Up to one-third of totally blind children are reported to suffer from a developmental disorder which has many features in common with autism in the sighted. The aetiological basis of this worrying condition is discussed. There are major problems in defining diagnostic criteria for autism in visual impairment, with the discriminant capabilities of empirically derived rating scales being compromised by overlaps between autistic symptoms and normal 'blindisms', and schedules based on existing diagnostic criteria being too visually dependent to allow valid administration. The need for a clearer understanding of normal social development in infants with visual impairment is presented as an important prerequisite for an understanding of this developmental disorder and its early identification and remediation.
AMERICAN PSYCHIATRIC ASSOCIATION (1980) Diagnostic and Statistical Manual of Mental Disorders, 3rd edn (DSM-III). Washington, DC: APA.
2.
AMERICAN PSYCHIATRIC ASSOCIATION (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV). Washington, DC: APA.
3.
BETTELHEIM, B. (1956) 'Childhood Schizophrenia as a Reaction to Extreme Situations', Journal of Orthopsychiatry26: 507-518.
4.
BLACK, M. M. & SONKSEN, P. M. (1992) 'Congenital Retinal Dystrophies: A Study of Early Cognitive and Visual Development', Archives of Disease in Childhood67: 262-265.
5.
BLANK, H. R. (1975) 'Reflections on the Special Senses in Relation to the Development of Affect with Special Emphasis on Blindness', Journal of the American Psychoanalytic Society23: 32-50.
6.
BROWN, D.E. , SIMMONS, V. & METHVIN, J. (1979) The Oregon Project for Visually Impaired and Blind Preschool Children, rev. edn.Medford, OR: Jackson County Education Service District.
7.
CASS, H. , SONKSEN, P. & MCCONACHIE, H. (1994) 'Developmental Setback in Severe Visual Impairment', Archives of Disease in Childhood70: 192-196.
8.
CREAK, M. (1961) 'Schizophrenic Syndrome in Childhood: Progress of a Working Party', Cerebral Palsy Bulletin3: 501-504.
9.
DALE, N. & BROUGH, K. (1996) 'Normal and Deviant Social and Communicative Development in Blind Infants', paper presented at the British Psychological Society Annual Conference, Oxford.
10.
DEKABEN, A. S. (1972) 'Mental Retardation and Neurological Involvement in Patients with Congenital Retinal Blindness', Developmental Medicine and Child Neurology14: 436-444.
11.
FAY, W. H. (1973) 'On the Echolalia of the Blind and of the Autistic Child', Journal of Speech and Hearing Disorders38: 478-489.
12.
FIELDER, A.R. , BEST, A.B. & BAX, M.C.O. (1993) 'The Management of Visual Impairment in Childhood', in Clinics in Developmental Medicine, 128. London: MacKeith.
13.
FRAIBER G, S. (1977) Insights from the Blind. London: Souvenir.
14.
FRAIBERG, S. & FREEDMAN, D. (1964) 'Studies in the Ego Development of the Congenitally Blind', Psychoanalytic Study of the Child19: 113-169.
15.
GENSE, M.H. & GENSE, D.J. (1994) 'Identifying Autism in Children witl Blindness and Visual Impairments', RE:viewXXVI(2): 55-62.
16.
GOMEZ, M. R. (ed.) (1988) Tuberous Sclerosis. New York: Raven.
17.
GOODMAN, R. & ASHBY, L. (1990) 'Delayed Visual Maturation and Autism', Developmental Medicine and Child Neurology32: 814-819.
18.
GOOD MAN, R. & MINNIE, C. (1995) Questionnaire Screening for Comorbid Pervasive Developmental Disorders in Congenitally Blind Children: A Pilot Study', Journal of Autism and Developmental Disorders25 (2): 195-203.
19.
HALL, D. & HILL, P. (1996) The Child with a Disability, 2nd edn.Oxford: Blackwell Science.
20.
HAPPF, F. (1994) Autism: An Introduction to Psychological Theory. London: UCL Press.
21.
HARRISON-COVELLO, A. & LAIRY, G. C. (1985) 'Congenital Visual Deficiency: Chances and Difficulties of Management', Social Science and Medicine21(5): 559-570.
22.
HOBSON, R. P. (1990) 'On Acquiring Knowledge about People and the Capacity to Pretend: Response to Leslie', Psychological Review97: 114-121.
23.
HOSHINO, Y. , KANEKO, M., YASHIMA, Y., KUMASHIRO, H., VOLKMAR, F.R. & COHEN, D. J. (1987) 'Clinical Features of Autistic Children with Setback Course in their Infancy', The Japanese Journal of Psychiatry and Neurology41 (2): 237-246.
24.
JANSO N, U. (1993) 'Normal and Deviant Behaviour in Blind Children with ROP', Acta Ophthalmologica210: 20-26.
25.
KANNER, L. (1943) 'Autistic Disturbances of Affective Contact', Nervous Child2: 217-250.
26.
KEELER, W. R. (1958) 'Autistic Patterns and Defective Communication in Blind Children with Retrolental Fibroplasia', in P. H. H0CH & J. ZUBIN (eds) Psychopathology of Communication. New York: Grune & Stratton.
