Audiology Assesment : Hearing tests for Autism

Hi all,

@Longman - Thanks for your sharing your insight as always. In this instance Audiologist had the intention of starting a discussion in order to get some feedback, tips and advice regarding hearing assessments for children with autism. It is clear this is not student research. As long this remains general and not specific to individuals on here we think this would be a valuable discussion to have in the community. Please try not to be judgemental in your responses and remember that professionals sometimes make typos (I know I do!).

@Audiologist - It is ok to ask general questions about this but for more specific professional advice you might like to head over to Network Autism for our professional autism network.

Hope this helps,

Avi

Moderator

This is supposed to be a safe forum for people on the spectrum, parents and carers to seek advice.

There is a professional forum on the website which we cannot use without registering (and which is very difficult for us to register onto). Professionals can read what is written here as guests. However it is only proper and courteous to ask the moderators if you are going to ask people questions for professional application.

It might seem a convenient option but consider. Anything disclosed in reply might reveal confidential information either about the individual or other services used. People making these disclosures have a right to know how any information they impart is used, and how confidential it will be. Some respondents here fall within the definition of vulnerable adults.

You have said nothing about yourself except you are a practicing NHS audologist, but that could still mean a private clinic. People on the spectrum and their families are often charged very high fees for autism support services, of varying  quality and efficacy. So it isn't fair to use a forum for free advice.

There are procedures for consultation which most organisations undertake, and in which I happily participate.

My comment is there were more errors than seemed reasonable and the reference to 'us professionals' seemed to me inappropriate. I was pergfectly right to ask if you were a student doing a dissertation. You should have explained better who you were, preferably identifying a practice or a Health Service Trust, if the Moderators would allow. Otherwise you could be anybody.

P.s I have no intentions of research just a wish to give better care to my patients with helpful "tips" I take great care and pride in my work  Just a place to get basic everyday info for those who have the everyday strtuggle of autism!!

Like I say I do not appreciate the past comment

Good luck with the forum but I no longer wish to be invloved or accused of being someone I am not !

A forum should be a like minded place for "everone" from all walks of life" to air there views and opinions and I do not feel "spelling" errors and acusations should not be magnified to the great lengths you have!!

Like you have said yourself you may come across as not intended so that is exacly why you should not cast acusations to me either !!

No hard feeling but i am left disappointed! good luck

My future resources will be from other links -

Regards

I would also point out, at the risk of confirming "a love of dictionary and perfectionism", that there are confidentiality issues, especially where information obtained is used commercially.

There are ways to ask.

We are bombarded by research requests on this forum. The rules are clear, you should, as a courtesy, ask the Moderators for permission.

We get lots of undergraduate dissertation requests, despite the understanding across universities that such approaches should be discouraged. But we also get suubtler approaches that make out something that isn't true.

As I said I'm not being pedantic. The reference to "us proffesionals" did not ring true.

You may not appreciate I'm a retired professional. I don't think your angry response shows professionalism. I was quite right to point out the problem and ask the question.

You should have asked permission before using the site for research.

heyhey, timeout!

@longman, whilist i understand your point, it is actually rather common for any form of professionals to make spelling mistakes, have lost count how many spelling mistakes ive found in some well published books (even in textbooks published for learning purposes and various articles published by professiors of many different fields, including literature itself!) in newspapers(where there are both professional journalists writing the articles and then specialist people going over for it for spell checks and still miss things!), election campaigns etc etc.

@audiologist- while i understand why your upset, i myself wouldve been very offended aswell at such a reply, please do understand this is an asperger/autism forum and in many cases the love of dictionary and perfectionism is rather common in many aspies, accompanied with limited understanding how others find things or might feel when reading their reply, so please do not take it so hard, most of us are more than happy to help where we can:) In his defence i would say this forum has been previously used or be attempted to be used by students coming along both on here and a few other similar forums quite openly asking for information for their research, some even going as far as asking the community members to help carry out the research personally! and ive only been here a few days! So try not to judge him too harshly. Am sure his reply was simply with keeping the best intests of the community in mind:)

Forgive my spelling errors as you state yourself these are "type errors".

