Understanding Visual Skills in Children on the Autism Spectrum Disorder: A Critical Area of Development
By Savannah Smith, student of the Expert Certificate in Vision Therapy
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that significantly impacts social interactions, communication, and behaviour. But what about visual skills? Visual skills play a crucial role in how children with ASD process and interact with the world around them. Though often overlooked, visual processing is vital for tasks like reading, recognizing faces, and understanding one’s environment. In fact, children on the autism spectrum can experience unique visual processing challenges that affect their everyday lives. In this blog post, we’ll dive into the fascinating world of visual processing in children with ASD and explore clinical interventions that can help improve their visual skills.
Visual Processing: What’s the Big Deal?
Visual processing is how the brain interprets and makes sense of visual stimuli. According to Roberston and Baron-Cohen (2017), individuals with autism are described as “seeing the trees, but not the forest”. They will often show faster detection of single details enclosed within cluttered visual displays and have a relatively inattentiveness to the number of distractors in the display (Robertson & Baron-Cohen, 2017).
This indicates an over stimulation of their ventral stream. The information that goes through this pathway is responsible for processing of the detail in visual stimuli and long-term memory storage whereas the dorsal stream permits the processing of peripheral vision, location, spatial orientation and motion perception. Individuals with Autism often present with difficulties in visual processing as they utilise the ventral stream more than the dorsal stream.
In typically developing children, visual processing skills are essential for tasks such as reading, writing, recognizing faces, and understanding the environment. However, children on the autism spectrum often display unusual visual processing, which can manifest in several ways, including hypersensitivity to visual stimuli, difficulty with visual attention, and challenges in interpreting visual cues. Thus impacting their ability to engage in social situations or engage with their environment in an appropriate manner.
One of the key differences in visual processing for children with ASD is their tendency toward restricted visual attention. Research by Keehn et al. (2013) suggests that children with autism may fixate on specific objects or features, often overlooking the bigger picture. This phenomenon, known as perceptual narrowing, can make it difficult for children to engage with a variety of visual stimuli in an integrated way. For example, while a typically developing child may quickly spot the whole group of people in a room, a child with autism may focus on a single object or person, making it harder to follow social cues.
The Impact on Social Skills and Learning
Individuals with ASD often display differences in visual attention and processing speed. For instance, a study by O’Hearn et al. (2010) demonstrated that children with ASD are more likely to exhibit visual fixations on objects rather than people, which can affect social development. Social interactions, which are typically guided by the ability to recognize facial expressions and gaze, are thus often disrupted. Additionally, children with ASD might struggle to integrate visual information from different sources, making it challenging to engage in complex tasks that require visual coordination. This will impact a child’s ability to reach their developmental milestones as well as hinder their academic performance in school settings.
Further studies have explored the relationship between visual processing and sensory sensitivities in children with ASD. A study by Jones et al. (2009) found that children with ASD often experience heightened sensitivity to visual stimuli, such as bright lights or moving patterns. This hypersensitivity can lead to sensory overload and avoidance behaviours, which further disrupt their ability to engage with the environment in a meaningful way. Sensory processing difficulties are commonly reported with ASD individuals, and understanding the visual component of these challenges is critical for designing effective interventions to promote effective engagement within their environment and with others.
How Visual Skills Develop in Typical and ASD Children
One of the first visual skills that develop in infants and young children is visual tracking, the ability to follow moving objects with the eyes. This skill is foundational for later cognitive development, as it enables children to engage with the environment and focus their attention on important stimuli. However, children with ASD often show delays in visual tracking, which can hinder their ability to interact with others and understand their surroundings (Jones & Klin, 2013).
Visual skills are fundamental to many aspects of paediatric development. In early childhood, the development of visual skills is crucial for motor coordination, cognitive development, and social interactions. For children on the autism spectrum, the development of these skills may be delayed or atypical, impacting various developmental milestones.
As children grow, they develop the ability to discriminate between different visual stimuli. This skill is essential for tasks such as reading, identifying objects, and recognizing faces. In children with ASD, visual discrimination skills can be impaired, leading to difficulties in tasks that involve categorization, pattern recognition, and distinguishing between similar objects (Minshew & Williams, 2007). This impairment may contribute to the difficulties that children with ASD experience in academic settings, as they may struggle to interpret visual information accurately.