27.
KRUG, D. , ARLICK, J. & ALMOND, P. (1980) 'Behaviour Checklist for Identifying Severely Handicapped Individuals with High Levels of Autistic Behaviour', Journal of Child Psychology and Psychiatry21: 221-229.
28.
LE COUTEUR, A. , RUTTER, M., LORD, C., RIOS, P., ROBERTSON, S., HOLDGRAFER, M. & MCLENNAN, J. (1989) 'Autism Diagnostic Interview: A Standardized Investigator-Based Instrument', Journal of Autism and Developmental Disorders19(3): 363-387.
29.
LORD, C. (1991) 'Methods and Measures of Behaviour in the Diagnosis of Autism and Related Disorders', Psychiatric Clinics of North America14(1): 69-80.
30.
MAXFIELD, K.E. &BUCHHOLZ, S. (1957) A Social Maturity Scale for Blind Preschool Children: A Guide to its Use. New York: American Foundation for the Blind.
31.
MOORE, V. & MCCONACHIE, H. (1994) 'Communication between Blind and Severely Visually Impaired Children and their Parents', British Journal of Developmental Psychology12: 491-502.
32.
NORRIS, M. , SPAULDING, P. & BRODIE, F. (1957) Blindness in Children. Chicago, IL: University of Chicago Press.
33.
PREISLER, G.M. (1991) 'Early Patterns of Interaction between Blind Infants and their Sighted Mothers', Child: Care Health and Development17(2): 65-90.
34.
PREISLER, G. M. (1993) 'A Descriptive Study of Blind Children in Nurseries with Sighted Children', Child: Care Health and Development19(5): 295-315.
35.
REYNELL, J. (1979) Manual for the Reynell-Zinkin Scales. London: National Foundation of Education Research.
36.
ROBERTS-HARRY, J. , GREEN, S.H. & WILLSHAW, H.E. (1990) 'Optic Nerve Hypoplasia: Associations and Management', Archives of Disease in Childhood65: 103-106.
37.
ROGERS, M. (1996) 'Vision Impairment in Liverpool: Prevalence and Morbidity', Archives of Disease in Childhood74: 299-303.
38.
ROGERS, S.J. & NEWHART-LARSON, S. (1989) 'Characteristics of Infantile Autism in Five Children with Leber's Amaurosis', Developmental Medicine and Child Neurology31: 598-608.
39.
ROWLAND, C. (1983) 'Patterns of Interaction between Three Blind Infants and their Mothers', in A. E. MILLS (ed.) Language Acquisition in the Blind Child: Normal and Deficient, pp. 114-132. London: Croom Helm.
40.
SCHOPLER, E. , REICHLER, R., DEVILLIS, R. & DALY, K. (1980) 'Towards an Objective Classification of Childhood Autism: Childhood Autism Rating Scale (CARS)', Journal of Autism and Developmental Disorders10: 1-103.
41.
SONKSEN, P.M. (1989) 'Constraints upon Parenting: Experience of a Paediatrician', Child: Care, Health and Development15: 29-36.
42.
SONKSEN, P. M. (1996) 'Recognition and Management of Visual Impairment', in L. R0SENBLUM (ed.) Clinical Paediatrics 4(3): Diagnosis and Management of Neurological Disabilities in Childhood, pp. 451-466. London: Bailliere Tindall.
43.
TO BIN, M. (1994) Assessing Visually Handicapped People: An Introduction to Test Procedures'. London: David Fulton.
44.
TROSTER, H. & BRAMBRING, M. (1992) 'Early Social-Emotional Development in Blind Infants', Child Care Health and Development18: 207-227.
45.
UR WIN, C. (1983) 'Dialogue and Cognitive Functioning in the Early Language Development of Three Blind Children', in A. E. MILLS (ed.) Language Acquisition in the Blind Child, pp. 142-161. London: Croom Helm.
46.
VANKREVELEN, D. (1971) 'Early Infantile Autism and Autistic Psychopathy', Journal of Autism and Childhood Schizophrenia1: 82-86.
47.
WARREN, D. H. (1984) Blindness and Early Childhood Development, 2nd edn.New York: American Foundation for the Blind.
48.
WARREN, D. H. (1994) Blindness and Children: An Individual Differences Approach. Cambridge: Cambridge University Press.
49.
WAUGH, M. C. , CHONG, K., & SONKSEN, P. M. (in preparation) 'Primary Visual Disorders in Childhood; Brain MRI and CT Findings'.
50.
WING, L. (1989) 'The Diagnosis of Autism', in c. GILLBERG (ed.) Diagnosis and Treatment of Autism. New York: Plenum.
51.
WING, L. & GOULD, J. (1979) 'Severe Impairments of Social Interaction and Associated Abnormalities in Children: Epidemiology and Classification', Journal of Autism and Developmental Disorders9: 11-29.
52.
WORLD HEALTH ORGANIZATION (1993) The ICD-10 Classification of Mental and Behavioural Disorders. Geneva: WHO.