Although I find your comment rather offensive INSULTING and rude!!!

I am a qualified NHS Audiologist and have been for 8 years and am using this forum as it should be intended to be used (to get advice from those who know best!!!) I do not feel I have should not have to justify as to who I am and why I want information as like I say I am an honest professional who just wanted some helpful tips from those who have been in the same situation as many patients I see on a daily basis

Forgive me for thinking this would be a place that could answer my honest questions

I will now be withdrawing from any further comments and will be making an official complaint in regards to your comments!

I strongly suggest you take the time to think about your inappropriate comments in the future as it would be a real shame to lose members of such a useful forum due to your behaviour and insulting comments!!

I must add it seems such a shame as I did think this could be a good resource for me and my “professional” colleagues as we are attempting to make services better for those individuals.

Many thanks for the constructive comments from others

Regards

Forgive me if this spounds pedantic but I'm a little worried when someone describes themselves as proFFeSional.......I'm not simply pointing out wrong spelling of professional, it makes me wonder how genuine is this enquiry.

Granted you may have dyslexia, for which apologies for making the point, but all the same it is important if you are presenting yourself as a professional enquirer - cocnerns, refferals, paediatircian's (para 3) etc. While this interface does seem to produce typos, a professional might go over their reply.

I venture to ask are you a student doing a dissertation?

We've all responded helpfully, but there are proper procedures (see Forum Guidelines), and it would be unfair to use the forum as a quarry for a dissertatation.

Hi all

Many thanks for your replies they are all very helpful to us as proffesionals

Our main issue or cocnerns lay with children aged 2-6 yrs we often find these the most difficult to test! We recieve a large amount of refferals from paediatricians asking for a hearing test when they have a child in the process of being diagnosed with autism. Majority of the time parents do not have concerns with hearing but will often find themselves at the door of the audiologist to have the hearing children just in case.

All babies at birth now do get a hearing check at the bedside at birth so this should therefore eliminate any issues of hearing in the future , although paediatircians still wish to refer in for hearing tests!

In order to test a young childs hearing a test called VRA (Visual reinforcement Audiometry) is carried out, this involves having the child sit on the parents lap whilst two speakers are situated eiother side of the child in the corner of the room, a sound is played and the idea is to teach the child when a sound is heard for them to look towards where the sound is coming from where there will then be a puppet above the speaker that lights up and jumps up and down and acts as a reward. This can sometimes cause upset and distress for those children we see with suspected autism and are therfore unable to acess their hearing realiably.

We are thinking of investing in some calming toys and light systems that may help, but as said before we are rather limited in our knowledge on how to deal with such children and if or what we can do to help when they come and see us.

I agree with the idea of making appoitment letters more detailed so we can inform the parents better of what is going to happen on the day and I think this is a good starting point.

OOOOOPS double post

I suppose it depends on the level of autism a child has, my son coped well, i had prepared him for what was comming each time, i was told by the audiologist not to look for a label when i mentioned autism,however i want to know whats wrong with him and how we and others can help him,so that left me slightly offended but only slightly because he was a lovely man.

My son now has the specail hearing aids to reduce noise and they are working well,some days he doesnt want to wear them thats fine, we are going with the flow,sometimes he says they hurt his ears, so we take them out.

I am thankful to the audiologist that we may get somewhere, to the point we may be able to use an outside toilet or to the point he wont have a meltdown in the supermarket,we shall have to wait and see.

Hi .  My son was diagnosed in the 80s.  He was a non-verbal 3 yr old.  I remember they sat him on the carpet + from a short distance behind him made certain sounds, such as quiet sounds, loud sounds, with different things, 1 of which was a child's rattle.  As far as I could see he didn't respond to any of these noises.  However, the audiologist said he was hearing the noises because his eyes would move in the correct direction of the sound, even tho his head didn't move!  Can I say, I am rather shocked that training in this area appears to be wanting, from what you say??  Good luck.

If possible let the parent know in advance what will happen during the test so that they can tell their child what to expect. We really like to know whats going to happen and hate surprises or unknown situations

Be aware of literal responses. The classic psychiatrist's tale is the one where a child on the autistic spectrum was asked if he heard voices, to which he gave the honest answer "yes".

