Does my child have hearing loss or autism?

Within the first few months of life, babies respond to their own name by moving or motioning toward the person who called them. Typical babies are very responsive to the voices of familiar people, and often respond with smiles and looks. In contrast, infants who fail to respond to their own name may later be diagnosed with autism and in fact do not have a hearing loss. That is, when these children are /called by name, they tend to turn and look at the person only about 20% of the time as found in the videotaped one year-old birthday parties of children with autism (researchers continue to study the early development of children with autism, and include such video tapes as part of their studies). They also are often selectively responsive to sounds. They may ignore some sounds and respond to others that are of the same loudness. Thus, they may fail to respond to their parent calling their name, but immediately respond to the television being turned on. It is not unusual for parents to suspect their child has a hearing loss.¹ This requires the parent to be very observant throughout a child’s day so there is an understanding regarding the subtle differences in the child’s response to sounds within their environment. If you suspect your child has a hearing loss, it is imperative that you speak with your physician. However, parents that have observed their child throughout different environments and engaged in various activities, experiencing different sounds at various levels, will be better prepared to share with their child’s physician the specific nuances displayed by their child that may not be pointing to a hearing loss, but more specifically, a child who later might later be diagnosed with autism.

Although autism is usually diagnosed when the child is 3 to 4 years old, parents often sense that something is wrong much earlier. On average, parents start to worry about their child's development by 18 months of age and voice some of their concerns to a doctor or another professional by age 2. Many physicians and professionals are hesitant to diagnose autism at very early ages. They know that the early development of children varies, and are often uncertain if a behavior will persist into being considered atypical, or if behaviors that should be present will continue to be absent. Fortunately, the American Academy of Pediatrics now recommends that all children be screened for autism spectrum disorder twice before age 2 -- once at 18 months and once at 24 months -- as part of well baby checkups. Further, it recommends that treatment for autism be started when autism spectrum disorder is suspected, rather than when a formal diagnosis is made.² This opens the door towards better collaboration between physicians and parents as parents seek to understand various developmental milestones in a much more comprehensive manner. This also facilitates a better understanding of autism spectrum disorders among physicians who will now actively seek opportunities to better educate themselves towards better diagnosis and intervention for autism spectrum disorders.

1. The Exceptional Parent, December, 2002
2. American Academy of Pediatrics