Autism and Auditory Hypersensitivity: Causes and Treatment

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A recent report from the U.S. Department of Health and Human Services indicates that autism spectrum disorder prevalence has significantly increased to over 2% of all children in the United States, with an estimated 1 in 28 boys currently with an autism diagnosis.

Professionals working with children diagnosed with autism spectrum disorder (ASD) may find that these children are overly sensitive to sounds. These professionals and parents are often concerned as to why children may have auditory hypersensitivities.

The journal Autism Research and Treatment recently published a peer reviewed article which discusses the neural mechanisms identified underlying hypersensitive hearing in people. I wrote this article with Dr. Jay R. Lucker of Howard University. Our article focuses on brain research to support the idea of the non-classical auditory pathways being involved in connecting the auditory system with the emotional system of the brain. We also discuss brain mechanisms believed to be involved in auditory hypersensitivity, and treatments for hypersensitive hearing.

This Wednesday, February 3rd at 8 pm Eastern, Dr. Jay R. Lucker will join me on The Listening Program Radio to discuss the topic of Autism and Auditory Hypersensitivity, the causes, treatment, and hope for those suffering from sound sensitivities.

Register here for this free program and to ask us a question we can answer live. You’ll receive an email with the call-in number and a web link to listen online 3 hours before the show.

Could a Simple Hearing Test Diagnose Autism?

Big Ear

A recent study published in Autism Research is stirring controversy over reports that a simple hearing test may help with early autism diagnosis. The test is the auditory stapedial reflex (ASR) test which measures how one of the two middle ear muscles called the stapedius contracts in response to loud sounds.  According to the authors of the study an absent reflex would indicate an autism risk factor.

The reflex attenuates sudden loud sound to protect the delicate inner hair cells from damage. Without this sound dampening the auditory system is bombarded by sound which results in a number of behavioral responses such as covering of ears, running from the sound, aggression, and more.  These are characteristically fight/flight behaviors seemingly in response to sound, in this case a stressor. Last year I published an article with Dr. Jay Lucker in Autism Science Digest identifying that in most cases the response is an emotional rather than auditory response that can be trained with music listening therapy and behavioral techniques and is not exclusive to people diagnosed with autism.

If you read the research abstract (link below) you’ll see the investigators are making an argument for absent reflexes as an autism biomarker. My concern is they tested children with autism compared to a smaller group which was “neurotypical” but not other neurodevelopmental disorders which based on my experience would very likely yield the same results… Auditory deficits are a common feature in autism chief among them hypersensitivity to sound in which the brain appears unable to filter out undesirable sound resulting in pain or discomfort.  However this is also true of Sensory Processing Disorder, ADHD, Auditory Processing Disorder, etc.

I’m pleased to see the attention on the auditory system in the autism research field, but caution looking to the ASR as a reliable autism biomarker without further study. What are your thoughts?

Abstract:  Quantification of the Stapedial Reflex Reveals Delayed Responses in Autism Autism Res 2013

The ear bones connected to the head bone…

Bone Conduction

Guest Post By: Seth Horowitz, Ph.D., Neuroscientist and author The Universal Sense

