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.
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Data Availability
The data that support the findings of this study are available from the corresponding author upon reasonable request.
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Appendix A
A soundfield speaker was used initially for conditioning before switching to insert-earphones (air conduction transducer) to obtain ear-specific results. The Hughson-Westlake procedure was used to determine hearing thresholds, with a modified initial 20dB descending step-size to optimize testing at the child’s best attention. Test frequencies included 250Hz, 500Hz, 1000Hz, 2000Hz, and 4000Hz. The reliability of the test was determined by obtaining at least two responses at the same intensity level at a particular frequency. If cooperative, children with hearing thresholds of 25dBHL and above would proceed with bone conduction testing. Tympanometry 226Hz (GSI Tympstar) was conducted on all children to determine their middle ear status (refer to Supplementary Material, Table 2 for the categorization of different tympanograms).
Appendix 2: Community analysis
Auditory Brainstem Response (ABR) and Auditory Steady State Response (ASSR; Interacoustic Eclipse EP25) were conducted under sedation to establish the child’s hearing thresholds. Transient-Evoked Otoacoustic Emission (Otodynamics) was included as part of the test battery to determine the integrity of the outer hair cells in the cochlea. The severity of hearing loss was determined by the hearing threshold in decibel levels [Supplementary Material, Table 1] (Clark, 1981).
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Ting, F.N., Kiing, J.S., Li, W.W. et al. 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. J Autism Dev Disord (2023). https://doi.org/10.1007/s10803-023-06060-0
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DOI: https://doi.org/10.1007/s10803-023-06060-0