Hyperacusis in Children
We have compiled some some general information  on Hyperacusis in children and advice on management to help further your understanding of the condition.

There is very little information available on the subject of Hyperacusis in children.

Several terms have been used to describe Hyperacusis including ‘hypersensitivity of hearing’, ’deceased sounds tolerance’ etc. A useful definition of Hyperacusis would include ‘unusual tolerance to ordinary environmental sounds ‘(Vernon 1987a) or 'consistently exaggerated or inappropriate responses or complaints to sounds that are neither intrinsically threatening nor uncomfortably loud to a typical person' (Klein et al, 1990).

Hyperacusis does not mean better or more acute hearing than normally hearing population and in some instances it may co-exist with hearing impairment.

The reasons for Hyperacusis are not fully understood but there are several theories how this happens, one commonly quoted being the unusual central gain, i.e. that the brain perceives some sounds as being too loud or uncomfortable or unpleasant (Baguley & Anderson, 2007) and this has a bearing how this condition is managed.

Hyperacusis can happen to children of any age as well as in adults. However, unlike adults, very young children may find it difficult to describe what they feel and how it affects them when it happens. It is therefore their behavioural and emotional reactions one needs to observe carefully.

Managing Hyperacusis

Mild Hyperacusis

    Where Hyperacusis is not impacting on family or school life on a regular basis or causing avoidance of particular situations, it may suffice to explain the source of sound and reassure your child. You may well develop your own coping strategies in very specific situations, which you know causes some distress to your child.

    Please remember, it is not advisable to use earplugs or ear protection as that may make the situation worse. You may also wish to discuss with your child’s teachers or carers coping strategies.

Moderate Hyperacusis

    In some children, not only can certain sounds or loud noises be unpleasant and distressing, it can also be definitely painful and has been described by adults as “knives through the ears or head”, “grating of the nerves” etc. This can lead to a panic response in the child leading to aggression, crying, going very quiet or withdrawn or trying to escape from the situation. Children often find it very difficult to express what they are feeling because of their limited communication skills.

    It is therefore very important to breakdown the association of sound exposure with anxiety and or fear and can be achieved with the following steps:

    1. When your child becomes distressed to certain sound exposure, move away from the sound where possible and then comfort and reassure them
    2. Explain the source of sound
    3. Allow your child to have some control over sounds by allowing him/her to make sounds, such as clapping hands, tapping a table, shaking rattles or start and stop the Hoover etc. – all as part of play activities
    4. Repeated gentle exposure to particular sounds or noise that causes distress can help desensitisation: for instance, certain sounds (eg: Hoover, laughter, child screaming or crying, assembly, playground noise, thunder, lorry passing by, clapping, sirens etc) can be recorded onto a mobile phone or CD and played at a very low volume which will allow your child to recognise the sound but without being distressed. Very gradually over a period of days or weeks the volume can be increased to levels your child will tolerate without becoming distressed. These all have to be done as part of play to be successful and if appropriate let your child have the volume control. It is the unexpected exposure to sounds that causes anxiety and fear, much less so when expecting it
    5. Your child must not be forced to stay in a situation that is causing obvious distress as this can worsen the situation and increase the fear/anxiety association
    6. Older children may feel reassured if they know that they have the Teacher’s permission to leave for a few minutes if they are exposed to aversive noise. There is no evidence to suggest that children abuse such arrangements
    7. Do not use earplugs, muffs or defenders other than in extreme or unavoidable circumstances and for short periods only such as travelling