Audiological Assessment of Children With Autism Spectrum Disorder

Abstract

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is marked by social communication and interaction difficulties, along with restricted and repetitive behaviors and interests, and abnormal responses to certain sounds. Problems related to responses to sounds are common in ASD, especially in children, and can be a sign of actual hearing loss. As hearing is a prerequisite for speech, language, and communication, the presence of hearing loss along with autism can complicate the child’s development even more. Hence, it is vital to assess the hearing of a child with autism objectively to differentiate between the actual hearing loss and behavioral responses to sounds, which are a feature of autism itself. Objective: The objective of the study was to assess the type and degree of hearing loss in children with autism spectrum disorder using objective audiological evaluation. Methods: A descriptive cross-sectional study was designed to assess the hearing of children with autism spectrum disorder, where a total of 71 children with ASD, ranging from 2 to 15 years, who underwent audiological evaluation in clinical settings in Lahore, Pakistan, during June 2024 to June 2025, were included in the study using a purposive sampling method. Audiological evaluation was done, and the degree of hearing loss was classified according to the standard decibel scale of hearing loss. The data were analyzed using SPSS version 25. The results were then presented in the form of frequencies and percentages. Result: The majority of the sample consisted of children aged between 2-6 years. Out of the total sample, 60.6% were within this age group. In otoscopic examination, normal results were found in 90.1%. In OAE tests, normal results were found in 71.8%. On the other hand, refer results were found in 28.2%. In ABR tests, normal results were found in 69%. Mild, severe, and profound hearing loss were found in 8.5%, 9.9%, and 12.7%, respectively. In hearing loss type, normal results were found in 70.4%. On the other hand, conductive and sensorineural hearing loss were found in 8.5% and 21.1%, respectively. In tympanometry tests, normal results were found in 87.3%. Conclusion: In the study, it has been found that the majority of the sample with ASD have normal hearing thresholds. However, a significant number of the sample have clinically significant hearing impairment. In this study, sensorineural hearing loss has been found to be significant. Hence, it has been found that objective audiological tests are essential in the evaluation of hearing in ASD children.