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215 13 Deafness, Autism, and Diagnostics: A Case Study Benito Estrada Aranda Georgina Mitre Fajardo Ricardo Canal Bedia For some years, the literature has often addressed autism in deaf people. The diagnosis of autistic spectrum disorders (ASD) is particularly difficult when compounded by the presence of prelocutive, profound deafness, mainly because of the issues surrounding communication problems (Roper, Arnold, & Monteiro, 2003). Until recently, very little was known about deafness and autism in children (Vernon & Rhodes, 2009), but we do know that deaf children with autism present the same symptoms as hearing children with autism, even though the former are usually diagnosed at more advanced ages than the latter (Steinberg, 2008). Autism occurs in approximately 1 out of 80 children with deafness (Gallaudet Research Institute, 2007). A study of autism prevalence in deaf children in the United States during the 2009–2010 school year estimated the incidence of deaf children with autism at 1 out of 53 students (Szymanski, Brice, Lam, & Hotto, 2012). When examining specifically 8-year-old deaf children, the prevalence decreased to 1 out of 59 students (ibid.). Deaf children with autism and hearing children with autism share the same deficit even though it is provoked by two different causes: a delay or an alteration in oral language development. Absence of a focused intervention in this specific area may contribute to few opportunities to develop their potential, a general sense of isolation, and difficulties with integration into different environments: school, work, family, and so on. They also share the same etiology, such as genetics ; maternal exposure to a virus or toxins; complications at birth or during prenatal development; and rubella during pregnancy. However, deaf children who present autism have even more reason to show language delay and difficulties in establishing an efficient communication method (Vernon & Rhodes, 2009). ara86542_13_ch13.indd 215 ara86542_13_ch13.indd 215 12/10/15 6:56 PM 12/10/15 6:56 PM Benito Estrada Aranda, Georgina Mitre Fajardo, and Ricardo Canal Bedia 216 The simultaneous effects of autism and deafness create a complex life, one that is full of great challenges, especially language development. To deaf children, the sense of sight (eye contact, joint attention) represents the main access to the world by enabling them to build reality, establish interpersonal relationships, and learn a language. However, when deafness and autism coexist, the sense of sight, although it is not physically affected, can be compromised since pragmatic use is weakened. These children could make eye contact; however, its limited nature can affect the overall quality of the message received or prevent it from being received at all. This singular feature emphasizes the difficulties that could be experienced during the development of persons with multiple disabilities. Deaf children are included in this category because they are at risk of having additional disabilities; in fact, data from the Gallaudet Research Institute indicate that, during the 2009–2010 school year, approximately 40% of deaf children in the United States had additional disabilities (Szymanski, Brice, Lam, & Hotto, 2012). On the other hand, a child with hearing loss can exhibit behaviors that appear autistic (e.g., not listening or responding when called); social interaction is poor, and isolation and self-stimulation behaviors can develop (Szymanski & Brice, 2008). The deaf child can present with these behaviors, which are also found in autistic disorders, and is thus at risk of being incorrectly diagnosed with autism; as a result, the child may not receive the appropriate attention, treatment, and education. Regarding the autism-deafness binomial, Gordon (1982, 1999) has proposed the theory that autism could be an unusual variance of peripheral deafness or ear disease even though there is no solid evidence of this. Knoors and Mathijs (2011) explain that other studies have found hearing loss in children with autism. One of these (Klin, 1993) reviewed 11 studies of children and adolescents with autism. Although no clear evidence of brain dysfunction was found, signs of peripheral hearing loss were evident in subjects with autism (ibid.). Percentages of prevalence varied from 13% to 44% (ibid.). Another study (Rosenhall, Nordin, Sandström, Ahlsén, & Gillberg, 1999) identified a 7.9% mild-to-moderate loss of hearing in a group of 199 children and adolescents with autism in Sweden. Profound hearing loss was found in 3.5% of those children, which is significantly higher than in the general population of children, whose percentages of profound hearing loss are typically no higher than 0.1% or 0.2% of all children (Marschark, 1993). Some authors (e.g., Malandraki & Okalidou, 2007) report...


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