Children’s Hyperacusis

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Hyperacusis is an excessive sensitivity to everyday sounds. It is individual to the sufferer and, a bit like a headache, can’t be tested or measured. It is not clear why some sounds cause problems while other (often louder) sounds do not. If a sound becomes associated with pain or discomfort it can lead to a fear of the sound. Children with hyperacusis often want to avoid certain situations and this can cause problems for the family or in school. If it is managed well the problem usually lessens over time.

Common troublesome sounds include the sound of:
• the vacuum cleaner
• traffic noise
• hand driers
• children laughing or shouting.

Avoiding noise is not the answer. Listening to sounds in a relaxed and calm way helps to ‘reset’ the ‘volume control’ in the brain so that gradually sounds which were distressing become less of a problem. Do not use ear defenders. It is important for children to be exposed to a range of normal sounds. The regular use of ear plugs, earmuffs or ear defenders must be avoided. While they may seem to improve the situation in the short-term, in the long-term they can make the problem worse. Earplugs deprive the ear of sound. The ears try to compensate by amplifying the quieter sounds which in turn makes the ears even more aware of the sounds when the earplugs are removed.

Things you can do to help:
• Find out exactly what sounds are distressing your child and how they react. This can help others caring for your child to recognise behaviours associated with the reactions to sounds.

• Comfort and reassure your child and try to explain the source of the sound. Be sympathetic but do not dwell on the distress – focus on an enjoyable aspect of the sound, for example the colour of fireworks.

• Controlling the sound themselves can often stop the child’s fear, so, for example, encourage them to play with and pop balloons, or to start and stop the vacuum cleaner at home etc.

• Involve them in the noisy activity that bothers them – for example turning on the vacuum cleaner, playing a musical instrument. Encourage noisy play.

• Gently repeating the sound may help the child to get used to it. A good way to do this is to get or make a recording of one or more of the sounds that upset the child. Play the sound at a very low volume and gradually increase the volume over a period of days or weeks. Play the sound as often as you can – this can be done in a play setting, for example pretend to vacuum while the noise of the vacuum is playing. You could also encourage the child to operate the sound source themselves. This ‘desensitisation’ takes a long time ( many months) and the more often you can do it
the better.

• Don’t force children to stay in a situation that causes them distress. This may lead them to link that situation with pain and then they will be afraid of the sound – making their reaction to the sound worse. If the child is distressed move them away from the sound and comfort them – this is more helpful than avoiding the problem sound.

• Allow the child to leave a situation that obviously causes them distress, even for a short time – for example during singing in a school assembly. Children may feel less anxious about the sound if they know they can have a break from it.

• Prepare the child before going into noise situations – for example firework displays.

• Involve other carers/ teachers in these suggestions so that everyone manages the problem in the same way.

• Be aware of your own anxiety. It is natural for parents to feel anxious about how their child is going to react and children can pick up on this and become more anxious themselves. Try to stay as calm as possible.

Relaxation is a vital part of helping children to tolerate noises that they find distressing. It is a skill that requires regular practice, ideally every day. If you practise regularly the child will more easily remember the relaxed feeling when they are in a stressful situation. Try to build some time for relaxation into your daily schedule.

Here are some ideas you may find helpful:
• Make a relaxing space – maybe the sofa with soft pillows or blankets, have a few items which are always associated with relaxation time, remove distractors e.g. no TV, find a scent that your child finds calming eg lavender oil, some children like calming sounds playing, eg the sound of waves, some children find it easier to relax when they have something to hold, stroke or fiddle with – this can be kept in a pocket so that it can be easily accessed.

• Progressive muscle relaxation- this method helps the child to notice the difference between tension and relaxation in their muscles. The child is encouraged to tense and then relax each part of the body working from the head down to the feet.

• Breathing exercises- teach your child to take long slow deep breaths in, then hold the breath and then slowly exhale. It can be helpful for the child to think of a word or phrase which is calming to them at the time they exhale. This word then becomes associated with the relaxed feeling. For younger children this slow breathing can be called “balloon breathing”. The child is encouraged to slowly inflate the balloon in their tummy and then slowly deflate it.

This approach can help the child to feel less anxious about noises by gradually exposing them to the feared noises. For children fearful of a lot of noises, try to encourage them to engage in increasingly noisy play, with the noise created within their control. This can most easily be done with a musical instrument such as a tambourine. Using an instrument with a volume control, such as a keyboard, can be helpful as the child can steadily increase the noise exposure and you can monitor their progress.

The Hyperacusis Clinic
If your child is referred to the Hyperacusis Clinic the audiologist will help you to develop various ways to make troublesome sounds more acceptable to your child. You may be given equipment to help with this. The ideas on this leaflet will be expanded upon and you will be helped to make them applicable for your child. Desensitisation is often a long process and involves you and any of your child’s carers/teachers following the advice given by the clinician. Treatment can involve several visits to the department.

Where to get further help
You may be able to receive further support in using these approaches through local services such as the Child and Adolescent Mental Health Service, Child Psychology Service, or Child Development Centre. If you are interested in getting more support speak to your GP to request a referral.