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Karen Wang
BY Karen Wang
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Noise Control: 11 Tips for Helping your Child with Autism Deal with Noise

One of my son’s most frequent questions is, “What’s that sound, Mommy?”

I often can’t hear what he’s hearing. He can hear the school bus when it’s still half a mile from our house. With all the windows closed inside our home, he can hear the next-door neighbors’ sump pump switch on or their garage door opening. He can hear a whisper in the next room or an air vent in a busy department store or an airplane’s high-pitched engine long before it’s visible in the sky.  At a noisy carnival, he can hear his favorite song playing across the park.

The downside to sound sensitivity is that noise quickly becomes painful and can even trigger a panic attack. When a person can hear everything simultaneously, it becomes almost impossible to pay attention to the task at hand. Separating and prioritizing sounds drains a person’s energy, and the constant assault of noise causes a person’s anxiety level to escalate.

When my son was a toddler, he had a panic attack every time our washing machine clicked loudly to change cycles. He developed a phobia of all types of bells. He covered his ears and cried in crowds. But he became calm, even joyful, every single time we went for a walk in the woods, visited the library or entered any kind of religious environment: his stiff, tight muscles would relax instantly in my arms.

Creating a Plan to Deal With Sounds

All of these observations gave me food for thought as I developed a plan to help him cope with his sensitivity to sound. Over the years his ability to tolerate noise has steadily increased, and barking dogs are his only remaining noise-related phobia.

Here are eleven ways to help a highly sensitive person learn how to cope with and enjoy everyday noisy situations.

1. Know the types of sensitivity

There are several different types of noise sensitivity, and there are different treatments for each type. Consult with an audiologist to pinpoint which type of sensitivity is affecting your quality of life. These are the 5 most common types of sensitivities, but keep in mind that a person may be affected by more than one issue. For example, my son has hyperacusis in addition to phobias of specific sounds.

  • Hyperacusis is an intolerance of everyday environmental sounds and is often associated with tinnitus, a ringing in the ears.

  • Hypersensitive hearing of specific frequencies is often (but not always) associated with autism. A person is able to tolerate most sounds at normal levels, but certain frequencies are intolerable, especially above 70 decibels. For example, a person may have no difficulty being near a noisy dishwasher, but the higher frequency and higher decibel level of the vacuum cleaner will be painful.

  • Recruitment is directly related to sensorineural hearing loss. It is defined as an atypical growth in the perception of loudness. Hair cells in the inner ear typically “translate” sound waves into nerve signals. Damaged or dead hair cells cannot perceive sound, but at a certain decibel level, surrounding healthy hair cells are “recruited” to transmit, and the person experiences a sudden sharp increase in sound perception that can be shocking and painful.

  • Phonophobia (also called ligyrophobia or sonophobia) is a persistent and unusual fear of sound, either a specific sound such as an alarm or general environmental sounds. People with phonophobia fear the possibility of being exposed to sounds, especially loud sounds, in present and future situations, and sometimes become homebound due to this anxiety.

  • Misophonia is an emotional reaction, most often anger or rage, to specific sounds. The trigger is usually a relatively soft sound related to eating or breathing, and may be connected to only one or a few people who are emotionally close to the affected person. For example, my friend Lisa’s son Nate becomes angry and runs out of the dining room because his father makes sounds while chewing food, but Nate does not become angry when his mother and sister make similar sounds.

2. Provide relief

Headphones and earplugs offer instant comfort and relief. Noise-canceling headphones are the most effective, because they replace irritating environmental noise by producing calming white noise. Earplugs are usually made of either foam or wax, and it is worth trying both types to determine which is more comfortable.

However, most audiologists, physicians, therapists and educators recommend against frequent use of headphones and earplugs, because a person can quickly become dependent on them. In the long run, blocking out noise can reduce coping skills and increase social withdrawal.

3. Identify safe environments

One of the first steps that I took for my son was to make a list of his “safe” places and increase his participation there. Depending on an individual’s needs, this could mean:

  • volunteering at the library
  • attending library storytime
  • taking a walk in a nature area every day
  • visiting a park that is near a railroad crossing or helicopter landing pad
  • attending services, prayers or social events at the Shul more often

4. Allow control over some types of noise

At its heart, anxiety is a fear of being unable to control reactions and situations. When my son had a phobia of bells, I gave him several different types of bells to handle and experiment with at home. When we saw bells at customer service desks or in other public places, I allowed him to ring the bell. He gradually became comfortable with the sounds, and he even began identifying speaker systems, alarm systems and other sources of sounds everywhere we went.

