Deafness and autism

Primary school age deaf boy with autism smiling in garden

Figures suggest that around 2-4% of deaf children are also autistic.

Both deafness and autism can have a significant impact on communication and language development.

On this webpage, we focus on some of the additional challenges that families may face if their child is both deaf and autistic. 

What is autism?

Autism is a lifelong condition that affects how people see the world and interact with other people.

All people with autism share certain characteristics, but autism will affect them in different ways.

The symptoms of autism range from mild to severe, so it’s often referred to as autistic spectrum disorder (ASD).

Signs of autism can include:

  • difficulties with social communication and interaction (e.g. avoiding eye contact, not drawing parents’ attention to objects or events, difficulty understanding other people’s feelings or emotions)
  • repetitive behaviors, activities and routines (e.g. fixating on particular things, resistance to change)
  • an over or under sensitivity to sounds, touch, tastes, smells, light, colours, temperatures or pain (e.g. startling easy, appearing to find noise painful).

Find out more about possible signs of autism.

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Diagnosis

Many children in the UK are identified as having a permanent hearing loss at birth through newborn hearing screening.

Hearing children are rarely diagnosed with autism before age two, if a deaf child also has autism, this will often be diagnosed later. This is because some of the indicators of deafness are similar to those of autism. These include:

  • a delay in acquiring language
  • appearing withdrawn
  • appearing indifferent to other people
  • preferring to play alone.

The delay in making a firm diagnosis of autism is because the professionals need to be sure that these behaviours are due to autism, not deafness.

Some parents find it helpful to track their child’s development to see if they’re developing as expected. Parents can use the Early Support Monitoring Protocol to identify any potential concerns about their child’s development.

These may include:

  • poor eye contact
  • not using common gestures such as waving
  • delay in pretend play
  • poor body awareness and balance: bumping into things, rocking, spinning or moving the whole body to look at something.

If you have any concerns, you should raise them with your GP, health visitor or Teacher of the Deaf, and ask for a referral for a possible diagnosis of autism.

A diagnosis of autism is usually carried out by a team of clinicians (for example a child psychologist, speech and language therapist, a paediatrician). Ideally, it will be carried out by professionals who have expertise in both deafness and autism (but this isn’t always possible), alongside family and professionals who know the child best.

Research is currently underway to develop an assessment for autism in deaf children. Find out more at www.comic.org.uk/research/diagnostic-instruments-for-autism-in-deaf-children.  

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Supporting deaf children who have autism

We’re still learning about the impact of both deafness and autism on children and there is a lack of robust evidence on ‘what works’ or has the most impact.

Since autism is a spectrum condition and there are also different levels of deafness there is no one approach which is right for every child.

Finding what works for your child will often be trial and error, but building on your child’s interests and strengths is important.
 

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Communication

Communication can be complicated when it comes to children who are deaf and have autism.

It’s important to be open and supportive to your child and communicate in whatever way they can.

Whatever method of communication your child uses, it should be used consistently – both at home and in education.

Children with autism struggle with eye contact and joint attention (when parents naturally draw their child’s attention to something by, for example, looking at it themselves or using gestures) which can make the communication approaches often used by deaf children, such as lip-reading or sign language, more difficult.

Some families use non-verbal forms of communication, such as a Picture Exchange Communication System (PECS). A speech and language therapist may also be able to provide advice on the use of PECS and other non-verbal forms of communication.

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Behaviour

Deaf children with autism can display challenging behavior. This can be due to frustration at not being able to express themselves due to delayed language, or because of a ‘meltdown’.

For children without language it can be difficult to know what’s causing challenging behavior, but it’s important to work with the child to try to find the cause so you can then act to reduce or remove it.

By being reflective, tracking and observing carefully it may be possible for parents and professionals to determine the cause of a meltdown, including if it’s the result of a particular sensory issue. To do this, it can be helpful to think ‘ABC’.

A (antecedent, what happened before the meltdown)
What was the child doing?
Where was the child?
Who was with the child?
What was the environment?
Was there a possible sensory trigger? Light, sound, smell etc.

B (behaviour)

What is the child’s reaction/how do they behave?
How long did the behaviour last?

C (consequence)

What did you/other people present do?
What impact do your/their actions have/not have?
What happens next?

Using ABC it should be possible to establish any patterns between meltdowns and specific triggers such as information or emotion overload, or sensory issues such as light levels, textures, sounds, smells.

As children mature and develop more language, they can share what they find stressful or frustrating, and begin to recognise how their body and feelings change in these situations.

This allows them to anticipate and think about how they can control their feelings and their response in the future.

Our resource What are you feeling? may be helpful in supporting your child to identify their emotions and talk about their feelings.

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Education

Many deaf children with autism will have an Education, Health and Care (EHC) plan (England), statement (Wales and Northern Ireland) or a coordinated support plan (Scotland). These are legal documents which set out your child’s special or additional needs, their school placement and the support that has been agreed.

More information about this can be found on our website at www.ndcs.org.uk/sen.

As the number of deaf children with autism is small, it’s unlikely that there will be a school in your area with the specialist support your child needs already in place.

This means that it’s vital the different professionals supporting your child work together to make sure your child’s needs are being met and frequently reviewed.

For example, if a special school for children with autism is agreed to be the best placement for your child, it’s very important that they still get support from a Teacher of the Deaf and specialist speech and language therapist who can advise on hearing technology and communication needs.

It’s also important that the school your child goes to gives them the opportunity to use their preferred language and communication approach.

Some special schools for the deaf offer places to children with autism if they are able to meet their needs, for example, by supporting and developing the child’s social communication skills

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Mental health

Deaf children are 60% more likely to experience mental health issues than hearing children, and children with autism can also be vulnerable to mental health problems.

This doesn’t mean that your child will definitely have problems with their mental health, but being aware of the risks and taking steps to develop emotional resilience and wellbeing is vital.

Deaf Children and Adolescent Mental Health Services (CAMHS) can help if you have any concerns about your child’s mental health.

Our resource What are you feeling? may be helpful in supporting your child to identify their emotions and talk about their feelings. 

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More information

The National Autistic Society is the leading charity for people with autism and their families.

A video about families’ experiences of raising a deaf child with autism:

The British Association of Teachers of the Deaf (BATOD) Foundation have created a short guide about deafness and autism.
 

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