Hearing impairment is more prevalent in individuals with Autism Spectrum Disorders (ASD) than the general population, and although ASD is not caused by hearing impairment, symptoms may be made worse by difficulty hearing. Sixty participants with ASD and 16 typically developing peers ages 5-18 underwent a comprehensive screening of communication abilities (expressive and receptive language, speech articulation, phonological processing, and vocal emotion recognition) and audiology (pure tone audiometry, uncomfortable loudness level, tympanometry, acoustic reflexes, distortion product otoacoustic emissions, and auditory brainstem response). The ASD group had a higher rate (55%) of abnormal findings on at least one measure of audiological functioning than typically developing peers (14.9%) or the general population estimate (6%). The presence of sound sensitivity in at least one ear was also considerably higher for the ASD group (37%) compared to the typically developing participants (0%) or general population estimates (8-15%). When participants with ASD were divided into groups with and without evidence of abnormal audiology, there were no significant group differences in communication; however, when the relationship between hearing thresholds and communication was examined, thresholds at middle range frequencies (2000Hz) were in fact significantly related to performance on all measures of speech articulation and language. These results suggest that classifying hearing as normal versus abnormal may not be sufficient to understand its association with ASD symptoms and that treatment studies for mild/subclinical hearing loss may be worthwhile for children with ASD.
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