Socio-Communicative Difficulties in Severely Visually Impaired (VI) Children WHO ARE at Risk of Autism As Measured By the Social Communication Schedule (SCS) and Parental Report

Saturday, May 14, 2016: 11:30 AM-1:30 PM
Hall A (Baltimore Convention Center)
N. J. Dale1, E. Sakkalou2, M. O'Reilly2, R. MacKechnie3, C. Springall3 and A. Salt2, (1)UCL Institute of Child Health/ Great Ormond Street Hospital for Children, London, United Kingdom, (2)Clinical Neurosciences, UCL Institute of Child Health, London, United Kingdom, (3)Great Ormond Street Hospital for Children, London, United Kingdom

Young children with congenital profound or severe visual impairment (VI) have a high risk of developing difficulties in social communication and interaction and behaviour problems. Children with profound VI (PVI) children, with light perception at best, are at greater risk for autism than children with basic ‘form’ vision (SVI) with difficulties becoming evident around the 2ndyear of life (Dale & Sonksen, 2002). Existing tools used to measure early social communicative development are highly vision-dependent and not valid for children with VI. The Visual Impairment and Social Communication Schedule (VISS - Absoud et al., 2010) has had preliminary validation with children with VI and was highly reliable in predicting a later diagnosis of ASD; we are now developing this further to include standard behavioural items and social ‘presses’ (Social Communication Schedule -SCS).


To examine socio-communicative skills and difficulties in a sample of 2-year-old children with PVI and SVI using the SCS and Negative Behaviour Screener (NBS), and further examine relations with parent report of infant socio-communicative skills and pervasive developmental problems. 


Preliminary data from 51 children (M=26 months; 11 PVI, 40 SVI), with ‘simple’ congenital disorders of the peripheral visual system were rated using the SCS (high scores indicated better social communicative abilities) and the NBS (higher scores indicated more negative behaviours), whilst engaging in social and independent play tasks. Functional vision was assessed with the Near Detection Scale (Sonksen et al., 1983) to establish lower PVI and higher SVI. Parents rated the Vineland Adaptive Behaviour Scales (VABS) and the Child Behavior Checklist (CBCL). The subscales Communication and Social Skills from the VABS and the subscale Pervasive Developmental Problems (PDP) from the CBCL were utilised. These subscales have shown predictive relations with ASD in previous studies (Volker et al, 1987; Sikora et al, 2007).


Strong negative relations found between SCS scores and NBS scores (r= -.74, p<.001) showed that children who scored higher on socio-communicative abilities on SCS had lower negative behaviour scores on NBS.  A correlational analysis of the effect of vision level showed higher SCS scores and lower negative behaviours with higher level of functional vision (r= .48, p<.001; r= -.35, p<.01). Positive correlations were found between the SCS and VABS Communication (r=.53, p<.001) and Social Skills (r= .60, p<.001) and negative correlations between the NBS and VABS Communication, r= -.36, p<.01 and Social Skills, r= -.50, p<.001. Children with lower SCS scores and higher NBS scores were rated higher on the PDP by parents (r= -.37, p<.01, r= .33, p<.05 respectively).  


Children with VI with higher social communicative abilities at 2 years showed lower negative behaviours. Lack of functional vision was a risk factor with children with lowest functional vision (PVI) demonstrating weaker socio-communicative behaviours and higher negative behaviours. Together with promising validation with the parent report measures, the findings suggest that this ‘early stage’ tool may provide a useful means of differentiating behaviours which may be early signs of autism in this at risk population.