Research Paper
Childhood vision impairment, hearing loss and co-occurring autism spectrum disorder

https://doi.org/10.1016/j.dhjo.2013.05.003Get rights and content

Abstract

Background

Limited population-based data on prevalence of childhood vision impairment (VI) and hearing loss (HL), and their co-occurrence with autism spectrum disorder (ASD) exists.

Objective

To examine prevalence and characteristics of VI, HL and co-occurring ASD among 8-year-olds in metropolitan Atlanta 2000–2008.

Methods

We used data from the population-based Metropolitan Atlanta Developmental Disabilities Surveillance Program. Prevalence, birth and parental characteristics, presence and severity of other co-occurring developmental disabilities, and age of earliest identification of ASD, were examined for children with VI and HL, by co-occurring ASD.

Results

VI and HL prevalences were 1.2 and 1.3 per 1000 8-year-olds, respectively. Approximately 6–7% of children with VI or HL had co-occurring ASD. Children with VI or HL with co-occurring ASD differed from those without co-occurring ASD by select birth characteristics and the presence of other co-occurring DDs. The median age of earliest known ASD diagnosis was significantly later among children with VI and ASD compared to children with ASD without VI (79 vs. 56 months). Children with HL and ASD were first evaluated by a community provider significantly earlier than those with ASD without HL (40 vs. 50 months).

Conclusions

The frequency of co-occurring ASD with VI and HL is higher than the population prevalence of ASD. The significant delays in diagnosis of ASD in children with VI and lack of earlier diagnosis of ASD among children with HL despite earlier evaluation highlight the importance of developing screening tools for early identification of ASD among children with VI and HL.

Section snippets

Data source

MADDSP uses a multiple source methodology for active population-based surveillance of five DDs including VI, HL, ASD, CP, and ID in five counties (Clayton, Cobb, DeKalb, Fulton, and Gwinnett) of metropolitan Atlanta, Georgia. Children are identified from record review at nine public school systems and selected private and public health sources that treat, diagnose, and/or serve children with DDs. Multiple records for a given child are compiled into one composite record which is then reviewed by

Vision impairment

The prevalence of VI during 2000–2008 was estimated as 1.2 per 1000 8-year-olds (95% CI = 1.1–1.4). Prevalence estimates across 2000–2008 were stable (p = 0.12) (data not shown). VI prevalence was higher among Hispanic children compared with White non-Hispanic children (p = 0.05), but did not differ significantly between boys and girls or between White and Black non-Hispanic children (Table 2). Sixty three percent of children with VI had at least another DD (including ASD, CP, ID, and/or HL).

Discussion

This is the first US population-based report detailing the frequency, presence, and timing of community identification of co-occurring ASD among children with VI or HL. Early identification of ASD is particularly important among children with sensory disabilities, as these children may require different or additional interventional approaches or both, relative to children with ASD, but without VI or HL. Furthermore, disparities in the timing of evaluation and diagnosis of children with VI or HL

Conclusions

In summary, our findings demonstrate that the frequency of co-occurring ASD among children with VI or HL has been stable over time, but consistently higher than ASD prevalence among 8-yr-olds in metropolitan Atlanta for 2000–2008. The delay found in the age of diagnosis for children with VI, and lack of earlier ASD diagnosis despite earlier evaluation among children with HL, underscore the need for development of valid and reliable diagnostic tools coupled with greater awareness of behaviors

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    This work received no funding and was not presented at any conference.

    The authors declare no conflicts of interest

    Disclosure: The findings and conclusions of this report are those of the authors and do not necessarily represent the official position of the Centers for Disease and Prevention.

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