Auditory

A child’s sense of hearing might become overloaded if you’re surrounded by loud noise (e.g. a concert or sports game) or if you’re hearing multiple sounds at once.

Children may find certain sounds overstimulating but not react at all to others. While some children report only mild discomfort, some experience pain when sounds are too intense.

For more information about auditory see the Vision and Hearing section- auditory processing and sound sensitivity and the impact of hearing impairment on social interaction.

Auditory Processing

Some children have difficulty processing everyday sensory information. Any of the senses may be over or under sensitive, or both, at different times. These sensory differences can affect behaviour and can have a profound effect on a person’s life.

Too much information

Sometimes children may behave in a way that you wouldn’t immediately link to sensory sensitivities. A child who struggles to deal with everyday sensory information can experience sensory overload, or information overload. Too much information can cause stress, anxiety, and possibly physical pain. This can result in withdrawal, challenging behaviour or meltdown.

Many children have difficulty handling auditory input, even if they have normal hearing. Auditory processing refers to how the central nervous system and brain recognise and make sense of sounds. Having auditory processing difficulties is different from being deaf or having a hearing loss. Auditory processing difficulties are caused by a mix-up with the signal of sound as it travels to the brain.

Reacting to sounds

Listening is a very complex process that involves both hearing and processing sounds. Sound has many dimensions: intensity (loudness), frequency/ pitch, duration, and localisation.

Children with difficulties in this area have difficulty in discriminating which sounds are relevant and in blocking out or not attending to irrelevant sounds. This can have an overwhelming effect when trying to discriminate between sounds and can result in behavioural/ emotional responses during situations.

A child may have difficulty with auditory processing in a variety of settings. These difficulties may be associated with functional impairment at home, at school and in the community. For example, they may become distracted in school when the teacher is giving instructions as they are unable to attend to the relevant sounds and may be distracted by background noises that other people are unable to notice.

Signs of auditory processing problems

Under sensitive

May not acknowledge particular sounds such as Name being called
Slow response to environmental sounds
May demonstrate difficulties discriminating sounds even in low levels

Things that may help your child:

Reduce back ground noise
Turn off tv/ radio
Consideration of position in class/ at dining table
Gain eye contact before giving instructions
using visual supports to back up verbal information, and ensuring that other people are aware of the under-sensitivity so that they can communicate effectively

Over sensitive

Noise can be overwhelming, and sounds become distorted and muddled.
May be able to hear sounds and conversations in the distance (lawn mowers, hand dryers, vacuum cleaner).
Difficulty managing in crowded or large space.
Frequently covers ears.
May behave disruptively in order to escape.
Makes own sounds such as humming to drown out background noise.

Seeking

Shouting
Banging
Playing music very loud

Implications for learning

A multi-sensory approach will be important in the presentation of information.
Acoustics in a setting such as a school or restaurant may result in the child being unable to discriminate between sounds for example the noise from the corridors, classrooms, gym and dining hall will all have an impact.
A child with difficulty processing auditory stimuli may appear unable to follow directions or hear well from a distance. Some children may be particularly distressed by intense, repetitive, or high-pitched sounds, such as a shrill bell.

Strategies that might help

Shutting doors and windows to reduce external sounds
Preparing the person before going to noisy or crowded places
Providing ear plugs and music to listen to
Creating a screened workstation in the classroom, positioning the person away from doors and windows.
Gain the child’s attention before giving any instructions or information. Use of visual presentation as well as auditory may help them to attend. Instructions for tasks should be clear and concise, and possibly in picture format so that they can check for themselves if they have done what they has been asked to do.
The child may find it helpful to use earphones or listen to music when they are out in busy/ noisy environments.
Sit in a position closest to the teacher
Sit in an area to do 1:1 work with less distraction, away from doors and access points and away from possible loud noises e.g. window, bell etc.
Prepare the child for expected loud noises a few minutes before it is going to happen i.e. the bell ringing at the end of lesson.
It is not always possible to prepare the child for unexpected loud noises, ensure they have strategies in place if this causes anxiety.
Trial headphones with music at a low level if the child is entering a busy environment e.g. crowd, supermarket.
Carry out heavy muscle/ proprioceptive activities prior to activities that involve loud noise to prepare and calm child’s nervous system.
Use a combination of looking and listening (pictures to reinforce auditory information within the classroom and use flip chart during circle time/ white board, hand outs/ worksheets etc.
Repeat important information.

