A quarterly publication of the Autism Research Institute

The Autism Research Review International is quarterly publication of the Autism Research Institute

Winter, 2019 | Number 1, Volume 33

Hearing test may help identify children at higher risk for ASD

A particular type of hearing test may allow doctors to identify infants at elevated risk for autism spectrum disorders (ASD), according to a new study.

Amanda Smith and colleagues say that while infants undergo routine hearing tests, these tests merely determine whether the children can hear on a pass/fail basis. In contrast, they say, stapedial reflex testing—a noninvasive procedure that measures pressure changes in the middle ear in response to sounds—assesses an infant’s sensitivity and response times to a wide range of frequencies. 

The researchers note that there is “an abundance of data” showing that the structure and function of the auditory brainstem are abnormal in many individuals with ASD. “Furthermore,” they say, “there is evidence from a number of functional studies for asymmetries in brainstem processing of sound in ASD.” They add, “Both functional and anatomical investigations indicate that auditory issues are present at birth.”

The researchers stress that an abnormal stapedial reflex test would not be diagnostic for autism since it could be an indication of other problems. However, they say, “At the very least, auditory function could be used to raise suspicion of ASD or identify children at high risk of ASD manifesting later in life.”

The researchers say that early identification of at-risk children could lead to intervention while the brain is still very plastic. For instance, they note, “There is… evidence that auditory integration training normalizes brainstem responses in children with ASD and even improves behaviors.”


“Structural and functional aberrations of the auditory brainstem in autism spectrum disorder,” Amanda Smith, Samantha Storti, Richard Lukose, and Randy J. Kulesza, Jr., Journal of the American Osteopathic Association, Vol. 119, No. 1, January 2019, 41-50 (free online). Address: Randy J. Kulesza, Jr., Department of Anatomy, Lake Erie College of Osteopathic Medicine, 1858 W. Grandview Blvd., Erie, PA 16509-1025, [email protected].


“Researchers say auditory testing can identify children for autism screening,” news release, American Osteopathic Association, January 7, 2019.