Identifying Autism In Children Who Are Deaf / Hard of Hearing

The average age of Autism diagnosis in some countries, such as the USA, is around 3 years. However, according to a shocking statistic, children who are Deaf / hard of hearing actually receive a diagnosis of Autism around 3 years later than this, on average (McFayden et al., 2023). This means that some children are not being diagnosed with Autism until 5.5 to 6.5 years old.

This is alarming, because in this case, children are missing the critical learning window - the first 5 years of a child's life, where a child's brain is wired to learn new skills and concepts most efficiently. 

What is Deaf or Hard of Hearing?

​According to the World Health Organization:

- Deaf people mostly have profound hearing loss, little or no hearing. They may benefit from cochlear implants. Some use sign language to communicate.
 
- Hard of hearing refers to people with hearing loss ranging from mild to severe. They usually communicate through spoken language and can benefit from hearing aids, cochlear implants and captioning.

Since Autism presents as communication disorder, the signs of Autism often overlap with being Deaf or hard of hearing. It is important for parents, educators and medical professionals to identify if a child may have both diagnoses. The purpose of this is not to label a child, but rather to understand the child's unique profile, so that they can be best supported through Intervention and education. It is also important to address this, as there are several individuals who even as adults, may not be aware that they also have Autism.

What are some signs that a child may have Autism, as well as being Deaf / hard of hearing?

• A child does not respond to their name or to other culturally appropriate ways to gain their attention
• They have difficulty understanding facial/signed emotion cues
• The child has limited gestures and rarely uses pointing
• A child repeats words or phrases over and over, either verbally or through the use of signs
• The child invents signs or words rather than using a formal sign or word
• A child may present as more ‘deaf’ than indicated on hearing test

What Is The Next Step?

If you are a parent or educator of a child who you think presents with both Autism and Deaf / hard of hearing, the next step is to arrange a developmental evaluation with a Developmental Pediatrician or Clinical Psychologist. The evaluation will look into different areas of development, as well as, rule out or confirm an Autism diagnosis. This is crucial for supporting each individual as a whole.

Speak soon,
The Expat Speechie

References:

Flynn, S., Clark, T., & Szarkowski, A. (2014). Dually Diagnosed: A Retrospective Study of the Process of Diagnosing Autism Spectrum Disorders in Children Who Are Deaf and Hard of Hearing. Seminars in Speech and Language, 35(04), 301–308. https://doi.org/10.1055/s-0034 1389102

McFayden TC, Culbertson S, DeRamusM, Kramer C, Roush J, Mankowski J. Assessing Autism in Deaf/Hard-of-Hearing Youths: Interdisciplinary Teams, COVID Considerations, and Future Directions. Perspect Psychol Sci. 2023 Jun 14:17456916231178711. doi: 10.1177/17456916231178711.

World Health Organization www.who.int/news-room/fact-sheets/detail/deafness-and-hearing-loss