The Use of Listening Devices to Ameliorate Auditory Deficit in Children with Autism

Published:November 01, 2013DOI:


      To evaluate both monaural and binaural processing skills in a group of children with autism spectrum disorder (ASD) and to determine the degree to which personal frequency modulation (radio transmission) (FM) listening systems could ameliorate their listening difficulties.

      Study design

      Auditory temporal processing (amplitude modulation detection), spatial listening (integration of binaural difference cues), and functional hearing (speech perception in background noise) were evaluated in 20 children with ASD. Ten of these subsequently underwent a 6-week device trial in which they wore the FM system for up to 7 hours per day.


      Auditory temporal processing and spatial listening ability were poorer in subjects with ASD than in matched controls (temporal: P = .014 [95% CI −6.4 to −0.8 dB], spatial: P = .003 [1.0 to 4.4 dB]), and performance on both of these basic processing measures was correlated with speech perception ability (temporal: r = −0.44, P = .022; spatial: r = −0.50, P = .015). The provision of FM listening systems resulted in improved discrimination of speech in noise (P < .001 [11.6% to 21.7%]). Furthermore, both participant and teacher questionnaire data revealed device-related benefits across a range of evaluation categories including Effect of Background Noise (P = .036 [−60.7% to −2.8%]) and Ease of Communication (P = .019 [−40.1% to −5.0%]). Eight of the 10 participants who undertook the 6-week device trial remained consistent FM users at study completion.


