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How To Conduct Hearing Screenings For Kids With Autism

It can be a challenge testing hearing in children with autism spectrum disorder (ASD). However, it's important to detect hearing impairments in kids who already have problems with verbal communication. Even a minor hearing problem can interfere with a child's ability to communicate and learn.

Speech-language pathologists and other licensed professionals who conduct hearing screenings often have more success when they have a better understanding of an individual child's behavior. Knowing how the child thinks and behaves can help you choose the appropriate screening strategies.

  1. Know how the child communicates. Some children with ASD use methods other than, or in addition to, verbal communication. Even an autistic child who can speak may have difficulty understanding and using words. When screening kids with autism, standard hearing testing equipment isn't always enough. In some cases, an audiology sound booth can be used for testing.

    Find out if the child uses assistive technology, such as an augmentative and alternative communicative device (AAC), picture cards, or a PECS (Picture Exchange Communication System) book. If you don't have these assistive devices available, see that the child brings his or her own to the hearing screening.

    Some kids with ASD use AAC in addition to oral speech to communicate their thoughts, and let others know what they need and want. Picture and symbol communication boards and electronic communication aids are types of aided communication.

  2. Use a visual picture schedule to show the child what to expect. Showing pictures beforehand of what the screening routine will involve can help make the child less anxious about the testing. A visual schedule tells the child what is going to happen and in what order the steps will occur. This type of visual aid also gives autistic kids extra time to process, understand, and follow the instructions you are giving them.

  3. Put the child at ease. Autistic kids get upset easily by the unexpected or what they don't understand. If they can't effectively communicate what they are feeling through words, their behavior can signal discomfort or an oncoming meltdown.

    Create a calm and relaxed environment before beginning the testing. It helps to know the child's developmental level. For a child with autism, chronological age and developmental age don't always match.

    Since many kids with autism also have sensory issues, allow the child to explore the earphones before wearing them. Let the child choose between insert earphones or supra-aural (ear pad) headphones that are light in weight and merely rest on the ears. Have the child practice wearing the earphones before the screening begins.

    Wearing a weighted belt or weighted vest on the child also can help him or her feel more secure during the screening. The deep pressure of the belt or vest helps an agitated child refocus.

  4. Choose an alternative method of testing. Although classic hearing testing requires children to raise their hand when they hear a beep, autistic kids don't always understand these instructions. You can use visual cues to help kids with ASD understand they must raise their hands in response to the auditory stimulus you provide. Show the child what to do with pictures or by practicing raising your hand together each time you play a tone.

    You also can play one of the child's favorite videos as a reward for appropriate responses during the hearing screening. When you rely on a video as a reinforcer, whether you use a tablet or laptop computer, the child can use the touch screen to play a clip of the video following the responses. The key is for the child to associate being allowed to play the video with responding to the auditory stimuli.

    Speech audiometry is another method for conducting hearing screening. Instead of responding to beeps, the child points to the picture that matches a recorded word. Talk to experts like Pacific Hearing Care for more information.


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