Autism and the Audiologist’s Role

April is Autism Awareness Month, and in addition to raising awareness about autism, it also serves as an important reminder of the role healthcare providers play in treating and caring for autistic patients. One such role is that of the audiologist.

Autism spectrum disorders (ASDs) are reported to affect one in 110 children in the United States alone. Research increasingly suggests autism often involves difficulties in distinguishing and processing sound – one of the most basic skills needed to understand and use speech.

The clinical audiologist’s role in autism was a major lecture topic at this year’s American Academy of Audiology (AAA) in Columbus, Ohio. The presentation, titled, Marion Downs Lecture in Pediatric Audiology: Autism Spectrum Disorder: Considerations for Clinical Care in Pediatric Audiology was given to audiologists who attended the conference by Jolanta McCall, MA, MSc and two of her colleagues. The lecture covered techniques used to modify standard testing to accommodate the needs of autistic children; the unique behaviors of children with autism; and some of the common misconceptions about the science of autism.

Children with autism may exhibit various behaviors and responses to sounds that are different than what might be expected with typically developing (or “neurotypical”) peers. This includes covering one’s ears in situations that don't seem particularly noisy to most people; humming in response to chatter or other noises; and/or feeling distressed when surrounded by a lot of chatter or other noise. Parents often notice these “auditory hypersensitivities” when their children are quite young, possibly even before they are diagnosed with autism.

"Some of the behaviors of young autistic children mimic the behaviors of young children with hearing loss,” said Lindsay Bondurant, PhD, director of the Pennsylvania Ear Institute (PEI) of Salus University. “These may include inconsistent responses to sound; lack of interaction when caregivers and others are talking; and difficulty communicating needs.” According to Dr. Bondurant, it’s impossible for parents and pediatricians to rely solely on observation to accurately determine if a child has completely normal hearing, which is, why it is crucial any child with suspected autism or other communication disorders have a hearing evaluation with a pediatric audiologist to rule out hearing loss before proceeding with other evaluations.

According to the American Speech-Language-Hearing Association (ASHA), many autistic children can have their hearing tested using traditional methods. However, testing the hearing of some children with disabilities, such as ASDs, can be a challenge even for the most experienced clinician. Learning ways to adapt screenings and exams for all types of patients in order to provide them with accurate testing results is what makes a great and thorough practitioner.

"A pediatric audiologist has the expertise, knowledge and training to work with typically developing children as well as those who may have disabilities,” said Jenny Rajan, AuD, CCC-A, FAAA, PEI clinical educator who specializes in pediatrics. According to Dr. Rajan, PEI welcomes families of children with autism to ask questions and work with the staff audiologist. The audiologist will tell you what to expect during the appointment while the parents and caregivers can provide valuable insight to help reduce any fears or anxieties the child may have during the appointment. It is quite common to see the child back for multiple visits to have the full hearing evaluation completed. “We are flexible and will work with your child’s schedule to determine if morning or afternoon appointments would be best," Dr. Rajan said.

ASHA encourages audiologists to get to know what the patient likes; how to best reward them and not hesitate to ask parents what works best for their child. Incorporating technology is also a great way to aid the exam.

For parents, ASHA also suggests bringing a laptop to screenings in order to pull up videos and make it fun for the child, or being goofy to reduce the fear and anxiety that goes along with testing. 

For an appointment at PEI, please call 215.780.3180 or fill out this online form.