Association between early childhood symptoms of common ear, nose and throat problems and autism – new research

Apr 25, 2023

3 min

Dr Amanda Hall



  • Researchers find an association between autistic traits and young children with ear, nose and throat problems
  • The study used data from the Children of the 90s study which found 177 children were identified with a probable diagnosis of autism – 139 boys and 38 girls
  • The study looked at data from over 10,000 children from birth to four years old.


Ear, nose and throat (ENT) problems, relating to the ears, hearing and the upper respiratory system, are more common in young children with a subsequent diagnosis of autism, or who have demonstrated high levels of autism traits - finds new research published in BMJ Open.


The study, which was led by researchers from the University of Bristol and Aston University, looked at data from over 10,000 young children from birth to four years old, who were part of the Bristol’s Children of the 90s study. The team investigated whether early ear and upper respiratory signs are associated with the development of autistic traits.


Previous studies have found increased prevalence of ENT and related hearing conditions in children with autism compared with typically developing children, but much of this research has been carried out using health records, which can be biased.


In the new study, researchers used data from Children of the 90s study, a general population cohort which recruited over 14,000 pregnant women from the Bristol area between 1991 and 1992 and has followed the lives of their offspring ever since.

Within Children of the 90s, 177 children were identified with a probable diagnosis of autism – 139 boys and 38 girls. Those with autism traits were defined as the 10% of the sample with the highest trait scores.


The team analysed responses to three questionnaires in which mothers recorded the frequency of nine different signs and symptoms relating to the ears, hearing problems and upper respiratory system when their child was aged 18 to 42 months. These included signs such as mouth breathing, snoring, pulling/poking of the ears, ears going red, worse hearing during a cold, ear discharge and rarely listening.


The results found that the frequency of these symptoms was associated with high scores on each of the autism traits: social communication, coherent speech, sociability and repetitive behaviours, plus those with a clinical diagnosis of autism. Pus or sticky mucus discharge from the ears was especially associated with autism (an increased risk of 3.29) and for impaired hearing during a cold (an increased risk of 2.18).


Dr Amanda Hall, senior lecturer in audiology, at Aston University, said: “Thanks to the data available from Children of the 90s, we were able to analyse results from a large number of children. We found that common ear and upper respiratory signs and symptoms appear to be more prevalent in those with a subsequent diagnosis of autism or demonstrated high levels of autism traits.

“However it is also important to note that these ENT symptoms are very common in childhood and most children who experience these signs and symptoms do not go on to be diagnosed with autism.

“For example, of the group of around 1,700 children who snored at age 30 months, most of those 1,660 children did not get a later diagnosis of autism. Our results suggest the need for increased awareness of possible ENT conditions.”


Connect with:
Dr Amanda Hall

Dr Amanda Hall

Lecturer, Audiology

Dr Hall's research focuses on the causes and impact of hearing loss in children, at both the individual and the population level.

AudiologyShared Decision MakingAudiology Health Services ResearchCauses and Impact of Childhood Hearing LossLongitudinal Cohort Studies

You might also like...

Check out some other posts from Aston University

2 min

How mitochondria shape brain health from childhood to old age

From the first spark of neural development to the challenges of ageing, Dr Lissette Sánchez Aranguren is uncovering how the cell’s powerhouses — mitochondria — hold the key to a healthy brain across the human lifespan. Her pioneering research at Aston University explores how these microscopic energy generators safeguard the brain’s communication network and how their dysfunction may underlie conditions such as dementia, stroke, and neurodevelopmental disorders. Mapping the brain’s energy defence system Dr Sánchez Aranguren’s work focuses on the partnership between brain cells and the blood vessels that nourish them — a relationship maintained by the blood–brain barrier. When mitochondria fail, that protective interface can weaken, allowing harmful molecules to penetrate and trigger inflammation or cell loss. Her team’s studies show that mitochondrial malfunction disrupts the dialogue between neurons and vascular cells, an imbalance seen both in the developing and ageing brain. To counter this, she and her collaborators have engineered a mitochondria-targeted liposome, a nanoscale “bubble” that delivers restorative molecules directly where they are needed most. By re-balancing cellular energy and communication, this innovation could one day reduce brain injury or slow neurodegenerative decline. From heart cells to the human mind Originally trained in cardiovascular science, Dr Sánchez Aranguren became fascinated by how mitochondria regulate energy and stress in blood-vessel cells — insights that ultimately led her toward neuroscience. View her profile here “Mitochondria do much more than produce energy. They send signals that determine how cells communicate and survive.” That realisation inspired her to trace mitochondrial signalling across the continuum of life — linking early brain development to later-life vulnerability. Her research now bridges traditionally separate fields of developmental biology, vascular physiology, and ageing neuroscience, helping identify shared molecular pathways that influence lifelong brain resilience. Global collaboration for a healthier brain Her work thrives on multidisciplinary and international partnerships. At  Aston, she collaborates with scientists from Coventry University, Queen’s University Belfast, and the University of Lincoln, alongside research partners in the Netherlands, Italy, Malaysia, and China. Together they integrate chemistry, biology, and computational modelling to understand mitochondrial function from molecule to organism — and translate discoveries into practical therapies. Towards mitochondria-targeted brain therapies The next frontier is refining these mitochondria-targeted nanocarriers to enhance precision and efficacy in preclinical models, while exploring how mitochondrial signals shape the brain’s vascular and neural architecture from infancy through adulthood. Dr Sánchez Aranguren envisions a future where protecting mitochondrial health becomes central to preventing brain disease, shifting medicine from managing symptoms to preserving the brain’s natural defence and repair systems. “If we can protect the cell’s own energy engines,” she says, “we can give the brain its best chance to stay healthy for life.”

