SIGHT VISION VOR VSR 4/25/13 DO CHILDREN WITH ASD DIFFER IN THEIR VISUAL ABILITIES COMPARED TO NON ASD CHILDREN? 20/20 20/40

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Felicia Doyle
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SIGHT 20/20 VS DR. JEFFREY BECKER OD VISION/NEUROSENSORY KINGSTON, PA USA JBECKER @KEYSTONENSC.

1 SIGHT 20/20 VS DR. JEFFREY BECKER OD VISION/NEUROSENSORY KINGSTON, PA USA 20/40 VISION ENCOMPASSES EYE MOVEMENTS TRACKING PURSUITS ACCOMMODATION THE ABILITY TO QUICKLY FOCUS FROM DISTANCE TO NEAR OBJECTS IN A SMOOTH FASHION MOVEMENT (VOR) Developmental Organization of the Sensory Systems Birth VOR Autism 2-3 months ADHD 8-10 months ADD PDD/NOS Aspbergers Dyslexia/CAPD VSR Dynamic Visual Acuity Dynamic Muscular Compensation months months Balance, Sensations, Cognition and Mood DO CHILDREN WITH ASD DIFFER IN THEIR VISUAL ABILITIES COMPARED TO NON ASD CHILDREN? ASD CHILDREN VISUAL SKILL NON ASD CHILDREN 66%/ 62% FINE MOTOR SKILLS 15%/ 6% 71%/68% BINOCULAR SKILLS 18%/ 20% 55%/ 49% ACC/FOCUSING SKILLS 8%/ 7% 62%/ 66% OCULOMOTOR SKILLS 14%/ 12% 51%/ 72% VESTIBULAR/VOR SKILLS 6% / 10% TRYING TO READ WHEN YOU HAVE A TRYING TO READ WHEN YOU HAVE A TRACKING TRACKING PROBLEM MAY CAUSE YOU PROBLEM MAY CAUSE YOU TO RE- READ WORDS, TO RE- READ WORDS, LINES, AND LINES, AND REDUCES YOUR REDUCES YOUR COMPREHENSION,CAUSING A CHILD TO NOT WANT COMPREHENSION,CAUSING A CHILD TO READ AND EVENTUALLY BEHAVIOR PROBLEMS TO NOT WANT TO READ AND EVENTUALLY BEHAVIOR PROBLEMS ASD 62% VS NON ASD14% EYE MOVEMENTS/ACCOMMODATION TRACKMAN PHD AOA/EUROPEAN PUBLIC HEALTH RISK ASSEST. FEB

2 BINOCULAR SKILLS DEFICITS ASD 71% VS 18% NON ASD EYE FOCUSING/ACCOMMODATION ASD 55% NON ASD 8% VOR: IT CONTROLS OUR AMBIENT VISUAL SYSTEM WHERE WE ARE IN SPACE ASD 51% VS 6%NON ASD VISUAL STIMMING: 88% ASD VS 2% NON ASD WHY DO THESE CHILDREN VISUALLY STIM? DAN YEAST ISSUE POOR NUTRITION LACK OF PROPER SUPPLEMENTATION REDUCED VISUAL PROCESSING FINE MOTOR, GROSS MOTOR, ACCOMMODATIVE, VOR, AND BINOCULAR SKILLS TYPES OF VISUAL STIMMING HAND FLAPPING LOOKING OUT OF CORNERS OF THE EYES TURNING HEAD TO VIEW OBJECTS LYING ON FLOOR WITH ARMS ABOVE OR AROUND HEAD Understanding VesNbular- Auditory- Visual InteracNons The vestibular system helps us understand the position of our head and body in space. It helps us with balance, spatial orientation, and maintaining a stable visual image while in motion. The vestibular system teams up with the auditory and visual systems to perform many functions that involve moving, looking, and listening. Without good information coming in from the vestibular system, sights and sounds in the environment do not make sense. All components of the Vestibular- Auditory- Visual Triad are needed to successfully function throughout life. Astronaut training activities can provide the sensory input needed to achieve optimal vestibular input. 2

3 4/25/13 Components of the VesNbular System Uticle and Saccule Horizontal, Superior, and Posterior Semicircular Canals Cochlea Vestibular- Ocular Reﬂex (VOR) Vestibular- Spinal Reﬂex (VSR) General Guidelines for Astronaut Therapy Used at the beginning of treatment to jump start the system and optimize the therapeutic beneﬁts of activities that follow. Activities should be functional and include proprioceptive activation to help regulate the system and integrate changes. Can be done with all ages Must receive solid support from a medical professional if the client has a history of seizures. All ﬁve vestibular receptors should be activated during each treatment session. The therapist can train others on the program for carryover Rotary AcNvaNon Frequency, DuraNon, and Intensity Two times a day may increase tolerance and speed the process of integration Gradually increase input to the child s tolerance level Gradually decrease frequency as gains are maintained Use the program as long as the client makes observable progress If there is regression after protocol is discontinued, return to the protocol for a boost Can be part of the client s maintenance program indeﬁnitely Rotary activation for the superior and posterior semicircular canals. Done in left and right side- lying position. Vertical saccadic and smooth pursuit eye movement activities are then completed in side- lying position. Horizontal saccadic and smooth pursuit eye movements are completed in upright position. 3

