Differential diagnosis: hearing loss or autism spectrum disorder

Abstract

Introduction: Hearing loss (HL) is characterized by a change in the auditory system, with decreased hearing ability, while the Autism Spectrum Disorder (ASD) is defined as a developmental and behavioral change. However, there are many symptoms of HL and ASD that overlap, requiring a differential diagnosis to be performed by a multidisciplinary team. Objective: To characterize the process of differential diagnosis between HL and ASD and its association in children from zero to twelve years of age, at a Hearing Health Outpatient Clinic (Serviço Ambulatorial de Saúde Auditiva - SASA). Method: This is a cross-sectional and qualitative document-based study in a database of 94 records of children attended by the clinic from 2012 to 2017, with at least one diagnostic hypothesis of ASD. The statistical analysis was descriptive with a comparison test between the two population proportions with a 5% significance level. Results: Of the 94 suspected cases of ASD, 36 were confirmed. There was a prevalence of males and the age group of three to four years at the time of the suspicion or confirmed diagnosis of ASD. Most of the children presented borderline hearing loss within the normal limits, and normal results in the Brainstem Auditory Evoked Potential (BAEP) responses. Although there was a prevalence of language delays in the language assessment, when this was associated with other communicative changes (symbolic function, communicative intention and/or echolalia) there was an increase in the changes in the BAEP. Conclusions: Multidisciplinary care is important for the differential diagnosis of HL, ASD, or the association between them, in order to ensure the most adequate intervention for each case.