Professional Approach Towards Autistic Child

Vision Science Academy

3 years ago

Naushin Fathima S, B. Optom

Fellowship in Clinical Optometry, Aravind Eye Care System, Chennai, India

Autism:

The defining feature of autism is the presence of a distinctive impairment in the nature and quality of social and communicative development. They have difficulty with imitation, imaginative play, and non-verbal communication (eye contact).⁽¹⁾

Causes:

Genetic cause – Hereditary, Genetic mutation, Down Syndrome, Fragile X syndrome, Rett syndrome.
Environmental cause – Maternal obesity, premature birth, fever during pregnancy, exposure to pesticides during pregnancy, depletion of neurotransmitters.
Idiopathic.

Signs:

The repetitive and restricted behaviour such as

Sensory feature:

Hypersensitivity to auditory, tactile, visual, and olfactory.⁽¹⁾
Low intensity exposure can result in distress and discomfort.⁽¹⁾
Delayed speech, difficulty in eye contact

Motor feature:

Rigid body
Compulsive behaviour – Ordering and Rearranging.⁽¹⁾
Ritualistic- Pattern walking and repetitive action like on and off lights.⁽¹⁾
Stereotypic- Hand and arm flapping, toe walking, repetitive jumping, head shaking, weaving and side to side rocking.⁽¹⁾

Aggression and self-injurious behaviour.

Figure 1: Signs of autistic child

[Image courtesy- https://www.momjunction.com/articles/children-with-autism-spectrum-disorder-types-causes-treatment_00780471/]

Assessment:

Parents, family members, physicians, and early childhood teachers play a vital role in monitoring and screening the developmental milestones of children from birth to 5 years of age.

Table 1: Assessment of autistic children

Functional Assessment	Other Routine Assessment
Psychologically assessing the adaptive behaviour and independent functioning of the child in the social environment.⁽¹⁾ Cognitive and Developmental assessment measures the IQ level.⁽¹⁾ Behavioural and functional assessment is the assessment of learning and understanding of the environment, physiological factors, and purposeful response to the opponent’s behaviour.⁽¹⁾ Oculomotor and postural physiology assesses the aspects of sensory, motor, and cognitive functions at multiple levels in neural pathways.⁽³⁾	Electrocardiogram Blood test. Brain Imaging Chromosomal Analysis Illicit drug and toxicology screening.

Functional Assessment

Other Routine Assessment

Psychologically assessing the adaptive behaviour and independent functioning of the child in the social environment.⁽¹⁾
Cognitive and Developmental assessment measures the IQ level.⁽¹⁾
Behavioural and functional assessment is the assessment of learning and understanding of the environment, physiological factors, and purposeful response to the opponent’s behaviour.⁽¹⁾
Oculomotor and postural physiology assesses the aspects of sensory, motor, and cognitive functions at multiple levels in neural pathways.⁽³⁾

Electrocardiogram
Blood test.
Brain Imaging
Chromosomal Analysis
Illicit drug and toxicology screening.

Management

Family centred support is a combination of emotional, educational, and social development.
Professional Therapy

Functional Therapy – such as Behavioural, Occupational, Speech, Auditory and Vision Therapy will help in the development of children.
Pharmacotherapy – depends on behavioural abnormalities (symptoms) and underlying biochemical (depletion of certain neurotransmitters).The goal of psycho pharmacotherapy is to correct both with an effective.⁽²⁾

Figure 2: Simple tips for managing the autistic child

[Image courtesy-https://www.artedguru.com/home/asd-autism-spectrum-disorder]

Professional approach:

Observing the child and collecting information in the area of interest.
Creating a bond between therapist and child by being playful, familiar, focusing on their interests.
To work, plan and organise the visual, realistic, and work difficulties of the child.
Keeping the child in the comfort zone is more important.
Approaching a child with permissive manner.⁽³⁾

Optometrist role:

Optometry role is not only performing refraction but also prescribing the Compensatory glass prescription.
Also assessing the visual acuity, extraocular muscles, pursuits, fixation, saccades, accommodation, and convergence.
Assessing the higher level of visual function such as eye and hand coordination, visual auditory response, visual perception.⁽⁴⁾

References:

Stone-MacDonald, A., Cihak, D.F., & Zager, D. (Eds.). (2016). Autism Spectrum Disorders: Identification, Education, and Treatment (4th ed.). Routledge. https://doi.org/10.4324/9781315794181
Moldin, S.O., & Rubenstein, J.L.R. (Eds.). (2006). Understanding Autism: From Basic Neuroscience to Treatment (1st ed.). CRC Press. https://doi.org/10.1201/9781420004205
(2022, October 17). Neural Engineering Techniques for Autism Spectrum Disorder, Volume 2 – 1st Edition. https://www.elsevier.com/books/neural-engineering-techniques-for-autism-spectrum-disorder-volume-2/suri/978-0-12-824421-0
Schulman, R. (2020, June 13). Optometry’s Role in Autism Spectrum Disorders – VisionHelp. VisionHelp. https://visionhelp.com/autism-sensory-integration/optometrys-role-in-autism-spectrum-disorders/