Autism is a serious pervasive developmental disorder. Its typical features are not only problems associated with communicating with people and forming social relationships but also integration of sensual perception. It is typical, that autistic children avoid social interactions and they are indifferent to people, even to those who are close relatives. They also avoid stimuli triggering a willingness to maintain emotional and verbal contact.
The prevalence for children with autism amounts to 1/160, and it is more common among boys than girls by a ratio of 4:1; however, the etiology of autism is most probably multifactorial and is not entirely elucidated. Nowadays, psychosocial factors have been replaced with views about dysfunction of the central nervous system, excessive sensitivity to stimuli and difficulties in their integration. However, as specific autistic changes in the central nervous system have not been found, biological factors are still believed to interact with psychological factors, although their contributions may differ in different autism cases.
The diagnostic criteria of autism were approved by the WHO in 1992. The disease starts before the end of the third year of life and disruptions in speech development are the cause of significant cognitive limitations and difficulties in achieving school readiness. Other characteristic features of autism are hypersensitivity to sensory stimuli, psychomotor hyperreactivity or excessive calmness, poor physical coordination despite proper motor activity, aggression and especially often self-aggression, disorders of multisensory integration, and sleep disorders. The prognosis regarding the cure is poor.
The treatment of children with autism should take into consideration the needs of the child and his/her family. The most common approach is improvement of behavior through behavioral therapy, therapy of disordered sensor integration, speech therapy, and symptomatic pharmacological treatment. However, due to the nature of the condition, the child’s caregivers often seek help from a number of different specialists, and as a consequence, the diagnosis of the disease often comes very late. The care of autistic children is also very demanding since along with behavioral and psychiatric conditions, there are other medical issues, that are in focus of many medical specialities .
In the age of widespread program of hearing loss screening among newborns, perceptive deafness can be detected before the age of 6 months and is offered until the end of the first year of life. The diagnosis of early hearing loss or its exclusion, which often suggests suspected autism, is very important for early hearing aid application, psychotherapy and psychiatric treatment. So it can be said that a program of early hearing loss detection makes a considerable contribution to the early detection of psychiatric disorders among children. Auditory brainstem response testing in such a group of children is difficult to assess because of the existence of many artifacts . To further complicate matters, a frequent problem, which occurs during the school and preschool periods, is conductive hearing loss, as well as mixed hearing loss, which is often unnoticed even among healthy children .
In the group of children with emotional and psychiatric/psychological problems, hearing loss may be masked by the child’s behavior and remains unnoticed. Hearing impairment among children with developmental disorders has a special significance: it can cause even more serious disorders connected with the people around them, which has a significant impact on the child’s development, rehabilitation, and psychiatric/psychological treatment . The problem is also present in children with unilateral hearing loss as it affects hearing in noise and sound source localization .
As subjective tests in autistic children are particularly challenging to perform due to the difficulty in making contact with them, using objective methods would seem to be the most suitable approach to assess hearing loss in the population of school and preschool children with psychological problems .