Toward More Effective Audiological Assessment of Children with Autism Spectrum Disorders

ABSTRACT

Pediatric audiologists should be well prepared for the challenges involved in the assessment of children with autism spectrum disorders (ASDs). Results of the formal audiological evaluation inform all subsequent testing, yet many variables can lead to limited and/or questionable findings. When these data are reported in vague terms, there is a potential for confusion and misinterpretation. This is significant, given that many individuals with ASDs have reported long-term auditory complaints. This article provides a fresh look at the typical pediatric audiological assessment protocol while considering the unique parameters of ASDs. A review of the auditory concerns voiced by parents and verbal adults with ASDs is included, and clinicians are encouraged to consider alternative testing approaches in addition to the traditional test battery. Specific strategies are explored for enhancing the level of cooperation exhibited by children with ASDs in the audiological assessment context.

KEYWORDS

Audiological assessment - autism spectrum disorders - pediatric

REFERENCES

• 1 Filipek P, Accardo P, Ashwal S et al.. Practice parameter: screening and diagnosis of autism.  Neurology. 2000;  55 468-479
• 2 Jure R, Rapin I, Tuchman R. Hearing-impaired autistic children.  Dev Med Child Neurol. 1991;  33 1062-1072
• 3 Student M, Sohmer H. Evidence from auditory nerve and brainstem evoked responses for an organic brain lesion in children with autistic traits.  J Autism Child Schizophr. 1978;  8 13-20
• 4 Taylor M, Rosenblatt B, Linschoten L. Auditory brainstem response abnormalities in autistic children.  Can J Neurol Sci. 1982;  9 429-433
• 5 Gravel J, Kurtzberg D, Stapells D, Vaughan H, Wallace I. Case studies.  Semin Hear. 1989;  10 272-287
• 6 Verpoorten R, Emmen J. A tactile-auditory conditioning procedure for the hearing assessment of persons with autism and mental retardation.  Scand Audiol Suppl. 1995;  41 49-50
• 7 American Speech-Language-Hearing Association .Pediatric Audiologic Assessment. Preferred Practice Patterns for the Profession of Audiology. Rockville, MD; ASHA 1997: 32-34
• 8 Jerger J, Hayes D. The cross-check principle in pediatric audiometry.  Arch Otolaryngol. 1976;  102 614-620
• 9 Northern J, Downs M. Hearing in Children, Fifth Ed. Philadelphia, PA; Lippincott Williams & Wilkins 2002
• 10 Konstantareas M, Homatidis S. Ear infections in autistic and normal children.  J Autism Dev Disord. 1987;  17 585-593
• 11 Anzalone M, Williamson G. Sensory processing and motor performance in autistic spectrum disorders. In: Wetherby A, Prizant B Autism Spectrum Disorders: A Transactional Developmental Perspective. Baltimore, MD; Brookes 2000: 143-166
• 12 Siegel B. The World of the Autistic Child. New York; Oxford University Press 1996: 77-78
• 13 Hughes R. Running with Walker. New York; Jessica Kingsley 2003
• 14 Grandin T. Thinking in Pictures. New York; Doubleday 1995: 67-73
• 15 Chermak G, Musiek F. Central Auditory Processing Disorders: New Perspectives. Albany, NY; Delmar 1997: 91-107
• 16 Palkovitz R, Wiesenfeld A. Differential autonomic responses of autistic and normal children.  J Autism Dev Disord. 1980;  10 347-360
• 17 Rosenhall U, Nordin V, Sandstrom M, Ahlsen G, Gillberg C. Autism and hearing loss.  J Autism Dev Disord. 1999;  29 349-357
• 18 Brandy W. Speech audiometry. In: Katz J Handbook of Clinical Audiology. 5th ed. Philadelphia, PA; Lippincott Williams & Wilkins 2002: 96-110
• 19 Prizant B, Duchan J. The functions of immediate echolalia in autistic children.  J Speech Hear Disord. 1981;  46 241-249
• 20 Rydell P, Prizant B. Assessment and intervention strategies for children who use echolalia. In: Teaching Children with Autism: Strategies to Enhance Communication and Socialization New York; Delmar 1995: 105-129
• 21 Wetherby A, Prizant B, Schuler A. Understanding the nature of communication and language impairments. In: Wetherby A, Prizant B Autism Spectrum Disorders: A Transactional Developmental Perspective. Baltimore, MD; Brookes 2000: 109-141
• 22 Baron-Cohen S. Perceptual role-taking and protodeclarative pointing in autism.  Br J Dev Psychol. 1989;  7 113-127
• 23 Carpenter M, Tomasello M. Joint attention, social orienting, and communication in autism. In: Wetherby A, Prizant B Autism Spectrum Disorders: A Transactional Developmental Perspective. Baltimore, MD; Brookes 2000: 31-54
• 24 Wetherby A, Prizant B, Hutchinson T. Communicative, social/affective, and symbolic profiles of young children with autism and pervasive developmental disorders.  Am J Speech Pathol. 1998;  XX 79-91 7
• 25 Fowler C, Shanks J. Tympanometry. In: Katz J Handbook of Clinical Audiology, 5th ed. Philadelphia, PA; Lippincott Williams & Wilkins 2002: 175-204
• 26 Gelfand S. The acoustic reflex. In: Katz J Handbook of Clinical Audiology, 5th ed. Philadelphia, PA; Lippincott Williams & Wilkins 2002: 205-232
