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Auditory Hypersensitivity and Autism Spectrum Disorders: An Emotional Response by Dr. Jay Lucker and Alex Doman

Auditory Hypersensitivity and Autism Spectrum Disorders: An Emotional Response by Dr. Jay Lucker and Alex Doman

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www.autismone.orgREPRINTEDWITHPERMISSIONAUTISMSCIENCEDIGEST:THEJOURNALOFAUTISMONEISSUE04
audiTory hypersensiTiviTy andauTism specTrum disorders
One concern parents and proessonals ma have wth chldren who have been dagnosed wth anautsm spectrum dsorder (ASD) s that some o these chldren cannot tolerate lstenng to certansounds. Ofen, parents observe that the chldren putther hands over ther ears, run awa rom sounds,or sometmes lose control o ther behavors nthe presence o certan sounds. Tese chldren areofen dented as havng
 auditory hypersensitivity
 or
hypersensitive hearing 
.
1-10
Although concernabout audtor hpersenstvt has been especall ocused on chldren on the autsm spectrum, man nonautstc chldren also present wth behavorslabeled as audtor hpersenstvt.
2-4,6-9
For man ears, experts ocusng on audtor hpersenstvt and treatment or problems o hpersenstve hearng looked at ths phenomenonas an audtorsstembased problem nvolvngabnormal hearng but not hearng loss. Somedened audtor hpersenstvt as an overreactonto sounds that should (over tme) no longer warrantsuch responses. However, recent research has ledus to a better understandng o what ma be gongon n chldren who have hpersenstve hearng. Anunderstandng o possble mechansms can assst usn provdng more approprate nterventons to helpchldren overcome audtor senstvt problems.Ts artcle dscusses audtor hpersenstvt wtha ocus on the current state o our understandng o the problem and treatment or such problems.
hearing versus percepTionand audiTory processing
Genercall, audtor hpersenstvt usuall reersto a person who s consdered overl senstve tosounds, especall loud sounds. Tere are man  who mght thnk that chldren wth audtor hpersenstvtes, thereore, have hearngrelated
audiTory hyPersensiTiviTy and auTismsPeCTrum disorders:
 
an emoTional resPonse
By JAy R. LUCKER, EDD, CCC-A/SLP, FAAA, AND ALEX DOMAN
problems. However, the ollowng three dentonsclar that audtor hpersenstvt has to do wthour
 perception
o sound rather than our
hearing 
o sound:
1
One denton o audtor hpersenstvt s “abnormall senstve hearng n whchnormall tolerable sounds are perceved asexcessvel loud.”
11
 
2
Another denton s “an ncreasedsenstvt to sound percepton, subjectven nature.”
12
3
in dscussng audtor hpersenstvt,Gomes and colleagues
5
cte Kanner,
13
  who dscusses chldren on the autsmspectrum as havng
 aversions 
to certanloud sounds rather than havng problemshearng or lstenng to loud sounds.
Abstract
Many children diagnosed with an autism spectrum disorder are described as having auditory hypersensitivities. Thispaper describes auditory hypersensitivities, the systems involved in hypersensitive hearing, methods or evaluatingauditory hypersensitivity in children, and possible treatments. Auditory hypersensitivity involves the non-classicalauditory system and is an emotional response to sound rather than an auditory response. Children described asbeing hypersensitive to sound have negative emotional reactions to sounds and situations in which the soundsare present. It is possible to desensitize these negative emotional reactions and reprogram the emotional memorysystem so that children are no longer rightened by sounds.
103
 
AUTISMSCIENCEDIGEST:THEJOURNALOFAUTISMONEISSUE04REPRINTEDWITHPERMISSIONwww.autismone.org
 
aLex DOMan
 
is ounder and CEO o AdvancedBrain Technologies. He is also a bestsellingauthor, producer, and speaker. He has ocused hiscareer on sound, music, and technology and theircapacity to improve brain health and perormance.His credits include being co-producer o
 
 Music for Healing at the Speed of Sound™ 
 
and
 
 Music for Babies™ 
as well as executive producer, creator, orcollaborator on more than 50 other music albumsand products including
 
Sound Health®, Musicfor the Mind™, BrainBuilder®,
 
and
 
The ListeningProgram®.
 
Doman is coauthor o the bestsellingbook
Healing at the Speed of Sound®.
See also
 
www.dvdbi.om
.
 Jay r. LucKer, eDD, ccc-a/SLP, faaa,
 
is an associate proessor in the Department oCommunication Sciences & Disorders at HowardUniversity in Washington, DC. He is also a certifed/licensed audiologist and speech-language pathologistspecializing in auditory inormation processing disorders(APD). Dr. Lucker is president, coounder, and chair o theboard o the National Coalition on Auditory ProcessingDisorders (NCAPD). See also
www.pd.og.
104
AUTISMSCIENCEDIGEST:THEJOURNALOFAUTISMONEISSUE04REPRINTEDWITHPERMISSIONwww.autismone.org
 
