Autism and Deafness: Guide

Technology

Technology covers a range of amplification such as hearing aids, cochlear implants, and bone conduction and bone anchored devices.  There is a wide variety of practice and of outcomes in terms of access to sound and functional listening.  Outcomes can be shaped by many factors.

There are also assistive listening devices as well as equipment to support communication, learning and quality of life.

Assistive Listening Devices

There are a range of assistive devices which can provide a better sound signal to a listener via a direct connection. The main two are:

Radio aids

A radio aid can often be used to extend the opportunities for hearing sound and can provide a better listening experience over distance as well as emotional support for both wearers and parents.  A radio aid consists of a transmitter worn by the  main speaker and a receiver worn by the recipient. The closeness of the microphone to the speaker’s mouth and direct transmission of sound (via infra-red, FM, bluetooth) to the receiver’s ear (or hearing device) means they can hear as if the speaker is next to them regardless of the true distance away.  There is much research evidence that radio aids benefit deaf children (see Radio Aid MESHGuide)

Soundfield systems

A soundfield works in a similar way for a whole room, delivering an equal sound signal to any spot in a room (within the range of the loudspeaker).  There is anecdotal evidence to show that use of Soundfield Systems and personal radio aids can help autistic children focus on what the teacher is saying in classrooms as they promote speech over background noise.

Amplification and deaf autistic children

Currently there are no detailed statistics of children and young people with a dual diagnosis of autism and deafness.  Just as deaf children present a varied picture in terms of acceptance and use of hearing devices so it is with deaf autistic children.  A small number could be affected by hyperacusis – (intolerance of everyday sound leading to distress) which might cause them to reject any hearing device. Sometimes ear defenders are given to these children.  However this is not always considered best practice in the long term and where hyperacusis is a challenge, it is felt that little by little sound needs to be introduced so that a gradual tolerance is built up as sound becomes better understood.

So, as with deaf children, if listening and speaking is the desired outcome wearing hearing devices should be encouraged, even if in short bursts and if lots of re-fitting is needed.  One family remember replacing the aids 18 times in one day on their profoundly deaf Autistic toddler.  Having used sign language as a baby and been implanted at 4 years he speaks fluently in a clear, intelligible voice at the age of 5 years.  Often the child’s tolerance of wearing a hearing aid  will contribute to the criteria for receiving a cochlear implant.  It is important to ensure that there is a positive experience, something interesting to listen to, which reinforces the point of wearing the device.

The Case Studies section demonstrate some real experiences with equipment.

References:

Thompson N., and Yoshinaga-Itano C. Enhancing the Development of Infants and Toddlers with Dual Diagnosis of Autism Spectrum Disorder and Deafness    Semin Speech Lang 2014; 35: 321-330  

Tablet technology

Tablet technology is now recognised as a useful tool for a range of purposes.  Tablets can be used for motivation and reward.

There is small scale research and a great deal of anecdotal evidence that support use of tablet devices for communication and learning.  Many apps have been designed specifically for these.

Some children and young people have a heightened technical aptitude for Information Technology and demonstrate outstanding competence.

Tablet technology and resources which may be useful are available as a download.