Behaviors Interfering with Audiometry Associated with Eventual Diagnosis of Autism

Meagher, Sean P; Carlson, Betsy L; Elrod, Marilisa

doi:10.1007/s10803-020-04385-8

Cited by 5 publications

(2 citation statements)

References 15 publications

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“…In the literature, there is evidence of abnormal otolaryngologic and audiologic findings in objective and subjective 172 tests in individuals with ASD, even in the absence of hearing loss, including changes in ABR absolute and interpeak latencies, 173 , 174 , 175 reduced amplitude in cognitive auditory event-related potential (P300), 176 changes in central auditory processing, 177 behaviors interfering with the measurement of auditory thresholds in pure tone assessment, 172 and auditory hyper-responsiveness. 170 …”

Section: Evidence-based Evaluation and Diagnosis Of Hearing Loss In C...mentioning

confidence: 99%

Task force Guideline of Brazilian Society of Otology ‒ hearing loss in children – Part I ‒ Evaluation

Silva

Pauna

Lavinsky

et al. 2023

Brazilian Journal of Otorhinolaryngology

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Section: Evidence-based Evaluation and Diagnosis Of Hearing Loss In C...mentioning

confidence: 99%

Task force Guideline of Brazilian Society of Otology ‒ hearing loss in children – Part I ‒ Evaluation

Silva

Pauna

Lavinsky

et al. 2023

Brazilian Journal of Otorhinolaryngology

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“…Compared to typically-developing, age-matched controls, laboratory studies using clinical methods have confirmed that fewer behavioral thresholds are obtained for infants and children who have multiple conditions ( Gans and Gans, 1993 ); 3- to 10-year-old children who have autism spectrum disorder (ASD; Tharpe et al, 2006 ); or 6- to 72-month-olds with DS ( Greenberg et al, 1978 ). Similarly, retrospective clinical studies confirm that children who have developmental disabilities are at risk for not obtaining behavioral thresholds ( Meagher et al, 2021 ; Trudeau et al, 2021 ), and thresholds were obtained from children who have DS at ages later than recommended ( Nightengale et al, 2020 ). We posit that it is difficult to measure behavioral thresholds in children who have developmental disabilities because clinical methods are based on assumptions of typical child development.…”

Section: Introductionmentioning

confidence: 98%

Identifying reduced hearing in children who have developmental disabilities: Insights for inclusive research practices with electronic health records

Bonino

Mood²

2023

Front. Psychol.

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IntroductionRecent advancements in big data analytics and the formation of large-scale clinical data repositories provide a unique opportunity to determine the current state of pediatric hearing health care for children who have developmental disabilities. Before answering unresolved questions about diagnostic practice, it is paramount to determine a standard and reliable method for identifying children who have reduced hearing because clinical management is affected by hearing status. The purpose of this study was to compare 5 different methods for identifying cases of reduced hearing from pure-tone thresholds based on developmental disability status.MethodsUsing retrospective clinical data from 100,960 children (0–18 years), hearing status was determined for a total of 226,580 encounters from three clinical sites. 9% of the children had a diagnosis of intellectual disability, autism spectrum disorder, Down syndrome, or cerebral palsy.ResultsResults revealed that encounters from children who have developmental disabilities were more likely to have insufficient data to allow hearing status to be determined. Moreover, methods with higher data demands (i.e., number of thresholds and ear-specific thresholds) resulted in fewer classifiable encounters. The average child age when hearing status was classified for the first time was older for children who have developmental disabilities than for children in the comparison group. Allowing thresholds to build up over multiple test sessions did result in more children who have developmental disabilities being classified than for single-encounter methods, but a meaningful decrease in child age at the time of classification was not seen for this strategy. Compared to the comparison group, children who have developmental disabilities were more likely to have reduced hearing that was stable over time, yet their hearing status was determined at older ages.DiscussionResults provide key guidance to researchers for how to determine hearing status in children for big data applications using electronic health records. Furthermore, several assessment disparities are spotlighted for children who have developmental disabilities that warrant further investigation.

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Rethinking the Accessibility of Hearing Assessments for Children with Developmental Disabilities

Bonino,

Mood,

Dietrich

2024

J Autism Dev Disord

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We aim to determine the accessibility of gold-standard hearing assessments – audiogram or auditory brainstem response (ABR) – during the first 3 months of hearing health care for children with and without developmental disabilities. Electronic health records were examined from children (0–18 years) who received hearing health care at three hospitals. Children with developmental disabilities had a diagnosis of autism, cerebral palsy, Down syndrome, or intellectual disability. Assessments from the first 3 months were reviewed to determine if ≥ 1 audiogram or ABR threshold was recorded. To evaluate differences in assessment based on disability status, logistic regression models were built while accounting for age, race, ethnicity, sex, and site. Of the 131,783 children, 9.8% had developmental disabilities. Whereas 9.3% of children in the comparison group did not access a gold-standard assessment, this rate was 24.4% for children with developmental disabilities (relative risk (RR) = 3.79; p < 0.001). All subgroups were at higher risk relative to the comparison group (all p < 0.001): multiple diagnoses (RR = 13.24), intellectual disabilities (RR = 11.52), cerebral palsy (RR = 9.87), Down syndrome (RR = 6.14), and autism (RR = 2.88). Children with developmental disabilities are at high risk for suboptimal hearing evaluations that lack a gold-standard assessment. Failure to access a gold-standard assessment results in children being at risk for late or missed diagnosis for reduced hearing. Results highlight the need for (1) close monitoring of hearing by healthcare providers, and (2) advancements in testing methods and guidelines.

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Behaviors Interfering with Audiometry Associated with Eventual Diagnosis of Autism

Cited by 5 publications

References 15 publications

Task force Guideline of Brazilian Society of Otology ‒ hearing loss in children – Part I ‒ Evaluation

Task force Guideline of Brazilian Society of Otology ‒ hearing loss in children – Part I ‒ Evaluation

Identifying reduced hearing in children who have developmental disabilities: Insights for inclusive research practices with electronic health records

Rethinking the Accessibility of Hearing Assessments for Children with Developmental Disabilities

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