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A systematic evaluation of ShoeBox Audiometry as method for audiometric assessment of individuals with Autism Spectrum Disorder

Principal Investigator(s):

Williams Espericueta Luna

Grant Type:

Graduate Research




University of North Texas

Year Awarded:



In Progress


Education and School Aged Children; Health and Sensory Issues


According to the World Health Organization (2018), about 34 million children have a disabling hearing loss. Early identification, diagnosis, and intervention of hearing loss can minimize the negative effects on social and language development. Behavioral assessments of hearing are the “gold standard” for identifying hearing loss (American Academy of Audiology, 2012). Behavioral assessments provide information about the entire auditory system and measure an individual’s functional hearing abilities. Conventional pure-tone audiometry, a type of behavioral assessment, is the most frequently recommended assessment for hearing screening because it is quick and is sufficiently sensitive to identify potential hearing impairment. However, studies have reported that evaluating the hearing of individuals with autism spectrum disorder (ASD) presents challenges like difficulties sitting still, intolerance of headphones, difficulty attending to instructions, and habituating to tones quickly. For some individuals with ASD these challenges can prevent the completion of a behavioral assessment, necessitate additional testing, and could limit an accurate diagnosis.. A tablet-based behavioral assessment technology, ShoeBox® audiometry, shows promise in addressing the challenges presented when evaluating the hearing of individuals with autism. The purpose of Study 1 is to evaluate whether the ShoeBox® audiometry assessment produces similar audiological results to the conventional pure-tone audiometry assessment with children with ASD. The purpose of Study 2 is to assess whether a combination of ShoeBox® audiometry assessments and supplemental behavioral interventions, specifically selected for their ease of implementation and research support, will increase the likelihood that an child with ASD will complete a hearing evaluation based on their hearing ability and not behavioral challenges. The results of these studies may suggest that ShoeBox® with supplemental behavioral supports can be utilized as an effective method to evaluate the hearing of children with ASD.