      Sustained use of FM listening devices can enhance speech perception in noise, aid social interaction, and improve educational outcomes in children with ASD.
      APHAB (Abbreviated Profile of Hearing Aid Benefit), ASD (Autism spectrum disorder), FM (Frequency modulation (radio transmission))
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        • American Psychiatric Association (APA)
        Diagnostic and statistical manual of mental disorders (DSM V).
        5th edition. APA, Washington, DC2013
        • Kanner L.
        Autistic disturbances of affective contact.
        Nerv Child. 1943; 2: 217-250
        • Alcántara J.I.
        • Weisblatt E.J.
        • Moore B.C.J.
        • Bolton P.F.
        Speech perception in high-functioning participants with autism or Asperger's syndrome.
        J Child Psychol Psychiatry. 2004; 45: 1107-1114
        • Alcántara J.I.
        • Cope T.E.
        • Cope W.
        • Weisblatt E.J.
        Auditory temporal-envelope processing in high-functioning children with autism spectrum disorder.
        Neuropsychologia. 2012; 50: 1235-1251
        • Groen W.B.
        • van Orzo L.
        • tar Horne N.
        • Winkles S.
        • van der Gaga R.-J.
        • Butler J.K.
        • et al.
        Intact spectral but abnormal temporal processing in autism.
        J Aut Dev Disord. 2009; 39: 742-750
        • Beck D.L.
        • Bellis T.J.
        (Central) auditory processing disorders: overview and amplification issues.
        Hearing J. 2007; 60: 44-47
        • Cameron S.
        • Glyde H.
        • Dillon H.
        Efficacy of the LiSN & Learn auditory training software: randomized blinded control study.
        Audiol Res. 2012; 2e15: 86-93
        • Song J.
        • Skoe E.
        • Banai K.
        • Kraus N.
        Training to improve hearing speech in noise: biological mechanisms.
        Cereb Cortex. 2012; 22: 1180-1190
        • Anderson S.
        • White-Schwoch T.
        • Parbery-Clark A.
        • Kraus N.
        Reversal of age-related neural timing delays with training.
        Proc Natl Acad Sci USA. 2013; 110: 4357-4362
        • Crandell C.C.
        • Smaldino J.J.
        Classroom acoustics for children with normal hearing and with hearing impairment.
        Lang Speech Hear Serv Schools. 2000; 4: 362-370
        • Hawkins D.
        Comparisons of speech recognition in noise by mildly- to moderately-hearing-impaired children using hearing aids and FM systems.
        J Speech Hear Disord. 1984; 49: 409-418
        • Johnstone K.N.
        • John A.B.
        • Hall J.W.
        • Crandell C.C.
        Multiple benefits of personal FM system use by children with auditory processing disorder (APD).
        Int J Audiol. 2009; 48: 371-383
        • Rance G.
        • Corben L.A.
        • DuBourg E.
        • King A.
        • Delatycki M.B.
        Successful treatment of auditory perceptual disorder in individuals with Friedreich ataxia.
        Neuroscience. 2010; 171: 552-555
        • Schafer E.C.
        • Mathews L.
        • Mehta S.
        • Hill M.
        • Munoz A.
        • Bishop R.
        • et al.
        Personal FM systems for children with autism spectrum disorders (ASD) and/or attention-deficit hyperactivity disorder (ADHD): an initial investigation.
        J Commun Disord. 2013; 46: 30-52
        • LeCouteur A.
        • Rutter M.
        • Lord C.
        • Rios P.
        Autism Diagnostic Interview: a standardized investigator-based instrument.
        J Autism Dev Disord. 1989; 19: 363-387
        • Lord C.
        • Rutter M.
        • LeCouteur A.
        Autism Diagnostic Interview–Revised: a revision of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders.
        J Autism Dev Disord. 1994; 24: 659-685
        • Magyar C.I.
        • Pandolfi V.
        Factor structure evaluation of the Childhood Autism Rating Scale.
        J Autism Dev Disord. 2007; 37: 1787-1794
        • Needelman H.
        • Schnoes C.J.
        • Ellis C.R.
        The new WISC-IV.
        J Dev Pediatr. 2006; 27: 127-128
        • Viemeister N.F.
        Temporal modulation transfer functions based on modulation threshold.
        J Acoust Soc Am. 1979; 66: 1364-1380
        • Cameron S.
        • Dillon H.
        Development of the listening in Spatialized Noise-Sentences Test (LiSN-S).
        Ear Hear. 2007; 28: 196-211
        • Rance G.
        • Ryan M.M.
        • Carew P.
        • Corben L.A.
        • Yiu E.
        • Tan J.
        • et al.
        Binaural speech processing in individuals with auditory neuropathy.
        Neuroscience. 2012; 226: 227-235
        • Petersen G.E.
        • Lehiste I.
        Revised CNC lists for auditory tests.
        J Speech Hear Disord. 1962; 27: 62-70
        • Anderson K.
        • Smaldino J.
        Listening Inventories for Education: a classroom measurement tool.
        Hearing J. 1999; 52: 74-75
        • Cameron S.
        • Dillon H.
        • Newall P.
        Development and evaluation of the Listening in Spatialized Noise Test.
        Ear Hear. 2006; 27: 30-42
        • Ashburner J.
        • Rodger S.
        • Ziviani J.
        Sensory processing and classroom emotional, behavioural, and educational outcomes in children with autism spectrum disorder.
        Am J Occ Ther. 2008; 62: 564-573
        • Corbett B.
        • Constantine L.
        Autism and attention deficit hyperactivity disorder: assessing attention and response control with the integrated visual and auditory continuous performance test.
        Child Neuropsychol. 2006; 12: 335-348
        • Klin A.
        Auditory brainstem responses in autism: brainstem dysfunction or peripheral hearing loss?.
        J Aut Dev Disord. 1993; 23: 15-35
        • Rosenhall U.
        • Nordin V.
        • Brantberg K.
        • Gillberg C.
        Autism and auditory brainstem responses.
        Ear Hear. 2003; 24: 206-214
        • Russo N.
        • Nicol T.
        • Trommer B.
        • Zecker S.
        • Kraus N.
        Brainstem transcription of speech is disrupted in children with autism spectrum disorders.
        Dev Sci. 2009; 12: 557-567
        • Russo N.
        • Zecker S.
        • Trommer B.
        • Chen J.
        • Kraus N.
        Effects of background noise on cortical encoding of speech in autism spectrum disorders.
        J Autism Dev Disord. 2009; 39: 1185-1196
        • Micheyl C.
        • Carlyon R.P.
        • Gutschalk A.
        • Melcher J.R.
        • Oxenham A.J.
        • Rauschecker J.P.
        • et al.
        The role of auditory cortex in the formation of auditory streams.
        Hear Res. 2007; 229: 116-131
        • Rance G.
        • Ryan M.M.
        • Bayliss K.
        • Gill K.
        • O'Sullivan C.
        • Whitechurch M.
        Auditory function in children with Charcot-Marie-Tooth disease.
        Brain. 2012; 135: 1412-1422