Treatment options tend to depend upon which diagnosis is made first - deafness or autism. Instructors and families may see that the child is not responding to their efforts and think the child is not trying or not able. Worse, families are emotionally stressed by the child's behaviors - limited eye contact, withdrawal or possibly, aggressive behaviors. Grandparents may blame the parents for the child's behaviors, or withdraw support when they do not understand. The parents may also have a hearing impairment, which limits their ability to interact with support sources and adds to the parents' isolation.
Some families come apart when the emotional supports are exhausted.
This is the saddest outcome - the separation of families, cultures and opportunities for children. In contrast, when a child is first diagnosed as autistic, educational priorities focus on behavioral interventions to access social and educational learning, including communication. Hearing screening tests may be attempted. It is very difficult for some children with autism to tolerate the sensory demands of the test. Unfortunately, other problem behaviors may also prolong the detection of progressive hearing loss because repeated testing is avoided.