sensory processing disorder the auditory system

Understanding Sensory Processing Disorder: Auditory System

“I know there’s nothing wrong with her hearing but I have to call her name 100 times!”

Sound familiar?

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:Sensory processing disorder auditory system

  • 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.

Click here to learn about the subtypes of Sensory Processing Disorder.

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15 replies
  1. Mahjabeen
    Mahjabeen says:

    Hi Shannon,
    Plz help me to identify any method or procedure to reduce my 4 year old boy sensitivity towards clapping unexpected sounds loud cheer. He quite often a try to either shut himself cry loud or try to runaway from the scene.
    He is regularly attending OT and she suggest the special sound therapy. What do you think about it and how it works.

    Reply
  2. jano
    jano says:

    Hi Shannon,
    My 4 year old is nervous about loud cheer applause clapping and welcome. He is regularly attending OT and she suggest the sound therapy. Kindly tell me how it works and how I can help him to accept full fledge sounds of life.

    Reply
  3. Shannon
    Shannon says:

    Thanks for your question! Sound-based therapies can be very effective at decreasing auditory hypersensitivities such as those your son is experiencing. It is important to ask your OT for information on the specific program that she is recommending, as there are several sound-based programs out there. All of them are set up a little differently but the goal is to mature or refine the auditory system in order to better process the appropriate sounds at the appropriate level. In the meantime, it may be helpful to offer your child noise-cancelling headphones or ear plugs when in locations that expose him to upsetting levels of noise. Whenever possible, prep him by discussing what he should expect and options for what he can do if the noise becomes too much. Hope this helps!

    Reply
  4. Mary
    Mary says:

    My son is struggling in college due to being oversensitive to noises both in the classroom and especially in the apartment complex where he lives. He is unable to sleep at night due to the noise of his roommates and neighbors. This has him extremely agitated and depressed. I have always wondered if he might have an auditory sensitivity. What is the first step toward diagnosis. He saw a counselor as a child, and we mentioned his auditory sensitivities, but she did not recommend testing of any kind. He lives in Emporia, Kansas.

    Reply
    • Shannon Phelan
      Shannon Phelan says:

      Thank you so much for your question. I am sorry to hear about the negative effects your son is experiencing related to auditory hypersensitivities. Many sensory processing concerns were not as well known until more recently so I can image that he has had to cope with a lot of challenging situations. There are a few therapeutic listening programs such as Vital Links and The Listening Program that offer some great information on their website including practitioners from different areas who use the program or ways to get started. I also suggest consulting with an occupational therapist on helpful accommodations that fit his life style.”

      Reply
  5. Frances O'Brien
    Frances O'Brien says:

    Hi Shannon,

    I am a Speech Therapist working in Ireland, I have had a recent query from a client whose son I am treating. Her query was in relation to his older daughter who is 20 years old. She has a diagnosis of autism & epilepsy. She had developed extreme noise sensitivity which is impacting tremendously upon her daily functioning. She has physical pain in relation to certain noise e.g. sirens, babies crying, cars beeping.

    Is there any specific recommendations you could make? Her mother is thinking of the Listening program. Have you any knowledge of this specific program.

    I would be grateful for any advice in relation to this matter?

    Kind Regards,
    Frances

    Reply
    • Shannon Phelan
      Shannon Phelan says:

      Hi Frances, thank you for your question. I’m sorry to hear that she is in pain from those situations. Although I do not have experience with the Listening Program specifically, I do think that this program or a similar one such as Therapeutic Listening from Vital Links could be very beneficial for her. I do recommend that the family be sure to find a provider who has completed formal training through the program that they are using. Given her diagnoses, it is very important that the provider is choosing the most appropriate course of treatment and closely monitoring her responses. Although these programs are considered safe for those with most seizure disorders, it should not be used with those who have sound-induced seizures. I hope you find this information helpful and I wish the best of luck to your client’s family!

      Reply
  6. Kelly
    Kelly says:

    My child makes sounds constantly, which can be distracting and disturbing to others around him. How do we attend to this sensory need? He most often does this when tired, or when he is watching visually stimulating sometimes repetitive motion.

