Sound Sensitivity in Children with Autism

Written by Kika Young, B.A., BCaBA

One of the most commonly reported challenges for children with autism spectrum disorders (ASDs) is hypersensitivity to sound. Children or individuals with ASDs have been known to cover their ears and flee from situations that might include loud, sudden, unusual, and unpleasant sounds.  Here are some behaviors your child may exhibit if sensitive to particular sounds in the environment.

• Covering of ears with hands
• Screaming at loud or specific noises
• Trying to flee
• Self-injury
• Humming or making other noises to try to drown out the other sound

Be aware that these behaviors are signs the child is trying to deal with unpleasant or even painful sensations.  If a child demonstrates auditory sensitivity, the first step is to determine what sounds he or she is sensitive to.  Keeping a diary or a log is a good way to track and identify sound responses.  When the child shows signs of sound sensitivity, write down what was going on in the environment before the behavior, and any sounds or things that happen after the child engage in the escape behavior. Keep in mind that some sounds that are irritating to a child with autism may be barely perceptible to others, such as a florescent light bulb buzz or an electronic hum.  A pattern should emerge fairly quickly.

Many parents go to great lengths to protect their children on the spectrum from undesirable sounds, often having them use earplugs, head phones, or shortening family activities.  Teachers and school-based speech-language pathologists also make special adaptations for children with autism who cannot tolerate the noise of the gym, cafeteria, class parties, or playground.  Additionally, some movie theaters offer special, quieter showings for children with autism and their families marketed as sensory-friendly events.  

Currently there is no compelling empirical evidence showing that the hearing of individuals with ASD differs physiologically from their typical peers.  There are no known differences in the peripheral or central auditory systems of individuals with autism that would result in hypersensitivity to sound. Gravel et al. (2006) found that children with autism did not exhibit more sensitive hearing, nor did they protest the tone used to stimulate the acoustic reflex more often than typical peers.  In a related study, Tharpe et al. (2006) found no evidence that children with ASDs had more sensitive hearing than typical peers, although in the majority of cases, parents reported that their child experienced pain or distress when exposed to certain sounds.

Some researchers view the strong avoidance reactions exhibited by some individuals with autism as an emotional regulation issue, possibly as a result of learned responses that are either fear- or annoyance-based (Stiegler & Davis, 2010).  Fear of noise is common in typical development but tends to be resolved at a young age.  Children with autism may feel threatened by certain sounds and may experience uncomfortable sensations related to sound.  Their natural reaction may be self-protective (Koegel, Oppendon, & Koegel, 2004).

Unfortunately, auditory sensitivity in ASD is often improperly managed or it is ignored entirely.  The most common intervention is simple sound isolation, and it usually involves fitting an individual with bulky, industrial sized ear muffs.  This technique, while crude, has some important short term benefits.  Incoming sounds are reduced to very low decibel levels, creating a buffer between the individual and the sounds she or he finds threatening or painful.  Sound isolators merely manage auditory sensitivity, and they make no attempts to treat the underlying condition.  In an effort to completely cure auditory sensitivities, some individuals undergo a treatment called Auditory Integration Therapy (AIT).  Typical AIT treatments involve multiple half hour sessions, in which patients are exposed to customized, frequency filtered music.  According to practitioners of this therapy, the music is specifically designed to re train the ears, causing an individual to lose sound sensitivities after multiple treatment sessions.  Unfortunately, the therapy lacks clear empirical evidence thus far, necessitating further research to determine its therapeutic efficacy.

For individuals with specific sound sensitivities, exposure therapy or desensitization may be a useful intervention.  The technique has many variants, but the general principle involves gradually reintroducing an offending stimulus at progressively closer ranges until habituation occurs.  Recently, Koegel and colleagues used exposure therapy to treat sound sensitivities in several children diagnosed with autism.  As is commonly reported in ASD, the children in this study had problems with certain specific types of sounds. One child, for instance, could not stand to hear blenders or vacuums, while another child was extremely averse to the sounds of certain electronic toys.

Desensitization is one of the many techniques used at Behavioral Consulting of Tampa Bay to treat a variety of challenges, including sound sensitivity, feeding disorders, and increasing tolerance for grooming and medical procedures.  If you’d like more information, call as at 813-814-2000 or visit our website to learn more about our services.