Book review: Seeing through new eyes

Last week, I finished reading Seeing through new eyes: Changing the lives of children with autim, Asperger syndrome and other developmental disabilities through vision therapy by Melvin Kaplan. Dr. Van Dyke at the Rimland Center tipped us off to this book and the work this author/doctor does. I had never heard of anything like it.

Kaplan uses prism lenses (special glasses) and vision therapy to alter how people see and perceive their world. He posits that many "undesired" behaviors we see in autism--toe-walking, hand-flapping, dragging hands along walls, stimming, staring at spinning objects (like Nate does)--are children's coping mechanisms, their "logical strategies for adapting to sensory disturbances" (p. 45). These children are "seeing" 20/20 but are not perceiving correctly. He writes that these behaviors are not the problem; they are the solution! They show us what is going wrong perceptually.

He writes that children's toe-walking, stimming with their hands, touching walls when they move "stem from their inability to handle both themselves and space simultaneously. To orient themselves, they flap their hands or touch objects, providing sensory input that tells them where they are in space" (p. 18). Many people with autism have problems with orientation of self (where am I?) and/or organization of space (where is it?).

The purpose of ambient prism lenses is "to actually alter perception in ways that cause patients to reoganize their visual processes[...]. The behavioral changes caused by this alteration of perception often are instantaneous and dramatic. Patients with autism or related disabilities have spent a lifetime developing strategies to compensate for their visual deficits. By the time they arrive at the optometrist's office, these strategies--eye turns, postural warps, self-stimulating behaviors, etc.--are habitual and ingrained. Ambient prism lenses instantly create a new visual world, in which those adaptive mechanisms are no longer either necessary or relevant. As a result, patients must rapidly re-awaken previously suppressed visual processes, in order to make sense of their altered surroundings" (p. 34). Kaplan believes that altering these patients' perception can level the playing field in a way, making it possible for other therapies to be even more effective.

Kaplan includes many interesting and relevant case studies in addition to descriptions of the tests he uses in his practice (including tests for non-verbal patients).

This book was a page turner for me, not only because I found the case studies so interesting, but also because I saw so many children I know reflected in the pages. I see many children at Nate's therapy center walking on their toes while dragging one hand along a wall while a therapist leads them by the other hand. Though I've read of other explanations of some of the behaviors (e.g., toe-walking is the body's response to painful GI tract problems), many of Kaplan's explanations really resonated with me.

I'm not sure if Nate is an excellent candidate for vision therapy, as he doesn't display some of the markers Kaplan mentions multiple times. Nate doesn't toe walk. He doesn't drag his hands along walls. He doesn't flap his hands regularly. However, here are the tidbits in the book I did highlight that describe Nate:

"[Individuals with autism] display a fetish for numbers and letters, as well as spinning objects [...]. Higher visual development, in contrast, involves smooth eye movements and visual search patterns. The autistic pattern is marked by static attention, which is unsustainable, where the latter involves dynamic attention and is sustainable. Dynamic attention requires a concentration of internal energy, and patients who cannot coordinate their eyes are unable to achieve this level of concentration" (p. 55).

"Sometimes children will be comfortable watching certain sections of a video, but cover their ears, scream, or turn their eyes away during other sections. Such behaviors provide valuable insights into the type and amount of visual and sensory input a patient is capable of handling" (p. 61).

There are other times when Nate seems to completely zone out/stare into space when a question is asked, and I've often interpreted it as sensory overload, which may include visual/perceptual components.

I plan on recommending this book to anyone who asks for my "long list" of autism treatment information.