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Pediatric Therapy Corner: VISION…It's More Than Meets the Eye

By:  Cara Koscinski, MOT, OTR/L, The Pocket Occupational Therapist
My son with autism complained of frequent headaches, squinted, and showed difficulty reading. His pediatrician recommended an evaluation by an eye doctor.  We anxiously awaited the appointment with the ophthalmologist and felt we would get answers.  It was a surprise that James’ vision was ‘normal.’  He was seeing a perfect 20/20 for distances both near and far (perfect visual acuity).  We left with no answers about the problems James was having. I’m guessing many of you have had similar experiences.

Our story is not unusual.  Many children who have autism experience difficulties with copying from the board, coordinating eyes with hands, frequent headaches after completing class and homework.  Vision concerns manifest themselves in many ways.  All children are required to have regular vision screenings which test for structural defects and deficits in eyesight.  When we think of an eye exam, we picture the chart with letters of decreasing sizes. (FYI, it’s called the Snellen chart and was invented in the early 1860s.) While it is important that we ‘see’ the information properly, how we extract meaning and understanding of what we see requires further testing.  Our brains devote a huge amount of space for visual processing. There are many more parts of the brain involved in vision and making sense of what we see.  When we see colors, light, movement, and distance.  According to, “in the brain itself, neurons devoted to visual processing number in the hundreds of millions and take up about thirty percent of the cortex, as compared with eight percent for touch and just three percent for hearing.”

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