But what he meant was he could hear, not that he heard imaginary voices in his head, as the psychiatrist intended.

Because children with autism find eye contact difficult, they place greater reliance on the spoken word. Some children with autism therefore turn their ear towards the speaker to get the best of the audio input, because the visual input isn't helpful. But that could be interpreted as hard of hearing.

Also because they do not make good use of visual input (facial expression, gestures etc) they may misunderstand some spoken words, especially in informal situations where gesture and facial expression play a greater part. That could be misinterpreted as a hearing difficulty.

Some people find it difficult to focus on explanation, because it is tiring having to concentrate so much more. Or they may become absorbed in some detail, like a pattern on the wall, or the clothing/jewelry worn by the speaker, such that they miss some of what was said. Again not having fully understood what was said could be misinterpreted.

When there is background noise, especially complex background, people with autism are not good at filtering out this background, and it may affect what they hear. Also some people on the spectrum will hear distant conversations or sounds at almost the same volume as those near to them. This isn't peculiar to autism and indeded is quite a commonly reported problem, but it seems more prevalent with autism. The resulting break-up of speech may come over like a foreign language.

This is a big issue for me personally. I cannot 'mingle' in a social gathering because my comprehension of what is being said deteriorates rapidly. I can just manage to socially converse if I stand or sit near a wall, so the sounds come from one direction. Yet my hearing is still sharp without competition.

Similarly background noises of continuous pitch or slowly varying pitch can distract, or be experienced as pain.  Some fluorescent light tubes can be seen and even heard to flicker. Office equipment or medical equipment can be very irritating and compete, affecting what is picked up in conversation. Many visual stimuli as Moonlight indicates could compete and distract.

All this requires greater effort to follow a conversation and is therefore quickly tiring, so there may be a faster depreciation of apparent effective hearing in a consultation/ clinical session.

Testing the hearing of those on the autistic spectrum certainly needs an in depth understanding of factors influencing hearing that are other than due to actual physical hearing capability.

And then just go through with it step by step, dont overload with information. Not sure how it works with the results, as hearing can be measured there and then im assuming they can get any relevant comments-suggestions and what to do next or whatnot straight away without any waiting, right?

Also dont forget to tell them to let you know immediately if the sound hurts them as many autistic people are sensitive to certain sounds to a different degree, some of which can go as far as causing intense pain, which can result in a rather intense reaction, especially if its something they are unable to stop instantly

hi, im not sure i can help you much here, as ive never been to an audiologist, nor do i have any children, but as someone with aspergers, i may be able to point out some things that may help. I am assuming a visit to an audiologist would in general be similar to a visit to a doctor, dentist or psychiatrists. It would be helpful, if a few weeks before the test they would recieve a letter explaining in great detail what the appointment will be like, who they will be seeing, what you will be doing and why, and a picture of you may be helpful. Now as for the appointment itself,  one of the worst things is the wait time, especially if the appointments end up not being on time, which allows the levels of anxiety to build up. If there were any waiting times before, after or in between for whatever reason, it would be good if you took a minute to explain to the child the reason of the wait, a good estimate of how long they will have to wait and maybe a few suggestions what they can do while waiting(if theyd like to, but make sure not to put any pressure on them). It would also be helpful, if any waiting is needed, if there was a possibility for them to do so in a quiet non-crowded place, having to wait in a corridor or a small waiting room crowded with people(mind you, 2 or 3 people can easly be counted as a crowd in case of autism). Also make sure any areas the autistic children have to spend any lenght of time in are free from strong smells, fluroscent or flashy lights, loud noises etc. (for me, the clinical smell of many surgeries and the whithe light with a bluey undertone make me feel physically sick). Now before you start it would be helpful if you briefly recap what youll be doing(in the right order!), just for reassurance, can refer to the letter theydve recieved, but please do avoid talking as if they were stupid, jsut because we need assurance we know whats going to hapen doesnt mean were stupid(sorry, jsut had to put that one in, some people go overboard)