Honey is a 30-month old child on the autism spectrum who attends the appointment with her childminder. She has been rubbing her eyes a lot and has developed an infection in both eyes. Honey’s parents and childminder do not know why Honey has been rubbing her eyes so much, but it is often when they go into brightly lit places such as the local supermarket and the shopping mall.

Strategies

• An eye examination needs to be undertaken.
• Before examination, allow Honey to feel and hold the equipment with her childminder’s help.
• Use your judgement on how to approach Honey, following the ACER approach – ask, check, explain and reinforce/repeat.  Discuss your approach with the childminder.
• Discuss details of when Honey is rubbing her eyes and where she is looking when she does this.
• Suggest that the childminder and parents keep a log of the exact circumstances when Honey rubs her eyes in order to establish patterns, identify possible environmental causes and monitor whether Honey seems uncomfortable or stressed when it occurs.
• Discuss possibility of visual sensory overload.
• If possible sensory overload, discuss whether Honey needs to visit such venues and/or mediation of the effects e.g. wearing baseball cap; sunshade or sunglasses or providing an activity for Honey that might mediate the effects of bright lighting.