January 11, 2019
Autism spectrum disorder (ASD) is notoriously hard to diagnose, often causing parents worry for years before they finally get an answer. But what if there was a test to find out the likelihood of your child having autism, right at birth? New research published in the Journal of the American Osteopathic Association finds this might be possible through an unlikely source: a hearing test.
You might know that children with ASD are sensitive to sound, and loud noises can be upsetting. This is because they often have auditory problems that make their ears and brain over-responsive to certain sounds and frequencies. So it makes sense that diagnosing these auditory dysfunctions could also help detect ASD—and that's exactly what the recent study discovered. "Research from my lab has found that individuals with ASD have structural and functional changes in auditory parts of their brain that can be detected using simple, non-invasive screening tests," study author Randy Kulesza, Jr, Ph.D., professor of anatomy at Lake Erie College of Osteopathic Medicine, tells Parents.com.
Aren't babies given a hearing test already?
Newborns do have their hearing tested at birth, but it's usually on a pass/fail basis. "In many states, these tests are performed on all newborns, but the results need to be carefully examined to identify any changes," Dr. Kulesza says. His study used acoustic (also called stapedial) reflex testing, which can provide specific info by measuring pressure changes in the middle ear in response to different frequencies. "We propose that early auditory testing—the week the child is born—can lead to much earlier detection," he says.
Identifying these hearing problems in newborns would allow them to get help ASAP, which can benefit them in the long-run."The earlier a diagnosis is made, the sooner enrichment therapies or interventions can be introduced to optimize outcomes," Dr. Kulesza says. Because babies' brains are so adaptable, they might even be able to "train out" auditory problems to improve the child's function later in life.
Right now, children aren't usually diagnosed with ASD until they're in preschool or older, missing a crucial window in language, speech, and social development. "A suspicion of ASD is often first made by parents based on observation of their child's behaviors, when he or she at least a few years old," he says. By that time, the brain may not be as receptive to therapies.
Hearing tests still can't diagnose autism
But this hearing test isn't a definitive diagnosis for autism. Unfortunately, parents will still have to wait for that, because although most children with ASD have hearing issues, not all children with hearing issues have ASD. "Confirmation of ASD may not be possible until the child approaches speech and social milestones," Dr. Kulesza says.
Plus, hearing screenings won't identify all children with ASD either. "We certainly need more research to understand how ASD impacts the brain and how widespread auditory dysfunction is in this condition," Dr. Kulesza says. "Autism is a spectrum disorder, so we expect there will be some children with completely normal hearing."
Early intervention benefits all babies with hearing issues
Even so, this hearing test would help parents know if their child is at greater risk for ASD. And any child with hearing problems that this test could identify would benefit from early detection and treatment, whether they have ASD or not. "Identification of a hearing issue should be met with counseling, interventions, and therapies," Dr. Kulesza says.
Dr. Kulesza hopes this screening program will be put in place, but until then, parents should listen to their gut if they suspect their child may have hearing issues or ASD. "Parents know their child's behavior best and are usually the first to recognize odd behaviors," he says. "If parents are concerned that their child might have ASD they should seek out individuals who specialize in diagnosing and caring for children with ASD." Your child's pediatrician can help point you in the right direction.
