Dr Kate Wilkins1,4, Ms Libby Smith1, Ms Jessica Xu1, A/Prof. Valerie Sung1
1Murdoch Children’s Research Institute, Parkville, Australia, 2Royal Children’s Hospital, Parkville, Australia, 3University of Melbourne, Parkville, Australia, 4Barwon Health, Geelong, Australia
Introduction
Deaf and hard-of-hearing (DHH) children often experience symptoms of Autism Spectrum Disorder (ASD), but making the additional diagnosis is often missed or delayed. We aimed to describe early communication profiles in DHH children and determine whether the Communication and Symbolic Behaviour Scale (CSBS) can be used to identify DHH children at risk of ASD.
Methods
Communication profiles of DHH children aged 6 to 24 months enrolled in a population-based longitudinal databank were measured using the CSBS Infant Toddler Checklist. We reported descriptive statistics, used Chi-square test to identify associations between child/family characteristics and CSBS scores, and logistic regression to analyse the relationship between CSBS scores and subsequent ASD diagnosis.
Results
Caregivers of 288 (81%) children fully completed the CSBS. Of these, 87 (30%) reported total CSBS score in the ‘concern’ range. Children with bilateral hearing loss, hearing amplification, prematurity and language other than English were more likely to have total CSBS scores in the ‘concern’ range. Of 147 caregivers who later reported on additional medical diagnoses, 17 (11.5%) reported their child had ASD. Children with total CSBS scores in the ‘concern’ range were 6.6 times more likely than those with scores in the ‘no concern’ range to have a subsequent diagnosis of ASD (95% CI [2.2, 20.9]). Children with Communication subscale scores and Symbolic subscale scores in the ‘concern’ range were 10.9 and 12.9 times more likely than those with scores in the ‘no concern’ range to have a subsequent diagnosis of ASD.
Discussion
This study describes, and identifies factors associated with early communication profiles, and suggests that the CSBS Infant Toddler Checklist can identify DHH children at risk of ASD. These findings have implications for screening and early intervention in young DHH children.
Biography:
A/Prof Valerie Sung is a paediatrician and director of the Caring for Hearing In Children Clinic at the Royal Children’s Hospital, and leads a hearing loss health services research group at the Murdoch Children’s Research Institute to identify early predictors of child outcomes and establish evidence-based management through population and clinical cohorts as well as intervention trials. Valerie chairs the Childhood Hearing Australasian Medical Professionals (CHAMP) Network which developed national guidelines for managing childhood hearing loss. She is a committee member of the Australian Newborn Hearing Screening Committee, and editorial panel member of the Journal of Paediatrics and Child Health.