1. What questions should I ask when I am trying to
find an optometrist for my child?
It is important to know if the optometrist is willing
to examine a pediatric patient on the autism spectrum. A parent or guardian should ask what
experience the doctor has working with this special population. Does the clinic
have hours that would be convenient (early, evenings, Saturdays?) What is the cancellation policy? Is the optometrist willing to communicate
with the teachers or other professionals on the team? It is most important that
the child and their family feel comfortable and welcome in the office and the
doctor and staff are friendly and accommodating.
2. Would an optometrist be open to consulting with a parent
before the appointment, to review and plan best strategies in order to ensure
the visit is a success for both the child and optometrist? Would there be an additional fee for this
meeting?
Most optometrists would be open to scheduling this
type of meeting, so this is another question that should be asked when
searching for an optometrist. This would
not be covered under OHIP, and different offices may have varying policies
regarding fees. Our office does not
charge for this service, but we ask that as much information as possible is
provided in advance (e.g. by email) in order to have the most productive
meeting possible. It is helpful to know medical/ocular health history, sensory
issues, behavioural triggers, level of functioning etc. A phone consultation is
often the most convenient method.
3. Children with autism often have difficulties with
transitions and new environments. Is it
reasonable for a parent to request that their child visit the office prior to
the appointment?
Absolutely! Depending on the needs of the patient, several
visits may be appropriate. Sometimes the
patient will come and play with the toys in the reception area, and meet the
doctor and staff. The next visit may
include a “tour” of the exam room, to see the equipment, & touch or sit in
the chair. Often it is helpful if a
parent or sibling has an eye examination while the ASD child observes. They can receive some positive reinforcement
(stickers, jelly beans, toys etc.) as an enticement to return to the office for
their appointment. We would recommend
scheduling it when the office isn’t as busy, such as mid-morning or around
noon, and when the child is well rested.
4. Many children with autism have sensory issues, how
can an optometrist accommodate this?
Knowing in advance what particular sensory issues
there are would be helpful. For example,
if noise is a concern, then the stereo system would be turned down or off
during the visit. Lighting can be dimmed
in the examination room. Some bright
lights are used to assess the health of the eyes, but the intensity can also be
reduced as much as possible. Children
who are uncomfortable sitting on a vinyl surface would be encouraged to bring a
soft blanket they like that they could sit on.
If perfumes or other scents are a concern, they would be eliminated as
much as possible during the visit. If a child has a particular comfort
object/toy, they are encouraged to bring it with them. We have ”examined “ many stuffed animals’ eyes before
the child has his turn.
5. Are optometry services covered by OHIP? What other fees may I need to pay?
Children are covered for one complete eye examination
per year until they turn 20 years of age. Partial re-assessments are covered as
needed. After the age of 20, people on
disability are covered every two years.
Fees would be charged for eye glasses or contact lenses.
6. How often should my child see an optometrist?
Children grow very quickly, and should be seen at
least once a year for a routine eye exam or more often if recommended by the
doctor. It is not unusual for several
shorter visits to be necessary to obtain and confirm all the information
regarding visual acuity, refraction, binocular vision & ocular health,
especially if they are new to the office.
If any changes or problems are detected, then the child should return to
the office as soon as possible.
7. How do you test the eyesight of children who are
non-verbal or who have difficulty expressing themselves verbally?
It is necessary to rely on objective tests if the
child is non-verbal. Some of these tests are observational – for example,
ocular motility can be assessed while watching the child follow a toy moving
side to side or in different positions of gaze.
Refraction can be determined by “neutralizing” the reflection of light
from the back of the eye. Ocular health
can be checked by looking inside the eye. In certain cases, it is necessary to
put drops in the eyes to determine the refraction and ocular health (which is
only done with parent/guardian permission).
The more co-operative the child, the more accurate and complete the
tests results will be.
Dr. Linda Kwasnick, O.D. received her degree from the
University of Waterloo and was named on the Dean’s Honour Role. Her private practice in Orleans has been
operating for over 30 years. She is the
mother of two sons, who are both studying at Carleton University and she
developed a special interest in ASD after her eldest son was diagnosed with
Asperger’s Syndrome 10 years ago. Linda has been active in local parent support
groups, attending seminars, and working with charities that support children on
the spectrum and their families. |