Autism, Dyslexia, Down syndrome, Attention deficit hyperactivity disorder, Computer vision syndrome
About 1 percent of the general population is thought to have Intellectual Disability , and about 10% of individuals with Intellectual Disability have Autism Spectrum Disorder (ASD). Autism does assume developmental delays in ‘Adaptive ability ‘
Individuals vary in how they process information. Vision is vital and needs assessment as well as reading and writing.
The brain is now thought to be neuroplastic and capable of learning or rewiring with the correct nutrition, sensory integration and neurofeedback.
The combined first trimester screening test is done between 9 weeks and 13 weeks (plus 6 days) into the pregnancy to calculate the risk of a number of abnormalities, including Down syndrome.
Retinal examinations can provide a window to the brain function as electrical information is transferred from the eye to the brain.
The electrical signals in the retina appear to be different in children on the autism spectrum and is the subject of much research as are possible biomarkers for neurodevelopmental conditions including attention deficit hyperactivity disorder (ADHD.) Early diagnosis via ERG (electroretinogram) allows for appropriate treatment to be instigated.
Hundreds of genes are known to be associated with retinal diseases and by genetically mapping the human retina disorders can be identified.
Development disorders such as Autism, Dyslexia, Down syndrome, Attention deficit hyperactivity disorder through to Computer vision syndrome are some of the conditions among many that need a full assessment of eye health and vision.
AUTISM (ASD) SPECTRUM DISORDER
Autism is not an Intellectual Disability. Intellectual ability (or deficits in Intellectual ability) is not part of the diagnostic criteria of Autism. There is no one type of autism, but many.
Autism, or autism spectrum disorder (ASD), refers to a broad range of mild to moderate to severe conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication. Autistic children have difficulty with communication and social interaction. A noninvasive test for Down syndrome is highly accurate but noninvasive prenatal testing for autism is limited. Tests can screen for mutations in a range of genes, including some related to autism.
Vision problems can include lack of eye contact, fleeting side glances, or peripheral vision difficulty.
There is not one autism but many subtypes, and each person with autism can have unique strengths and challenges.
A combination of genetic and environmental factors influence the development of autism of which there are many subtypes, and autism often is accompanied by medical issues such as:
- Gastrointestinal (GI) disorders
- Sleep disturbances
- Aversions to certain sights, sounds and other sensations.
Neither optometrists nor other professionals actually treat dyslexia.
We do test for accommodation and convergence imbalances affecting visual function or vision perception problems which may affect learning, and if a child has symptoms of pattern glare we may suggest colorimetry testing to see if a specific tint helps their vision issues.Amongst the signs for dyslexia the language-based learning disability is prominent.
- Processing the sounds in words (phonological deficit)
- Auditory short-term memory
- Retrieving words from vocabulary (naming speed)
- Recognising and remembering the ‘look’ of words (orthographic processing)
- Attaining automaticity in underlying and component skills needed for reading and written language
There is no single test for diagnosing dyslexia. To get tested for dyslexia is to determine all the reasons for a child’s learning difficulty often not possible until ages from seven years of age or older.
It affects the way the brain processes written and spoken language and mapping letters onto sounds so interfering with their ability to understand what they read. People with dyslexia do not neccessarily have an an ocular problem. It is not simply just not reading difficulties.
It tends to be hereditary and lifelong and runs in families. As many as 15 to 20 percent of people have some symptoms of dyslexia,difficulty with words, such as trouble with reading, spelling and writing, or mixing up similar words.
The poor connection between sounds and letters generally diagnosed when they learn to read in kindergarten.
The challenge is to learn to read and then to read to learn.
Coloured overlays for “dyslexia” were noted by Meares and Irlen in the early 1980’s which led to franchised coloured lenses for the so called scotopic sensitivity syndrome.
Colourimetry and Visual stress
The Intuitive Colorimeter offers many thousands of colour combinations, and offers true precision to the patient.Precision tinted lenses have also been shown to make a significant difference to the quality of life for Migraine sufferers. Symptoms of some other neurological conditions such as Autism, MS and closed head injury may also appear to be reduced with the application of a precision tint.
A full eye examination is important to rule out any ocular problems as a first step.
Visual Stress is a term used to describe visual discomfort and perceptual distortions when looking at stressful patterns. Symptoms can be experienced in varying degrees from simple fatigue when reading, to an inability to look at text.
Visual Stress is thought to affect up to 40% of poor readers and 20% of the general population.
Visual Stress and Dyslexia are different conditions but often run concurrently with one other. There is a greater propensity amongst the dyslexic population to suffer from Visual Stress.The symptoms of Visual Stress can be reduced using coloured filters, such as coloured overlays placed over text, or precision tinted lenses worn in spectacles.Research has shown that offering a large number of colours allows for optimal results.
