A Summary of Current Understanding Regarding Children with Autism Spectrum Disorder Who Are Deaf or Hard of Hearing Amy Szarkowski, Ph.D., 1,4 Deborah Mood, Ph.D., 2 Aaron Shield, Ph.D., 3 Susan Wiley, M.D., 5 and Christine Yoshinaga-Itano, Ph.D. 6 ABSTRACT This article provides a consensus perspective based on the authors’ expertise and the limited available literature regarding our understanding of children with an autism spectrum disorder (ASD) who are deaf or hard of hearing (D/HH). The challenges in the accurate identification of an ASD in children who are D/HH, including red flags for a potential ASD and screening and assessment for ASD, are described in this article. Additionally, strategies to guide professionals in their communication about a possible ASD with families and to frame the need for expanding aspects of communication important for this group of children are suggested. KEYWORDS: Deaf, hard of hearing, autism spectrum disorder, assessment Learning Outcomes: As a result of this activity, the reader will be able to (1) identify “red flags” warranting referral for a possible autism spectrum disorder (ASD) for a child who is deaf or hard of hearing (D/HH); (2) describe issues that arise in screening and assessing ASD in children who are D/HH; (3) be able to discuss concerns with family members when there is suspicion about ASD for their child who is D/HH. 1 Deaf and Hard of Hearing Program, Boston Children’s Hospital at Waltham, Waltham, Massachusetts; 2 Child Development Unit, Children’s Hospital Colorado, Aurora, Colorado; 3 Department of Psychology, Boston University; 4 Department of Psychiatry, Harvard Medical School, Bos- ton, Massachusetts; 5 Division of Developmental and Be- havioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; 6 Department of Speech, Lan- guage & Hearing Sciences, University of Colorado, Boul- der, Colorado. Address for correspondence: Amy Szarkowski, Ph.D., Deaf and Hard of Hearing Program, Boston Children’s Hospital at Waltham, 2nd Floor, West Wing, 9 Hope Ave., Waltham, MA 02453 (e-mail: Amy.Szarkowski@childrens.harvard.edu). Screening, Diagnosing and Implementing Interven- tions for Children Who Are Deaf or Hard of Hearing with Autism Spectrum Disorder; Guest Editors, Christine Yoshinaga-Itano, Ph.D. and Amy Thrasher, M.A., CCC-SLP. Semin Speech Lang 2014;35:241–259. Copyright # 2014 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel: +1(212) 584- 4662. DOI: http://dx.doi.org/10.1055/s-0034-1389097. ISSN 0734-0478. 241 Downloaded by: Thieme Verlagsgruppe. Copyrighted material.