Research Request – Frequency modulation (FM) systems for ASD literature review

DOCUMENT 9

FOI-24/25-0120

Research Request – Frequency modulation (FM) systems for ASD

literature review

| Brief | The University of Melbourne - Autism Spectrum Disorder (ASD) Listening
Clinic, make very strong statements (See position paper attached)
suggesting that all children with ASD have central auditory processing
problems and all need to be fitted with an FM system which needs to be
worn all day for 2 years. Is this true? They present a list of research
articles to back up their claims.

They are very vocal about the need for these FM systems. We receive
many of these support requests in TAB. Our position has been that they
do not meet R&N. We have a meeting with Melbourne Uni in the
planning stages. The meeting will probably happen in early 2021. Your
expert opinion is very welcome to allow us to have informed
discussions. | | Date | 24/12/20 | | Requester | Jane redacted: s47F - personal privacy (Assistant Director – TAB)
Peta redacted: s47F - personal privacy (Senior Technical Advisor – TAB) | | Researcher | Jane redacted: s47F - personal privacy – (Research Team Leader – TAB) |

Contents

Summary ………………………………………………………………………………………………………………………………………. 2

References ………………………………………………………………………………………………………………………………….. 18

Please note:

The research and literature reviews collated by our TAB Research Team are not to be shared external to the Branch. These are for internal TAB use only and are intended to assist our advisors with their reasonable and necessary decision making.

Delegates have access to a wide variety of comprehensive guidance material. If Delegates require further information on access or planning matters they are to call the TAPS line for advice.

The Research Team are unable to ensure that the information listed below provides an accurate & up- to-date snapshot of these matters

P a g e | 1 Research Request – Frequency modulation (FM) systems for ASD literature review Page 1 of 19

FOI-24/25-0120

Summary

• Abnormal responses to sensory stimuli across multiple modalities are a consistently reported feature of ASD and are now a recognised component of diagnosis.
  • Hearing impairment is relatively common in this population with 2–10% of cases presenting with impaired sound detection thresholds [1, 2]
  • A high proportion (>50% of paediatric cases) show auditory processing deficits which are thought to be related to a distorted representation of temporal cues in the central auditory pathways [3, 4]
• The resources provided in the position paper are mainly of low quality. Those that conducted an investigation using FM systems are case studies (mainly without a control group, use subjects as own control) with very small sample sizes. The remaining literature are editorials, narrative reviews or thesis
• A systematic review has been conducted on FM system use in those with ASD. The authors concluded that;
  • Further research is clearly needed into improving SNR to improve classroom performance in children with ASD, and at least two warnings from the studies reviewed here should be heeded – these were
    1. Some children with ASD are unable to tolerate the personal FM systems used. This promotes the need to further investigate other technologies that could increase the signal level in the classroom without challenging the tactile sensitivities found in many students with ASD, such as the Soundfield amplification systems
    2. There is a need to include functional outcome measures in studies involving children with ASD (such as video classroom observation, sensory and listening experience-focussed questionnaires, etc) as some children included in the studies were not able to complete some of the more widely used behavioural outcome measures
• Studies commonly investigated FM systems over 5-6 weeks and for 45mins to 6 hours per day (some studies didn’t even record use time). Based on this, hard to justify 2 year usage.

Given the level and quality of evidence provided, and the fact that less than 50 participants have been investigated in total across all studies I would not support FM systems as evidence based practice. However, the results are promising and require further investigation with bigger samples using study designs which are less prone to bias.

P a g e | 2 Research Request – Frequency modulation (FM) systems for ASD literature review Page 2 of 19

Author	Aim/Objective	Methods	Results	Level & Quality of evidence
Glaaser [5]	Investigate the effects of improved classroom acoustics on the educational and behavioural performance of individuals with ADHD-Inattentive Type or Combined-Type.	Thesis — unpublished, non-peer reviewed 7 participants (aged 14-18) Multiple baseline across participants design with a reversal component was used to assess the effects of the Soundfield Amplification System on the participants’ educational and behavioural performance. Participants were observed across four phases: * baseline * intervention (implementation of the Soundfield system) * reversal * re-implementation of the Soundfield system Dependent variables * on-task behaviour * verbal disruptions * work accuracy	Soundfield system increased the on-task behaviour (by 10.5%) and decreased verbal disruptions (48.7%). The data on work accuracy was highly variable. Six of the seven participants, did not demonstrate improvements consistently when the intervention was implemented	Level: N/A Quality = Very Low (The true effect is probably markedly different from the estimated effect) Non-peer reviewed and unpublished. These results should not be considered accurate or reliable Very small sample. Investigated ADHD not autism or CAPD
Johnston, John [6]	Evaluate the potential benefits in speech perception and	Case-Control study	no longer a significant difference between the control group and APD group	Level: III-2 Quality: Low (The true effect might be

Research Request — Frequency modulation (FM) systems for ASD literature review

Page 3 of 19

Page |3