4 OMT FOR IPAD ADVANTAGES OF THE IPAD Intuitive User Interface. Direct control, point tap with a finger on the screen versus indirect control as with a mouse on a desk. Widely available Multi- use, not dedicated to only therapy Acceptance, no stigma attached to using one They are cool and everyone wants to use one The ApplicaNon Anti- Visual Stimulation Designed specifically for use with an ipad Does not require any software installation No configuration needed on the patient s ipad Therapeutic exercises disguised as a game Different themes to appeal to a wider range of individuals all have similar exercises Robot Asteroid Theme Player Feedback The game starts with a robotic voice telling how the player must save the earth from an attack by robots. The player is instructed to choose a mission to play. As the progress is made additional levels are unlocked for the player. The player simply taps the game / level they wish to play. Through out the games VISUAL feedback is given on each successful hit / score. Spoken reinforcement and instructions are given between the action. No sound effects or other distractive effects are used during the games. Robot Scanner PaNent Reports Robots are trying to sneak on to earth by disguising themselves as people the player must use a plasma scanner to verify who is human and who is robot. The scanner moves from le_ to right, top to bo`om as if reading. (OpNonally it can scan R>L or Top>Bo`om as needed) Either a skeleton or robonc gears will be revealed, the player taps a bu`on to blast the robots. As the care giver you will be able to check panent progress for all panents or detailed reports for a specific panent. Each Nme a game is played the details are recorded. You will know how o_en, how long, and how well the panent uses the applicanon. 4

5 80% OF WHAT ALL OF US LEARN IS THROUGH THE VISUAL SYSTEM: THEREFORE IF: VISUAL DEFICITS FOR AN ASD CHILD RANGE FROM 51% TO 71% COMPARED TO NON ASD CHILDREN. THESE INDIVIDUALS HAVE SIGNIFICANT VISUAL/VESTIBULAR PROBLEMS RELATED TO THEIR OVERALL RECOVERY A VISION THERAPY PROGRAM NEEDS TO BE IMPLEMENTED TO ADDRESS THESE DEFICITS IF NOTHING IS DONE WE WILL MOST LIKELY NOT SEE FULL REHABILITATION/RECOVERY POTENTIAL LENGTH OF THERAPY TRYING TO RE- PROGRAM THE BRAIN TAKES TIME THE BRAIN AND THE NEUROSENSORY SYSTEM CAN ONLY CHANGE AT A VERY SLOW PACE NEW SKILLS ARE A LEARNED PROCESS AND NEED TO BE CONSISTANTLY REPEATED IN ORDER TO EMBED THE SKILLS STOPPING VISION THERAPY ONLY SLOWS THE PROGRESS AND OLD SKILLS WILL START TO TAKE OVER UNTIL THE NEW SKILLS ARE SET IN THE NEUROSENSORY PATHWAYS LENGTH OF THERAPY, (CONT) MINIMUM 2-3 TIMES PER WEEK MONTHS OF CONSISTANT TREATMENT NEED TO RE- LEARN ANY LOST OR NON DEVELOPED SKILLS REMEDIATION WILL NEED TO BE DONE ROUTINE RE- EVALUATIONS ARE NECESSARY TO ADJUST THE PROGRAMS PROTOCOLS IMPORTANCE OF VISUAL SKILLS IN ALL ASD CHILDREN: IMPROVES FINE MOTOR CONTROL IMPROVES GROSS MOTOR CONTROL IMPROVES VISUAL//AUDITORY PROCESSING IMPROVES EYE CONTACT IMPROVES SOCIAL SKILLS IMPROVES THE EDUCATIONAL/LEARNING PROCESS IMPROVES OVERALL SPATIAL DEVELOPMENT VISION..IT MAKES ALL THE DIFFERENCE VISION: IT CONTROLS GROSS MOTOR 5

6 VISION: IT CONTROLS FINE MOTOR IT CONTROLS SELF ESTEEM PrevenNon and New Research Homocysteine as a Biomarker Homocysteine as a Biomarker of PrevenNon Abnormal homocysteine typically defined as below 5 (Normative range 5-12) Random sampling of Spectrum Disordered children (Age 1-20) Homocysteine Levels Affected Children (n = 413) All levels of Spectrum Disorder represented Total Study: 413 children Age: Range: different laboratories Homocysteine Range: Avg. level: 4.02 Ø 91% of children below level of 6.50 Ø 78% of children below level of 5.0 Ø 3% of children above 10.0 Homocysteine Value Age (days) The Future NeuroImmune Prevention By understanding the genetic modifications in these syndromes, we can then recognize families at risk and propose wide-spread risk education and avoidance. Patent pending: Utilization of the Homocysteine Marker at early age to assess risk of immune dysfunction and poor response to immunizations Recommendation to treat Low Homocysteine Children with a modified vaccine schedule and a specific methylated B vitamin lotion/patch/oral preperation to lessen risk and improve vaccine efficacy Potential Pitfalls and Concerns Physicians are inherently skeptical Hard to change practice habits No control group for young children DR. JEFFREY BECKER OD VISION/NEUROSENSORY KINGSTON, PA USA 6

JEFFREY BECKER OD VISION REHABILITATION SPECIALIST NEUROSENSORY CENTER OF EASTERN PA

JEFFREY BECKER OD VISION REHABILITATION SPECIALIST NEUROSENSORY CENTER OF EASTERN PA 570 763 0054 jbecker@keystonensc.com www.keystonensc.com 80 % OF WHAT WE LEARN IS PROCESSED VIA THE VISUAL SYSTEM THEREFORE: