Nova researchers defining optometry’s role in caring for patients with autism spectrum disorder

September 15, 2012

Stanley Tien, an optometrist from Malaysia, visits Nova Southeastern University to learn about vision therapy for patients with autism spectrum disorder from Stacey Coulter, O.D.

Every 20 minutes, a child is diagnosed with autism spectrum disorder (ASD). According to the Centers for Disease Control and Prevention, the prevalence of the condition is one out of 88 children and one out of 55 boys. Given the current prevalence rates, most optometrists can expect to encounter at least one patient with ASD in their day-to-day practice.

The core deficits of ASD include difficulties in communication and social interaction and abnormalities in sensory processing. These deficits challenge the practitioner who aims to examine these patients or address their vision needs. Currently, very little research is available regarding optometric evaluation of patients with ASD.

Research under way at Nova Southeastern University (NSU) focuses on answering clinically relevant questions:

  • What are expected findings for eye examination in children and adolescents with ASD and how do these compare to those of typically developing kids?
  • How can vision testing be modified to enable patients to successfully complete testing?
  • Are children and adolescents with ASD more likely to have eye teaming (convergence) problems?
  • If patients with ASD have significant refractive error and need spectacle correction, do they adjust to spectacle wear differently than typically developing peers?
  • Is there a relationship between optometric test findings and occupational therapy sensory processing measures of vision?

Yin Tea, O.D., measures near visual acuity.

The studies, led by Rachel A. “Stacey” Coulter, O.D., and Annette Bade, O.D., are multidisciplinary and include pediatric optometrists as well as occupational therapists, and a psychologist with expertise in ASD.

“Autism has been identified as an urgent public health concern. Researchers and health care professionals from all disciplines are striving to meet the demands of caring for these patients and supporting their families,” said Dr. Coulter. “Good vision is critical for these patients to function and it is important that optometrists bring their expertise to the health care arena.”

Results of these studies, the Convergence in Children and Adolescents Diagnosed with Autism Spectrum Disorder (CICADA) Study and Adaptation to Spectacle Wear Study, will be presented at this year’s American Academy of Optometry meeting in a special symposium on Demystifying Vision in Autism. This research will help to define the standard of care for patients with ASD.

Annette Bade, O.D., fits spectacles on a young patient.

In addition to research, the NSU pediatric optometry clinic provides training, for optometric students and residents, in how to evaluate and provide intervention including vision therapy to patients with ASD.

NSU has piloted optometric strategies and content to meet the social and communication difficulties and vision integration challenges that often confront patients with ASD.

“As optometrists and educators, we have a threefold responsibility to teach our students and future optometrists about ASD, to employ scientific research to determine the best practices for patients with ASD and to use evidence-based practices in the optometric care of our patients with ASD. Studies such as those being led by Drs. Coulter and Bade are critical in allowing us to achieve these goals,” said Yin Tea, O.D., another Nova researcher.

Disseminating information to practicing optometrists is also a priority.

Faculty member Mary Bartuccio, O.D., is a co-editor of the recently published text “Vision and the Special Needs Patient: Diagnosis and Management” that focuses on optometric care of special needs patients, including those with ASD.

Optometrists, such as Stanley Tien, who recently visited the NSU clinic from Malaysia, are able to observe and learn useful clinical techniques.

The research, scholarship and clinical activities of the Pediatric Optometry Service support the work of the Autism Institute, a university-wide group that focuses on collaborative activities in the field of autism spectrum disorders.

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