“I know there’s nothing wrong with her hearing but I have to call her name 100 times!”
Much like the tactile system, discussed in the previous post of this series, the auditory system refers to our ability to take in information, process it, and produce an appropriate response. When a child overreacts to sounds or seems easily distracted by noise that many of us can tune out, she is demonstrating auditory hypersensitivity. This may be due to an improperly functioning stapedius, which is a middle ear muscle that contracts in response to loud noise in order to protect the hair cells of our inner ears. When this muscle is not properly contracting, sounds may seem louder to these children. This understandably puts extra stress on them and causes difficulty filtering out background noises that most of us don’t even notice. On the other hand, you may see a child with a hyposensitive auditory system seeking out loud noises or demonstrating difficulty localizing and distinguishing sounds.
Below are red flags for hypo and hyper sensitivity to noise:
- Fear of sounds from hair or hand dryers, vacuums, flushing toilets, etc
- Overreaction to loud or unexpected sounds (covering ears, crying, running away, aggression)
- Annoyed or distracted by sounds most of us either don’t notice or become used to such as fans, clocks, refrigerators, outside traffic, etc
- Becomes upset with others for being too loud (but are often times very loud themselves)
- Prefers to keep television, radio, or music very loud
- Dislikes noisy places such as malls, movie theaters, parades, fairs, etc…
- Enjoys making noise just to make noise
- Doesn’t respond promptly to name being called
- Needs you to repeat yourself often or doesn’t seem to understand what you said
- Unable to recognize where sound is coming from
It’s important to note that terms related to auditory processing are not always defined consistently. While auditory hyper and hypo sensitivities could be considered an auditory processing disorder (since they refer to a dysfunction in the processing of sound), this term is commonly used to describe dysfunction in the brain’s ability to translate sounds. Central auditory processing disorder (CAPD), now commonly referred to as simply auditory processing disorder (APD), is when normal hearing is present, yet the brain has difficulty interpreting what it hears. Symptoms of this condition can look similar to auditory hyper and especially hypo sensitivities in many ways, yet key symptoms include difficulty with interpretation of sounds or language, speech delay, and difficulty learning to read. In this instance, an audiologist will help identify the issue and may refer to a speech and language pathologist for treatment.
However, if you have concerns that your child is exhibiting some of the red flags listed above for hyper and hyposensitivity, it is worth consulting with an occupational therapist to identify helpful supports for your child. There are a variety of sound-based programs out there and an occupational therapist (OT) can help identify if one may be beneficial for your child. Additionally, issues with the auditory system are often accompanied by issues with other sensory systems and a comprehensive plan should be put in place. Your OT may also provide you with useful tips to minimize distractions for activities in which concentration is required, guide you on the use of noise cancelling or minimizing headphones, and offer other suggestions such as repeating back instructions prior to beginning a task.