An optometric approach to patients with sensory integration dysfunction.

BACKGROUND: Sensory integration dysfunction is a neurologic condition that can cause children to process environmental sensations in an inappropriate way. As a result, they may either seek out strong sensations or avoid even mild sensations. Some of the characteristics of these children may be hyperactivity, poor awareness of pain, high risk taking, listening to loud sounds, clumsiness, poor fine motor skills, poor gross motor skills, poor visual tracking, problems with sequencing, and problems with balance. Sensory integration dysfunction often is related to children with developmental disabilities, autism, and attention deficits.

METHODS: Two children from the same family were examined for general eye examinations because of a history of sensory integration problems. J.H., an 11-year-old girl, and her 6-year-old half-brother, A.T., returned to the clinic for visual-perceptual testing: the Test of Variables of Attention (TOVA), the Developmental Eye Movement Test (DEM), and the Visagraph (Compevo AB, Stockholm, Sweden). The use of yoked prisms with these children was also explored.

RESULTS: Both children showed oculomotility problems based on the DEM and Visagraph results. Whereas J.H. performed well on the visual-perceptual profile overall, A.T. showed problems in many areas such as reversals, visual spatial relations, visual sequential memory, visual form constancy, and attention. Both children were low hyperopes and showed positive postural and balance changes when tested with yoked prisms.

CONCLUSIONS: Children with sensory integration dysfunction can have a number of signs and symptoms that may bring them to the optometrist's office. It is important to thoroughly test their visual, perceptual, and oculomotor systems to determine the best way to help these patients. The use of vision therapy and yoked prisms can be beneficial treatment options for many of these patients.