Presentation is loading. Please wait.

Presentation is loading. Please wait.

The View From the Clinic Miss Rachel Pilling.  Origins  Theory  Research  Case studies.

Similar presentations


Presentation on theme: "The View From the Clinic Miss Rachel Pilling.  Origins  Theory  Research  Case studies."— Presentation transcript:

1 The View From the Clinic Miss Rachel Pilling

2  Origins  Theory  Research  Case studies

3 The theory.....  Coloured lenses and filters  Suppress wavelengths which cause visual stress symptoms  May improve print clarity

4 The problem....  Cross over with symptoms  Refractive error  Other eye pathology  Cerebral visual impairment/visual processing  Dyslexia

5  discomfort or difficulty reading in bright or fluorescent light  difficulty reading print, numbers or music  problems with concentration  slow reading rate  feeling sleep, tension or getting headaches when reading  eye strain  difficulty copying writing (either from paper, a book or a whiteboard)

6

7 What about the research  Positive evidence is limited  Very few studies scientifically sound  Excluded those who didn’t improve  Other interventions also used

8 Scotopic Sensitivity Syndrome

9 Dyslexia  Receptive language based learning disability  Difficulties decoding  Probem with fluent word recognition  Poor reading comprehension skills  Deficit in phonologic component

10 Visual symptoms of dyslexia  Difficulties with storage, retrieval and decoding  Require 40 exposures to a word to “learn” it (vs 4-14)  Reading is tiring, slow  Causes fatigue, headache, poor concentration, blurred vision, eye strain or pain,

11 Role of coloured lenses and filters?  Suppress wavelengths which cause visual stress symptoms  May improve print clarity  Do not solve problems with decoding or phonologic awareness  Do not solve problems with processing and comprehension

12 Research  No pre and post reading speed assessment  Improvement over period of months  Improvement could be  Developmental anticipated  Due to additional input

13 Case 1  6 year old  Poor vision detected age 5  Surgery at start of Year 1  Normal vision LE, moderate reduction RE  No symptoms fatigue or visual stress  Struggling with reading  Staff suggested Irlen’s syndrome as cause  Pressure on Mum to obtain referral

14 Case 2  11 year old boy  Difficulties reading at school apparent KS2  Bright child, high achieving parents  Referral for Irlen’s suggested by school  Lilac glasses  Vision normal  Some improvement in concentration

15 Case 2  Reading accuracy good for larger print  Difficult with small print, blinks a lot  Poor accomodation  Prescribed weak “reading” glasses  Symptoms disappeared overnight

16

17 Why does the medical profession have a problem with Irlen’s syndrome?  Promoted condition and treatment via media  Based on anecdotal evidence and patient testimonies  No formal research undertaken or published until after initial promotion  Wide range of symptoms make it non specific  Many of positive results can be explained by placebo/additional time spent with child

18 Why does the medical profession have a problem with Irlen’s syndrome?  No scientific explanation  Distraction from real pathology and treatments  Doesn’t help underlying cause  May improve print clarity  Do not solve problems with decoding or phonologic awareness, processing, awareness  Cost

19 Vision and the Autistic Child  Do children with autism have vision problems?  Why do children sometimes not seem to “see”?  Do children with autism have problems reading?  Why do children with autism not look directly at people?

20 Literature  Vast  Over 1000 publications  Neuroscience  Little on practical solutions

21 Do children with autism have vision problems?  Some do and some don’t

22 Do children with autism have vision problems?  Small, selected cohorts  Wide range of acuity  Increased incidence squint  ?struggle to integrate binocular input  Increased incidence of refractive error  But not needing glasses

23 Visual behaviours in autism  Light sensitivity  Unusual blinking or eye rubbing  Clumsiness or poor coordination  Unusual posture  Avoids near tasks

24  out central vision – use only periphery

25

26

27

28

29

30 How can we help?  Keep environment very simple  Clutter, colour, spacing  Eg PE, pencils in box, counting  Finding edge of paper  Distraction of wall display/hangings  Reduce strip lighting  Reduce ambient noise

31 Why do children sometimes not seem to “see”?  Seeing the world differently  Local vs global processing. Baron-Cohen S. The cognitive neuroscience of autism. J Neurol Neurosurg Psychiatry 2004;75;

32

33

34 Why does my child not seem to “see”?  Peripheral vs central  A) can’t “switch off”  B) can’t integrate  A) - can’t concentrate on centre of page (eg reading) if lots of pictures round edge – too much to process

