• Posted March 24, 2023

Kids With Autism Face Higher Odds of Vision Issues, But Many Don't Get Screened

Children with autism are less likely than their peers to receive important vision screening despite a high risk for serious eye disorders, researchers report.

Only about 36% of children with autism spectrum disorder (ASD) completed vision screenings during their health checkups, a new study found. That was far fewer than the 59% rate for children without ASD.

In addition, the screening rate for Black children with ASD was just under 28%, compared with nearly 40% for white and multiracial kids, the findings showed.

"I noticed that many of our patients with autism have never had vision screening, even though it's recommended for all young children,"said senior author Dr. Brittany Perry, a pediatrician at the Nemours Swank Autism Center in Wilmington, Del.

"So, I wanted to study whether this might be a broader disparity -- whether kids with autism receive vision screening less often than other kids,"she added in a Nemours news release.

Early childhood is crucial for vision development, as well as for early detection and treatment of eye problems, the study authors noted.

For the study, Perry's team examined data for more than 63,800 well visits across a primary care network in Delaware, Pennsylvania and Florida. Children were 3 to 5 years of age.

In Florida, nearly 46% of kids with ASD had vision screening, compared to 28% each in Delaware and Pennsylvania.

About 80% of Florida medical practices used photoscreening, in which a specialized camera or video system captures detailed images of a child's eyes. In comparison, only 13% of medical practices in Delaware and Pennsylvania used photoscreening, the researchers noted.

The study authors explained that photoscreening is particularly helpful for children with ASD because they cannot always understand and verbally respond to instructions or questions in conventional vision tests.

The American Academy of Pediatrics recommends annual instrument-based vision screening, particularly for children with developmental delays.

Reimbursement is necessary to bring about greater use of photoscreening in primary care, the researchers said.

Perry said increased use of photoscreening could be a great way to increase vision screening in vulnerable groups.

"The key takeaway from this study for providers is to be aware that these disparities exist for all children with autism, so we can work to provide better care,"she said. "And for parents, it may help them to better advocate for their children with autism and to request a vision screening at a well visit, or a referral to an eye specialist, if their child is overdue."

The researchers are now investigating the COVID-19 pandemic's effect on pediatric vision screening.

The report was published March 21 in the journal Pediatrics.

More information

The American Academy of Ophthalmology has more about increased risk of ophthalmologic disorders in children with autism.

SOURCE: Nemours Children's Health, news release, March 21, 2023