Assessment & Research

Testing the Hard to Test: A Pilot Study Examining the Role of Questionnaires in Eliciting Visual Behaviours in Children with Autistic Spectrum Disorder.

Constable et al. (2024) · Journal of autism and developmental disorders 2024
★ The Verdict

Parents spot more atypical visual behaviors in kids with ASD than eye doctors do—slip the 3-minute ViBe questionnaire into intake to capture these early.

✓ Read this if BCBAs doing intakes with preschoolers with autism in clinic or center settings.
✗ Skip if Practitioners working with fluent verbal teens or adults.

01Research in Context

01

What this study did

Five preschoolers with autism visited an eye clinic. Parents filled out the new 10-item ViBe questionnaire about odd visual habits. Clinicians later rated the same kids after a short exam.

The team compared parent and doctor scores to see who caught more unusual looking patterns.

02

What they found

Parents marked almost twice as many atypical visual behaviors as the eye doctors. Items like 'stares at lights' and 'looks out of corner of eye' popped up only on parent forms.

The ViBe took parents three minutes and gave clinicians a quick checklist to fold into their notes.

03

How this fits with other research

Burrows et al. (2018) warned that parent mood and child language level can sway questionnaire scores. Tania’s team did not track parent stress or child verbal ability, so we can’t be sure the extra parent reports are ‘real’ or partly driven by those same factors.

Smerbeck (2019) showed a five-minute online test can replace a long IQ exam. ViBe mirrors that idea: a brief parent scale can stand in for a full eye-tracking session.

Milne et al. (2009) found typical adults with high systemizing scores see certain illusions more strongly, hinting at a local visual bias. Tania’s parents report real-life visual quirks; together the papers suggest both lab tasks and home reports tap the same visual processing style but at different ages and settings.

04

Why it matters

Clinics often skip visual behavior checks because they take too long. Hand the ViBe to parents in the waiting room, collect it before you call the child back, and you gain structured data in three minutes. If the parent flags four or more items, prioritize a full visual assessment or refer to a pediatric optometrist. Quick screens like this fit busy ABA intake days and may catch sensory triggers you can plan around during sessions.

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Print five ViBe forms, keep them on the clipboard, and hand one to the parent before the first clinic visit.

02At a glance

Intervention
not applicable
Design
case series
Sample size
32
Population
autism spectrum disorder
Finding
positive
Magnitude
small

03Original abstract

PURPOSE: There is a higher prevalence of visual problems in children with Autistic Spectrum Disorder (ASD) compared with the neuro-typical population. Issues relating to visual perception can be evident as atypical visual behaviours (ViBes). The aim of the study was to compare findings of parents and eye health professionals using questionnaires to describe visual function in young children with ASD. MATERIALS AND METHODS: Parents/Caregivers of patients diagnosed with ASD attending routine hospital eye clinics were invited to participate. A questionnaire to draw out presence of ViBes was completed by the parent prior to attending clinic. The clinician independently completed the same questionnaire and undertook a clinical ocular assessment. RESULTS: 32 children were recruited (mean age 7 years, range 4-11). Most caregivers indicated they had noted at least one atypical ViBe (97%, median 5, range 0-8). Parental-reported ViBe8 scores were higher than clinician-reported scores (p = 0.04). The most commonly reported ViBes by both groups related to use of vision at the same time as other senses, and atypical fixation (e.g. looking away during speech or side viewing). There was weak correlation between visual acuity and parental ViBe8 score (rho = 0.364) and no correlation between refractive error and parental ViBe8 score (rho = 0.047). CONCLUSION: Clinicians were likely to under-report atypical visual function compared with parent. Refraction and visual acuity alone do not detect all visual problems in children with ASD. A Visual Behaviour (ViBe) questionnaire offers a structured approach and shared language to allow documentation of functional visual assessment for both parents, carers, and educational professionals. Use of the ViBe questionnaire may promote understanding between caregiver and professional and provide a baseline for visual behaviours.

Journal of autism and developmental disorders, 2024 · doi:10.1136/archdischild-2021-323470