Adults with intellectual and developmental disabilities (IDDs) are likely to seek help from an audiologist at some point in their communication journey. Those with IDDs have been diagnosed with disorders that affect one’s physical, intellectual, and/or emotional development, 1 which may affect one’s ability to communicate. It is important for the audiologist to determine if hearing loss may be among the disorders for someone with an IDD and to treat the hearing loss accordingly.
Testing and Diagnosis
A traditional hearing test typically involves behavioral testing or testing that requires the patient to reliably respond on their own to beeps and words. Those with intellectual and developmental disabilities may need adjustments to this evaluation to ensure the results are accurate. These modifications may include making the testing more interesting with games or videos, accommodating for differences in communication, like pointing at pictures instead of repeating back words, or simply making the patient more comfortable in the sound booth. These changes may allow the audiologist to obtain the same hearing status information in a way that may be more comfortable for a patient with IDD.
There are times, however, that adults with intellectual and developmental disabilities may not be able to reliably provide behavioral information. If you suspect this may be the case, consider making an appointment at a center that has access to equipment with objective measures; these tests do not require a response from the patient to determine status of the ear. These can include tests of the middle ear and acoustic reflex system, as well as deeper structures to help us estimate hearing levels, like outer hair cell and brainstem tests. These tests will also help determine if there is a need for evaluation by an Ear, Nose, and Throat physician to treat other underlying causes of hearing loss, like ear infections.
Treatment and Management
Hearing aids may be an option for patients with IDD, depending on their daily lifestyle needs and accommodations.
- Can a family member or caregiver help with changing batteries or charging the hearing aids?
- Will the patient tolerate the hearing aids on their ears, or will they try to take them off and lose them?
Audiologists are prepared with strategies to try to adjust this process for each patient. There may be times where a small device is not safe for the patient to use, such as if they are likely to swallow the device, and in that case, other communication tools may be recommended.
Communication goes beyond audiologic testing, but if a patient with IDD has untreated hearing loss, they may not be able to succeed in other therapies. As hearing aids are not the only tool to improve communication, the caregivers should consider working with other professionals, including speech therapists and occupational therapists to allow for a well-rounded lifestyle. Sign language or communication boards may be helpful when verbal language cannot be achieved. Working with a team of healthcare professionals will allow you to develop communication goals to best suit the patient.
If you have questions about hearing loss or a family member needs to see an audiologist, use the Academy’s Find an Audiologist Directory to find an audiologist near you.
For additional resources for adults with intellectual and developmental disabilities, consider contacting your state’s Department of Intellectual and Developmental Disabilities
1Intellectual and Developmental Disabilities (IDDs): Condition Information | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development (nih.gov)