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Autism

Visual impairment and autism: Does social engagement hold the key? Peter Hobson and Tony Lee Tavistock Clinic and Institute of Child Health, UCL. Autism. Autism involves: A profound impairment in interpersonal engagement Characteristic abnormalities in language

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Autism

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  1. Visual impairment and autism: Does social engagement hold the key?Peter Hobson and Tony LeeTavistock Clinic and Institute of Child Health, UCL.

  2. Autism Autism involves: • A profound impairment in interpersonal engagement • Characteristic abnormalities in language • A severe restriction in symbolic and flexible thinking

  3. Someone else Hobson (1993): The Relatedness Triangle Child Thing

  4. Are there autistic like features in congenitally blind children?Brown, R., Hobson, R.P., Lee, A., and Stevenson, J., (1997)Journal of Child Psychology and Psychiatry, 38, 693-703 Participants: 24 congenitally blind children aged 3 and 9 years • Totally blind or minimal light perception from birth, no identifiable neurological impairment • Selected from six schools in England • 15 with VIQ>70, 9 with VIQ<70 Upper ability were compared with 10 sighted children matched for age and IQ Lower ability compared with 9 sighted children with autism, matched for age and IQ

  5. Group of 24 children with congenital blindness: Scores on Childhood Autism Rating Scale

  6. Hobson, R.P., Lee, A., and Brown, R., (1999)Are there autistic like features in congenitally blind children?Journal of Autism and Developmental Disorders, 29, 45-56. Participants: On the basis of a seeded cluster analysis of clinical features from the DSM-III-R, 9 congenitally blind children from the study were placed in the cluster with the children with autism • All 9 children satisfied DSM-III-R criteria for autism • 4 boys and 5 girls, with diagnoses of congenital optic atrophy (4), ROP (3), bilateral retinal dysplasia(1) and Leber’s amaurosis (1) These participants were compared with a newly constituted group of 9 sighted children with autism (all male), matched according to age and VMA (verbal subtests of WISC or WIPPSI)

  7. Hobson, R.P., Lee, A., and Brown, R., (1999)Are there autistic like features in congenitally blind children?Journal of Autism and Developmental Disorders, 29, 45-56.

  8. Study 1: DSM-III-R clinical features among non-sighted and sighted children with autism Study 1

  9. Study 1: DSM-III-R clinical features among non-sighted and sighted children with autism

  10. Reversible autism among children with congenital blindness? A controlled follow-up study. Hobson, R.P., & Lee, A. (2010). Journal of Child Psychology and Psychiatry, 51, 1235-1241. * n = 8

  11. Diagnosis of autism at T2, according to DSM criteria

  12. Study 2: DSM-III-R clinical features among non-sighted and sighted children with autism

  13. Study 2: DSM-III-R clinical features among non-sighted and sighted children with autism

  14. Childhood Autism Rating Scale: T1 vs T2

  15. What happens to verbal ability?

  16. Conclusions • Autism is a syndrome • This syndrome is heterogeneous in pathogenesis as well as aetiology • Congenitally blind children who fulfil the diagnostic criteria for autism early in childhood may no longer satisfy those criteria 8 years later – and in this respect, there is a contrast with sighted children with autism • What are the pros and cons to considering autism among VI children ‘autism-like’?

  17. So…Visual impairment and autism: Does social engagement hold the key? We are left with the possibility that • both in sighted children with autism • and for different reasons, visually impaired children who develop clinical features considered typical of autism - ‘autism’ arises through impediments to interpersonal engagement vis-à-vis a shared, visually specified world.

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