HEARING LOSS WITH AUTISM SPECTRUM DISORDER INDIVIDUAL

HEARING LOSS WITH OTHER DISABILITIES
 

Individual with hearing loss and additional disabilities represent by extensively varied and complex population. They vary in the type and degree of their hearing loss, the type and degree of their associated disability, and their general level of functioning.  About 30-40% of newborns who have hearing loss have additional neurodevelopmental disorder. Table 1 below shows the percentage of disabilities that occur in children with hearing loss by Gallaudet Research Institute (2005).

Additional disabilities	% of children with hearing loss
No additional disabilities	57.6
Low vision / legal blindness	4.6
Intellectual disabilities	10.0
Autism	1.0
Orthopedic disabilities (including cerebral palsy)	3.7
Learning disabilities	9.2
Attention deficit disorder/ attention deficit hyperactivity disorder	6.3
Emotional disabilities	1.9
Other	6.9

Table 1: The percentage of disabilities that occur in children with hearing loss by Gallaudet Research Institute (2005)

AUTISM SPECTRUM DISORDER (ASD)

What is Autism? Autism is a developmental disorder characterized by a triad of symptoms including qualitative impairments in social interaction, qualitative in communication, and restricted, repetitive, and stereotyped patterns of behaviours, activities, and interests (American Psychiatric Association, 1994). Autism spectrum disorder (APD) also includes pervasive developmental disorder (PDD), Asperger’s syndrome, Rett’s syndrome and childhood disintegrative disorder. 

            There is no solid evidence to suggest that individual with autism have a greater risk of hearing loss than the general population but the incidence of unusual sensory responses, including abnormal responses to sounds is considered as associated characteristic of autism.  For example, individual with autism normally to be too sensitive to sound, when loud or unexpected sounds arise, they covering theirs ears with their hands.  

HEARING TEST FOR ASD INDIVIDUAL 

            Children with autism who have hearing loss are diagnosed on average, almost 1 year later than those without hearing loss (Madell et al., 2005). Majority those with autism show cognitive deficits, behaviours abnormalities, and hypersensitivity to sensory stimulation, thus modification to traditional hearing testing should be considered. 

Audiologist will want to minimize physical contact with autistic children who have tactile sensitivities. For example audiologist may require initial testing in sound filed which is using the speaker instead of using the earphone. 

            Regardless of the chronological age of the individual, audiologist will use behavioural test procedures that are appropriate for their cognitive.  For example typical behavioural testing procedure used with infant or young children such as visual reinforcement audiometry (VRA) or play audiometry will be used with older children or even adults. 

            If an individual with autism not allow the placement of earphone or probes for individual ear testing, audiologist may have to re-establish to sedate procedures for certainly for those plans to fit with hearing aids. Individual with autism are hard to sedate with pediatric sedation agent and are at risk for seizure while under sedation (Mehta et al, 2004).

HEARING AID FOR INDIVIDUAL WITH ASD

            Individual with autism who has tactile sensitivities and hearing loss, we should expect some struggle and rejection to wear hearing aids.  

Technique to introduce the hearing aids to individual with AS3D:

1.     Start by having the parent or caregiver gently massage the patient’s ear several times a day until little or no resistance is offered.  This may require some time; days, weeks or months depending to the degree of tactile sensitivity.

2.     Introduce to one ear only, with a soft earmould first, without connected with the hearing aid until they willing to wear for longer period of time.

3.     Once the earmould is tolerated with little resistance, the hearing aid can be couple with the earmould and switch on. Then, introduce the hearing aids at another side.

4.     The hearing aid need to be secured to their clothing by using the special hearing aid clip so that even they pull the hearing aids from their ears, the hearing aid is secured to their clothing.    

REFERANCE

Katz et al. (2009). Handbook of Clinical Audiology 6^th.. Edition. Lippincott Williams & Wilkins.  

ATIQAH SOLEHAH BINTI JAMIL
AUDIOLOGIST EARTISTIC HEARING AND BALANCE CENTER, TT