Autism, A High Risk of Hearing Loss
Autism, a high risk for several different types of hearing loss not part of a routine hearing evaluation. A hearing deficit is rarely deafness. Cheri Moore has found through her work with clients coexisting auditory and visual processing difficulties. Many behaviors associated with autism are also associated with hearing loss and visual processing difficulties.
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Cheri Moore has been helping children and adults improve the brain’s ability to respond to intervention while minimizing negative behavioral responses.
It has been my privilege to successfully co treat patients with Cheri Moore over the last few years. I have found her to be extremely knowledgeable about vestibular and auditory processing systems. In addition to her background in special education, she has broad experience working with specialists in addressing a wide variety of diagnosis. This positions her so well to apply her therapy appropriately. Furthermore I have personally witnessed her tenacity in going well beyond the expected in working with her clients to ensure complete resolution of their difficulties.
Dr. Neil W. Margolis, O.D., F.A.A.O., F.C.O.V.D.
Higher Rate of Hearing Loss with Autism
According to a national survey conducted by the Center for Disease Control and Prevention (CDC, 2018), one out of every 59 children, eight years of age, are diagnosed with autism. In 2013, one out of every 50 children, 6 to 17 years of age, were found to have a diagnosis of autism. (Centers for disease control & prevention, (2013). Special education or early intervention services (table 17) and Learning disability or ADHD (Table 3)(Series 10, 2&). Retrieved from website: http:// www.cdec.gov)
A 12-year study in Sweden found hearing loss at a higher rate in 199 children (153 boys, 46 girls) diagnosed with autism (21-7 yrs.) when compared to studies researching hearing loss in typically developing children. Researchers found several different types of hearing loss:
- Mild to Moderate Hearing Loss in the cochlea – Testing of inner cochlea hairs required a response
- Severe to Profound Central Hearing Loss – Auditory Brainstem Response Test (ABR) assesses the inner ear’s cochlea and auditory pathways to the brain – requires no response
- Conductive Hearing Loss from ear infections negatively affects ear drum movement and middle ear bone movements – testing requires no response (Rosenhall, U., Nordin, V, Sandstrom, M., Ahlsen, G., Fillberg, C., 1999. Autism and hearing loss. Journal of Autism and Developmental Disorders. 29:5)
Researchers also found that studies of typically developing children found much lower percentages (0.1% – 0.2%) of pronounced and profound hearing loss (Braden, 1994; Davis, Wood, Healy, Webb, Rowe, 1995; Kankkunen, 1982; Martin et al., 1981; Parving, 1983; Sehlin et al., 1990; van Rijn, 1989)
Researchers found a bone anomaly in participants’ inner ear vestibular canals called “superior semicircular canal dehiscence syndrome (SSCD)” in 29% out of 14 participants with a diagnosis of autism and hypersensitivity to sound. This can cause a hearing loss due to disruption to inner ear hair cells. (Thabet, EM., Zaghloul, HS., (2013). Auditory profile and high resolution CT scan in autism spectrum disorders children with auditory hypersensitivity. European Arch Otorhinolaryngology. doi: 10.1007/s00405-013-2482-4. Epub2013 Apr 12)
Higher Rate of Visual Processing Difficulties with Autism
A parent, a loved one, and even the individual may be unaware there is an eye turn. An individual tends to avoid what feels uncomfortable or causes unclear vision. Strabismus causes unusual postures, which aligns the eyes. Strabismus can be:
- Intermittent, occurring only when a person’s eye grow tire after having to focus on a target (reading)
- May only occur with one eye
- May occur in each eye, one eye at a time
- May occur in both eyes
- Chronic strabismus is often referred to as crossed eyes
The best course of action with any academic delays, despite intelligence, is a comprehensive visual evaluation by a developmental behavioral optometrist or neuro-rehabilitation optometrist.
Vision therapy stimulates visual neural pathways strengthening control eye muscles needed to stabilize eye position and movement.
Strabismus — Questionnaire visual processing activities teach you how to observe and what to observe
Strabismus is when both eyes do not line up together like so:
One eye is closer to the nose.
One eye is closer to the ear.
One eye floats up
Researchers found significantly higher rates of strabismus in individuals with autism. Out of 7,640 families, 18% of boys and 29% of girls had strabismus when compared to children without a diagnosis of autism; 2% of boys and 4% of girls. (Kaplan, M., Edelson, SM., Rimland, B., (1999). Strabismus in autism spectrum disorder. Focus on Autism and Other Developmental Disabilities. V14 n2 p101-05.)
Only one dolphin should be seen by both eyes. This picture shows that each eye is working
independent from the other. Researchers found a significantly higher rate of strabismus in 44 children with autism (5 out of 44) when compared to no strabismus found in 44 typically developing children. (Milne, E., Griffiths, H., Buckley, D., Scope, A., (2009). Vision in children and adolescents with autism spectrum disorder: evidence for reduced convergence. Journal of Autism and Developmental Disorders, 39(7); 965-975)
Cheri Moore's Findings Resulted in Improved Responses to AIT and Vision Therapy
Cheri Moore's desire to improve clients' emotional response during auditory integration training resulted in the discovery of a high rate of co-existing visual processing difficulties with sound intolerance, with or without a hearing loss. After some clients experienced increased visual processing difficulties during AIT, like chronic double vision, Cheri Moore collaborated with optometrists specializing in vision therapy to track client's progress. Auditory-visual protocols have resulted in improved responses to auditory integration training and vision therapy.
You rock! You are making the world a better place and I am so thankful for you!
FDA Statement On AIT
"Auditory Integration Training remediates impairments in auditory discrimination (sound sensitivity and auditory distortion) associated with Autism, Learning Disabilities, and related disorders - ADD, ADHD, CAPD (Central Auditory Processing Deficits), SPD (Sensory Processing Disorder), Dyslexia."
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