Autism, A High Risk for Hidden Hearing Loss

boy with autism at a desk getting one on one instruction due to hidden hearing loss
Cheri Moore

Written by Cheri Moore

March 24, 2022

I remember my surprise when I realized that many of the behavioral characteristics associated with autism are also associated with hidden hearing loss and visual processing difficulties. Since anybody can experience hearing loss, you may recognize some of these behavioral characteristics in yourself.

Behaviors like expressive speech difficulties or vision that blurs are commonly found in all ages with a diagnosis of autism. Thus, I asked myself, “When there is a diagnosis of autism, do you have a high risk of atypical, hidden hearing loss and visual processing difficulties? According to researchers, yes!

The good news is that Auditory Integration Training improves sound tolerance. Thus, my past clients who needed hearing aids but had sound intolerance were able to successfully transition into hearing aids.

A Typical Hearing Test Can Fail to Identify Hidden Hearing Loss in Those Diagnosed with Autism

Expressive Speech Difficulties in Hidden Hearing Loss

During Auditory Integration Training, I saw improvements in my clients’ ability to express themselves, to say what they wanted to say. However, after Auditory Integration Training some clients began to struggle to express themselves again. They also continued to experience sound intolerance. These clients exhibited a weak response to Auditory Integration Training.

Thus, I began collaborating with audiologists to help parents and adults request additional hearing tests. Sometimes, additional hearing tests revealed a hidden hearing loss showing the need for hearing aids. Once the hearing system consistently received sound energy stimulation from hearing aids, these clients made wonderful progress.

woman completing a hearing test.

Temporary Hearing Loss Occurs in Those with Autism

Toddlers, preschoolers, and children with autism can experience temporary hearing loss from ear infections or enlarged adenoids. Both trap fluid in the middle ear distorting sounds. In fact, there are more than 5 Surprising Reasons that Hearing Loss Begins. Temporary hearing loss can occur in anybody, including those with a diagnosis of autism with hidden hearing loss.

While yes, many behaviors are associated with a label or attributed to personality. I challenge you to consider the meaning behind those behaviors. When there is a lack of speech or expressive speech difficulties commonly seen in all ages of those with autism, the additional challenge of understanding the meaning of behaviors feels overwhelming. Imagine what your loved one is experiencing while listening to distorted speech.

Temporary Hearing Loss Distorts Speech

Poor ear, nose and throat health can distort speech sounds, muffle hearing, and create sound intolerance. This is very frustrating when ear health comes and goes.

Have you ever played The Listening Game while holding your breath underwater? If so, you were listening to distorted speech. When I played this game, I rarely knew what the other person was saying.

a boy and girl playing the listening game underwater in a pool. They are both wearing goggles. The boy is talking, and the girl is listening.

A child’s developing brain cannot rely on past experiences and knowledge. A sentence missing a word or two is confusing. Consistently not hearing a vowel sound results in words being misspoken. Mild hearing loss creates feelings of frustration and anger. It is not your intelligence; it is your hearing.

Food Allergies & Sensitivities Reduce Hearing

There are six foods known to contribute to poor ear health. Client’s food allergy testing often confirmed the presence of food allergies and sensitivities. Inflammation in eustachian tubes can result in a temporary hearing loss. Once I shared my gluten and milk free recipes and how to eliminate allergens, I was amazed by how quickly clients began to express themselves more easily. Then, these clients experienced greater benefits from their second Auditory Integration Training Program.

A Hearing Evaluation for Everyone with Autism

Good news! Hearing evaluations are possible for everyone to complete. Lack of speech is not a barrier to a hearing evaluation. I work with you and your loved one using activities to help you prepare to complete a hearing evaluation with confidence. Even my adult clients benefit from these activities. Knowing what to expect improves the accuracy of your responses during your hearing evaluation and lowers your anxiety.

Hearing Aids Benefit Those with Autism

Hearing aids benefit those with and without severe sound intolerance. If your hearing evaluation finds typical hearing loss and/or hidden hearing loss, I work with you and your audiologist. Together we create an intervention plan to improve sound tolerance.

boy with autism who has a hearing loss wearing a hearing aid at school. He is sitting facing a chalkboard.

Since hearing loss contributes to the development of sound intolerance, clients benefit from hearing aids that suppress competing background speech and noise. When there is significant sound intolerance, your hearing system is weak making it more difficult to adjust to hearing aids. This makes it even more important to first complete five to ten days of Auditory Integration Training after your hearing evaluation.

I use your hearing evaluation results to personalize your Auditory Integration Training Program. Past clients successfully transitioned into hearing aids. Once your hearing improves, you also need help improving auditory processing skills like auditory memory, listening, and expressive speech. Auditory Integration Training improves your tolerance to sounds and strengthens your auditory system. Software programs like Hear Builder improve auditory processing skills.

