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10 Tips for Examining ASD Patients

By Lauretta Justin, OD, Orlando, Florida 32835

Autism, or autism spectrum disorder, refers to a range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication, as well as by unique strengths and differences. We now know that there isn’t one autism but many types, caused by different combinations of genetic and environmental influences.

According to the CDC, 1 in 68 children (1 in 42 boys) have ASD. With such high prevalence, we all will eventually have a patient with ASD in our chair. As a mother of 2 boys in the spectrum, I know from personal experience that this population has unique needs. As optometrist, we need to remain informed and aware in order to properly care for people with ASD. I compiled this list of tips to help us be more prepared for the ASD patient.

Remember, the term “spectrum” reflects the wide variation in challenges and strengths possessed by each person with autism. Each patient will be different therefore these tips will not apply to all patients.

10 Tips for examining patients diagnosed with ASD:

1. Use few words when giving directions and wait patiently for their response due to a potential delay in processing.
2. Be VERY SPECIFIC when giving instructions. People diagnosed with autism are concrete thinkers, they have difficulties with inferences.
3. Talk to them, not at them – These patients want to know that they can trust you. They should be treated as equals.
4. Be observant – Observe how the patient walks into the room, if they make eye contact, if they are sensitive to lights or sounds
5. Get the patient’s ok, before performing a test – People diagnosed with ASD do not like surprises or unexpected touch.
6. Respond, don’t react – Staying calm is a key thing to remember when examining patients on the spectrum.
7. Do the exam in free space as much as possible – For example: Retinoscopy with lens rack, prism bars for binocular testing. Careful binocular testing is a must!
8. Demonstrate a test on yourself or a parent first – For example: Stereopsis with polarized glasses.
9. Use Visual Support – Visuals decreases frustration and may help decrease problem behaviors that result from difficulty communicating. Visuals can promote appropriate, positive ways to communicate. Use I-phones, I-pads, ect
10. Be flexible! – Being able to adjust and modify your examination techniques according to the patient needs will help you and the patient greatly.