When we think about hearing (if we think about it at all), we tend to focus on its ephemerality.  Sound comes from vibrating air molecules moving so gently that we can’t feel them (unless we’re standing dangerously close to a speaker), inducing motion in micron scale tufted cells waving in a fluid filled inner ear, needing to go through complicated processing to bringing out powerful cognitive, emotional or even physical responses from a listener.  But what we think of as a soft interface between air and fluid will actually reflect away most sounds without something to bridge the divide.  Something that, based on its stiffness and structure, can act as a natural or induced amplifier and overcome the normal difference in impedance that lets us hear air borne sounds in our fluid filled ears.  And while James Wheldon Johnson’s old song is wrong and the ear bones (ossicles) are not connected to the headbone (skull), bones are critical to normal hearing.
Hearing airborne sounds requires a tremendous amount of amplification, and much of it depends on lever action by the ossicles, the three tiny bones that link the air outside the eardrum to the fluid in the cochlea via the oval window.   The malleus (Latin for “hammer”) attaches to the eardrum which has an approximate surface area of 55-60 square millimeters.  The innermost surface of the malleus articulates with the much smaller incus (anvil) which then passes the pressure onto the stapes (stirrup) whose faceplate contacts the oval window with a surface area of only 3 – 3.5 square millimeters.  This allows the three bones to provide 22 times more pressure to the inner ear than received at the eardrum, while still responding fast enough to maintain the exquisite timing needed for proper pitch discrimination. But despite their rigidity compared to the other elements of the peripheral auditory system, these bones are delicate and subject to all the other woes that precise skeletal joints are heir to, ranging from dislocation to arthritis.  While many clinical treatments have emerged to treat damage to the ossicles, they still remain critical and highly vulnerable elements in the hearing pathway and pathology or injury can have serious and sometimes permanent effects on detection of airborne sounds.
But we hear with more than just our ears, as you can tell if you go to a concert for the deaf or watch Evelyn Glennie perform.  Due to her severe hearing loss, she often performs with her feet bare to pick up vibrations from the stage and her body placed precisely to pick up vibrations directly from the instruments.  Like her, your entire body is sensitive to vibrations and your skeleton can act as a series of rigid low frequency transducers. In humans, this pathway is limited to detecting (not hearing) very loud low frequency vibrations (or, more often, a pathway to induce vibroacoustic disease as often experienced by heavy machinery operators).  However, it is a remnant of the earliest way vertebrate animals detected sounds when they emerged onto the land hundreds of millions of years ago.  Many non-avian and non-mammalian land animals still rely on transmission of lower frequency sound through skeletal pathways, called the “extratympanic pathway” that transmit vibrations through their limbs to their shoulder girdle and finally to their skull and ears.  But this evolutionary “remnant” has provided us with an opportunity for overcoming some forms of damage to our tympanic pathway.  By vibrating our skull, some hearing aids such as the Baha® bone anchored system or Advanced Brain Technologies’ wearable Bone Conduction System called WAVES™ use this lower frequency pathway transmit vibrations to the inner ear directly to overcome some of the drastic effects of damage to the tympanic system.   So while it seems counter intuitive, our densest bodily structures are critically important for maintaining one of our most fluidic and delicate sensory systems, and highlight how no one system is ever truly isolated from the rest of our physiological makeup.

Follow @SethSHorowitz

Auditory Hypersensitivity and Autism

Sound is everywhere, it’s as much a part of our lives as the air we breathe and the food we eat. Yet, many people become stressed or uncomfortable with sounds in their own home, school, work, and public places, and aren’t even aware of it.The cause, NOISE!

Negative sound exposure has a scientifically proven impact on health, sleep, attention, learning, communication, listening, hearing, stress and more. A 2011 report from the World Health Organization and the European Commission’s Joint Research Centre Burden of Disease From Environmental Noise states that “noise like this is second only to air pollution as an environmental cause of ill health.” There is no question noise is a major health concern, something my co-author Don Campbell and me wrote about extensively in our book Healing at the Speed of Sound®.  Each of us is impacted by noise, some more than others. But millions with autism spectrum disorders, sensory processing disorders and brain injury are not only impacted by noise, but often develop a negative emotional response to sound.

Dr. Jay Lucker, associate professor in the Department of Communication Sciences & Disorders at Howard University in Washington, DC recently co-authored an article with me for Autism Science Digest which explores sound sensitivities in a growing population of children and adults with autism that are known to commonly have hypersensitivities to sound. The article titled “Auditory Hypersensitivity and Autism Spectrum Disorders: An Emotional Response” is in the current issue 04, which is available at Barnes and Noble through July.

Article Abstract- Many children diagnosed with an autism spectrum disorder are described as having auditory hypersensitivities. This paper describes auditory hypersensitivities, the systems involved in hypersensitive hearing, methods for evaluating auditory hypersensitivity in children, and possible treatments. Auditory hypersensitivity involves the non-classical auditory system and is an emotional response to sound rather than an auditory response. Children described as being hypersensitive to sound have negative emotional reactions to sounds and situations in which the sounds are present. It is possible to desensitize these negative emotional reactions and reprogram the emotional memory system so that children are no longer frightened by sounds.