Roger Focused FM System Helps Those with Autism

In 2014, the Hearing Review shared that researchers found benefits when students used a Roger Focused FM System, a hearing aid with an amplification system. Students with a diagnosis of autism, ADHD, or a hidden hearing loss like Central Auditory Processing Deficits shared that they:

“Could hear the teacher’s words better,

communicate with their fellow students better, and

were generally more engaged in classroom activities

than without the wireless microphone technology,”

Hidden Hearing Loss Related Behaviors Communicate Needs

Hidden hearing loss related behaviors are a form of communication, non-verbal communication. They tell us about ourselves and others.

When a child with autism is frustrated by their inability to communicate their needs and wants, it makes sense for them to have a complete meltdown. It also makes sense that home is a safe place to let go after a full day of feeling overstimulation from sounds and working to listen. They no longer have to cope. Explore ways with your loved ones to find a healthy way of releasing their inner stress.

An example of a mild hearing loss coping behavior is repeating what you just heard, echolalia. In preschoolers younger than three years of age, echolalia helps them develop speech. When it is not outgrown, repeating what you just heard helps you check for understanding. It also gives you more time to think before responding.

Repeating what you hear also sends stronger sound energy to your brain’s speech center than just listening. When you speak, your voice should stimulate your right ear more strongly than your left ear. Enjoy the activity in this video to learn if your voice strongly stimulates your right ear helping you speak fluently and say what you want to say.

Hearing Loss is NOT Deafness Even with an Autism Diagnosis and Lack of Speech

Do you assume that expressive speech difficulties or even lack of speech are simply due to an autism diagnosis or another diagnosis? Behavioral characteristics of mild hearing loss are clues you need to complete a Moore Auditory-Visual Questionnaire.

A Moore Auditory-Visual Questionnaire asks questions associated with hearing loss, sound intolerance, auditory processing skills, and visual processing difficulties. Follow-up questions help you share the intensity of the behaviors to communicate more clearly what you experience every day.


If you reply, Yes, to even one of the questions about yourself or a loved one, I encourage you to complete a Moore Auditory-Visual Questionnaire. Or learn more by scheduling a free phone consultation.

Auditory Behavioral Characteristics:

  • While listening, do you feel you must interrupt?
  • When interrupted while talking, do you forget what you were going to say?
  • Do you do most of the talking during a conversation?
  • Do you turn the TV up so loud it is uncomfortable for others?
  • To understand directions, do you watch others?
  • Do you talk in a monotone, flat voice?
  • Do you repeat what you heard to check for understanding?
  • Is one-on-one help needed to understand directions?
  • After listening to directions, do you ask others to repeat the directions?
  • If others begin to talk in the same room when you are already talking with someone, do you become upset?
  • Do you complain about noise tolerated by others?
  • When spoken to from behind, do you startle?

Are you still unsure if you should complete a Moore Auditory-Visual Questionnaire? If so, learn what to observe and how to observe by purchasing a Moore Auditory Observation Activity Booklet. Enjoy games that strengthen auditory processing skills.

I encourage you, parents, spouses, and loved ones to be kind to yourself. You are seeking answers. Support is available through a FREE phone consultation.

Hidden Hearing Loss in Autism Affects Self-Control

When hearing loss that may even be hidden exists versus deafness, the cost to your loved one’s emotional health is significant. Family members and friends are unaware of the full impact of mild hearing loss in children with a diagnosis of autism. It is difficult to know which behaviors help the child with hearing loss cope with everyday challenges. Versus, chosen behaviors are typically seen in children trying to manipulate others for something they want.

One of the greatest benefits of completing a Moore Auditory-Visual Questionnaire is its impact on relationships. You will learn to discern the difference between coping behaviors and behaviors that are manipulative. Each question opens the door to communication. Each pre-questionnaire observation activity helps you look at your loved one’s behaviors with a new perspective.

Your Moore Auditory-Visual Questionnaire Report shares the intensity of behaviors associated with sound intolerance, hearing loss, auditory processing, and visual processing difficulties.

  1. When do you …?
  2. How often do you … each week?
  3. What are emotional responses?
  4. Describe …

Resources Improving Communication

Here are three resource videos about sign language:

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References

  1. Ha, S., Sohn, I. J., Kim, N., Sim, H. J., & Cheon, K. A. (2015). Characteristics of Brains in Autism Spectrum Disorder: Structure, Function and Connectivity across the Lifespan. Experimental neurobiology, 24(4), 273–284. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4688328/
  2. Wan, C. Y., & Schlaug, G. (2010). Neural pathways for language in autism: the potential for music-based treatments. Future neurology, 5(6), 797–805. https://doi.org/10.2217/fnl.10.55

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