2 min

From circular supply chains to global sustainability leadership: How Dr Luciano Batista is shaping the future of the circular economy

When it comes to transforming how organisations produce, consume, and reuse resources, Dr Luciano Batista, professor of operations management at Aston University, is a global pioneer. His research sits at the crossroads of innovation, digital transformation, and sustainability, tackling one of humanity’s most pressing challenges: our overconsumption of the planet’s resources. Reimagining the economy around renewal Dr Batista’s work focuses on circular supply chains —a model he helped establish at a time when 'closed-loop' systems dominated sustainability thinking. His early research laid the foundation for how businesses could move beyond recycling and linear take-make-dispose models, instead designing systems that reuse, restore, and regenerate.  View his profile here From theoretical frameworks to real-world applications, his studies—such as comparative analyses of circular systems implemented by Tetra Pak in China and Brazil—demonstrate the measurable economic and environmental benefits of circularity in action. His 2022 Emerald Literati Award-winning paper introduced a methodology for mapping sustainable alternatives in food supply chains, earning international recognition for its real-world impact. A global voice for industrial symbiosis and circular innovation The influence of Dr Batista’s work reaches far beyond academia. He has advised the European Commission’s Circular Cities and Regions Initiative (CCRI) and contributed insights to policymakers through the UK All-Party Parliamentary Manufacturing Group. His expertise continues to inform national and regional strategies for sustainable production and industrial symbiosis —where one company’s waste becomes another’s resource. Today, he extends that impact globally as a visiting professor at the Massachusetts Institute of Technology (MIT), conducting research at the MIT Center for Transportation & Logistics on circular supply chain innovations, supported by Aston University’s study-leave programme. He also mentors future leaders in sustainability as part of Cambridge University’s Institute for Sustainability Leadership (CISL). Driving the next wave of sustainable transformation Looking ahead, Dr Batista is spearheading collaborations through Aston’s Centre for Circular Economy & Advanced Sustainability (CEAS), working with the Energy & Bioproducts Research Institute (EBRI) and West Midlands Combined Authority (WMCA) on projects developing biochar-based clean energy systems for urban districts. He is also advancing the social dimension of the circular economy—ensuring that the move toward sustainable production is inclusive and equitable. His Symposium on the Socially Inclusive Circular Economy, held at the 2025 Academy of Management Conference, has sparked new international research partnerships with Monash University (Australia) and the Vienna University of Economics and Business. A vision for a regenerative future At the heart of Dr Batista’s work is a simple but urgent truth: humanity is consuming resources at a rate our planet cannot sustain. Through his research and global collaborations, he is helping organisations, policymakers, and communities move toward a future where growth and sustainability coexist. “The transition to a circular economy is not optional—it is essential,” says Dr Batista. “Our goal must be to redesign systems that allow people, businesses, and ecosystems to thrive together.”

2 min

Aston University’s Ian Maidment helps develop training for pharmacy staff supporting those with long COVID

The e-learning resource, Supporting people living with long COVID, was developed by the Centre for Pharmacy Postgraduate Education (CPPE) It is designed to help community pharmacy teams build their skills, knowledge and confidence The programme offers video and audio resources, practical consultation examples and strategies for supporting individuals. Professor Ian Maidment at Aston Pharmacy School has been involved in a project with the Centre for Pharmacy Postgraduate Education (CPPE) to develop a new e-learning programme for community pharmacists, called Supporting people living with long COVID. The programme is designed to help community pharmacy teams build their skills, knowledge and confidence to support people managing the long-term effects of COVID-19. It was developed with researchers undertaking the National Institute for Health and Care Research (NIHR)-funded PHARM-LC research study: What role can community PHARMacy play in the support of people with long COVID? During the development of the e-learning resource, as well as with Professor Maidment, CPPE worked in collaboration with researchers from Keele University, the University of Kent, Midlands Partnership University NHS Foundation Trust and lechyd Cyhoeddus Cymru (Public Health Wales). The research draws on lived experience of long COVID, as well as the views of community pharmacy teams on what learning they need to better support people living with the condition. This new programme offers video and audio resources, practical consultation examples and strategies for supporting individuals through lifestyle advice, person-centred care and access to wider services. Professor Maidment said: “As an ex-community pharmacist, community pharmacy can have a key role in helping people living with long COVID. The approach is in line with the NHS 10 Year Health Plan, which aims to develop the role of community pharmacy in supporting people with long-term conditions.” Professor Carolyn Chew-Graham, professor of general practice research at Keele University, said: “Two million people in the UK are living with long COVID, a condition people are still developing, which may not be readily recognised, because routine testing for acute infection has largely stopped. For many, the pharmacy is the first place they seek advice about persisting symptoms following viral infection. The pharmacy team, therefore, has the potential to play a really important role in supporting people with long COVID. This learning programme provides evidence-based information to develop the confidence of pharmacy staff in talking to people with long COVID. Developed with people living with long COVID, the programme’s key message is to believe and empathise with people about their symptoms.” Visit www.cppe.ac.uk/programmes/l/covid-e-01 to access the e-learning programme. This project is funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number NIHR205384).

View all posts