Skip to main content
The Egyptian Journal of Otolaryngology
Download PDF

Audiologic evaluation and communication disorders in a group of Egyptian children with autistic features

The Egyptian Journal of Otolaryngology volume 28, pages 108–116 (2012)Cite this article

En

Abstract

Objectives

The aim of this work was to perform an audiological evaluation on a group of children with autistic features and to correlate the results with the intelligent quotient, communication skills, and sensory integration function of these children.

Study design

Descriptive cross-sectional study.

Patients and methods

The study was carried out on 25 Egyptian children with autistic features and 25 age-matched and sex-matched typically developing children. All the children’s age ranged from 4 to 9 years. All the children were subjected to the following: history taking, basic audiological evaluation, transient evoked otoacoustic emissions, N100, and P300. The children were also subjected to communication assessment, sensory integration dysfunction questionnaire, psychometric evaluation, and the Childhood Autism Rating Scale. The results obtained from the two groups were then compared. In addition, correlation studies were carried out for all the results obtained.

Results

Autistic children presented with normal hearing sensitivities and cochlear function, and delayed N100 and P300 latencies and small P300 amplitudes compared with the control group. There was a significant negative correlation between N100 latency and verbal and nonverbal communication abilities. In addition, there was a significant correlation between P300 latency and amplitude and each of the following: intelligent quotient, the Childhood Autism Rating Scale, and dynamic assessment of verbal and nonverbal communication. The auditory and visual modalities of the sensory integration dysfunction score correlated positively with P300 latency but not amplitude.

Conclusion

The auditory deficits in autism involve controlled attention processes, speed of perceptual classification, and allocation of attention. N100 is a correlate of the level of communication and language development rather than a marker of autism. P300 abnormalities affect verbal and nonverbal communication, mental development, autistic features, and sensory integration function in autism and may be used as a tool to assess the prognosis of autism.

References

  1. Szatmari P, Mérette C, Bryson SE, Thivierge J, Roy MA, Cayer M, et al. Quantifying dimensions in autism: a factor-analytic study. J Am Acad Child Adolesc Psychiatry. 2002; 41: 467–474

    Article  PubMed  Google Scholar 

  2. Bomba MD, Pang EW. Cortical auditory evoked potentials in autism: a review. Int J Psychophysiol. 2004; 53: 161–169

    Article  PubMed  Google Scholar 

  3. O’Riordan M, Passetti F. Discrimination in autism within different sensory modalities. J Autism Dev Disord. 2006; 36: 665–675

    Article  PubMed  Google Scholar 

  4. Bruneau N, Roux S, Adrien JL, Barthélémy C. Auditory associative cortex dysfunction in children with autism: evidence from late auditory evoked potentials (N1 wave-T complex). Clin Neurophysiol. 1999; 110: 1927–1934

    Article  CAS  PubMed  Google Scholar 

  5. Rosenhall U, Nordin V, Brantberg K, Gillberg C. Autism and auditory brain stem responses. Ear Hear. 2003; 24: 206–214

    Article  PubMed  Google Scholar 

  6. Benasich AA, Tallal P. Infant discrimination of rapid auditory cues predicts later language impairment. Behav Brain Res. 2002; 136: 31–49

    Article  PubMed  Google Scholar 

  7. Cunningham J, Nicol T, Zecker S, Kraus N. Speech-evoked neurophysiologic responses in children with learning problems: development and behavioral correlates of perception. Ear Hear. 2000; 21: 554–568

    Article  CAS  PubMed  Google Scholar 

  8. Rapin I. Current concepts: autism. N Engl J Med. 1997; 337: 97–104

    Article  CAS  PubMed  Google Scholar 

  9. Nieto Del Rincón PL. Autism: Alterations in auditory perception. Rev Neurosci. 2008;19:61–78

    Article  PubMed  Google Scholar 

  10. Ors M, Lindgren M, Blennow G, Nettelbladt U, Sahlén B, Rosén I. Auditory event-related brain potentials in children with specific language impairment. Eur J Paediatr Neurol. 2002; 6: 47–62

    Article  PubMed  Google Scholar 

  11. Dunn M, Vaughan H Jr, Kreuzer J, Kurtzberg D. Electrophysiologic correlates of semantic classification in autistic and normal children. Dev Neuropsychol. 1999; 16: 79–99

    Article  Google Scholar 

  12. Kayaalp L, Dervent A, Saltik S, Uluduz D, Kayaalp IV, Demirbilek V, et al. EEG abnormalities in West syndrome: correlation with the emergence of autistic features. Brain Dev. 2007; 29: 336–345

    Article  PubMed  Google Scholar 

  13. Pervasive developmental disorders. Diagnostic and Statistical Manual of Mental Disorders. 4th ed Arlington, VA: Amer Psychiatric Pub; 2000. pp. 69–70

    Google Scholar 

  14. Schopler E, Reichler RJ, Renner BR The Childhood Autism Rating Scale (CARS) for diagnostic screening and classification of autism. Los angeles, CA Western Psychological Services; 1988.

