Exploring the Diagnosis Process and Educational Services for Children with Autism Spectrum Disorder and Visual Impairment

The proposed research will use a convergent mixed methods design (Creswell, 2021) to examine the assessment, diagnosis, and service experiences of children with profound autism spectrum disorder (P-ASD) and visual impairment (VI). Children experiencing a visual impairment in combination with autism spectrum disorder (ASD+VI) are diagnosed an average of two years later than their peers without VI (de Verdier et al., 2018; Gense & Gense, 2005) and consequently do not receive timely and appropriate early intervention services, ultimately impacting school readiness (Hebbeler et al., 2007; IDEA, 2019; Root et al., 2020; Whalon & Fleury, 2023). This is particularly troublesome for children with P-ASD who have complex communication and extensive support needs. A lack of vision and symptoms of ASD impede all aspects of development (Hughes et al., 2023a, 2023b; NASEM, 2016; Rainey et al., 2016) and the co-occurrence of the two disabilities is well-documented (de Verdier et al., 2018; Jure et al., 2016; Wrzensinka et al., 2017) including common manifestations in children born with complex neurological conditions, a history of early brain damage (Chokron et al., 2021), and/or the presence of other disabilities (Kiani et al., 2019). Assumptions about the comorbidity impede timely access to appropriate health and educational practices that impact early development leading to positive life outcomes (Fazzi, et al., 2005; Gense & Gense, 2005; Pasco, 2018; Pring, 2005). As such, children experiencing ASD+VI remain underdiagnosed and underserved. To properly support these students, a timely diagnosis of the dual condition is necessary. I aim to use a national survey and parent interviews to identify factors influencing the diagnostic process and subsequent educational outcomes of children with P-ASD+VI in the US to inform future research, policy, and practice regarding equitable access to appropriate early intervention therapies and services.