, seeing is tiring, and the more there is to see, the more tiring it is. Busy environments, like shopping centres, classrooms with lots of artwork, or busy playgrounds can quickly become overwhelming for them.

What can be done?

It is helpful for the person themselves and those who support and care for them to have these vision differences clearly identified, understand the impact they will have on the person’s function and overall wellbeing, and to understand how best to adjust the environment to minimise the disability they can cause.

A functional vision assessment can help in understanding a person’s visual profile and assist in setting the environment up, or improving tailoring of existing supports to ensure full access.

Interested in learning more?

If you would like to book in, or would like to discuss what an eye examination might look like for an Autistic child or adult, then please reach out. We are always happy to make any adjustments we can to make our eye exams as accessible and comfortable as possible and we acknowledge that you know best how to do that.

Our practice is located in Enoggera, on the Northside of Brisbane. You can call us on: 07 3544 6167, email: reception@specialeyesvision.com.au, or book in for an initial free chat with the Optometrist

Attribution: Infinity symbol image designed by Freepix.