Outline. Background Methods Results Conclusions Acknowledgements References

Transcription

1 Visual Reinforcement Audiometry Versus Video Visual Reinforcement Audiometry in Children with Autism Spectrum Disorder and Other Developmental Disabilities Megan Costanzo, B.A. Test Facility Waisman Center Audiology Extern at Mayo Clinic Health System, La Crosse, WI 4 th Year Doctoral Student of Audiology University of Wisconsin-Madison

2 Outline Background Methods Results Conclusions Acknowledgements References

3 Outline Background Methods Results Conclusions Acknowledgements References

4 DSM5 Guidelines: Autism Overview Social Impairment Symptoms in Early Ages Repetitive Behavior Symptoms Limit Daily Function Varying data on prevalence of Autism Spectrum Disorder (ASD) and hearing loss (HL) [1]

5 Differences between Autism and Hearing Loss [2] Autism Spectrum Disorder 18 months of age Lack of joint attention Repetitive behaviors Hearing Loss 0 months of age Normal motor development

6 Similarities between Autism and Hearing Loss [2] Unintelligible speech Delayed speech and language Disinterest in environmental sounds or conversation Sensitive to touching of ears Poor eye contact

7 Statistics on Children in U.S. 2-3:1,000 congenital HL [3] 3:4 ear infection by age 3 [3] 1:68 diagnosed with ASD [4] 1.7-4% have HL & ASD [5, 6]

8 Significance Must know How to evaluate When to refer Outcomes If HL is missed If HL is identified early

9 Project Goals Identify alternate approaches to evaluate hearing of children with special needs Gather research data for special populations

10 Outline Background Methods Results Conclusions Acknowledgements References

11 Visual Reinforcement Audiometry (VRA) Beep! Beep! Successful between developmental ages of 5-36 months [2]

12 VRA Set-Up

13 Video Visual Reinforcement Audiometry (V-VRA) Beep! Beep! No previous studies have looked at ASD or other developmental disabilities

14 V-VRA Set-Up

15 Test Room Set-Up

16 Inclusion criteria Participants Children referred to the Waisman Center with ASD or other developmental disabilities Children from 6 mos. to 6 years of age who can be assessed through VRA Exclusion criteria Children who cannot be reliably tested through VRA

17 Methods Test order Transducer Conditioning phase Initial stimulus presentation: 40 db HL Control trials Maladaptive behaviors

18 Outline Background Methods Results Conclusions Acknowledgements References

19 Data Collection

20 Subject Sex Age Diagnosis A001 M 33 months Autism Spectrum Disorder A002 M 30 months Autism Spectrum Disorder A003 M 34 months Apraxia of Speech A004 F 5 years Developmental Delay, Gross Motor Delay A005 F 3 years Hypotonia, Chromosomal Abnormality A006 M 23 months Spastic Displasia V001 M 21 months Developmental Delay V002 M 4 years Developmental Communication Disorder, Gross Motor Delay, Other Developmental S/L Disorder V003 M 27 months Expressive Language Delay V004 M 21 months Developmental Delays V005 M 33 months Initial ASD consult V006 M 22 months Newborn Follow-Up, Speech/Language Delays Subject Profiles

21 Total Number of Head Turns Comparison of Reinforcement Method 24 Comparison of Reinforcement Method 22 VRA V-VRA Total Number of Head Turns VRA V-VRA

22 Response Consistency Hit Rate Response Consistency VRA V-VRA Hit Rate Trial

23 Outline Background Methods Results Conclusions Acknowledgements References

24 Response Consistency Comparison Hit Rate Hit Rate 1.0 Current Study Response Consistency Lowery, von Hapsburg, Plyler, and Johnstone (2009) 0.8 VRA V-VRA Hit Rate Trial VRA V-VRA

25 Summary of Findings No significant difference between VRA and V-VRA Number of head turns Hit rate No child reacted negatively to V-VRA V-VRA viable option for testing hearing in children with ASD and other developmental disabilities

26 Time to test Special populations Challenges to current study Limitations One test condition Incomplete evaluations

27 What Next? Crossover design Develop published protocol Larger sample

28 Clinical Implications Room for more research Additional methods of testing Benefit for clinic Accessibility of equipment Cost-efficient Behavioral testing

29 A Special Thanks to Waisman Center Participants and their families Waisman Center clinical staff Jon Douglas, Au.D. Jane Elliot, Au.D. Ruth Litovsky, Ph.D. Sammi Ginter, M.A. Sara Misurelli, Ph.D. Shelly Godar, M.A.

30 References 1 Kleinman, J.M., Robins, D.L., Ventola, P.E., Pandey, J., Boorstein, H.C., Esser, E.L., Deborah Fein. (2008). "The Modified Checklist for Autism in Toddlers: A Follow-up Study Investigating the Early Detection of Autism Spectrum Disorders." Journal of Autism Development Disorders 38, Katz, Jack, Robert Burkard, and Larry Medwetsky. (2002). Ch. 26, Individuals with Multiple Disabilities. Handbook of Clinical Audiology (668). Philadelphia: Lippincott Williams &Wilkins. 6 th Edition. 3 Compiled by National Institute on Deafness and Other Communication Disorders. Quick Statistics. National Institute on Deafness and Other Communication Disorders. 16 June Web. 21 April Baio, Jon. (2014). Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years Autism and Developmental Disabilities Monitoring Network 11 Sites, United States, Surveillance Summaries 63: C.A. Szymanski, P.J. Brice, K.H. Lam, S.A. Hotto. (2012). Deaf children with autism spectrum disorders. Journal of Autism Developmental Disorders 42: R. Jure, I. Rapin, R.F. Tuchman. (1991). Hearing-impaired autistic children. Developmental Medicine Child Neurology, 33: Images obtained from:

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