Abstract
Background and Objectives: This systematic review reports the evidence from the literature concerning the potential for using an automated vocal analysis, the Language ENvironment Analysis (LENA, LENA Research Foundation, Boulder, CO, USA) in the screening process for children at risk for autism spectrum disorder (ASD) and deaf or hard of hearing (D/HH). ASD and D/HH have increased comorbidity, but current behavioral diagnostic and screening tools have limitations. The LENA Language Autism Screen (LLAS) may offer an additional tool to disambiguate ASD from D/HH in young children. Materials and Methods: We examine empirical reports that use automatic vocal analysis methods to differentiate disordered from typically developing children. Results: Consensus across the sampled scientific literature shows support for use of automatic methods for screening and disambiguation of children with ASD and D/HH. There is some evidence of vocal differentiation between ASD, D/HH, and typically-developing children warranting use of the LLAS, but additional empirical evidence is needed to better understand the strengths and weaknesses of the tool. Conclusions: The findings reported here warrant further, more substantive, methodologically-sound research that is fully powered to show a reliable difference. Findings may be useful for both clinicians and researchers in better identification and understanding of communication disorders.
Highlights
The traditional definition of autism spectrum disorder (ASD) [1] does not include children who are deaf or hard of hearing (D/HH), nor children with significant intellectual disability, specifiers and modifiers are used to indicate comorbidities and known etiologies, including hearing loss (HL)
There is some evidence of vocal differentiation between ASD, D/HH, and typically-developing children warranting use of the Language ENvironment Analysis (LENA) Language Autism Screen (LLAS), but additional empirical evidence is needed to better understand the strengths and weaknesses of the tool
What is the evidence that the Language ENvironment Analysis (LENA) Language Autism Screen (LLAS) has demonstrated sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy to promote the use of the LLAS for the general population?
Summary
The traditional definition of autism spectrum disorder (ASD) [1] does not include children who are deaf or hard of hearing (D/HH), nor children with significant intellectual disability, specifiers and modifiers are used to indicate comorbidities and known etiologies, including hearing loss (HL). This population of D/HH children may be at higher risk for an additional disability of ASD due to increased time in the newborn intensive care unit, a known risk factor for autism [2]. Materials and Methods: We examine empirical reports that use automatic vocal analysis methods to differentiate disordered from typically developing children
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