Background & aimsCommunicative and sensory differences are core autistic traits, yet speech-perception abilities and difficulties among autistic individuals remain poorly understood. Laboratory studies have produced mixed and inconclusive results, in part because of the lack of input from autistic individuals in defining the hypotheses and shaping the methods used in this field of research. Little in-depth qualitative research on autistic experiences of speech perception has been published, yet such research could form the basis for better laboratory research, for improved understanding of autistic experiences, and for the development of interventions. Existing qualitative research describes widespread autistic listening differences with significant impacts, but these results rely on data gathered via oral interviews in a small sample. The present study addresses these limitations and employs a mixed-methods approach to explore autistic listening experiences.MethodsWe gathered survey data from 79 autistic individuals aged 18–55 without diagnosed hearing loss. The questionnaire included 20 closed-set questions on listening abilities and difficulties and three free-text questions on listening experiences. The free-text questions underwent deductive content analysis using a framework composed of themes from previous interview data on listening experiences (including auditory differences, contributing factors, impacts, and coping strategies). Concepts in the free-text data that were not part of the analysis framework were analyzed inductively.ResultsIn the closed-set data, participants reported listening difficulties in most specified environments, but complex background sounds and particularly background voices caused the most difficulty. Those who reported listening difficulties expressed having substantially greater difficulties than other people the same age. Participants indicated multiple impacts from listening difficulties, most prominently in their social lives. Concepts in the free-text data strongly supported previous interview data on listening differences and factors that affect listening ability, especially the diversity of types of listening difficulties. Consistent with the closed-set data, background-sound complexity and concurrent voices were especially troubling. Some concepts in the free-text data were novel, particularly difficulties with remote, broadcast, and recorded audio, prompting the creation of new themes.ConclusionsBoth forms of data indicate widespread listening differences—predominantly listening difficulties—affecting most autistic adults. Diverse types of listening difficulty are evident, potentially indicating heterogeneous underlying mechanisms, and complexity of background noise is consistently identified as an important factor. Listening difficulties are said to have substantial and varied impacts. Autistic adults are keen to share coping strategies, which are varied and usually self-devised.ImplicationsBased on both the quantitative and qualitative results, we provide recommendations to improve future research and support the autistic community. The data-revealing types of listening difficulties can guide better quantitative research into underlying mechanisms. Such research should take into account potential heterogeneity in listening difficulties. Suggestions for optimized collection of self-report data are also offered. Additionally, our results could be used to improve societal understanding of autistic listening differences and to create beneficial interventions for and with autistic individuals. Moreover, given the willingness of the autistic community to share coping strategies, systematic collation of these strategies could form the basis for self-help and clinical guidance.

中文翻译：

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自闭症患者言语感知困难的多样性

背景和目标沟通和感觉差异是自闭症患者的核心特征，但自闭症患者的言语感知能力和困难仍然知之甚少。实验室研究产生了好坏参半且不确定的结果，部分原因是自闭症患者在定义假设和塑造该研究领域使用的方法方面缺乏投入。关于自闭症患者言语感知经历的深入定性研究还很少发表，但此类研究可以为更好的实验室研究、提高对自闭症经历的理解以及制定干预措施奠定基础。现有的定性研究描述了广泛存在的自闭症听力差异，具有重大影响，但这些结果依赖于通过小样本口头访谈收集的数据。本研究解决了这些局限性，并采用混合方法来探索自闭症听力体验。方法我们收集了 79 名年龄在 18-55 岁且未诊断出听力损失的自闭症患者的调查数据。调查问卷包括 20 个关于听力能力和困难的封闭式问题以及 3 个关于听力体验的自由文本问题。使用由先前有关听力体验的访谈数据（包括听觉差异、影响因素、影响和应对策略）的主题组成的框架对自由文本问题进行演绎内容分析。对自由文本数据中不属于分析框架的概念进行了归纳分析。结果在封闭集数据中，参与者报告了在大多数特定环境中的听力困难，但复杂的背景声音，特别是背景声音造成的困难最大。那些报告听力困难的人表示，他们的听力困难比其他同龄人要大得多。参与者表示，听力困难会产生多种影响，其中最突出的是他们的社交生活。自由文本数据中的概念有力地支持了先前关于听力差异和影响听力能力的因素的访谈数据，特别是听力困难类型的多样性。与封闭集数据一致，背景声音的复杂性和同时出现的声音尤其令人不安。自由文本数据中的一些概念很新颖，特别是远程、广播和录制音频方面的困难，促进了新主题的创建。结论两种形式的数据都表明广泛的听力差异（主要是听力困难）影响了大多数自闭症成年人。不同类型的听力困难是显而易见的，可能表明异构的潜在机制，并且背景噪声的复杂性始终被认为是一个重要因素。据说听力困难会产生重大且不同的影响。自闭症成年人热衷于分享应对策略，这些策略多种多样且通常是自我设计的。启示根据定量和定性结果，我们提供改进未来研究和支持自闭症群体的建议。听力困难的数据揭示类型可以指导对潜在机制进行更好的定量研究。此类研究应考虑听力困难的潜在异质性。还提供了优化自我报告数据收集的建议。此外，我们的结果可用于提高社会对自闭症听力差异的理解，并为自闭症患者制定有益的干预措施。此外，鉴于自闭症群体愿意分享应对策略，这些策略的系统整理可以构成自助和临床指导的基础。