Journal of developmental and behavioral pediatrics : JDBP · 2025
Deafness and Hearing Problems and Their Association With Autism Spectrum Disorder Diagnosis and Symptoms.
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Talge Nicole M, Keim Sarah A, Yisahak Samrawit F, Findlen Ursula M, Bechtold Lindsey Kovacs, Ingersoll Brooke
Аннотация
OBJECTIVE: Problems with hearing feature prominently in autism spectrum disorder (ASD) but remain poorly characterized within population-based samples and according to symptom heterogeneity.
METHOD: We analyzed cross-sectional, caregiver-reported data from the National Survey of Children's Health (2016-2020). Our US-based sample included children with data on the presence/absence of "deafness or problems with hearing" (DPHs) and ASD (ages 3-17 years; n = 150,327). We used weighted logistic regression to examine the association between DPHs and (1) ASD diagnosis (no, yes), (2) ASD symptom severity (none, mild, moderate/severe), and (3) co-occurrences of ASD with intellectual disability (ID) (neither, ASD only, ID only, both) or attention deficit/hyperactivity disorder (ADHD) (neither, ADHD only, ADHD only, both). We also assessed effect modification by sex and preterm birth.
RESULTS: Deafness or problems with hearing were associated with greater odds of ASD (OR = 2.7; 95% CI, 1.8-3.9), with 4% of children with ASD having DPHs versus 1% of children without ASD. Associations were stronger for: moderate/severe ASD symptoms (OR = 3.5; 95% CI, 2.1-5.7) versus mild symptoms (OR = 1.8; 95% CI, 1.1-3.1); children with co-occurring ID (OR = 5.0; 95% CI, 2.8-9.0) or ID only (OR = 8.6; 95% CI, 6.0-12.4); and children with co-occurring ADHD (OR = 4.3; 95% CI, 2.5-7.2) than for ASD only. Findings persisted after adjustment and were stronger for females versus males but were not modified by preterm birth.
CONCLUSION: Deafness or problems with hearing are associated with ASD, particularly-though not exclusively among children with more severe symptoms and co-occurring ID. Future research is needed to determine whether DPHs in ASD are driven by sensory, cognitive, and/or motivational processes or residual confounding (e.g., congenital anomalies).
METHOD: We analyzed cross-sectional, caregiver-reported data from the National Survey of Children's Health (2016-2020). Our US-based sample included children with data on the presence/absence of "deafness or problems with hearing" (DPHs) and ASD (ages 3-17 years; n = 150,327). We used weighted logistic regression to examine the association between DPHs and (1) ASD diagnosis (no, yes), (2) ASD symptom severity (none, mild, moderate/severe), and (3) co-occurrences of ASD with intellectual disability (ID) (neither, ASD only, ID only, both) or attention deficit/hyperactivity disorder (ADHD) (neither, ADHD only, ADHD only, both). We also assessed effect modification by sex and preterm birth.
RESULTS: Deafness or problems with hearing were associated with greater odds of ASD (OR = 2.7; 95% CI, 1.8-3.9), with 4% of children with ASD having DPHs versus 1% of children without ASD. Associations were stronger for: moderate/severe ASD symptoms (OR = 3.5; 95% CI, 2.1-5.7) versus mild symptoms (OR = 1.8; 95% CI, 1.1-3.1); children with co-occurring ID (OR = 5.0; 95% CI, 2.8-9.0) or ID only (OR = 8.6; 95% CI, 6.0-12.4); and children with co-occurring ADHD (OR = 4.3; 95% CI, 2.5-7.2) than for ASD only. Findings persisted after adjustment and were stronger for females versus males but were not modified by preterm birth.
CONCLUSION: Deafness or problems with hearing are associated with ASD, particularly-though not exclusively among children with more severe symptoms and co-occurring ID. Future research is needed to determine whether DPHs in ASD are driven by sensory, cognitive, and/or motivational processes or residual confounding (e.g., congenital anomalies).