Misophonia, Children, Headphones & Inner Ear Devices

How much is too much? How much is not enough?

As an individual who suffers with misophonia, a therapist who works with misophonia families, and the mother of an adult child with misophonia, I spend a large amount time thinking about accommodations. While adult misophonia research is moving along at a surprising pace, research related to children and families is slower. Yet, I know that families remain desperate for help and guidance now. One of the most pressing questions that I often get from parents has to do with the use of headphones and other auditory devices.

Parents ask how much they should let their misophonic child wear these devices. Audiologists warn that “plugging” all day and avoiding sounds entirely may lead to a higher level of sensitivity. Simply put, if one is inside in the dark all day and goes outside into the sun, the sun will seem much brighter.

Most children and teens with misophonia do not plug or block all day. Instead, most utilize headphones or inner ear devices during the times they most need them. Yet, there are most certainly instances in which a child or adolescent is so sound-sensitive that they do utilize blocking, or plugging for more time than is considered ideal. Often these individuals suffer from co-occurring auditory disorders, such as hyperacusis (when sounds are perceived much louder than are objectively measured), or more general auditory over-responsivity (in which the individual cannot process multiple sounds in the environment).

In those cases, I am not sure removing this accommodation is healthy either, as the effects on the nervous system, emotional regulation, and daily living may become unmanageable. This begs the opposite question, “how much is too little.” In these cases, the pros and cons of attempting to decrease device use have to be carefully weighed out with parents, the individual with misophonia, and in consultation with an audiologist who is flexible and may offer other solutions.

Audiologists make other recommendations, such as sound masking and sound layering. Sound masking entails wearing inner ear devices that generate white noise (or other colors of noise), that allow for a moderate level of noise cancellation while still enabling the individual to hear and respond to conversation. Sound layering in which various sounds, such as music, fans, etc., work together to help de-emphasize triggers within the soundscape is an easy accommodation that can be made at home. Sound layering does not in any way harm the auditory system.

What about these kinds of accommodations in school? Most children and adolescents need auditory based accommodations in school. I have found that many schools are willing to offer these accommodations, especially after receiving a letter from either an advocacy group such as soQuiet, a letter from an audiologist or a letter from a psychologist. Often parents are able to get this accommodation with little assistance, or on their own. For parents who are going through this process without professional advocacy or without the assistance of a therapist, I suggest using research studies to support your child’s needs, and using these to make a case with the school. A paper by Porcaro, Alavi, Gollery, and Danesh (2019) is one paper that a parent or college bound student can certainly reference.

For this study, researchers conducted a survey of 686 undergraduate instructors to assess their knowledge of misophonia and their willingness to accommodate students. Not surprisingly, the researchers found that there is a need for greater awareness of misophonia in academia. However, the authors also recommended teachers make acceptable adjustments for students who have misophonia, such as enabling them to use earplugs, headphones, or white noise generators during lectures or tests, and possibly allowing for smaller testing venues.

This paper is an excellent source for parents, but we need more like it to really secure the kind of academic accommodations required for individuals with misophonia. For example, many children (and college students as well) need to also utilize inner ear devices during the school day apart from testing situations. We also need more research, specific to auditory based accommodations in terms of the risk/reward of their use for those who a truly unable to experience life without use of these devices more frequently. If you are a parent struggling with this issue, remember that you know what is best, but also what is possible, for your child. Misophonia ranges from mild to severe, and at this time research has not addressed how auditory based accommodations should be handled relative to severity, and/or co-occurring disorders.

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If you are interested in Parent Coping Skills, my next class is March 29th, 600-8:00 pm. Classes are $150.00 and the next one addresses “Preserving Family Relationships” and includes guest Audiologist Dr. Diana Callesano, who will cover issues related to sound accommodations at home. Contact me at Dr. Jennifer Jo Brout

References

Porcaro, Alavi, Gollery, and Danesh (2019) Misophonia: Awareness and Responsiveness among Academics, Journal of Postsecondary Education and Disability, v32 n2 p107-118