Children with autism spectrum disorder have reduced otoacoustic emissions at the 1 kHz mid‐frequency region

Abstract

Autism spectrum disorder (ASD) is a behaviorally diagnosed disorder of early onset characterized by impairment in social communication and restricted and repetitive behaviors. Some of the earliest signs of ASD involve auditory processing, and a recent study found that hearing thresholds in children with ASD in the mid-range frequencies were significantly related to receptive and expressive language measures. In addition, otoacoustic emissions have been used to detect reduced cochlear function in the presence of normal audiometric thresholds. We were interested then to know if otoacoustic emissions in children with normal audiometric thresholds would also reveal differences between children with ASD and typical developing (TD) controls in mid-frequency regions. Our objective was to specifically measure baseline afferent otoacoustic emissions (distortion-product otoacoustic emissions; DPOAEs), transient-evoked otoacoustic emissions (TrOAEs) and efferent suppression, in 35 children with high-functioning ASD compared with 42 aged-matched TD controls. All participants were males 6-17 years old, with normal audiometry, and rigorously characterized via ADI-R and ADOS. Children with ASD had greatly reduced DPOAE responses in the 1 kHz frequency range, yet had comparable DPOAE responses at 0.5 and 4-8 kHz regions. Furthermore, analysis of the spectral features of TrOAEs revealed significantly decreased emissions in ASD in similar frequencies. No significant differences were noted in DPOAE or TrOAE noise floors, middle ear muscle reflex activity, or efferent suppression between children with ASD and TD controls. In conclusion, attention to specific-frequency deficits using noninvasive measures of cochlear function may be important in auditory processing impairments found in ASD.

Using Visual Supports to Facilitate Audiological Testing for Children With Autism Spectrum Disorder

“…Even when audiological data are collected, unique features associated with ASD can make the data difficult to interpret. Specifically, studies suggest that both behavioral and physiological clinical tests may have different results for children with ASD compared to children that are neurotypical (Bennetto, Keith, Allen, & Luebke, 2017;Kwon, Kim, Choe, Ko, & Park, 2007;Roth, Muchnik, Shabtai, Hildesheimer, & Henkin, 2012;Tharpe et al, 2006). It appears that these differences are not a result of peripheral hearing loss but rather are due to potential underlying differences in auditory functioning and/or structural differences in the brain (e.g., Hyde, Samson, Evans, & Mottron, 2010;Kulesza, Lukose, & Stevens, 2011;Kulesza & Mangunay, 2008;Kwon et al, 2007;Roth et al, 2012).…”

“…Moreover, there is a growing debate in the literature about whether physiological data are clinically different for children with ASD. Compared to children who are neurotypical, children with ASD may have longer ABR latencies (Kwon et al, 2007;Roth et al, 2012; for contradictory findings, see Courchesne, Courchesne, Courchesne, & Lincoln, 1985;Dunn, Gomes, & Gravel, 2008;Tharpe et al, 2006) and reduced responses for OAEs (Bennetto et al, 2017;Danesh & Kaf, 2012; for contradictory findings, see Gravel, Dunn, Lee, & Ellis, 2006;Tharpe et al, 2006). Although the underlying mechanisms for abnormal findings are not clear, it has been suggested that differences may be attributed to overall structural brain differences (Hyde et al, 2010;Kulesza & Mangunay, 2008;Kulesza et al, 2011;Kwon et al, 2007;Roth et al, 2012).…”

Audiometric profiles in children with speech sound disorder: Subclinical hearing loss as a potential factor

“…They may also confirm a persisting cochlear hearing loss because of outer hair cell dysfunction in babies (Janssen, 2013). Reduced DPOAE responses have been observed in clinical groups of children with severe communication disorders, such as autism (Bennetto et al, 2017) and Williams syndrome (Silva et al, 2018). However, few studies have incorporated DPOAEs in their hearing evaluation of children with SSD.…”

“…However, two recent studies on clinical populations of children with autism, have found dips within the key frequencies of speech. For example, Demopoulos and Lewine (2016) found reduced hearing thresholds at 2 kHz in children 5-18 years with autism, and Bennetto et al (2017) found reduced otoacoustic emissions at 1 kHz in 6-17-year-old boys with autism. Demopoulos and Lewine (2016) also demonstrated a relationship between pure-tone auditory thresholds within the key-frequencies for speech, and expressive and receptive language measures.…”

“…Demopoulos and Lewine (2016) also demonstrated a relationship between pure-tone auditory thresholds within the key-frequencies for speech, and expressive and receptive language measures. Bennetto et al (2017) reasoned that attention to specific-frequency deficits may be important in clinical groups of children with auditory processing impairments. Still, there is limited knowledge about hearing sensitivity within the key frequencies for speech in children with SSD and how this is connected to middle-, and -inner ear functioning, speech discrimination and production.…”