By Published: Jan. 10, 2020

These CU Boulder-developed tools provide a way of preparing children with autism spectrum disorder to get their hearing tested—saving time and a whole lot of stress


For children with autism, getting diagnosed can be a struggle in and of itself. But new tools developed by audiologists at the University of Colorado Boulder may help.

These new materials, which are the first widely accessible tools of their kind and are highlighted in the American Journal of Audiology, provide a way for parents or clinicians to communicate to children through pictures and videos what they are about to experience. The researchers hope that incorporating them will reduce the child and family’s stress and increase the chances that audiologists will obtain a reliable and comprehensive audiological exam—which is one of the first steps towards a reliable diagnosis.

And these materials won’t just help the thousands of children diagnosed with autism each year. They could help children with any number of developmental delays.

Child getting tested

An unnamed 7-year-old boy with autism gets his hearing tested in one of the videos created by CU Boulder researchers.

“The World Health Organization specifically says that it’s a human right to be able to communicate. And for some children with Autism Spectrum Disorder, they don’t communicate with auditory oral communication,” said Angela Bonino, an assistant professor in speech, language and hearing sciences, a clinically trained pediatric audiologist and one of the authors of the paper.

“This provides an audiologist another strategy and type of tool to help facilitate communication with that patient to make sure that that child is also hopefully understanding what types of medical services are going to be provided to them.”

In the United States alone, about 1 in 59 children is diagnosed each year with Autism Spectrum Disorder, according to the Centers for Disease Control and Prevention—and that number has been rising every year since record-keeping began.

For these children, one of the first signs that something may be wrong is the challenges the child may be facing with delays in communication. That means that, according to the CU Boulder researchers, parents may first turn to the people who know hearing best to see if that’s the culprit: audiologists.

To get a proper hearing assessment or diagnosis, it can sometimes take multiple trips to an audiologist. For children—particularly those with some sort of developmental disability—those trips can be stressful. This can, in turn, slow down their diagnosis or even affect the results of the hearing test.

And that’s a problem, says researchers.

“It’s very important to make sure that their hearing test results are accurate and reliable and that we get a full understanding of their hearing,” said Haley McTee, an audiology graduate student and the lead author on the paper.

There is already clinically proven research proving the worth of visual and video support in testing children with autism or who are suspected of having autism. So, the researchers wondered: Could the same thing be applied in an audiological setting?

It’s very important to make sure that their hearing test results are accurate and reliable and that we get a full understanding of their hearing."

The team created two sets of diagnostic tools—video models (videos that can show children what they are about to experience) and visual schedules (matching laminated print outs)—that showcase eight children of diverse backgrounds, ranging in age from 4 to 12 years old.

While the materials themselves have yet to be fully tested, the researchers expect that they should help address the communication barrier faced by children with autism.

This research is part of the LEND (Leadership Education in Neurodevelopmental Disabilities) fellowship program, an interdisciplinary five-year training program for audiology graduate students. The goal of the program, which is offered by CU Anschutz Medical Campus’ School of Medicine, is to improve the health of those with disabilities, with a focus on infants, children and adolescents.

As part of the fellowship, students have to complete a project related to a developmental issue in audiology, with the theme this cycle being Autism Spectrum Disorder.

These materials, which were developed by this cycle’s LEND fellows, including McTee, are freely available online for anyone to use. However, the researchers still recommend contacting an audiologist if you have any concerns.

“I think it’s important to always communicate the best way you can with all of your patients,” said McTee. “For different languages, that means using interpreters … The video models I’ve created just assist in that communication gap for these kids.”