5. Allow distractions

When my husband and I took a Lamaze childbirth class many years ago, we learned about the power of distraction in pain management. By giving a person something like an iPad to focus on or an unusual privilege such as bringing along a favorite toy from home, it becomes possible to direct attention away from the offending noise.

6. Gradually increase exposure and proximity

The cure for a fear of snakes does not involve throwing a person into a snake pit. Similarly, relief from noise sensitivity requires a gradual desensitization and not a sudden exposure. Start by observing something from afar and take a step closer with each opportunity.

My son had a problem with sirens, so we started with pictures of fire trucks and emergency vehicles in a book.  I imitated the sound of a siren with my voice.  We read books about firefighters and police officers. My son wore firefighter and police costumes. We watched YouTube videos of fire trucks in action. I arranged for our playgroup to get a tour of the local fire station, and my son sat in the fire truck with a big smile. I pointed out fire trucks and ambulances while driving. Eventually, those emergency vehicles became a part of everyday life and the sirens did not bother him as much.

7. Alternate noisy and quiet

I discovered that my son’s tolerance for noise increased the most when I scheduled frequent quiet breaks. After a morning out doing errands, we enjoyed a quiet lunch at home. After a playgroup with 7 other children, we made time to snuggle on the sofa. When we felt brave enough to visit a large theme park, we booked a hotel inside the park so that we could retreat as often as necessary. We always take a break before the noise upsets him, so that he will want to return for more fun after resting.

8. Hyperacusis Retraining Therapy (Tinnitus Retraining Therapy)

Auditory Integration Therapy (AIT) is sometimes suggested to people with noise sensitivity, but there is very little peer-reviewed research published on the topic of AIT, and the existing research has generally not been favorable.

However, there is plenty of medical research on Tinnitus Retraining Therapy (TRT), which involves listening to broadband pink noise to habituate a person to ringing in the ears. Pink noise contains all audible frequencies, but with more power in the lower frequencies than in the higher frequencies. Most people report that pink noise sounds “flat.” Because of this, it helps to rebuild tolerance to sound.

9. Cognitive-behavioral therapy

Physicians widely recommend cognitive-behavioral therapy for phobias and anxiety because it teaches a person to self-manage emotions and coping skills. The goal of the therapy is to reframe a person’s thought processes about the cause for anxiety in order to increase quality of life.

10.Consider supplements

Many people with tinnitus or hyperacusis are deficient in magnesium or other minerals. Consult with a physician to determine if nutritional supplements may be able to help.

11. Avoid food additives

Certain food additives, especially those in the salicylate family, are associated with noise sensitivity. In fact, medical literature refers to salicylate as a “tinnitus inducer.”  Special diets, such as the Feingold Diet or a diverse whole foods diet, eliminate those additives and may help reduce sensitivity. Consult with a physician or dietician before making any major dietary changes.

Summary

The world is noisy, but a person can easily live a full life without fireworks shows, major league sporting events and rock concerts. When sound sensitivity interferes with everyday activities, then it is time to look more carefully and seek guidance. A systematic approach to sound sensitivity can lead to a greater enjoyment of relationships and increased inclusion in community-based activities. The Hyperacusis Network notes that in the end, “The ocean cannot escape its waves.”

Karen Wang

Written on May 6, 2014 by:

Karen Wang is a Friendship Circle parent. You may have seen her sneaking into the volunteer lounge for ice cream or being pushed into the cheese pit by laughing children. She is a contributing author to the anthology "My Baby Rides the Short Bus: The Unabashedly Human Experience of Raising Kids With Disabilities"
  • Cid

    The best ear protection we’ve found are the small ear plugs that we purchased at a gun store. They’re made to filter loud, percussive sounds, are light weight and almost invisible when worn.

  • ThePocketOccupationalTherapist

    I’m a pediatric Occupational Therapist and we have two children with sound sensitivity and created CDs to help them to control the sounds and learn that they are not going to hurt them. They are Sound-Eaze and School-Eaze and are on Amazon and http://www.pocketot.com site. Also, in many special needs related catalogues. Recorded to rhythms and songs so sounds become fun! They are not part of any listening program and can even be used in groups and classes to identify sounds as a game. Remember that the amygdala is where we register anxiety and this can cause “flight or fight” type reactions. It’s important to give kids a safe place to go when they feel anxiety with sound.
    GREAT article! Sharing for sure.