Having ascertained that ocular problems are not the cause of symptoms, an overlay assessment is an essential aid for teachers and vision professionals to help identify and treat Visual Stress. Overlays can be purchased.Following successful use of a coloured overlay for a trial period, the Intuitive Colorimeter is used to assess the patient and a precision tint is prescribed as appropriate.Since the launch of the first model of Intuitive Colorimeter over 25 years ago with the University of Essex and Professor Arnold Wilkins, three generations of the instrument have followed a manual assessment process, allowing the parameters of hue, saturation and brightness to be explored systematically.
However Optometrists attribute the cause to a type of pattern glare which is an abnormal sensitivity to light, flicker and certain spatial frequencies in stripes and patterns.
In people with the condition lines of print of a particular size act like stripes, and seem to move or jump or blur, which is not conducive to reading.
It is advisable to ensure the reading problem is not due to refractive or eye muscle co-ordination or even ocular pathology,and phonics instruction can be helpful before considering coloured filters
Symptoms of pattern glare commonly include:
- excessive photophobia
- sensitivity to some fluorescent lights (some shopping centres)
- sensitivity to striped or other patterns in shirts or carpets, or even venetian blinds
- sensitivity to flashing lights (disco strobes, light flickering through trees driving in the country)
- sensitivity to fast moving TV or movie action, or fast scrolling of computer print
- sensitivity to reflections off cars or glass windows
The cause is thought to be hypersensitivity of a particular part of the brain to light in certain frequencies.
Relevant history may include concussion, whiplash, head injury, stroke, migraine,epilepsy,tinnitus.
It is part of a group of specific learning difficulties, of which there are many including dyslexia, ADHD and Asperger’s syndrome.
ADHD,CVS, Aspergers, Down syndrome
Eye exams can be specially catered for specific circumstances including devopment disorders
Depending upon signs and symptoms of ADHD the person can be easily distracted and have a variety of mental health,hyperactive and impulsive tendencies.
Health professionals diagnose three types of ADHD and subtypes : Primarily Inattentive, Primarily Hyperactive or Combined subtype. Managing ADHD in children to reach their full potential requires effective treatment beyond the diagnosis of ADHD just as it does for adults and children with dyslexia or Down syndrome
Individuals with attention-deficit/hyperactivity disorder (ADHD) can concentrate better when they’re allowed to fidget even during an eye examination,particulary a child with ADHD
Of children with ADHD boys are more often diagnosed than girls.
For people with ADHD the condition is more disabling in people who have learning difficulties. About 10% of children are diagnosed with ADHD. Many Doctors treat adhd children by a stimulant medication to pay attention to counter the self stimulating diversions.
Computers can be employed but important factors in preventing or reducing the symptoms of computer vision syndrome CVS.
This includes lighting conditions, chair comfort, location of reference materials, position of the monitor, and the use of rest breaks.
Asperger’s is a less severe form of autism, not a separate condition.
An Aspergers youngster tends to lose track of time when absorbed in activities on the computer as can many parents. Monitor the time spent sitting in front of the screen, and make sure frequent breaks are taken.
Children with Down syndrome can have their proper development of vision effected and can be a cause of intellectual disability. A baby with Down syndrome physical features is more likely to have heart defects. Early intervention includes physical therapy, speech and language therapy, and occupational therapy. Children with Down syndrome can be diagnosed with autism via the autism spectrum disorder criteria from the Diagnostic and Statistical Manual of Mental Disorders.
A person with the most common form of chromosome disorders Down syndrome aka trisomy 21 have 47 chromosomes in each cell nuclei instead of 46. Humans normally have 46 chromosomes in each cell nuclei, divided into 23 pairs. An error in cell division forms a sperm or egg cell with an extra copy of chromosome 21 before or at conception. So this genetic condition results in the bodies cells’ nuclei instead of containing the 46 chromosomes having that extra chromosome 21.
There is an increased incidence of refractive errors,strabismus,keratoconus,cataracts,glaucoma,blepharitis,nasolacrimal duct obstruction and nystagmus in people with down syndrome.
Eye disease is reported in over half of patients with Down Syndrome, from less severe problems such as tear duct abnormalities to vision threatening diagnoses such as early age cataracts.
Autism spectrum, dyslexia and developmental disorders are complex, and there is no ‘one size fits all’ solution as in all health problems.
Dysgraphia is a specific learning disability that affects written expression. It can have visual-spatial repurcussions
Dyscalculia is a learning issue that makes it hard to make sense of numbers and math concepts.Vision problems can be factor.
People with dysphasia or aphasia in severe form may experience difficulties using or comprehending speech. Symptoms depend on the location and severity of brain damage which can inolve vision.