Helping Patients with Autism

Excerpted from page 36 of the April 2015 edition of AOA Focus.

A program with the University of Miami-Nova Southeastern University Center for Autism and Related Disabilities, Optometry Cares®—The AOA Foundation and other organizations was designed to educate parents, teachers and other professionals on vision care for children on the autism spectrum. Supported by a research grant from the Optometry Cares Healthy Eyes Healthy People ® program—made possible through a generous grant from Luxottica—the South Florida Autism Vision program has created educational resources about autism and visual health, with a goal to distribute them at parent-teacher meetings. The project also targets therapists who work with children on the autism spectrum.

Parents aren’t always aware that there are practitioners who can help patients with autism.

Annette Bade, O.D., an associate professor of optometry and clinical research coordinator at Nova Southeastern University College of Optometry in Florida who is involved with the program, says, “Maybe they had a bad experience and were concerned about bringing the kids in and having it not go well.”

Children with autism often have specific sensory issues, so a big concern for practitioners is having these children become distressed and not participate in an eye exam, Dr. Bade says. To avoid these situations, Nova Southeastern University’s Eye Care Institute sets aside extra time to see these patients. “We have a room where they’re seen away from the other children so it’s not as noisy or distracting,” she says.

“If you have tools to communicate with them, and explain to them what you’re trying to do,” that will increase their understanding and reduce anxiety over the exams. Coordination with other providers has been key: Dr. Bade says the clinic worked in conjunction with speech pathologists and therapists in designing an eye exam that explains certain terms in a manner that a child with autism can understand.

To help them prep for an eye exam, children receive a book that explains and illustrates what the exam will be like at the clinic. For example, the book describes the concept of “near point of convergence,” Dr. Bade says.

This is when an OD takes an object and pushes it all the way up to the child’s face. “The question for a typically developing child is: Tell me when this doubles, and tell me when it becomes single again as you pull it away,” she says. ODs also can use colloquialisms such as the object “breaking in two” as it gets closer to a typically developing child’s face.

Such an experience may differ for a child on the spectrum. They may interpret “breaking in two” in literal terms: meaning they’re waiting for the object to physically break into two pieces. “When that doesn’t happen, they don’t respond. The book shows them what it will look like when it is doubled. Then they understand what ‘break into two’ actually means and know how to respond,” Dr. Bade says.

The clinic uses other tools, such as phone apps, to better communicate with these patients. A child who can’t verbalize his or her concerns can hit “yes” or “no” on an iPhone or iPad app, tools that a lot of kids on the spectrum are using for communication, she says.

Learn how optometrists adapt to the needs of their patients to help them achieve better vision and quality of life in the April 2015 edition of AOA Focus.

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