    Google Scholar 

  15. Kemp DT. Otoacoustic emissions, travelling waves and cochlear mechanisms. Hear Res. 1986; 22: 95–104

    Article  CAS  PubMed  Google Scholar 

  16. Sami KL, Osman DM, Selim MH, Mohamed RA. Communication skills, sensory integration functions and auditory brainstem response findings in a group of Egyptian children having autistic features. Egypt J Otolaryngol. 2012; 28: 94–108

    Google Scholar 

  17. Terman LM, Merrill MA Stanford–Binet Intelligence Scale: manual for the third revision form L-M. Boston: Houghton Mifflin company; 1961.

    Google Scholar 

  18. Snell ME. Using dynamic assessment with learners who communicate nonsymbolically. Augment Altern Commun. 2002; 18: 163–176

    Article  Google Scholar 

  19. Koomar J, Kranowitz C, Szkut CS, Marin SL, Haber EE, Sava D Answers to questions teachers ask about sensory integration. Las Vagas: Sensory Resources; 2004.

    Google Scholar 

  20. Ahmed D, Aziz A. A study of sensory integration disorder in relation to autistic features in children with delayed language development. Egypt J Otolaryngol. 2005; 22: 77–84

    Google Scholar 

  21. Perry W, Minassian A, Lopez B, Maron L, Lincoln A. Sensorimotor gating deficits in adults with autism. Biol Psychiatry. 2007; 61: 482–486

    Article  PubMed  Google Scholar 

  22. Ozmenek OA, Nazliel B, Leventoǧlu A, Bilir E. The role of event related potentials in evaluation of subclinical cognitive dysfunction in epileptic patients. Acta Neurol Belg. 2008; 108: 58–63

    PubMed  Google Scholar 

  23. Filipek PA, Accardo PJ, Baranek GT, Cook EH Jr, Dawson G, Gordon B, et al. The screening and diagnosis of autistic spectrum disorders. J Autism Dev Disord. 1999; 29: 439–484

    Article  CAS  PubMed  Google Scholar 

  24. Gravel JS, Dunn M, Lee WW, Ellis MA. Peripheral audition of children on the autistic spectrum. Ear Hear. 2006; 27: 299–312

    Article  PubMed  Google Scholar 

  25. Tharpe AM, Bess FH, Sladen DP, Schissel H, Couch S, Schery T. Auditory characteristics of children with autism. Ear Hear. 2006; 27: 430–441

    Article  PubMed  Google Scholar 

  26. Ornitz EM. Autism at the interface between sensory and information processing. In: Dawson G. Autism: nature, diagnosis and treatment. 1st ed New York: Guilford Press; 1989. pp. 174–207

    Google Scholar 

  27. Tas A, Yagiz R, Tas M, Esme M, Uzun C, Karasalihoglu RA. Evaluation of hearing in children with autism by using TEOAE and ABR. Autism. 2007; 11: 73–79

    Article  PubMed  Google Scholar 

  28. Rimland B, Edelson SM. The effects of auditory integration training on autism. Am J Speech Lang Pathol. 1994; 3: 16–24

    Article  Google Scholar 

  29. Ellis MA. Bilateral, ipsilateral and contralateral auditory efferent suppression of otoacoustic emissions in children with autism. Diss Abstr Int. 2004; 65: 1758–1769

    Google Scholar 

  30. Seri S, Cerquiglini A, Pisani F, Curatolo P. Autism in tuberous sclerosis: evoked potential evidence for a deficit in auditory sensory processing. Clin Neurophysiol. 1999; 110: 1825–1830

    Article  CAS  PubMed  Google Scholar 

  31. Kemner C, Verbaten MN, Cuperus JM, Camfferman G, Van Engeland H. Auditory event-related brain potentials in autistic children and three different control groups. Biol Psychiatry. 1995; 38: 150–165

    Article  CAS  PubMed  Google Scholar 

  32. Lincoln AJ, Courchesne E, Harms L, Allen M. Sensory modulation of auditory stimuli in children with autism and receptive developmental language disorder: event-related brain potential evidence. J Autism Dev Disord. 1995; 25: 521–539

    Article  CAS  PubMed  Google Scholar 

  33. Oades RD, Walker MK, Geffen LB, Stern LM. Event-related potentials in autistic and healthy children on an auditory choice reaction time task. Int J Psychophysiol. 1988; 6: 25–37

    Article  CAS  PubMed  Google Scholar 

  34. Pang EW, Taylor MJ. Tracking the development of the N1 from age 3 to adulthood: an examination of speech and non-speech stimuli. Clin Neurophysiol. 2000; 111: 388–397

    Article  CAS  PubMed  Google Scholar 

  35. Belmonte M, Carper R. Neuroanatomical and neurophysiological clues to the nature of autism. In: Garreau B, editor. Neuroimaging Child Neuropsychiatr Disord Springer-Verlag. 1998; 23: 157–171

