Computer-based instruction can teach children with autism or developmental disabilities and suspected hearing loss how to respond accurately during hearing tests

It all started when Kat Stremel-Thomas, a researcher who was studying language development in children with cochlear implants, told Kate Saunders and Dean Williams that even though many children with developmental disabilities were getting $90,000 per ear cochlear implants, audiologists were having trouble adjusting them. She suggested that, as behavioral scientists with decades of experience studying learning difficulties of people with intellectual disability, they should apply for a grant to support the development of a technology to train kids to take a hearing test.

Those would be the kids who, because of autism, intellectual or developmental disability, have difficulty following spoken instructions and communicating to audiologists that they hear tones during a hearing test. It can take multiple teaching sessions to learn this skill—too much time for the clinic setting.

The researchers are developing and testing a software program designed to enable teachers, therapists and paraprofessionals to shape a child’s behavior to respond to audio tones.

The program records everything that occurs during a teaching session, including whether the child presses a button during tone presentations and does not press the button when the tone is off.

“If a child responds when there is a tone, the program signals the trainer to deliver a reinforcer,” explained Williams. “The program can even operate toys— like a jumping dog—but usually, rewards are enthusiastic praise, treats or tokens.”

A large percentage of people with profound hearing loss also have a second or third disability, said Williams. “The most common is intellectual disability or autism.”

Although enabling children to benefit from expensive cochlear implants helped persuade the U.S. Department of Education to fund the development of the prototype, in practice, said Saunders, there are many more children who simply need a valid assessment of their hearing.

“This technology is based on shaping and reinforcement procedures to teach children what to do during a hearing assessment,” said Saunders. “If a loss is detected and remediated, that opens up the path to communication—and that’s a game changer.”