Hearing testing in autistic spectrum disorder: is it unnecessary in low and middle-income countries?

Background: In low and middle-income countries where the health care is in a weakened state, spending money on unaffordable and probably unnecessary investigations might be substituted by a reliable, simple and more informative tool that can deal with the problem. Aims: To examine current medical practice of measuring auditory brainstem response for all children with autistic spectrum disorder, and assess the value of this test in these children and its applicability in low and middle-income countries such as Libya. Methods: We reviewed the medical records of all children with autistic spectrum disorder who presented to neurodevelopment clinics of Al-Khadra Teaching Hospital, Tripoli, Libya between January 2010 and December 2014. Results: In 71 of 2368 children with autistic spectrum disorder, the family were concerned about their children's hearing and reaction to loud noises. Auditory brainstem response confirmed that 26 of these 71 children had sensorineural hearing loss. Conclusion: We consider auditory brainstem response measurement to be unnecessary in children with autistic spectrum disorder without clinical signs suggesting hearing impairment and without any parental concerns about hearing.