Abstract

This study explored the diagnostic approaches used by pediatric audiologists when evaluating difficult-to-test children, including those who may present with hearing loss and/or Autism Spectrum Disorder (ASD). An electronic survey was distributed to pediatric audiologists across the United States through professional networks which included Special Interest Groups (SIGs) of the American Speech-Language-Hearing Association (ASHA) and a major diagnostic hospital. Survey questions addressed participants’ testing preferences, referral practices for sedation and auditory electrophysiological testing, and perceived clinical effectiveness of various assessment methods. The study’s findings revealed that while many pediatric audiologists felt more comfortable with behavioral testing methods, auditory electrophysiological tests were viewed as more clinically effective for evaluating difficult-to-test patients. Statistically significant differences were also observed in the referral patterns for imaging and genetic screening and/or testing depending on whether the patient had unilateral or bilateral hearing loss. Participants also reported variability in their familiarity with sedation protocols and the concept of “diagnostic overshadowing.” The results suggest a need for more evidence-based guidelines and additional training to support accurate, comprehensive hearing assessments in complex pediatric populations.

Advisor

Goldberg, Donald

Department

Communication Sciences and Disorders

Disciplines

Communication Sciences and Disorders | Speech Pathology and Audiology

Keywords

auditory electrophysiological testing, autism spectrum disorder (ASD), behavioral hearing testing, diagnostic overshadowing, difficult-to-test children, pediatric hearing loss, sedation

Publication Date

2025

Degree Granted

Bachelor of Arts

Document Type

Senior Independent Study Thesis

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