www.autismone.orgREPRINTEDWITHPERMISSIONAUTISMSCIENCEDIGEST:THEJOURNALOFAUTISMONEISSUE04
All o these descrptons and dentons look ataudtor hpersenstvt as a problem wth behavor(percepton) and not wth hearng. As thesedentons ndcate, the phenomenon we reer to asaudtor hpersenstvt s not a problem wth theaudtor sstem beng hpersenstve but wth theperson beng hpersenstve to sounds. We wll takeup the topc o wh a person becomes overl senstveto sound though the hearng or audtor sstem sunctonng perectl normall as we proceed.
 Hearing 
can be descrbed as senstvt to sounds.Better stated, t s our ablt to recognze that a sound has entered our ears and traveled to our brans where the sound s “heard” or regstered as present.Tus, hearng s the recognton o the presenceo a sound. Ts recognton does not mean weunderstand the meanng o the sound nor does tndcate that we have an percepton o the sound.
 Perception
s our cogntve ablt to gve
meaning 
 to a sound. in contrast to hearng, whch s justthe awareness o the presence o sound, when weperceve a sound, we make a cogntve decson asto what that sound means. Consder the ollowngexample. you are sttng at home and ou suddenl hear a rappng sound. it comes as “tap, tap, tap,” wththree taps or bangs that are o the same exact ptchor requenc, o the same loudness or ntenst,each lastng the same length o tme wth the sameshort gap o quet between each o the taps. youraudtor sstem merel hears these sounds andnotes the pattern o sounds. However, when oureact to the sounds, get up, go to the door, ask whos there, and open the door, our cogntve decsonmakng sstem has taken that audtor pattern andmade sense out o t. Recognzng that the “tap, tap,tap” s a unque pattern that ou have heard beore, ou perceve that ou have a memor trace or thspattern. Tat memor trace leads ou to know  what the pattern means. you even have a name ort, callng t “knockng on the door,” and ou havea mental mage that when ths pattern occurs, oushould respond b seeng who s at the door. Tspercepton occurs through a seres o processes wereer to as
 auditory processing 
.
processing in audiTory hypersensiTiviTy 
Consder that ou are a lttle chld, and ou hearcertan sounds. your
 processing systems 
make thedecson that the sounds are rghtenng, annong,and ver loud. What do ou do? you ma cr, runawa, hde, or merel tremble n ear. Ts ma be a normal response n a ver oung chld. Terghtenng sound strkes our cogntve sstem, and ou react n a negatve emotonal wa. What happensnext could be that the memor o ths rghtenngsound s stored so that the pattern o sound, whenheard, s agan perceved as a rghtenng sound. youma react wth ear not onl toward the sound butalso toward the stuaton n whch the sound occursand the thng makng the sound. Over tme, just asPavlov’s dogs began to salvate at the sound o thebell wthout ood beng present, the rghtenngsound tsel ma no longer be needed to elct thenegatve emotonal memor assocated wth thesound. Te stuaton or thng that made the soundalso can set o our ear responses. Eventuall,somethng called generalzaton occurs so thatsmlar stuatons or objects smlar to the onesthat made the orgnal rghtenng sound also wllelct the negatve emotonal reactons. Ts s how an ntal audtor-based hpersenstvt becomesa more general hpersenstvt to sound and thestuatons n whch the sound occurs.Audtor processng nvolves at least sxntegrated sstems.
6,14
Tese sstems nclude:
Te audtor sstem tsel 
Te cogntve decson makng sstem
Memor (ncludng emotonal memor)
Te emotonal sstem
Language sstems
Sensor regulaton sstemsOver tme, the audtor sstem tsel ma not bethat mportant n the processng o loud sounds,and we ma nstead draw on the other sstems.Tat s, we ma 
think
that a sound wll be loud andrghtenng (cogntve decson makng sstem); we ma 
remember 
the wa the orgnal sound scaredus (memor); we ma want to avod sounds andthe stuatons n whch these rghtenng soundsoccurred (emotonal sstem); or we ma have anautonomc nervous sstem reacton, whch tpcall nvolves what are called
  fght or ight 
responses. Forexample, n antcpaton o the rghtenng sound, we ma lose control o our behavor and tr torun awa (ght); we ma put up a strong, negatve
Hearng s the recognton o the presence o a sound. Ts recognton does notmean we understand the meanng o the sound nor does t ndcate that we have an percepton o the sound.
 Perception
s our cogntve ablt to gve
meaning 
to a sound.in contrast to hearng, whch s just the awareness o the presence o sound, when weperceve a sound, we make a cogntve decson as to what that sound means.
emotonal ght to avod the sounds (ght); or wema retreat nto ourselves seekng to calm ourselvesthrough behavors such as rockng or runnngaround n a crcle (another tpe o ght response).Tus, a hpersenstve reacton can occur nantcpaton o a sound, even  the sound tsel sabsent. Tese reactons can also occur when wehear a sof, nonthreatenng sound  our processngsstem persuades us that the stuaton or sound sor wll be the same as a prevousl heard sound. inths wa, we can enter nto automatc, negatve, andemotonall reactve behavors and maladaptveresponses. Tese maladaptve responses arebehavoral reactons that result rom our ear o a sound and our ear that the sound ma occur wthout warnng. Behavors are consdered maladaptveand napproprate when the perpetuate oreven strengthen the chld’s ear. For example,some chldren demand to be removed rom oravod partcpatng n certan stuatons. Otherchldren go rom wearng earplugs (or earmus orheadphones) n a ew stuatons to wearng earplugsall the tme or wearng earplugs and avodng certanstuatons. Ts tpe o maladaptve response notonl can lmt a chld’s experences but also doesnot take care o the problem because t ocuses ontreatng the audtor/hearng sstem rather thanthe real underlng sstems nvolved.
classical and non-classicalaudiTory paThways
Let us revew the basc audtor sstem, whch salso known as the
classical auditory system
. Ts sstemstarts wth the ear. Te ear has three parts beoreenterng the central audtor pathwas, whch arealso called the central audtor nervous sstem(CANS). Te three parts o the ear nclude:
1
Te outer ear: Te outer ear ncludes what wesee and call “the ear,” whch s reall the pnna oraurcle. Te outer ear collects sound and brngst to the ear drum or tmpanc membrane.
2
Te mddle ear: Te tmpanc membranebegns the mddle ear, whch also nvolvesthe three bones o the mddle ear: malleus orhammer, ncus or anvl, and stapes or strrup.Te basc uncton o the mddle ear s to delverthe sound sgnal to the nner ear or cochlea.
105

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