  36. Dawson G, Finley C, Phillips S, Galpert L, Lewy A. Reduced P3 amplitude of the event-related brain potential: its relationship to language ability in autism. J Autism Dev Disord. 1988; 18: 493–504

    Article  CAS  PubMed  Google Scholar 

  37. Polich J. P300 clinical utility and control of variability. J Clin Neurophysiol. 1998; 15: 14–33

    Article  CAS  PubMed  Google Scholar 

  38. Hoeksma MR, Kemner C, Kenemans JL, Van Engeland H. Abnormal selective attention normalizes P3 amplitudes in PDD. J Autism Dev Disord. 2006; 36: 643–654

    Article  PubMed  Google Scholar 

  39. Gomot M, Giard MH, Adrien JL, Barthelemy C, Bruneau N. Hypersensitivity to acoustic change in children with autism: electrophysiological evidence of left frontal cortex dysfunctioning. Psychophysiology. 2002; 39: 577–584

    Article  PubMed  Google Scholar 

  40. Samson F, Mottron L, Jemel B, Belin P, Ciocca V. Can spectro-temporal complexity explain the autistic pattern of performance on auditory tasks? J Autism Dev Disord. 2006; 36: 65–76

    Article  PubMed  Google Scholar 

  41. Lincoln AJ, Courchesne E, Harms L, Allen M. Contextual probability evaluation in autistic, receptive developmental language disorder and control children: event-related brain potential evidence. J Autism Dev Disord. 1993; 23: 37–58

    Article  CAS  PubMed  Google Scholar 

  42. Ferri R, Elia M, Agarwal N, Lanuzza B, Musumeci SA, Pennisi G. The mismatch negativity and the P3a components of the auditory event-related potentials in autistic low-functioning subjects. Clin Neurophysiol. 2003; 114: 1671–1680

    Article  PubMed  Google Scholar 

  43. Salmond CH, Vargha Khadem F, Gadian DG, de Haan M, Baldeweg T. Heterogeneity in the patterns of neural abnormality in autistic spectrum disorders: evidence from ERP and MRI. Cortex. 2007; 43: 686–699

    Article  PubMed  Google Scholar 

  44. Courchesne E, Lincoln AJ, Kilman BA, Galambos R. Event-related brain potential correlates of the processing of novel visual and auditory information in autism. J Autism Dev Disord. 1985; 15: 55–76

    Article  CAS  PubMed  Google Scholar 

  45. Musiek FE, Baran JA, Pinheiro ML. P300 results in patients with lesions of the auditory areas of the cerebrum. J Am Acad Audiol. 1992; 3: 5–15

    CAS  PubMed  Google Scholar 

  46. Kotchoubey B. Event-related potentials, cognition and behavior: a biological approach. Neurosci Biobehav Rev. 2006; 30: 42–65

    Article  PubMed  Google Scholar 

  47. Leekam SR, Nieto C, Libby SJ, Wing L, Gould J. Describing the sensory abnormalities of children and adults with autism. J Autism Dev Disord. 2007; 37: 894–910

    Article  PubMed  Google Scholar 

  48. Nelson CA III, McCleery JP. Use of event-related potentials in the study of typical and atypical development. J Am Acad Child Adolesc Psychiatry. 2008;47:1252–1261

    Article  PubMed Central  PubMed  Google Scholar 

  49. Gillberg M, Coleman C. Biology of the autistic syndromes. London: Mac Keith Press; 2000.

    Google Scholar 

  50. Munson J, Faja S, Meltzoff A, Abbott R, Dawson G. Neurocognitive predictors of social and communicative developmental trajectories in preschoolers with autism spectrum disorders. J Int Neuropsychol Soc. 2008; 14: 956–966

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. ENT Department, Kasr El-Aini Hospital, Cairo University, Cairo, Egypt

    Kamal Labib Samy

  2. Audiology Unit, Kasr El-Aini Hospital, Cairo University, Cairo, Egypt, 11121

    Mona Hassan Selim

  3. Phoniatric Unit, Kasr El-Aini Hospital, Cairo University, Cairo, Egypt

    Dalia Mostafa Osman

  4. Phoniatric Unit, Hearing and Speech Institute, Cairo, Egypt

    Reham Ahmed Mohamed

Authors
  1. Kamal Labib Samy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mona Hassan Selim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dalia Mostafa Osman
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Reham Ahmed Mohamed
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mona Hassan Selim.

Additional information

Conflicts of interest

There are no conflicts of interest.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Samy, K.L., Selim, M.H., Osman, D.M. et al. Audiologic evaluation and communication disorders in a group of Egyptian children with autistic features. Egypt J Otolaryngol 28, 108–116 (2012). https://doi.org/10.7123/01.EJO.0000413588.51884.02

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.7123/01.EJO.0000413588.51884.02

Keywords