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The Autism Network for Deaf/Hard of Hearing
and Blind/Visually Impaired

 Autism Research Institute
4182 Adams Avenue
San Diego, California 92116 USA


Article by Margaret P. Creedon, Ph.D. titled "Autism and Sight or Hearing Loss: The Diagnostic Challenges of Dual Disorders."



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New Year greetings and welcome to the winter quarter newsletter. We hope you have shared information about the site, with family members and professional colleagues. That will expand the Network's connections including information about new studies you will see in a section that follows. Previous e-newsletters are also available there.


Margaret Creedon, Ph.D., ABPP

and Steve Edelson, Ph.D. 



In our last issue, Dr. K. Sharieff, a neuro-developmental optometrist, outlined the visual perceptual deficits related to Autism Spectrum Disorders (ASD) and the adaptive visual skills that should be evaluated.   This is central in facilitating social and educational goals for all persons with ASD including those who may have some but limited vision and certainly those deaf or hard of hearing. I am repeating this concern here to encourage teachers, speech and language and other specialists and parents to review skills related to eye movement, spatial awareness, binocularity or eye teaming, and visual-motor control.


Clinically, other professionals (such as occupational therapists, speech and language clinicians) and I have noted that as youngsters, small delays and/or errors in tracking and orienting may be overlooked especially for deaf and blind.  At the time of discovering the dual diagnoses of a  sensory disability and autism, it may seem reasonable to think delays may occur with shifts in communication systems and social relatedness issues. However, we should be very cautious that such differences do not become accepted as part of the overall behavior of autism and sensory loss.

As a result, we can begin to think children are less able and/or less interested in communication and consequently impact the educational and safety components of their everday lives.


It is also very important for deaf children to have the necessary tracking skills for receiving signed communication or even gestures directed to them. Without the advantage of sound or voice alerting them from the environment, teachers and family members may need to learn techniques to clarify sending and receiving messages.  


Deaf students with autism may have difficulty with both visual spatial components of presenting a sign to another person. They may need, for example, to anchor their arms on a desk surface when working on imitating, motor planning, and executing a sign. They must also learn the pragmatic elements of giving a sign to another communicator's receiving space. That is, it is ineffective for students to initiate signing in their lap or in a lower position in order to watch their own hands without recognizing that another person may not see it or mistake it for something else.


We have heard that they have "autistic-like tendencies" but not really autism. 


Terese Pawletko, Ph.D. responded to this question in her article titled "Autism and Visual Impairment," reprinted, in part, from FOCAL Points, Fall 2002 Volume 1, Issue 2, and with her permission.



Children with visual impairments can be  on the autism spectrum as well. Remember, it is a brain-based disorder so those children with neurological vulnerabilities (e.g., seizure disorders, septo-optic dysplasia, Prematurity associated with bleeds, agenesis of the corpus callosum, congenital rubella syndrome, etc.) may be at increased risk. The literature in the field of visual impairment needs to be more cautious in its use of the terminology "autistic-like" in that it can result in missed diagnosis and/or delay in procuring appropriate services for those children who are on the autism spectrum. Strategies useful for children who are visually impaired and autistic vary considerably from those effective for children who are just visually impaired. Key thing to remember: autism is a brain related disorder; that it is estimated that 50% of blind children have LD and 56% of those with severe LD or IQ<50 have autism (Steinberg et al., 2002).




It is important to begin to advocate for appropriate diagnosis for your children through collaborative efforts between autism diagnostic centers and teachers of the visually impaired, and by advocating with your primary care providers. Cooperative efforts between vision and autism programs will be critical as most of the strategies used for children with autism rely on vision - not always an option for our children and students. 


Julie Stefanski, a graduate student in the doctoral program in Audiology at Ohio State University is conducting a research study on parent experience  of individuals with dual diagnosis of autism spectrum disorder and hearing impairment. The research is qualitative in nature, and it is designed to raise awareness. 


The research is confidential and non-identifiable, and the purpose of the study is to further information about diagnosis, services, educational decisions, and the roles of interdisciplinary professional for this unique population.


If you are a parent and/or professional who can help with this project, please contact JulIe Stefanski at [email protected]. 

Michael D. Kanter


Michael D. Kanter 

The Deaf/HOH autism and the Jewish disabilities communities lost a pillar of their groups with the sudden death of Michael Kanter at age 56. Michael was the father of Brandon, a young deaf man with autism. Brandon and Michael were featured in a previous e-newsletter as well as a filmed interview available at the Network Advocacy and Resources link,on our website at .


Michael Kanter gave unending support to hundreds of families struggling with so many issues related to dual diagnoses. He was an incredible role model for single dads raising children with disabilities. As the ASI North Suburban (Illinois) chapter leader or at state and national conferences, his heart was open to anyone, no matter the hour.

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