35

36 Why does my child not seem to “see”?  Peripheral vs central  A) can’t “switch off”  B) can’t integrate  B) can only look at one part of picture at a time – can’t integrate whole scene

37

38

39

40

41

42  Reducing input, enabling partitioning of sections to allow processing

43 Lateral vision  Using only one visiual hemisphere - cannot integrate images from both eyes  Lower quality peripheral vision  Elimiate “flicker” Optometry and Vision DevelopmentVolume 40, No. 3, 2009

44

45 Will my child have vision problems?  May not see objects unless they are touching them  Translation  2D to 3D - picture of a cup vs real cup

46

47 How can we help?  Allow child to use head posture  Consider aligning child so they can use their posture to see board/teacher/ resources  Offer “real” objects rather than pictures  Consider other ways of assessing vision

48 Will my child have problems reading?  Skips lines or loses place when reading  Writes crooked or poorly spaced  Difficulty tracking moving objects  Poor reading comprehension  Confuses or reverses letters, words or numbers  Does not want to look at pages of words

49 Will my child have problems reading?  Overload

50 Will my child have problems reading?  Overload  Fatigue Onceuponatimetherewasa bigbearwholivedinacastle atthetopofthehillonedayhe leftthecastleandwentintot hetownhewasagentlebear whowaskindbuthescaredt hepeopleinthetowntheyra nawaywhenhecamenearto themandthismakethebear verysadsoonedayhedecide dtogotoanothertown

51

52 Will my child have problems reading?  Overload  Fatigue  May see “letters” not “words”

53 Will my child have problems reading?  Overload  Fatigue  May see “letters” not “words”  Problems with saccades

54 Once upon a time there was a big bear who lived in a castle at the top of the hill. “ once upon”

55 Once upon a time there was a big bear who lived in a castle at the top of the hill. “ a time”

56 Once upon a time there was a big bear who lived in a castle at the top of the hill. “ there was ”

57 Once upon a time there was a big bear who lived in a castle at the top of the hill. “ once upon”

58 Once upon a time there was a big bear who lived in a castle at the top of the hill. “ upon a”

59 Once upon a time there was a big bear who lived in a castle at the top of the hill. “ ”

60 Once upon a time there was a big bear who lived in a castle at the top of the hill. “ a time”

61 Once upon a time there was a big bear who lived in a castle at the top of the hill. “ was a”

62 Once upon a time there was a big bear who lived in a castle at the top of the hill. “ time the”

63 Once upon a time there was a big bear who lived in a castle at the top of the hill. “ there”

64 Once upon a time there was a big bear who lived in a castle at the top of the hill. “ ”

65 How can we help  Larger text  Less on a page  ?present one word at a time  Cover ups

66 Why does my child not look at me?  Eye movement disorder  Sensory Competition  Facial processing

67 Why does my child not look at me?  Sensory competition  Can’t “see” and “hear” at the same time

68 Can children with ASD “hear” a speaking face?  Mismatch auditory vs visual information  ASD children failed to complete as many tasks  Where fixing on face, less accurate  ASD not globally impaired in audiovisual perception tasks vs TD children  Delay in language re phonetic learning Child Dev September; 82(5): 1397–1403.

69 Why does my child not look at me?  Eye movement disorder  Sensory Competition  Facial processing

70 Why does my child not look at me?  2 studies  A) matching pictures of faces to one another  B) determing expression from “eye reading” Research in Autism Spectrum Disorders 5 (2011) 1327–1342 Research in Autism Spectrum Disorders 3 (2009) 462–473

71

72 Why does my child not look at me?  Both studies showing ASD perform same as TD  However, struggle with moving images  Test conditions Research in Autism Spectrum Disorders 5 (2011) 1327–1342 Research in Autism Spectrum Disorders 3 (2009) 462–473

73 How can we help  Do not give verbal and visual instructions at the same time.  Stand still when talking  Give verbal clue to facial expression

74 Vision and the Autistic Child  Will my child have vision problems?  Why does my child not seem to “see”?  Will my child have problems reading?  Why does my child not look at me?

75 How can we help?  Remove clutter, reduce noise  Reduce strip lighting  Encourage head postures  Larger print, single words, cover ups  Offer “real” objects  Avoid verbal and written instructions together  Stand still when talking

76 Thank you


Download ppt "The View From the Clinic Miss Rachel Pilling.  Origins  Theory  Research  Case studies."

Similar presentations


Ads by Google