Autism and hearing loss.

Njardvik et al. (1999) looked at hearing in 199 autistic children and teens. They checked for hearing loss and hyperacusis, a painful reaction to everyday sounds.

The team compared rates to typical peers. This was a case series, so they described what they saw rather than testing a treatment.

One in five autistic clients had a hearing problem that had been missed. Hearing loss and hyperacusis both showed up more often than in non-autistic kids.

Because these issues can mimic or worsen autism symptoms, the authors urged routine hearing screens at intake.

The finding fits with Laposa et al. (2017), who recorded high rates of unusual sensory behaviors in both infants at risk for autism and teens already diagnosed. Together the papers trace a line from early sensory red flags to later auditory pain.

Jones et al. (2010) and Barton et al. (2019) extend the picture. They show that hyperresponsive reactions—like covering ears—predict repetitive behaviors across all senses, not just sound. So a child who startles at the vacuum may also line up toys more often.

Critchfield (1996) foreshadowed this work. That earlier trial used daily listening sessions to cut sound distress and saw lasting gains in autism severity. The 1999 prevalence data gave clinicians a reason to try such auditory supports in the first place.

If a client ignores instructions or bolts from the room, rule out hearing issues before you write it off as non-compliance. A five-minute screen can spare months of failed programs. Once hearing status is clear, you can adjust your teaching space: lower the volume, use visual cues, or add noise-canceling time. Pair this with sensory supports shown in later studies—like predictable routines during COVID uncertainty (Karolina, 2026)—and you tackle both the ear pain and the stress it brings.