Abstract
There remains great interest in understanding the relationship between visual impairment (VI) and autism spectrum disorder (ASD) due to the extraordinarily high prevalence of ASD in blind and visually impaired children. The broad variability across individuals and assessment methodologies have made it difficult to understand whether autistic-like symptoms shown by some children with VI might reflect the influence of the visual deficit, or represent a primary neurodevelopmental condition that occurs independently of the VI itself. In the absence of a valid methodology adapted for the visually impaired population, diagnosis of ASD in children with VI is often based on non-objective clinical impression, with inconclusive prevalence data. In this review, we discuss the current state of knowledge and suggest directions for future research.
Highlights
Research into the presence of autistic-like features among blind children has a long history
Since autism spectrum disorder (ASD) is defined by a common set of behaviors, it is best represented as a single diagnostic category that is tailored upon the individual’s clinical presentation including clinical characteristics and associated features [120]
Assessing ASD in blind and visually impaired children is a very delicate process in which most of the common methods used to score autistic behavior, including several items linked to vision [121,122]
Summary
Research into the presence of autistic-like features among blind children has a long history. Restricted symbolic play, difficulties in social interaction with peers and imitation, echolalic speech, and increased stereotyped behavior have all been frequently reported in blind children [9,10,13,14]. These behaviors resemble subjects with ASD and are often termed “blindisms” since they are explainable in the context of VI [15]. The similarity between these “blindisms” and “autistic-like” behaviors, coupled with the lack of ASD assessment tools designed for blind and visually impaired children, complicates the diagnosis of ASD in these individuals. While the estimated prevalence of ASD among sighted children is between 1 and 2% in Europe [16], determining the prevalence in the visually impaired population still varies greatly, ranging from 2 up to
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