Speech Sound Perception in a Child Vvith High- Functioning Autism

Children with autism often have increased verbal communication difficulties in noisy environments. Although these difficulties have been attributed to impaired attention abilities, recent studies suggest a possible perceptual basis. However, previous efforts to evaluate speech perception abilities, even in relativelv high functioning autism, have been impeded by methodological limitations arising from the dependence of standardized tests on verbal responses. Because many high functioning autistic children liave a history of articulation difficulties, it is difficult to rule-out potentially confounding articulation effects on response accuracy. Here we describe results of coniprehensive auditorv function testing in a high functioning autistic boy, with a history of mild articulation difficulties. Results shovved impaired speech sound perception across multiple response modalities (verbal, motor). Tests of attention, auditory comprehension, and auditorv working memory were normal. Our patient's perceptual deficits were relatively subtle, emerging only when the speech signal was acoustically degraded. Degradation of acoustic cues occurs in high levels of background noise (e.g., < 5 dB S/N), thereby accounting for his increased communication difficulties in noisy environments. These results illustrate the utility of performing coniprehensive auditorv function testing, using multiple response modalities, in high functioning children witli autism.