• 27 Grewe T, Danhauer J, Danhauer K, Thornton A. Clinical use of otoacoustic emission in children with autism.  Int J Pediatr Otorhinolaryngol. 1994;  30 123-132
• 28 Hall J. Handbook of Otoacoustic Emissions. San Diego, CA; Singular 2000
• 29 Hall J. Handbook of Auditory Evoked Responses. Boston, MA; Allyn and Bacon 1992
• 30 Mehta U, Patel I, Castello F. EEG sedation for children with autism.  J Dev Behav Pediatr. 2004;  25 102-104
• 31 Coutinho M, Rocha V, Santos M. Auditory brainstem response in two children with autism.  Int J Pediatr Otorhinolaryngol. 2002;  66 81-85
• 32 Maziade M, Merette C, Cayer M et al.. Prolongation of brainstem auditory-evoked responses in autistic probands and their unaffected relatives.  Arch Gen Psychiatry. 2000;  57 1077-1083
• 33 Rosenblum S, Arick J, Krug D, Stubbs E, Young N, Pelson R. Auditory brainstem evoked responses in autistic children.  J Autism Dev Disord. 1980;  10 215-225
• 34 Rosenhall U, Nordin V, Brantberg K, Gillberg C. Autism and auditory brain stem responses.  Ear Hear. 2003;  24 206-214
• 35 Thivierge J, Bedard C, Cote R, Maziade M. Brainstem auditory evoked response and subcortical abnormalities in autism.  Am J Psychiatry. 1990;  147 1609-1613
• 36 Wong V, Wong S. Brainstem auditory evoked potential study in children with autistic disorder.  J Autism Dev Disord. 1991;  21(3) 329-340
• 37 American Speech-Language-Hearing Association .Central auditory processing: current status of research and implications for clinical practice. Task Force on Central Auditory Processing Consensus Development. Rockville, MD; ASHA 1995
• 38 Wetherby A, Koegel R, Mendel M. Central auditory nervous system dysfunction in echolalic autistic individuals.  J Speech Hear Res. 1981;  24 420-429
• 39 Bruneau N, Roux S, Adrien J, Barthelemy C. Auditory associative cortex dysfunction in children with autism; evidence from late auditory evoked potentials (N1 wave-T complex).  Clin Neurophysiol. 1999;  110 1927-1934
• 40 Bruneau N, Bonnet-Brilhault F, Gomot M, Adrien J, Barthelemy C. Cortical auditory processing and communication in children with autism: electrophysiological/behavioral relations.  Int J Psychophysiol. 2003;  51 17-25
• 41 Bomba M, Pang E. Cortical auditory evoked potentials in autism: a review.  Int J Psychophysiol. 2004;  53 161-169
• 42 Gomot M, Giard M, Adrien J, Barthelemy C, Bruneu N. Hypersensitivity to acoustic change in children with autism: electrophysiological evidence of left frontal cortex dysfunctioning.  Psychophysiology. 2002;  39 577-584
• 43 Ferri R, Maurizio E, Nivedita A, Bartolo L, Musumeci S, Pennisi G. The mismatched negativity and the P3a components of the auditory event-related potentials in autistic low-functioning subjects.  Clin Neurophysiol. 2003;  114 1671-1680
• 44 Bellis T J. Understanding auditory processing disorders in children. Available at: http://asha.org/public/hearing/disorders/understand-apd-child.htm Accessed January 23, 2005
• 45 Jerger J, Musiek F. Report of the consensus conference on the diagnosis of auditory processing disorders in school-aged children.  J Am Acad Audiol. 2000;  11 467-474
• 46 Katz J, Johnson C D, Tillery K L et al.. Clinical and research concerns-regarding Jerger & Musiek (2000) APD recommendations. Available at: http://www.audiologyonline.com/articles/arc_disp.asp?id=341 Accessed January 19, 2005
• 47 Musiek F, Charette L, Kelly T, Lee W W, Musiek E. Hit and false-positive rates for the middle latency response in patients with central nervous system involvement.  J Am Acad Audiol. 1999;  10 124-132
• 48 Hodgdon L. Visual Strategies for Improving Communication, Volume 1: Practical Supports for School and Home. Troy, MI; QuirkRoberts 1995
• 49 Gray C. Teaching children with autism to “read” social situations. In: Teaching Children with Autism: Strategies to Enhance Communication and Socialization New York; Delmar 1995: 219-214
• 50 Charlop-Christy M, Le L, Freeman K. A comparison of video modeling with in vivo modeling for teaching children with autism.  J Autism Dev Disord. 2000;  30(6) 537-552
• 51 Keeling K, Myles B, Gagnon E, Simpson R. Using the power card strategy to teach sportsmanship skills to a child with autism.  Focus Autism Dev Disabil. 2003;  18(2) 103-109
• 52 Park C. The Siege. Boston; Little, Brown & Company 1995
• 53 McDonnell J. News from the Border. New York; Ticknor & Fields 1993
• 54 Barron J, Barron S. There's a Boy in Here. Arlington, TX; Future Horizons 2002
• 55 Williams D. Nobody Nowhere. Australia; Perennial Currents 1994
• 56 Lawson W. Life Behind Glass: A Personal Account of Autism Spectrum Disorder. New York; Taylor and Francis 2000
• 57 Jackson L, Attwood T. Freaks, Geeks, and Asperger's Syndrome: A User Guide to Adolescence. New York; Jessica Kingsley 2002
• 58 Willey L, Attwood T. Pretending to be Normal: Living with Asperger's Syndrome. New York; Taylor and Francis 1999
• 59 Webb T. A is for Autism. [videocassette] United Kingdom; British Film Institute 1991 1 videocassette: sound, color