Diagnosing Autism in Deaf and Hard of Hearing Children
Tools for diagnosing autism are often not well suited to deaf children, which can make it challenging to diagnose. That is for two big reasons. The first is that the usual autism measures (e.g., the ADOS-2, ADI-R, and CARS2) focus on a child's use of spoken language. That makes them ill suited to measuring language skills in deaf and hard of hearing children who use sign language. The second reason these tools don't work will is that deaf kids are often at risk for language delays not because they have autism but because they've had limited access to language during early childhood. This is called language deprivation, and can cause a range of downstream effects on socioemotional, cognitive, and brain development. This can make it challenging for clinicians to differentiate between language deprivation and autism. A study by Arielle Spellun and colleagues asks whether a parent questionnaire many practitioners already use, the BASC-3, can be useful for deaf and hard of hearing children.
What they did
Spellun's team compared scores on the BASC-3 Parent Rating Scale across three groups of children, matched for age and sex, 16 in each:
deaf and hard of hearing children with autism
deaf and hard of hearing children without autism
typically hearing children with autism
What they found
The study found that the behavior patterns of children who are both deaf or hard of hearing and diagnosed with autism were more similar to hearing children with autism than to their deaf peers without autism. This is especially true in areas like social skills and communication.
This study demonstrates that the BASC-3 can provide meaningful insights for children who are deaf or hard of hearing and also have Autism Spectrum Disorder.
A few caveats
The sample was small and came from a single referral center, so it doesn't represent the full range of deaf children. The comparison group of deaf children without autism had also been referred for developmental concerns, so they weren't typically developing kids. Most important for this population: nearly all the children communicated in spoken English, not ASL, so we don't yet know how the tool performs with children who sign. The BASC-3 isn't a validated autism diagnostic, which means it is a good resource as part a comprehensive evaluation, but shouldn't be used independently. Formal validation work is still needed.
Read the full article.
