(A852) Prevalence of Otological Conditions in Medicaid Beneficiaries with Autism Spectrum Disorder

Monday, October 13, 2025

12:00 PM - 1:00 PM EDT

Location: OTO EXPO, Posters

Presenting Author(s)

LZ

Lauren L. Zhang, BA

Medical Student
Columbia University Vagelos College of Physicians and Surgeons
New York, New York, United States

Co-Author(s)

ZY

Zhixin Yang, MS

Columbia University Vagelos College of Physicians and Surgeons, United States
CD

Carolyn G. DiGuiseppi, MD

Professor
University of Colorado Anschutz Medical Campus
Aurora, Colorado, United States
AB

Ashley Blanchard, MD, MS

Assistant Professor of Pediatrics in Emergency Medicine
Columbia University Vagelos College of Physicians and Surgeons
New York, New York, United States
CI

Caleb Ing, MD

Columbia University, United States

Senior Author(s)

AL

Anil K. Lalwani, MD

Professor and Associate Dean
Columbia University
New York, New York, United States
GL

Guohua Li, MD, DrPH

Professor
Columbia Univerisity
New York, New York, United States

Disclosure(s):

Lauren L. Zhang, BA: No relevant relationships to disclose.

Guohua Li, MD, DrPH: No relevant relationships to disclose.

Introduction: Otological conditions are frequently reported co-morbidities in children with autism spectrum disorder (ASD), but there is a dearth of research that employs large samples involving children and adults; epidemiologic data are crucial to improving diagnostic ASD algorithms and tailoring interventions. This study therefore seeks to assess the prevalence of hearing loss (HL), tinnitus, otitis media (OM), and other abnormal auditory perceptions, e.g. hyperacusis, in those with ASD compared to those without across all age groups.

Methods: Cross-sectional data were obtained from the 2020 Medicaid database. Beneficiaries with ASD and otological conditions were identified using ICD-10 codes. Prevalence rates of otological conditions were compared between ASD and non-ASD beneficiaries by age and sex. Chi-square tests and adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs) were used to assess the strength of association between each diagnosis and ASD.

Results: Of 87,831,765 Medicaid beneficiaries aged 1 year and older, 993,956 (1.13%) were diagnosed with ASD, of which 14.46% had a disease of the ear and mastoid process, including HL (1.80%), tinnitus (0.15%), OM (7.49%), and other abnormal auditory perceptions (0.59%). Those with ASD had significantly higher prevalence of diseases of the ear and mastoid process (aOR: 1.51, 95% CI: 1.50–1.52), hearing loss (aOR: 1.57, 95% CI: 1.55-1.60), OM (aOR: 1.39, 95% CI: 1.38-1.41) and other abnormal auditory perceptions (aOR: 3.11, 95% CI: 3.01–3.21) than those without.

Conclusions: Individuals with ASD exhibit significantly higher prevalence rates of otological conditions, including hearing loss, tinnitus, otitis media, and other abnormal auditory perceptions, compared to those without ASD. If confirmed, these findings demonstrate the disproportionate burden of otological conditions among individuals with ASD, particularly across all age groups, and represent a critical step toward understanding the intersection of otological health and ASD.