A Hearing Test May Help Detect Autism Risk in Newborns

Key Takeaways

A standard hearing test may one day be used to detect autism in newborns.

The findings, published in November in the journalAutism Research, shed new light on the connections autism spectrum disorder (ASD) may have with hearing and other sensory systems.

Previous studies already found that children with autism have slow brain responses to sounds. This new research observed that newborns who were later diagnosed with autism also had slower brain responses to sounds. That suggests that a hearing test already administered to millions of babies worldwide could potentially identify newborns with higher autism risk months or years before typical diagnosis.

“Even though [autism spectrum disorder] may not manifest clinically until age 2, 3, or 4, at birth there’s already a difference for some of these patients,” co-authorIsaac Kohane, MD, PhD, a pediatric endocrinologist, tells Verywell “A lot of parents, understandably, see it happening at some point and say, ‘Oh my God, what happened at age 2?’ Well, this tells us for some of the patients, it’s already happening at birth—and maybe before.”

What This Means For YouResearchers are investigating whether a standard hearing test for newborns can be used to detect those at high risk of autism spectrum disorder, allowing for a diagnosis moths or years earlier.

What This Means For You

Researchers are investigating whether a standard hearing test for newborns can be used to detect those at high risk of autism spectrum disorder, allowing for a diagnosis moths or years earlier.

Researchers Used a Common Newborn Hearing Test

Researchers from Harvard Medical School and the University of Miami examined the results of newborns’ auditory brainstem response (ABR), a test that determines whether they have any hearing loss or impairments. Pediatrix Medical Group, which screens 850,000 newborns a year for hearing impairment in the United States, performed the ABR tests.

Tests for Hearing Loss

These sounds are soft enough that the tests can be performed while the babies are sleeping, around 35 decibels normal hearing level. This is a significantly lower sound level than what is typically used during ASD screening.

“Although the purpose of this is to check for hearing disorders, it in fact allows you to have this cheap neural physiologic experiment,” says Kohane, who is the inaugural chair of the Department of Biomedical Informatics at Harvard Medical School and associate professor of medicine at Brigham and Women’s Hospital in Boston.

“The ABR is a poor man’s [electroencephalogram] EEG. It was surprising to me that it could be picked up on a simple, 3-lead EEG as opposed to a 12- or 24-lead EEG [conducted in] controlled conditions," he says.

The ADI-R and Other Tests Used to Make an Autism Diagnosis

Slower Brain Responses to Sounds

Researchers analyzed nearly 140,000 ABR tests from babies born in the state of Florida between 2009 and 2015. The hearing test was performed in the hospital within the first week of birth, on average between one and two days after, unless it was postponed because of a medical condition.

Researchers found newborns who were later diagnosed with ASD had slower brain responses to sounds during their ABR tests, suggesting “a systematic difference between these kids who ended up having autism and those who don’t,” Kohane says.

He says their findings are significant because they could:

Long-term Implications

“We know that the brain has a much higher plasticity at younger ages,” Kohane says. “If you’re able to, with some degree of certainty, identify patients who are at risk for being on the spectrum, [then early interventions are] much more likely to be effective. That sometimes makes the difference between being able to live independently or not.”

How Early Intervention Can Help Your Autistic Child

Will the Test Be Used In the Future?

Researchers aren’t sure whether an ABR test performed at the lower sound intensity can accurately identify infants who will develop autism. They therefore need to replicate their findings to determine whether the test can provide clinically useful data.

Even if future studies prove the ABR can accurately detect at-risk children, clinicians will still need to rule out other diagnoses before referring infants for a behavioral autism diagnosis. In addition to hearing impairments, it’s possible the ABR test can help detect speech and language impediments and sudden infant death syndrome (SIDS), among other developmental disabilities. It’s also possible the ABR test can be performed repeatedly to examine changes over time, rather than a once and done test on newborns.

“Given the fact that we essentially have this free data being generated every day, [it] is an opportunity, without major expenditures, to study a way to both detect autism early and also to further characterize subgroups of autism," Kohane says. “It’s a great opportunity to move forward.”

“I just want to be clear: Our findings are not ready for prime time,” he says. “In other words, if I had a child, I would not use the results of this test right now to inform me of the risk of autism. It is encouraging, and … we’re thinking about how this test can evolve for the future.”

4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Miron O, Delgado RE, Delgado CF et al.Prolonged auditory brainstem response in universal hearing screening of newborns with autism spectrum disorder.Autism Research.November 2, 2020. doi:0.1002/aur.2422Wrightson AS.Universal Newborn Hearing Screening.Am Fam Physician. 2007 May 1; 75(9):1349-1352.Christensen DL, Baio J, Braun KV, et al.Prevalence and characteristics of autism spectrum disorder among children aged 8 years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2012.MMWR Surveill Summ.2016;65(No. SS-3)(No. SS-3):1–23. doi:10.15585/mmwr.ss6503a1Zwaigenbaum L, Bryson S, Rogers T, et al.Behavioral manifestations of autism in the first year of life.Intern J Develop Neurosci. 2005;23(2–3):143–152. doi:10.1016/J.IJDEVNEU.2004.05.001

4 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Miron O, Delgado RE, Delgado CF et al.Prolonged auditory brainstem response in universal hearing screening of newborns with autism spectrum disorder.Autism Research.November 2, 2020. doi:0.1002/aur.2422Wrightson AS.Universal Newborn Hearing Screening.Am Fam Physician. 2007 May 1; 75(9):1349-1352.Christensen DL, Baio J, Braun KV, et al.Prevalence and characteristics of autism spectrum disorder among children aged 8 years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2012.MMWR Surveill Summ.2016;65(No. SS-3)(No. SS-3):1–23. doi:10.15585/mmwr.ss6503a1Zwaigenbaum L, Bryson S, Rogers T, et al.Behavioral manifestations of autism in the first year of life.Intern J Develop Neurosci. 2005;23(2–3):143–152. doi:10.1016/J.IJDEVNEU.2004.05.001

Miron O, Delgado RE, Delgado CF et al.Prolonged auditory brainstem response in universal hearing screening of newborns with autism spectrum disorder.Autism Research.November 2, 2020. doi:0.1002/aur.2422Wrightson AS.Universal Newborn Hearing Screening.Am Fam Physician. 2007 May 1; 75(9):1349-1352.Christensen DL, Baio J, Braun KV, et al.Prevalence and characteristics of autism spectrum disorder among children aged 8 years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2012.MMWR Surveill Summ.2016;65(No. SS-3)(No. SS-3):1–23. doi:10.15585/mmwr.ss6503a1Zwaigenbaum L, Bryson S, Rogers T, et al.Behavioral manifestations of autism in the first year of life.Intern J Develop Neurosci. 2005;23(2–3):143–152. doi:10.1016/J.IJDEVNEU.2004.05.001

Wrightson AS.Universal Newborn Hearing Screening.Am Fam Physician. 2007 May 1; 75(9):1349-1352.

Christensen DL, Baio J, Braun KV, et al.Prevalence and characteristics of autism spectrum disorder among children aged 8 years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2012.MMWR Surveill Summ.2016;65(No. SS-3)(No. SS-3):1–23. doi:10.15585/mmwr.ss6503a1

Zwaigenbaum L, Bryson S, Rogers T, et al.Behavioral manifestations of autism in the first year of life.Intern J Develop Neurosci. 2005;23(2–3):143–152. doi:10.1016/J.IJDEVNEU.2004.05.001

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Key Takeaways#

What This Means For You#

Researchers Used a Common Newborn Hearing Test#

Slower Brain Responses to Sounds#

Long-term Implications#

Will the Test Be Used In the Future?#