Correlation between auditory brainstem responses, hyperacusis, and severity of autism spectrum disorder in young children with normal hearing at a tertiary referral center in Indonesia

Introduction: Autism spectrum disorder (ASD) is a complex condition impacting social communication, behavior, and interests. ASD affects 1 in 100 children globally, with a higher prevalence in boys. Auditory disorders, including hyperacusis, are common in ASD, yet the correlation between Auditory Brainstem Response (ABR) wave latencies and ASD severity, especially with hyperacusis, is under-researched. This study investigates ABR wave latencies in ASD children, exploring their relationship with ASD severity and h as a potential screening tool for ASD. Early diagnose and therapy could enhance the quality of life in ASD patients. Materials and Methods: A cross-sectional study was conducted by recruiting normal-hearing children aged 3-8 years old with ASD presenting to a national referral ENT clinic between October and December 2023. The severity of ASD was assessed using the Childhood Autism Rating Scale (CARS), while hyperacusis was diagnosed using Modified Check List for Autism in Toddlers, Revised (M-CHAT-R). Results: A total of 26 children with ASD, 23 of whom were male (88%), aged 3-8 years, were included in the analyses. Among these children, 18 (69.2%) had hyperacusis. Analysis of ABR click revealed a prolonged interpeak latency wave I and III (88.5%), followed by a prolonged latency in wave III (42.3%) and V (21.2%). Neither ABR wave latencies nor hyperacusis were correlated with the severity of ASD, although there was a marginally significant association between wave III latency and CARS score in the left ear (r=0.359, p=0.072). However, wave V latency and interpeak wave I-V latency were significantly longer in children without hyperacusis (right ear: p=0.042 and p=0.050; left ear: p=0.005 and p=0.004), while interpeak wave III-V only in the left ear (p=0.006) and wave III only in the right ear (p=0.029). Conclusion: There was no significant correlation between ABR wave latencies or hyperacusis and the severity of ASD, while ABR wave latencies were generally longer in children without hyperacusis. Further large studies involving a broader spectrum of children with ASD are warranted to confirm our findings.