My company Advanced Brain Technologies today announced the launch of TLP Spectrum™; a new auditory program for at home use, to improve sound brain fitness and reduce sensory sensitivities in children and adults who are or who may become hypersensitive to sounds. This program is a gentle way to desensitize emotional reactions to sound.

TLP Spectrum consists of evidence-based instrumental music which contains proprietary sound technologies to exercise the brain, and filter out unwanted sounds, while keeping the listener relaxed during fifteen-minute listening sessions with headphones. The program is ideal for those most susceptible to sound sensitivity; including children and adults with autism spectrum disorders, sensory processing disorders, brain injury and developmental delays, as well as typically developing toddlers (my 2 year old son is on the program), preschoolers, and the elderly.

I’ll be presenting this article and introducing TLP Spectrum at the Autism One/ Generation Rescue Conference 2012 in Chicago next month. Hope to see you there!

Use It or Lose It

Use it or lose it, we are all familiar with this adage. It is true for the body and true for the brain.

Without sufficient sensory stimulation a child’s brain does not develop as it should. Nor does an adult brain maintain full  functionality as a  result of negative plasticity. The auditory system thrives with the right input and suffers if deprived of sound or overstimulated by noise.

A new study by researchers from the Perelman School of Medicine at the University of Pennsylvania shows that declines in hearing ability may accelerate gray mater atrophy in auditory areas of the brain and increase the listening effort necessary for older adults to successfully comprehend speech.

Hearing aids can be an effective intervention. Another approach to  consider is music listening therapy. This is  neuroauditory training to improve sound brain fitness in part by stimulating the frequency bands where the deficits exist with specially modified music.  There has been good success helping people with mild hearing loss through the use of The Listening Program®. In many cases listeners no longer require hearing aids, because they trained their brain to better understand what it hears (auditory processing).

Many audiologists will share that when patients with mild hearing loss wear hearing aids for a period of time that their auditory discrimination improves on tests without the hearing aids. This is due to the brain now being able to perceive the auditory signal through sound amplification. The increased signal is enough to improve brain processing. In my opinion, a course of The Listening Program should be considered prior to using hearing aids in cases of mild hearing loss, and definitely needs to be used along with hearing aids. This is something proactive that can be done to stimulate the brain so people can continue to enjoy the richness that exists within the sounds of our loved ones voices, music, and nature.

Read more about this study published in the Journal of Neuroscience here.

Annoying Sounds Spark Major Rage

A couple days ago I posted an article Ouch That Hurts about an auditory condition called misophonia in which annoying sounds can cause major rage. This morning The Today Show did a segment on this topic that you can view here.

Most of the research into the cause of this and related disorders appears to be focused on auditory mechanisms.  However, Advanced Brain Technologies Scientific Advisory Board Member and audiologist Dr. Jay Lucker of Howard University has been researching strong behavioral reactions to sound in children and suggests it is the emotional reactions must be dealt with. This was his response to a question we posed on the Healing at the Speed of Sound Facebook page.

“I am in the process of revising a manuscript for publication on loud and annoying sounds in children. Findings revealed that this is NOT an auditory based problem in the overwhelming number of children seen in this study. The major problem is our negative emotional reactions to loud and annoying sounds. We must deal with the emotional reactions more so than the auditory based issues for most of our children with sound tolerance problems.”

Ouch! Do You Ever Find Sounds Annoying or Uncomfortable? What Are They? Post your response here.

Ouch That Hurts!

Ever annoyed by sounds?

Each of us have sounds we like or dislike, just as we prefer certain foods over others. But some people experience pain with certain sounds, something called hyperacusis. Others dislike some sounds, a condition called misophonia, while others experience phonophobia, a fear of sounds.

These conditions can be difficult to diagnose and hard to treat, although some have found relief with The Listening Program. Interestingly each of these auditory perceptual issues can trigger the body’s physiological response to stress, “fight/flight”.  For years I suffered from hyperacusis (fortunately no longer) and can tell you it can be unbearable at times. These issues can be so debilitating, people who suffer from them may not leave their home in order to avoid the triggers.

Yesterday The New York Times published an interesting article “When a Chomp or a Slurp Is a Trigger for Outrage. It delves into misophonia, and sheds some light on why sounds can trigger rage. If you read it please comment here. I am very interested in your reaction to this information.