It was a typical day when my youngest son, just five years old, suddenly looked terrified. The bathroom hand dryers we were using were a bit too loud for his comfort, and the sudden increase in noise seemed to startle him. This incident wasn't the first time such a thing had happened: He had a similar reaction whenever the vacuum cleaner was turned on or my wife used her hair dryer.
Strong reactions to sounds that would seem normal to others, like my personal example above, can happen frequently in children. The condition is called hyperacusis, which is common in preschool-aged children. For those suffering from it, even everyday sounds can cause pain and discomfort.
"We think of it more as how [children] process sounds in their brain, rather than their hearing structures," explains Dr. Aditi Arvind Bhuskute, Assistant Professor in the Department of Otolaryngology at UC Davis Children's Hospital.
The issue lies not in the ears but in how the brain interprets and reacts to sound. Hyperacusis is something that most children can grow out of, but until they do, there are effective ways you can manage the condition's symptoms. We'll explore some strategies to make loud sounds easier for your young child to tolerate.
The difference between hearing loss and hearing sensitivity
While it often comes with tinnitus, a condition usually associated with hearing loss that involves ringing, whistling, clicking, or roaring sounds in your ears, hyperacusis is not the same as hearing loss.
According to the World Health Organization, those who cannot hear as well as someone with normal hearing (hearing thresholds of 20 dB or better in both ears) suffer from hearing loss, which can affect one or both ears and range from mild to severe. Those with hearing loss have difficulty hearing conversations or loud sounds.
"Hearing loss is pretty well defined," says Bhuskute. "We have very structured ways of diagnosing and treating hearing loss in children."
On the other hand, hyperacusis is the inability to tolerate common and familiar sounds at a volume or pitch that would be normal to others, such as a gymnasium, a crowded restaurant, or bathroom hand dryers. Seeing your child with their hands over their ears, crying, or becoming anxious and avoiding certain places could be a sign they are dealing with a sound sensitivity.
"We don't have a test that shows a person is highly sensitive to sound because the way we test hearing is a response to sounds in a quiet audiology booth," says Bhuskute. "If a child has completely normal hearing, we don't have any other reason why a child is sensitive to noise."
How do I know if hyperacusis is part of a more significant condition?
As stated above, most children grow out of their sensitivity to sound and noise. However, symptoms can persist in those with neurodevelopmental issues, such as those with autism or attention-deficit/hyperactivity disorder (ADHD). Neurodivergent children's preferences in how they process sensory input can manifest in a number of ways, from their enjoyment of foods of a specific texture to their dislike of particular sounds and noises.
If you're concerned that hyperacusis could indicate a neurodivergent condition, Bhuskute recommends visiting a developmental pediatrician or a psychologist. They can screen and monitor your child for any developmental or behavioral conditions. She also recommends keeping an open line with your child's teacher.
"Some concerns that [a teacher] may have are often the first time parents notice that there's an issue," says Bhuskute.
How do I manage my child's hyperacusis?
Thankfully, as parents, you have the power to help your children manage their sensitivity to loud noises and sounds. There are several strategies that can be effective.
Use noise-canceling headphones or earplugs
Children, whether sensitive to noise or not, should wear ear protection at concerts or other loud environments. However, if loud sounds make your child physically uncomfortable in a typical environment, give them the option of wearing earplugs or headphones.
Warn them that noise is coming
If you know you're going to vacuum, turn on a blender, or use a hand dryer, let your child know ahead of time so they're relaxed and prepared when it comes on. They can put their hands over their ears if they don't like that sound.
Encourage them to make sounds of their own
Clapping, banging, and turning on the vacuum on their own can give children control over the noises they may not like, making a loud environment less stressful (for them; you, not so much).
Use a white noise machine
Increasing background sounds can make sudden loud sounds less surprising.