Sound Sensitivity

What is it?

Some children experience sensitivity to certain sounds, where they appear to find some sounds uncomfortable or upsetting, it can vary from child to child. This is sometimes called hyperacusis and a more extreme fear of certain sounds is known as phonophobia. Frequently the sensitivity appears to sudden, loud sounds such as sirens, vacuum cleaners, motorbikes, fireworks, balloons popping, hair dryers and hand dryers. For some children specific types of sounds (which may not seem that loud to other people) can be problematic.

What causes it?

Sound sensitivity can be a normal phase that children go through. A lot of young children find loud, sudden sounds scary, particularly if they don’t fully understand why the sound has appeared. Most children will adapt as they learn to understand what the noise is, where it comes from and that it isn’t anything dangerous. It is not uncommon for a child with additional sensory issues or complex needs to experience sound sensitivity. Occupational Therapy, your paediatrician or Child and Adolescent Mental Health Service (CAMHS) may be able to provide more specific support.

Glue ear and sound sensitivity

We often find children who have had glue ear are susceptible to sensitivity to sound once the glue ear has cleared. They often have reduced hearing for a period of time, when this clears the world seems a louder place and it takes time to get used to loud noises again.

What can I do to help?

Reassurance

Reassure your child when they come across a sound that they find upsetting. Explaining to them what the sound is, where it comes from and why it is loud can help them to understand. If you know the sound is coming, prepare your child by telling them about it in advance. It may be a good idea to keep track of which specific sounds irritate your child the most and share the list with any caregivers.

Remove the fear factor

Humour is a great way of removing the fear from an object. If your child is scared of the hairdryer or the washing machine, you could dress it up with big glasses and stick some funny ears on it and give it a silly voice, for instance. It’s very hard to be scared of something that you are giggling at.

Relaxation and breathing

Breathing techniques can help to relieve anxiety and give your child something else to focus on rather than the sound that is upsetting. There are many apps you can download to your smartphone or tablet. One very easy way is to use your child’s hand and encourage them to breathe in and out as they trace their way up and down their finger-tips. There are lots of suggestions for relaxation techniques for children available online.

Avoid silence

It can be tempting to remove your child from a distressing situation or to use ear defenders to help them. We do not recommend the use of ear plugs or ear defenders, even if your child finds a particular sound distressing. Unfortunately, this is likely to make a child even more sensitive to louder sounds in the long term, when they do come across it, they will find it all the more distressing for not having had a chance to get used to it.

Desensitisation

Allowing your child the opportunity to get used to the sound they dislike in a safe, controlled way can help them to become less sensitive to it. You can use videos on the internet to show your child a video clip of the sound they find upsetting, with the volume turned down, or even off completely. Prepare the child for the start of the clip, get them to press the “play” button, and allow them to alter the volume – this can give them a sense of control. Then gradually increase the volume as they become less sensitive to it. This can take time, for instance try five minutes one week at a certain level then again a few days later at a louder level.

Traffic light system

For older children, it can help to explain to your child that the reason they find some sounds upsetting is that their brain is being too clever.

You can use a traffic light system to show that their brain has switched on to high alert “red” and is flagging up too many sounds as scary. By flagging up so many sounds as scary, their brain is getting ready to deal with what it thinks is something to be worried about. We want their brain to go back to low alert “green” and let more sounds through as not scary. Encouraging your child to remember this each time they encounter an upsetting sound can help get their brain back to “green”.

https://www.esneft.nhs.uk/leaflet/sound-sensitivity-in-children/