Hearing Loss and Autism

When a child has been diagnosed with an Autism Spectrum Disorder (ASD), the symptoms of hearing loss may be overlooked.  This is especially true when the diagnosis is made in a very young child.  Difficulty with communication or other symptoms of autism may overshadow the symptoms of hearing loss.  Conversely, a hearing loss diagnosis may delay an ASD diagnosis.

Symptoms of Hearing Loss without ASD Diagnosis

In order to distinguish between the symptoms of regular hearing loss and hearing loss in a child on the autism spectrum, you must be familiar with standard symptoms of hearing loss in children.  These are as follows:

• Child uses eyes to follow people
• Likes hugs
• Attempts to communicate with gestures
• May have difficulty with language but asks questions
• Accepts changes (even if they have preferences)
• Doesn’t respond to name if called from behind

Depending on the age of the child, different hearing screenings can be used.

Symptoms of Hearing Loss in Children with ASD

If a child is first diagnosed with hearing loss, the ASD diagnosis may be delayed as the parents attribute behaviors to the hearing loss.  On the other hand, if the ASD diagnosis is made first, parents may miss hearing loss symptoms and attribute them to the ASD.  Here are the subtle symptoms of hearing loss in a child with ASD:

• Child does not make eye contact
• Child pulls away from hugs or contact
• Child may take a person’s hand to indicate wants or needs
• Does not communicate through facial expression
• Child insists on sameness, nothing can be changed
• Avoids certain lights, smells, or textures
• Head-hitting when upset

Hearing Screenings and Hearing Tests for Children with ASD

As with other medical professionals, it is best to find professionals that are familiar with treating patients with ASD.  Your local ASD support group the Autism Speaks online Resource Guide can refer you to professionals in your area.  Your pediatrician is equipped to handle basic hearing screenings, but if you need audiometry testing, otoacoustic emissions testing, or auditory brainstem response testing, ask the pediatrician for a referral.

Dr. Gail D Chermak, chair of the Department of Speech and Hearing Sciences at Washington State University, stresses the importance of auditory screening. “Comprehensive testing of auditory functions using behavioral and electrophysiological methods is important to identify children who can benefit from interventions, including assistive listening devices and environmental changes to improve signal-to-noise levels in the classroom.”  Her article, Pathways: Comprehensive Auditory Function Testing Vital for Children with CAPD is a complete look at testing.

Communication Strategies for Children with Hearing Loss and ASD

Here are some things you can do to lessen the frustration that can be caused by the combination of hearing loss and ASD.

Wear hearing aids – This can be a challenge, but acclimating your child to wearing hearing aids will be one of the most beneficial things you can do.  If your child is particularly sensitive to certain sounds or frequencies, be sure to work with your audiologist for proper hearing aid adjustment.

Try Sign Language – Since most children on the autism spectrum are visually stimulated, sign language might be a way to get them to communicate wants and needs. Also, many children with ASD thrive on repetition, and learning sign language may be a way to channel that need.

Utilize Visual Tools – If your child is non-verbal, this condition might continue through adulthood.  It is vital that you work on means of communication.  Using flashcards with pictures and visual cues is imperative to establishing communication.

In addition, the services of an audiologist or therapist can help with communication.   Here are just a few ways they can help:

• Auditory conditioning and training and learning to use Assistive Listening Devices
• Computer-based learning tools and speech and language processing
• Language processing training