Department of Occupational Therapy Program Faculty Articles

Eye examination testability in children with autism and in typical peers.

Publication Title

Optometry and vision science : official publication of the American Academy of Optometry

Publisher

Lippincott Williams & Wilkins

ISSN

1040-5488

Publication Date

1-1-2015

Keywords

Adolescent, Child, Child Development Disorders, Pervasive, Depth Perception, Female, Humans, Intraocular Pressure, Male, Peer Group, Physical Examination, Pilot Projects, Prospective Studies, Refraction, Ocular, Retinoscopy, Surveys and Questionnaires, Vision Disorders, Vision Tests, Vision, Binocular, Visual Acuity

Abstract

PURPOSE: To compare testability of vision and eye tests in an examination protocol of 9- to 17-year-old patients with autism spectrum disorder (ASD) to typically developing (TD) peers.

METHODS: In a prospective pilot study, 61 children and adolescents (34 with ASD and 27 who were TD) aged 9 to 17 years completed an eye examination protocol including tests of visual acuity, refraction, convergence (eye teaming), stereoacuity (depth perception), ocular motility, and ocular health. Patients who required new refractive correction were retested after wearing their updated spectacle prescription for 1 month. The specialized protocol incorporated visual, sensory, and communication supports. A psychologist determined group status/eligibility using DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision) criteria by review of previous evaluations and parent responses on the Social Communication Questionnaire. Before the examination, parents provided information regarding patients' sex, race, ethnicity, and, for ASD patients, verbal communication level (nonverbal, uses short words, verbal). Parents indicated whether the patient wore a refractive correction, whether the patient had ever had an eye examination, and the age at the last examination. Chi-square tests compared testability results for TD and ASD groups.

RESULTS: Typically developing and ASD groups did not differ by age (p = 0.54), sex (p = 0.53), or ethnicity (p = 0.22). Testability was high on most tests (TD, 100%; ASD, 88 to 100%), except for intraocular pressure (IOP), which was reduced for both the ASD (71%) and the TD (89%) patients. Among ASD patients, IOP testability varied greatly with verbal communication level (p < 0.001). Although IOP measurements were completed on all verbal patients, only 37.5% of nonverbal and 44.4% of ASD patients who used short words were successful.

CONCLUSIONS: Patients with ASD can complete most vision and eye tests within an examination protocol. Testability of IOPs is reduced, particularly for nonverbal patients and patients who use short words to communicate.

DOI

10.1097/OPX.0000000000000442

Volume

92

Issue

1

First Page

31

Last Page

43

Disciplines

Medicine and Health Sciences

Link to Full Text
Peer Reviewed

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