autism and cortical visual impairment

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http://www.tsbvi.edu/Education/vmi/autism-cvi.htm

Autistic Spectrum Disorders and Cortical Visual Impairment:

Two Worlds on Parallel Courses -

Part 2

Morse, Ph.D.*, Terese Pawletko, Ph.D. & Lorraine Rocissano, Ph.D.**

* Educational Consultant, N.H., ** Psychology Department,

land School for the Blind

AER/DENVER, July 18, 2000

Download " Autism and the Visually Impaired Child " PowerPoint slides (237k)

Note: the following sections were depicted as " icebergs. " They detail the key

diagnostic features of autism using an iceberg approach - the behaviors one

might

observe on the surface, and the processing difficulties that might account for

them.

Pattern and Predictability

YOU SEE:

Autism

Gets fixated on certain activities or sensory stimuli (e.g., certain visual

and

auditory patterns)

Insistence on things remaining the same (e.g., sequence of events,

placement of

objects)

Performance may be better with certain materials or in familiar context -

may

seem more impaired in new context

CVI

Fixated on certain sensory stimuli (e.g., certain colors, lights, finger or

hand

gazing, certain visual patterns)

Performance may be better w/some types of visual stimuli than others (e.g.,

objects, faces, spatial orientation) and in familiar context - may seem more

impaired

in new context

What you do not see:

Brain is looking for patterns it can recognize (e.g., visual, auditory;

sequencing)

in the environment - child may not recognize different phonemes and their

pattern and

sequence, yet recognize pattern in inflection or music and thus, more likely to

attend to the latter

Processing Problems: Figure-ground

YOU SEE:

Autism

Cannot discriminate foreground from background noise (e.g., seems to attend

to

conversations across the room while ignoring language directed toward him).

Fiddles with string while ignoring toy the string is attached to.

CVI

Difficulty discriminating what visual stimuli is important to attend to

Does not see and/or show recognition of some types of visual stimuli

What you do not see:

Brain is having difficulty sorting essential from non- essential information,

brain

may perceive things as a whole for some individuals, or attend only to certain

details disregarding the gestalt.

Processing Problems: Multi-sensory Input

YOU SEE:

Autism

Stops listening when cat jumps

Sensory overload can lead to total or partial shutdown, or over

over-arousal

CVI

Tends to look away when reaching/touching on lap

Has more difficulty in using vision when managing other sensory or motor

demands

Sensory overload can lead to total or partial shutdown, or over over-

arousal

What you do not see:

Brain is having difficulty regulating and processing information coming in

(e.g., type, rate, amount, multiplicity)

Brain may only be able to process information from only one modality at a

time

Can suffer from cumulative effects of overstimulation

Do Not Spontaneously Generalize Learning

YOU SEE:

Autism

May understand scripted directives in context but not out of context

CVI

May recognize objects or people in familiar context but not in unfamiliar

context

NOTE: typical child can be taught and know " a cup is a cup " across settings;

autistic

and CVI children are not able to apply old learning to new situations without

specific instruction.

What you do not see:

Brain relies on the " total package " to comprehend the situation. The package may

include a specific subset of the following kinds of features: the sequence of

events, location, specific materials, specific person teaching, specific words,

etc.

etc. etc. to define " the event " or " the concept. " What feature the child uses

as an

anchor is unique to the individual.

MISLEADING BEHAVIORS: Instability of Function

YOU SEE:

Autism

No reaction to loud noise at one one point in time, but may have extreme

reaction at another time (may change moment to moment)

Seems to understand instructions one day, seems lost the next

CVI

At one point in time seems to recognize objects and/or persons, but at

another

time (even moments later) may not recognize object or person

What you do not see:

Parts of the brain that regulate sensory thresholds, efficiency of

neurotransmission,

and ability to access memory may all impact on the child's functional ability at

any

point in time. This is also true for the child's physical condition (e.g.,

illness,

medication side effects, fatigue).

Note: the sections above were to begin to alert VI teachers to the some

potential

similarities and distinctions between some children who are autistic and other

children with CVI. The next sections offer concrete suggestions for intervention

and

make distinctions between what is used for non-autistic vs. autistic visually

impaired children; also to review the components of structured teaching that we

use

with our autistic-vi students across settings.

Components of Structured Teaching

Physical Structure

What activity will occur in " X " location?

What sensory sensitivities need to be addressed by the physical structure?

Ideally, only one activity occurs in one location (e.g., teacher table is sole

place

that 1:1 work occurs; independent work desk used only when child works

independently;

independent play activities occur in one location; craft activities occur in a

different location)

Processing and sensory needs: use controlled language, minimize extraneous noise

through use of sound absorbing materials (e.g., tennis balls on bottom of chair

feet,

hang sound absorbing materials from windows and walls, replacing faulty buzzing

fluorescent bulbs, staff to use conversational tones only); use barriers (e.g.,

book

cases) to define space, provide visually calm environment

Schedules

What will we do?

In what order?

Minimizes demands on memory and attention, decreases problems with time and

attention, compensates for problems with language comprehension, aids motivation

(e.g., " first work, then play " ), and allows for greater independence in

functioning.

Individual Work Systems

What am I going to do?

How much will I do/for how long?

When will I be finished?

What comes next?

Predictable, methodical, consistent approach to tasks - takes advantage of

autistic

individual's love of sameness - follows left to right, top to bottom format

Modify work system based so child can be successful in independent completion of

task

- if can't be independent, back down and add more structure