Strabismus ("crossed eyes") has been reported to be markedly elevated in individuals with autism. This article presents the findings from two studies of strabismus in autism. A clinical optometric examination of 34 individuals with autism, ages 7 to 19 years, found a strabismus rate of 50% (65% with exotropia and 35% with esotropia). A parent survey of 7,640 families found a reported incidence of 20% (18% in boys, 29% in girls). As strabismus occurs in only 2% to 4% of the general population, both studies reported here confirm the high rate of strabismus in autism. A number of concomitants of strabismus, derived from questionnaire data, are reported.
Autistic children often display abnormal postures, head tilts, and other spatial management dysfunctions. Methods were introduced to measure spatial orientation in tasks in a group of fourteen autistic children in Montreal, Canada. Ambient lenses were found to improve posture, correct head tilts, and improve ball catching abilities. A model of spatial orientation is described and recommendations are made to incorporate ambient lenses in treatment programs.
Symptoms of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) often co-occur, challenging timely and accurate diagnosis. We assessed the performance of three parent-report measures in discriminating ASD from ADHD without ASD (ADHDw/oASD) in school-age verbally fluent children. We examined the Autism Symptom Interview (ASI) School-Age and two widely used parent questionnaires: Social Responsiveness Scale-2nd Edition (SRS-2) and Social Communication Questionnaire-Lifetime (SCQ-L). Receiver operating characteristic curves assessed each instrument’s performance against the best-estimate clinician DSM-5 diagnosis of ASD or of ADHDw/oASD (n=74, n=102, respectively; 6-11 years). These yielded moderate accuracies: AUC=0.85, 0.79, 0.78 for SCQ-L, ASI, SRS-2, respectively. AUC pairwise comparisons reached our statistical significance (p<0.01) for the SCQ-L vs. the SRS-2. Within instruments, sensitivity and specificity varied across ASD cutoffs. Along with the between-instrument variability, this indicates that clinicians and researchers have valid options, depending on the settings and their goals. Comparing children correctly and incorrectly classified as ASD showed no differences in demographics, intellectual abilities, nor in any specific clinical profile(s), except for the degree of parent concerns across ASD- and comorbid psychopathology-related symptoms. Together, results suggest that complementing parent screeners with multiple sources may be needed to best differentiate school-age verbally fluent children with ASD vs. ADHDw/oASD.
Visual perception was evaluated with standard tests for 26 hospitalized patients with schizophrenia, 23 hospitalized patients with affective disorders, and 60 control subjects. Both patient groups differed significantly from the control group on low amplitude of accommodation, esophoria or exophoria, vergence duction suppression, and convergence and divergence recovery ductions. Only the affective group showed significantly reduced fusion at near distance, and only the schizophrenic group differed significantly from control subjects on disorganized left apex formation. These findings appear to confirm the presence of visual perceptual disorders that can cause disability in psychiatric patients, with important research and rehabilitation implications.
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