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  • Craig

    With regards to diet, a plant-based, whole foods diet is an absolute must for a sensitive person. No meat, or dairy. And limit processed foods as much as possible. Also, tulsi tea is amazingly good for keeping me calm.

    • StarlightMuse9

      Please do not make medical recommendations to desperate parents. There is absolutely NO proof that meat or dairy free diets help sensitive or anxious people. Those diets are not appropriate for growing children, or frankly, any omnivorous species… e.g. human. This trend is dangerous and damaging, and completely devoid of science. Even if you did feel you had adequate proof, it is not your place to recommend drastic measures. It’s easy to say people should be responsible for their choices but desperate parents often are susceptible to hearsay, it’s just part of the struggle… People recommend vegan for everything, and it solves very little, except maybe extreme food allergies.

      • Jordan Atnip

        I think that recommending dietary changes holds the same weight as recommending a certain brand/type of headphones or earplugs or other devices. It is nice to hear others thoughts and recommendations. We can take the information and use it how we see fit. Something as simple as addressing allergies, or needing to balance the bacteria in the gut with pro-biotics, or dealing with a nutrient deficiency can go a long ways for some of these kiddos/adults.

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  • Karen Hamman

    I have read your article above and find it very interesting. I however have a question, what is the possibility that a sound sensitivity could also be connected to behavior or habit.
    My 16 year old daughter can not stand the sounds made by children, when they are playing/ happy…
    I suspect that she might have been bullied by a friends children, a few years younger than her and the problem might have started then. At the moment it is so bad that she echoes the sound, with a very high pitched sound. This has resulted in the family not being able to go any out at all. If she so much as sees a child, she starts with her echoes and I don’t have to tell you that this does note go down well in public spaces such as restaurants, malls, movies. The sad thing is that she really loves these places and now it is so limited. I would really like to desensitize her, so we can take her to the places she loves. Where do I start and if it is perhaps partly a habit, how do I break this habit.
    We have invested in noise reduction earphones, but I try not to use them constantly. We write social stories whenever we can and try to prepare her as much as possible, but this only helps for a short while.

    • StarlightMuse9

      Yes, for sure. I am an adult on the spectrum with a child on the spectrum. And I don’t even think it needs to be an extremely traumatic event or anything, when it comes to autism or anxiety. My son had a scary incident with a dog jumping at him, and became frightened of ALL dog barks and reacts very intensely to them. He used to love dogs before this incident. He is also very nervous of children after ONE incident where a child threw sand at him. It was years ago, and went downhill from there. I just do what you do… ear phones and social stories. We talk a lot about what noises mean and why children and dogs scream or bark.

      Myself, I had some traumatic incidents in childhood and I do have a lot of “trigger noises” that remind me of the situations/people. I find when my stress level is high otherwise, my sound sensitivity gets much much worse. Like if it’s busy at work, my son is having a difficult phase, I’m not sleeping well, money problems, etc… my coping skills wear out. I use headphones with calming music a lot… or just try to avoid. I wish I had better advice but I’m trying to figure it out myself.

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  • Jessica Ann Doerfler

    When people scream it hurts my ears so I cover them.

  • I appreciated this article greatly! My wife is an OT, with years of experience working with students with Autism and SI issues to include sound. I am a soundproofing geek, by profession, treating commercial and residential environments for sound control. After reading this blog, I am very curious to understand more and pinpoint why I have not had more professional contact with applications related to Autism and sound sensitivities, after 15 years pf solving sound problems. I am inspired and motivated now to help people with Autism with my acoustic expertise. I look forward to the amplifying my understanding of sound in whole new way. (Of course, I must begin with my resident OT.) Your article was eye opening…and ear opening. Thank you very much! -Mitch Zlotnik

  • Juhani

    Good article, thank you. My ASD 3 year old has meltdowns when the lawn services mow our lawn, when the cleaning lady vacuums and at the mall’s public bathrooms when the handblowers come on. At our OT’s recommendations we have gotten wireless headphones that can play music. I’ve put his favourite music on there (disney songs and calming music). It helps so much when we go out. Works like a charm.
    Thanks for pointing out that we have to try to not become too dependent on this. Perhaps as he grows older and we can communicate better (non-verbal at this point) we’ll be better able to incorporate coping strategies.

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