Prevalence and Profiles of Late-Onset Hearing Loss in Preschool Children with Autism Spectrum Disorder Who Passed Newborn Hearing Screening in a South East Asian Population.
One in nine preschoolers with ASD who passed newborn hearing screening later showed hearing loss—schedule repeat audiology checks.
01Research in Context
What this study did
Doctors screened 333 preschoolers with developmental delays in Singapore. All kids had passed newborn hearing tests. The team gave each child full audiology exams to catch late-onset hearing loss.
They paid special attention to the the children with autism. Each child needed several visits to get clear results.
What they found
One in nine preschoolers showed hearing loss that the newborn screen had missed. The rate was 10.8 percent across all delays, and similar in the autism group.
Two children had moderate to severe loss. Kids with autism needed more return visits before testers could trust the results.
How this fits with other research
Faso et al. (2016) found that children with autism get twice as many serious ear infections. Ni’s team now shows that even without infections, hearing can slip later. Together the papers make a case for routine ear checks after the newborn period.
Spates et al. (2013) and Santos et al. (2017) used brain-stem tests and also found odd auditory responses in young children with autism. Ni adds real-world evidence that some of these brain differences translate to actual hearing loss you can measure in the clinic.
Russo et al. (2009) showed that background noise hurts speech processing in autism. If a child also has the late-onset loss Ni found, classroom noise becomes a double hit. Cutting noise and checking ears work hand in hand.
Why it matters
You can’t trust a passed newborn screen. Build one repeat audiology check into your autism assessment battery. Schedule it before you start intensive ABA or speech sessions. Catching even mild loss early keeps your reinforcement delivery clear and prevents goals from being blamed on “non-compliance” when the child simply can’t hear you.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add a hearing re-screen referral to your intake checklist for every new preschool client with ASD.
02At a glance
03Original abstract
Prevalence of hearing loss in children with autism spectrum disorder (ASD) is uncertain, as it is more challenging to assess hearing function in children with developmental difficulties (DD). We aimed to determine the prevalence and profiles of hearing loss in preschool children with ASD in a Southeast-Asian population who passed newborn hearing screening. A retrospective study of preschool children with DD (ASD, Global Developmental Delay (GDD), and Speech and Language Delay (SLD)) attending the Child Development Unit (CDU) at our hospital was performed. Three hundred and thirty-three children (ASD: n = 129; GDD: n = 110; and SLD: n = 94) underwent hearing assessments. Of these, 10.8% of children (n = 36, comprising 15 with ASD, 12 with GDD and 9 with SLD) had confirmed hearing loss. Hearing loss was predominantly bilateral in children with ASD and GDD; in those with SLD, unilateral and bilateral hearing loss were equally common. Conductive hearing loss occurred as frequently as sensorineural hearing loss in children with ASD and SLD, but was the dominant subtype in those with GDD. Moderate to severe hearing loss (n = 2) was noted only in children with ASD. Children with ASD and GDD required significantly more audiology visits and procedures to obtain conclusive hearing test results, compared to those with SLD. The need to identify hearing loss and monitor for resolution is particularly important in vulnerable populations with communication deficits, such as in those with ASD.
Journal of autism and developmental disorders, 2024 · doi:10.1080/14992027.2016.1211764