Download Managing Hypersensitivity to Sound in Individuals with ASD

Managing Hypersensitivity to Sound in Individuals with ASD
Lillian Stiegler, Ph.D, CCC-SLP
Rebecca Davis, Au.D, CCC-A
Southeastern Louisiana University
Hammond, Louisiana
Since (1) the auditory channel is the primary pathway for language-based learning, (2) hands should be free
for other pursuits, and (3) self-treatment not only doesn’t provide a long-term solution, but may lead to
lifelong avoidance of sound, interventionists and family members involved with children with ASD should be
more aware of the issues surrounding hypersensitivity to sound, and hearing in general. Many questions
might be asked:
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Did a certified audiologist perform the initial hearing assessment?
What do the test results really mean?
What is the set of possible hearing-related concerns that might affect a child with ASD?
If hearing is “adequate”, then why does a given child cover his ears with his hands? Why does
another child hum?
How might auditory hypersensitivity be addressed in intervention and family settings?
While we take the position that ASD is far too complex to be attributable to sensory differences only, we
believe that if, as interventionists and family members, we have a better understanding of auditory function
and audiological assessment, we may be more likely to contribute positively to children’s educational, social,
and prevocational development.
The literature on interventions designed specifically to treat auditory hypersensitivity in individuals with ASD
is extremely sparse. Further, many investigations that addressed the somewhat broader topics of auditory
integration and sensory integration have been severely criticized as poorly validated and lacking in scientific
rigor (Dawson & Watling, 2000; Goldstien, 2000). In response to an emphatic call for more carefully
controlled studies on sensory-based interventions in ASD, Koegel and colleagues (2004) recently tested a
systematic desensitization approach to treating auditory hypersensitivity in three very young children (mean
age=34 months) diagnosed with ASD. Each child displayed ear-covering behavior and other aversive
reactions, not only to sound stimuli, but to the mere sight and/or mention of noise-producing toys and
household appliances (e.g. blenders, toilets flushing). A detailed, individualized sound desensitization
hierarchy was developed for each child and implemented across a 12-20 week span. Post intervention and
follow-up measures showed that all three children were able to play comfortably with no aversive reactions
in the presence of sounds and objects that were previously judged to be intolerable (Koegel, Openden,
Koegel, 2004).
Interestingly, while this systematic desensitization approach to the treatment of auditory hypersensitivity has
not been commonly applied or reported in ASD intervention, it has for some time been considered best
practice in the treatment of individuals without developmental disabilities who present with the same sorts of
auditory hypersensitivity issues. Moreover, treatments such as using earplugs and limiting exposure to
sound are contraindicated, since they deprive individuals of the opportunity to learn to tolerate sound stimuli.
Chart Review (*Children with ASD enrolled in a University speech, language, hearing clinic over 10 year period, Davis &
Stiegler, in process)
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11/22 have hypersensitivity complaints (50%)
10/22 have history of otitis media (45%)
4/11 with hypersensitivity complaints have a history of OM (36%)
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