Another important aspect of visual skills is depth perception, which is the ability to judge the distance between objects. Depth perception plays a role in activities such as walking, climbing, and playing sports. Children with ASD may have difficulties with depth perception, which can lead to challenges in physical coordination and spatial awareness (Minshew & Williams, 2007). These issues may further hinder their ability to engage in social and recreational activities, which is often essential for overall development.
A more recent study by Little (2018) showed that in a group of 124 children with ASD, 9 percent had manifest strabismus, compared with 1.5 percent of controls. Strabismus is the misalignment of the eyes, causing one eye to deviate inward (esotropia) toward the nose, or outward (exotropia), while the other eye remains focused. It has previously been reported in the literature that exotropia is more common than esotropia in children with neurological or developmental disorders. Accommodative function was also assessed within this study and found that out of 124 children with ASD, 17.4 percent of children with ASD had a significant accommodative lag compared to a 4.9 percent of the controlled group. Accommodation is the eye’s ability to adjust focus on objects that are near or far. This will hinder their academic performance and engagement in class as they will experience visual fatigue rapidly and difficulty looking at the board in the classroom.
Convergence is the ability of the extraocular muscles to exhibit appropriate vergence movements as a near target advances in proximity toward the person. The near point of convergence is a measure of the limit of this, and is a useful clinical measurement of oculo-motor control. Little (2018) reported a significantly distant near point of convergence in their ASD group, and found there was a significant association between near point of convergence and low- and high-functioning ASD. This will have a major impact reading and learning skills.
Clinical Interventions and Strategies for Enhancing Visual Skills
One of the most commonly used therapeutic approaches is Visual Therapy, which involves exercises designed to improve visual processing, tracking and improving visual skills as well as working on visual perceptual skills like visual discrimination and depth perception. Visual Therapy programs, which are typically used for children with learning disabilities, have been adapted for children with ASD to help improve eye movement control, visual attention, and visual-motor integration (Ginsburg et al., 2005).
Yoked prisms can be incorporated to train visual motor integration. Prism actively engages the attention of a patient by presenting a mismatch between the visual pathway and vestibular-proprioceptive pathways. The patient must attend to these different sensory inputs and make adjustments to accomplish the activities. This will not only improve their visual motor integration but also assist with Visual Processing difficulties. Initial responses by autistic children to yoked prisms therapy showed remarkable improvements in the posture, body orientation and visual motor task performance (Au & Coulter, 2014).
Another promising intervention is the use of Sensory Integration Therapy, which aims to help children with sensory sensitivities by providing controlled exposure to sensory stimuli in a structured manner. Occupational therapists use sensory integration techniques to address hypersensitivities and help children gradually adapt to challenging visual stimuli, such as bright lights or fast-moving objects. The goal is to reduce sensory overload and help children process visual information more effectively (Miller et al., 2007).
An additional support for ASD individuals could be colour overlays while reading. Colour overlays are transparent coloured plastic sheets that can be placed over printed texts without interfering with their clarity. The Wilkins Rate of Reading Test was administered with and without Intuitive Coloured Overlays to 19 children with autistic spectrum disorders and to the same number of controls individually matched for age and intelligence. Findings showed that 15 out of 19 (79%) children with autism showed an improvement of at least 5% in reading speed when using a coloured overlay. In contrast only 3 of 19 (16%) control group children showed such an improvement. The findings suggest that coloured overlays may provide a useful support for reading for children with autism (Ludlow et al., 2006).
The Road Ahead
The study of visual skills in children with Autism Spectrum Disorder is an often overlooked yet critical area of research. As we’ve seen, visual processing difficulties can significantly impact various aspects of development, including social interactions, academic performance, and everyday functioning. However, the field of clinical intervention is growing, and there are several promising strategies to support children with ASD in developing their visual skills.
By focusing on these areas, clinicians, educators, and caregivers can help children with autism better engage with their environment and improve their quality of life. While challenges remain, the ongoing research and development of targeted interventions offer hope for a brighter future for children on the autism spectrum.
Final Thoughts
Understanding visual processing in children with ASD is a key step toward providing better, more tailored support for their development. By addressing visual processing difficulties early on, we can help these children navigate the world around them more effectively, fostering greater independence, social connections, and academic success.
If you’re a parent, teacher, or clinician working with children on the autism spectrum, consider exploring the interventions discussed in this post. Early intervention is crucial, and each child’s needs may vary, but there is always hope for improvement with the right support in place.
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