Toward Accessible Hearing Assessments and Support: Autistic Perspectives from Clinical and Research Contexts

Authors

Abstract

BackgroundAuditory environments can substantially influence wellbeing and quality of life for Autistic people. Autistic auditory profiles can include variations in sound sensitivity which can include difficulties filtering out background noise, and experiences that are not adequately captured by standard audiological testing. Clinical auditory assessments are traditionally designed to evaluate hearing function, with a particular emphasis on hearing thresholds, rather than considering the broader contextual factors that shape listening experiences. Additionally, little is known about how Autistic adults seek support for auditory challenges, experience auditory assessments, or how these experiences may inform more accessible hearing-health and auditory research practices.ObjectivesTo explore how Autistic adults experience auditory assessment processes across clinical settings and research contexts, identify barriers and facilitators to positive experiences and outcomes, and develop experience-informed recommendations to improve the accessibility of hearing health and auditory assessment practices.MethodsData were drawn from two existing studies examining auditory experiences among Autistic adults. Directed qualitative content analysis was conducted on open-text responses from 85 Autistic adults who had sought professional or therapeutic support for auditory challenges. A separate In-Person Research Participation Survey captured the experiences of eight Autistic adults who completed in-person audiology testing and a listening task, using quantitative ratings and open-text responses analysed using descriptive statistics and inductive content analysis.ResultsAnalysis of support-seeking accounts identified three broad domains: Barriers, Recommendations, and Independent Strategies. Participants described barriers to accessing and implementing support, recommendations from specialists that varied in their perceived helpfulness, and strategies they identified through community or developed themselves. For the In-Person Research Participation Survey; quantitative ratings were concentrated toward the upper end of the five-point agreement scale. Open-text responses identified three domains—Accessibility, Emotional Toll, and Experience Benefit—highlighting the importance of clear and consistent communication, sensory accessibility, opportunities for choice and control, and the demands associated with sustained listening and concentration.

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