Autism and Hearing Loss

April is Autism Awareness Month.  What does this have to do with hearing loss?  Approximately 40% of children with hearing loss have some sort of additional disability or condition, and many families and professionals are facing the task of helping children face the dual challenges of hearing loss as well as autism.

Here is a past post based on a research review I did for my presentation at the Early Hearing Detection and Intervention Conference 2011, including citations for a variety of articles dealing with outcomes and quality of life measures for multiply involved children with CIs.

What is the latest research on children with autism and cochlear implants?  In many studies, children with ASD + HL are just one subgroup of a larger group of “deaf+” children included in outcome studies.  THIS study deals specifically with children with autism who have received cochlear implants, and found that overall, the majority of the children showed improvement on both auditory and language measures.

All children are unique, and the same applies to children with ASDs.  However, here are some general guidelines that I’ve found to be useful when working with children with ASDs on my caseload:

• Use a visual schedule and a predictable routine for each session may be helpful to children who thrive on consistency.

• Spend extra time working on pragmatics and the social aspects of language that may come more naturally for children who are “just deaf.”

• For children who are more severely autistic, work with the family to identify functional language targets that will have the greatest effect over the greatest number of situations (for example, for some of these children, a small “core vocabulary” or words they use consistently may be more useful and attainable than learning academic curriculum words).

• Be creative with your assessments — many of these children may not be able to sit through a standardized test.  If they can, they may not scrape the bottom of a standardized score.  Instead, use criterion-referenced and dynamic assessments to measure progress.

• It’s always a good idea to maintain good relationships and frequent communication with other members of a child’s team.  Even for a “just deaf” child, this includes a lot of professionals.  For a child with autism, the team can be huge!  Be an active participant in the child’s care team and work to integrate care whenever possible.  I’ve found that Occupational Therapists, in particular, may have good suggestions about the best positioning for the child or how to incorporate sensory play in a way that does not trigger any unwanted behaviors.

• Be attuned to the unique needs and stresses of raising a child with multiple disabilities.  Help to connect parents with resources in the community (respite care, counseling, social work, etc.).

• Some children with ASDs are served primarily by special educators, not teachers of the deaf.  As the LSL professional on the team, it is your job to be sure that the “listening piece” of the child’s puzzle doesn’t get lost in the shuffle.  Even in a general special education classroom, attention can be paid to classroom acoustics, assistive listening devices, and opportunities to create a language-rich environment.

What are your experiences with hearing loss and autism?  What techniques have you found most helpful in working with this population?