    Reply
    • Shannon Phelan
      Shannon Phelan says:

      Thank you for your question! We all use different types of sensory input to help us maintain an organized state or attend to the task at hand. A common example of this with adults is fidgeting with your pen or doodling on paper during a long meeting. Your body needs input, but you know that you shouldn’t disrupt others so you choose something minimally distracting. This is your ability to self-regulate. Children often need much more input than adults and may need help choosing the most appropriate behaviors. When a child is over-responsive to sound or has difficulty filtering auditory input, they may produce their own noises in order to block out what is disorganizing to them. Your child could also be using this method to adjust his arousal level when he is tired and when he is over-stimulated visually. An occupational therapist may address this with two goals in mind. One is to target his sensory processing abilities so that he is better able to process input from his environment. The other is to help him recognize his body’s needs and appropriate strategies to address them. From what you’ve mentioned, I think it is worth doing an OT evaluation to assess your child’s specific needs and the most appropriate strategies. I hope you’ve found this helpful!

      Reply
  7. Anna
    Anna says:

    I’ve noticed that my otherwise cheerful, outgoing 7 y/o daughter panics in noisy situations and will walk around with her hands over her ears. Our recent trip to Disney World really highlighted how bad the problem is. She was miserable and anxious the entire time and walked through the parks with her hands over her ears anticipating any sudden loud noise. She does have an ADHD diagnosis, and I have mentioned SPD to the clinician who diagnosed her AND her pediatrician and they both brushed me off. People are going to begin to make fun of her, but more importantly she is miserable. Your thoughts?

    Reply
    • Shannon Phelan
      Shannon Phelan says:

      Hi Anna, I’m sorry to hear how miserable these situations are making your daughter. From what you’ve mentioned, it does sound like she is overwhelmed in these situations due to auditory sensitivities. While it’s unfortunate that you’ve felt as though your concerns have been brushed off, your daughter is certainly lucky to have you advocating for her needs. I absolutely think that it would be worth seeking an occupational therapy evaluation. Occupational therapists specialize in identifying and targeting skills and abilities that impact a person’s activities of daily living. If your daughter is unable to functionally engage when there is added noise in her environment, an OT can target her auditory processing abilities as well as help her develop strategies to handle those situations. Additionally, you mentioned that your daughter has an ADHD diagnosis. It is not uncommon for those with ADHD to exhibit sensory processing differences. OTs can also address difficulties with attention and executive functioning skills, which are also common with this diagnosis. I hope this has helped and that you’re able to get even more insight after meeting with an OT!

      Reply
  8. Alexis Weber
    Alexis Weber says:

    My name is Alexis Weber, and I’m 16. I have been wondering if something is wrong with my hearing. I get scared at very small sounds, like fire crackling, vaccums, hair dryers, etc. Ever since I was little as well I have a history of avoiding going to the bathroom because the flushing scares me(especially when it’s automatic). I am currently being treated for Depression, Panic Disorder, and Severe Anxiety. I don’t know if my reactions to sounds is because of Anxiety, or if my Anxiety/ Panic Attacks are caused by my sensitivity to sounds. I have brought it up to my doctor once, but I’m scared to bring it up again in case she thinks I’m being dramatic. Can you help me?

    Reply
    • Shannon Phelan
      Shannon Phelan says:

      Hi, Alexis. I’m sorry to hear about your history with everyday noises causing you fear and anxiety. I think it’s great that you are being proactive with the issue. Many of the sounds that you described are common examples of frequencies that may be more difficult to process for those with auditory hypersensitivities. It is also not uncommon for those with auditory hypersensitivities to experience anxiety when they are frequently surrounded by noises that are uncomfortable to process. Please don’t think that you are being dramatic to recognize the connection. If your doctor is unable to help you identify resources in your area, I would recommend checking out the STAR Institute’s website (spdstar.org) as they have lists of books, blogs, websites, and recommended professionals in your area. Another suggestion would be to look into the Masgutova Method (MNRI). This is a program that aims, in part, to address the concerns you mentioned. I hope that you find this information helpful and are able to find the appropriate resources for you!

      Reply
  9. Annette
    Annette says:

    Hi my 20 month old former 2lb 29 week twin boy had a very difficult beginning with months on life support. His ENT noted his ear tubes are extremely small and narrow. His hearing is fine yet he does not respond to his name at all. He only has 2 words. He loves to watch Mickey and play with cause and effect toys along with puzzles . He is very affectionate and social. A picky eater and loves the water just not on his face. OT thinks he has a APD along with sensory processing.
    Any thought or suggestions?

    Reply

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