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Diagnostic Utility of Parent Ratings on the Behavior Assessment System for Children-Third Edition in Children who are Deaf and Hard of Hearing and Diagnosed with Autism Spectrum Disorder

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Between 1 to 2 of every 1,000 children are born deaf or hard of hearing (DHH) and, of those, 30–50% have additional disabilities, including Autism Spectrum Disorder (ASD). Most measures assessing ASD characteristics rely on some degree of behavioral response to sound (e.g., responding to name, listening response), and may not be appropriate for use with children who are DHH. Further, ASD specific measures do not provide information on a child’s functional abilities across developmental domains. We conducted a cross-sectional analysis comparing mean T-scores on a standardized multidimensional measure, the Behavior Assessment System for Children, Third Edition, Parent Rating Scale (BASC-3 PRS), across three groups matched for age and sex: children who are DHH and diagnosed with ASD (DHH + ASD; n = 16); children who are DHH without ASD (DHH-ASD; n = 16); and children who are typically hearing with ASD (H + ASD; n = 16). Analyses revealed statistically significant differences across scales of Attention Problems, Atypicality, Withdrawal, Behavioral Symptoms Index, Social Skills, Leadership, Functional Communication, Activities of Daily Living, Adaptive Skills, Autism Probability Indices, and Developmental Social Disorders. Pairwise comparisons showed DHH + ASD and H + ASD mean T-scores were statistically similar and distinct from DHH-ASD mean T-scores on all these scales except for Withdrawal, Leadership, Functional Communication, and Activities of Daily Living, where pairwise comparisons varied. The findings add to the literature on ASD and DHH children and call for further exploration of the BASC-3 as a tool for both evaluation of ASD and the development of individualized treatment plans in this unique population.

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Fig. 1

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Data is available upon reasonable request to the corresponding author.


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The authors wish to acknowledge Christine MacDonald, AuD, CCC-A, PASC, CH-AP for her contributions reviewing the audiological variables in this manuscript.

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All authors contributed to the study conception and design. Material preparation and data collection were performed by Arielle Spellun, Megan Herlihy, Matthew Fasano-McCarron, Samantha Hasenbalg, Amber Graham, Kate Linnea, Emily Taketa, Peter Isquith, and Rachel Landsman. Data analysis was completed by Arielle Spellun, Matthew Fasano-McCarron and Emily Taketa. The first draft of the manuscript was written by Arielle Spellun and all authors read, contributed to, and approved the final manuscript.

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Correspondence to Arielle Spellun.

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Spellun, A., Herlihy, M., Taketa, E. et al. Diagnostic Utility of Parent Ratings on the Behavior Assessment System for Children-Third Edition in Children who are Deaf and Hard of Hearing and Diagnosed with Autism Spectrum Disorder. Res Child Adolesc Psychopathol (2023).

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