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MISDIAGNOSIS OF ANSD AS AUTISM INFLUENCE INTERVENTION OUTCOME - Coggle…
MISDIAGNOSIS OF ANSD AS AUTISM INFLUENCE INTERVENTION OUTCOME
ANSD MIMICKING ASD
Typical features
Hearing vary from normal hearing to profound HL
Hearing that changes over time
These features could cause concerning behaviours that might be confused or misunderstood as features that shown from kids with ASD
Difficulty understanding speech, especially with background noise
Difficulty in hearing rapid changes in speech
Speech recognition that is worse than predicted for one's level of hearing
OVERLAPPING CHARACTERISTICS
Inconsistent Auditory Responses
ANSD: Neural Dysynchrony
ASD: Hyper-systemizing (or "Internal Bias")
Communication Delays
Expressive Language
Receptive Language
Social Withdrawal
Reliance on Visual Cues
ASSESSMENT TOOLS TO DIFFERENTIATE
Audiological Findings Between
ANSD vs ASD
ABR
ANSD
Absent/ abnormal ABR
Cochlear microphonic present
ASD
Normal ABR
OAE
ANSD
OAE present - outer hair cells intact
ASD
OAE present
Acoustic reflexes
ANSD
Absent ASRT
ASD
Present of asrt
Audiometry test
ANSD
Can be vary :normal to profound
ASD
Responses may be inconsistent due to attention, hearing sensitivity often normal
Speech audiometry
ANSD
Poor speech perception especially in noise
ASD
Difficulty may be due to language or social communication
Behavioral Observations
Children with ANSD
maintain better eye contact
Engage in imaginative play
Use gestures/ facial expressions to communicate
Childedren with ASD
ASD deficits in:
Social interaction
Eye contact
Joint attention
Repetitive behaviors
Multidisciplinary team
Audiologist
Hearing & auditory pathway
Speech-Language Pathologist(SLP)
Communication & Language development
ANSD:Language delay due to poor auditory input
ASD: Language + social communication deficits
Pediatrician
Behavior, cognition & autism diagnosis
Occupational therapist
Identifies Sensory sensitivities & daily function
ASD: Strong sensory-seeking/avoidance pattern
ANSD: mainly auditory-related issues
DIFFERENTIAL DIAGNOSIS
ANSD
Peripheral (Inner hair cells or Auditory nerve)
Speech perception is disproportionately poor compared to pure-tone thresholds
Speech understanding collapses in background noise
Often shows strong desire to communicate via non-verbal means
Repetitive behaviours usually absent
ASD
Central/Neurodevelopmental
Speech perception often consistent with hearing levels (if tested)
Noise interference difficulty may be related to sensory overload
Qualitatively different social-emotional reciprocity
Present of stimming and rigid routines
RISK OF MISDIAGNOSIS AND THE CONSEQUENCES
Delayed and inappropriate intervention
Missed critical auditory stimulation period, affect speech and language development
Poor speech and language outcome
Persistent speech perception difficulties and delayed expressive language
Incorrect educational placement
Mismatch education strategies, limit communication progress
Phychosocial impact on child and family
Increased caregiver stress and potential misallocation of resources