Review identifies similar behavioural features between autism and severe visual impairment in childhood.
People with autism may have sight loss which is going undetected, because health and social care practitioners misdiagnose the symptoms.
A systematic review of research evidence, published in the ‘Review Journal of Autism and Developmental Disorders, found there are similar behavioural features between autism and severe visual impairment in childhood.
These include difficulties with spatial awareness, light and contrast sensitivity or facial recognition that may indicate visual processing difficulties associated with autism, but may equally result from ophthalmic issues. Other features include delay in the development of symbolic play, and repetitive mannerisms such as rocking, eye-poking and rubbing.
A study on autism and sight loss by the charities RNIB Scotland and Scottish Autism, and Edinburgh Napier University, has found there is not yet sufficient evidence to give a definitive idea of how pervasive vision impairment is among autistic people. Nevertheless, it is vital individuals have access to eye care so that vision problems can either be ruled out, or diagnosed and appropriate support given.
“Undiagnosed sight loss can have a serious impact on a person’s quality of life,” said Anne McMillan, adult social care operations and development manager with RNIB. “RNIB’s Complex Needs Services have been raising awareness of ‘hidden’ sight loss, among groups who might not be able to communicate problems as easily as others, for a number of years. When a person with complex needs has problems with communication their primary diagnosis may overshadow difficulties with their sight.”
As part of the Scottish Government’s Strategy for Autism, RNIB Scotland, Scottish Autism and Edinburgh Napier University have investigated ways of improving vision awareness and support through an education programme delivered to staff at Scottish Autism.
RNIB’s Bridge to Vision education programme comprises a one-day course to introduce practitioners to common vision issues, their impact on daily living, indicators of sight loss, and the need for regular sight tests. A more in-depth two-day course can then follow for ‘Vision Champions’, in which a smaller number of participants learn to make systematic observations for referral to optometry and receive a toolkit for improving support and documentation for vision needs.
The training is effective, as the results published in the Journal of Applied Research in Intellectual Disabilities demonstrate. One participant said: “A lot of the stuff we have been taught on visual impairment is very similar to behaviour which for years we have been putting down to someone’s autism.”
Participants in the training reported an increased number of people they support attending eye tests, as well as more detail on vision issues in clients’ support plans. Vision Champions spoke of paying closer attention to supporting those with known vision issues, ranging from thinking carefully about light sources in a room, to changing venues for activities and repainting rooms to ensure clear contrast between walls and doors.
The intention is to integrate RNIB Scotland’s Bridge to Vision education programme into Scottish Autism’s services. This will mean equality of access to eye care and ensure that vision issues do not go undiagnosed in people with autism.