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Rethinking the Accessibility of Hearing Assessments for Children with Developmental Disabilities

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Title: Rethinking the Accessibility of Hearing Assessments for Children with Developmental Disabilities
Language: English
Authors: Angela Yarnell Bonino (ORCID 0000-0002-3118-6202), Deborah Mood, Mary S. Dietrich (ORCID 0000-0003-4474-0767)
Source: Journal of Autism and Developmental Disorders. 2025 55(10):3711-3721.
Availability: Springer. Available from: Springer Nature. One New York Plaza, Suite 4600, New York, NY 10004. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-460-1700; e-mail: customerservice@springernature.com; Web site: https://link.springer.com/
Peer Reviewed: Y
Page Count: 11
Publication Date: 2025
Sponsoring Agency: National Institute on Deafness and Other Communication Disorders (NIDCD) (DHHS/NIH)
Contract Number: R21DC018656
R24DC012207
Document Type: Journal Articles
Reports - Research
Descriptors: Children, Adolescents, Screening Tests, Developmental Disabilities, Autism Spectrum Disorders, Cerebral Palsy, Down Syndrome, Intellectual Disability, Individual Characteristics, Hearing (Physiology), Auditory Tests
DOI: 10.1007/s10803-024-06461-9
ISSN: 0162-3257
1573-3432
Abstract: We aim to determine the accessibility of gold-standard hearing assessments -- audiogram or auditory brainstem response (ABR) -- during the first 3 months of hearing health care for children with and without developmental disabilities. Electronic health records were examined from children (0-18 years) who received hearing health care at three hospitals. Children with developmental disabilities had a diagnosis of autism, cerebral palsy, Down syndrome, or intellectual disability. Assessments from the first 3 months were reviewed to determine if [greater than or equal to] 1 audiogram or ABR threshold was recorded. To evaluate differences in assessment based on disability status, logistic regression models were built while accounting for age, race, ethnicity, sex, and site. Of the 131,783 children, 9.8% had developmental disabilities. Whereas 9.3% of children in the comparison group did not access a gold-standard assessment, this rate was 24.4% for children with developmental disabilities (relative risk (RR) = 3.79; p < 0.001). All subgroups were at higher risk relative to the comparison group (all p < 0.001): multiple diagnoses (RR = 13.24), intellectual disabilities (RR = 11.52), cerebral palsy (RR = 9.87), Down syndrome (RR = 6.14), and autism (RR = 2.88). Children with developmental disabilities are at high risk for suboptimal hearing evaluations that lack a gold-standard assessment. Failure to access a gold-standard assessment results in children being at risk for late or missed diagnosis for reduced hearing. Results highlight the need for (1) close monitoring of hearing by healthcare providers, and (2) advancements in testing methods and guidelines.
Abstractor: As Provided
Entry Date: 2025
Accession Number: EJ1489461
Database: ERIC
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  Data: We aim to determine the accessibility of gold-standard hearing assessments -- audiogram or auditory brainstem response (ABR) -- during the first 3 months of hearing health care for children with and without developmental disabilities. Electronic health records were examined from children (0-18 years) who received hearing health care at three hospitals. Children with developmental disabilities had a diagnosis of autism, cerebral palsy, Down syndrome, or intellectual disability. Assessments from the first 3 months were reviewed to determine if [greater than or equal to] 1 audiogram or ABR threshold was recorded. To evaluate differences in assessment based on disability status, logistic regression models were built while accounting for age, race, ethnicity, sex, and site. Of the 131,783 children, 9.8% had developmental disabilities. Whereas 9.3% of children in the comparison group did not access a gold-standard assessment, this rate was 24.4% for children with developmental disabilities (relative risk (RR) = 3.79; p &lt; 0.001). All subgroups were at higher risk relative to the comparison group (all p &lt; 0.001): multiple diagnoses (RR = 13.24), intellectual disabilities (RR = 11.52), cerebral palsy (RR = 9.87), Down syndrome (RR = 6.14), and autism (RR = 2.88). Children with developmental disabilities are at high risk for suboptimal hearing evaluations that lack a gold-standard assessment. Failure to access a gold-standard assessment results in children being at risk for late or missed diagnosis for reduced hearing. Results highlight the need for (1) close monitoring of hearing by healthcare providers, and (2) advancements in testing methods and guidelines.
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