BMC pediatrics · 2026
Otological conditions and autism spectrum disorder in Medicaid beneficiaries aged 1 to 20 years: a cross-sectional study.
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Zhang Lauren L, DiGuiseppi Carolyn, Blanchard Ashley, Ing Caleb, Russell Matthew T, Lalwani Anil K, Li Guohua
Аннотация
BACKGROUND: Otological conditions are known to be a contributing factor for delayed diagnosis of autism spectrum disorder (ASD). The co-occurrence of otological conditions and ASD, however, has not been adequately studied. This study aims to estimate the prevalence of ASD in children according to otological conditions and to assess the associations of otological conditions with ASD.
METHODS: A cross-sectional study of Medicaid beneficiaries aged 1 to 20 years using 2020 data on diagnoses and beneficiary demographics from the Transformed Medicaid Statistical Information System of the Medicaid and Children's Health Insurance Program was performed. Otological conditions examined included otitis media, sensorineural and conductive hearing loss, tinnitus, and hyperacusis. Prevalence and odds ratios of ASD adjusted for age group, sex, and race and ethnicity (aORs) were estimated according to otological conditions.
RESULTS: Of 40,990,295 participants, 10.4% were diagnosed with at least one otological condition. The prevalence of ASD was 2.79% in those with any otological condition and 1.73% in those without (aOR, 1.78 [95% confidence interval, 1.77-1.79]).The aOR of ASD increased 51% in children with otitis media (1.51 [1.50-1.52]), 54% in children with tinnitus (1.54 [1.43-1.65]), 227% in children with sensorineural hearing loss (3.27 [3.19-3.35]), and 274% in children with hyperacusis (3.74 [3.26-4.28]).
CONCLUSIONS: ASD prevalence is significantly higher in those with otological conditions. The association with ASD is particularly strong in children with sensorineural hearing loss and hyperacusis. The presence of sensorineural hearing loss and hyperacusis warrants heightened clinical awareness and consideration of neurodevelopmental evaluation and screening for ASD.
METHODS: A cross-sectional study of Medicaid beneficiaries aged 1 to 20 years using 2020 data on diagnoses and beneficiary demographics from the Transformed Medicaid Statistical Information System of the Medicaid and Children's Health Insurance Program was performed. Otological conditions examined included otitis media, sensorineural and conductive hearing loss, tinnitus, and hyperacusis. Prevalence and odds ratios of ASD adjusted for age group, sex, and race and ethnicity (aORs) were estimated according to otological conditions.
RESULTS: Of 40,990,295 participants, 10.4% were diagnosed with at least one otological condition. The prevalence of ASD was 2.79% in those with any otological condition and 1.73% in those without (aOR, 1.78 [95% confidence interval, 1.77-1.79]).The aOR of ASD increased 51% in children with otitis media (1.51 [1.50-1.52]), 54% in children with tinnitus (1.54 [1.43-1.65]), 227% in children with sensorineural hearing loss (3.27 [3.19-3.35]), and 274% in children with hyperacusis (3.74 [3.26-4.28]).
CONCLUSIONS: ASD prevalence is significantly higher in those with otological conditions. The association with ASD is particularly strong in children with sensorineural hearing loss and hyperacusis. The presence of sensorineural hearing loss and hyperacusis warrants heightened clinical awareness and consideration of neurodevelopmental evaluation and screening for ASD.