Background and aims

Humans communicate primarily through spoken language and speech perception is a core function of the human auditory system. Among the autistic community, atypical sensory reactivity and social communication difficulties are pervasive, yet the research literature lacks in-depth self-report data on speech perception in this population. The present study aimed to elicit detailed first-person accounts of autistic individuals’ abilities and difficulties perceiving the spoken word.

Methods

Semi-structured interviews were conducted with nine autistic adults. The interview schedule addressed interviewees’ experiences of speech perception, factors influencing those experiences, and responses to those experiences. Resulting interview transcripts underwent thematic analysis. The six-person study team included two autistic researchers, to reduce risk of neurotypical ‘overshadowing’ of autistic voices.

Results

Most interviewees reported pronounced difficulties perceiving speech in the presence of competing sounds. They emphasised that such listening difficulties are distinct from social difficulties, though the two can add and interact. Difficulties were of several varieties, ranging from powerful auditory distraction to drowning out of voices by continuous sounds. Contributing factors encompassed not only features of the soundscape but also non-acoustic factors such as multisensory processing and social cognition. Participants also identified compounding factors, such as lack of understanding of listening difficulties. Impacts were diverse and sometimes disabling, affecting socialising, emotions, fatigue, career, and self-image. A wide array of coping mechanisms was described.

Conclusions

The first in-depth qualitative investigation of autistic speech-perception experiences has revealed diverse and widespread listening difficulties. These can combine with other internal, interpersonal, and societal factors to induce profound impacts. Lack of understanding of such listening difficulties – by the self, by communication partners, by institutions, and especially by clinicians – appears to be a crucial exacerbating factor. Many autistic adults have developed coping strategies to lessen speech-perception difficulties or mitigate their effects, and these are generally self-taught due to lack of clinical support.

Implications

There is a need for carefully designed, adequately powered confirmatory research to verify, quantify, and disentangle the various forms of listening difficulty, preferably using large samples to explore heterogeneity. More immediate benefit might be obtained through development of self-help and clinical guidance materials, and by raising awareness of autistic listening experiences and needs, among the autistic community, communication partners, institutions, and clinicians.

中文翻译：

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追逐对话：言语感知的自闭症体验

背景和目标

人类主要通过口头语言进行交流，语音感知是人类听觉系统的核心功能。在自闭症人群中，非典型的感觉反应和社交沟通困难普遍存在，但研究文献缺乏关于该人群言语感知的深入自我报告数据。本研究旨在引出对自闭症患者的能力和感知口语的困难的详细第一人称描述。

方法

对九名成年自闭症患者进行了半结构化访谈。访谈时间表涉及受访者的言语感知体验、影响这些体验的因素以及对这些体验的反应。由此产生的访谈记录进行了专题分析。六人研究小组包括两名自闭症研究人员，以降低神经典型“掩盖”自闭症声音的风险。

结果

大多数受访者报告说在存在竞争声音的情况下感知语音有明显的困难。他们强调，这种听力困难与社交困难不同，尽管两者可以相加和相互作用。困难有多种，从强烈的听觉干扰到连续不断的声音淹没声音。影响因素不仅包括音景的特征，还包括多感官处理和社会认知等非声学因素。参与者还确定了复合因素，例如缺乏对听力困难的理解。影响是多种多样的，有时甚至是致残的，影响社交、情绪、疲劳、职业和自我形象。描述了各种各样的应对机制。

结论

对自闭症言语感知体验的首次深入定性调查揭示了多种多样的听力困难。这些可以与其他内部、人际关系和社会因素相结合，产生深远的影响。缺乏对这种听力困难的理解——自我、沟通伙伴、机构，尤其是临床医生——似乎是一个关键的恶化因素。许多自闭症成年人已经制定了应对策略来减轻言语感知困难或减轻其影响，但由于缺乏临床支持，这些通常是自学的。

启示

需要精心设计、充分有力的验证性研究来验证、量化和理清各种形式的听力困难，最好使用大样本来探索异质性。通过开发自助和临床指导材料，以及提高自闭症社区、沟通伙伴、机构和临床医生对自闭症听力体验和需求的认识，可能会获得更直接的好处。