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Misophonia in the Classroom: Students With a Decreased Sound Tolerance Disorder

written by: Rose Kivi • edited by: Donna Cosmato • updated: 2/8/2013

Imagine if certain sounds invoked feelings in you of rage and extreme anxiety. They do for people who have a rare disorder called misophonia. Learn more about this disorder, some of the symptoms and treatments and how to recognize and deal with it in the classroom.

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    Hatred of Sound

    Misophonia is a rare and little understood sound sensitivity disorder that is characterized by an extreme aversion to selective sounds. The disorder can occur in children and adults of any age. When exposed to certain sounds, the person experiences feelings of rage and extreme anxiety. The particular sounds that a sufferer is sensitive to vary with each person. Chewing is a noise that commonly bothers sufferers. Other common noise sensitivities are the sounds of scratching, tapping, throat clearing and nasal sniffling.

    The exact cause of the disorder is unknown. There may be psychological causes, neurological causes, or both. Some sufferers have also been diagnosed with obsessive compulsive disorder (OCD), which makes a psychiatric element to the disorder possible. Because not every person with sound sensitivities has OCD, however, it is believed that the condition is not purely psychological. It is common for misophonia and hyperacusis -- another rare disorder -- to coexist, which leads to the theory that the disorder is a neurological condition. It is believed that the brain does not process sound information correctly in people with misophonia. Normal sounds are perceived with an increased intensity and processed as danger sounds, instead of harmless noises.

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    In The Classroom

    Students with sound sensitivities often avoid other children and situations. They may cover their ears with their hands or wear earplugs to try to mask the sounds they are sensitive to. Students become anxious when they are forced to endure exposure to sounds that bother them. Students may exhibit extreme anxiety and irritability during times of exposure. Students may also develop a condition called phonophobia, which is defined as a fear of sound. Students who also have phonophobia may become anxious at the possibility of being exposed to a sound. Severe cases of misophonia can be extremely debilitating. The student may not be able to concentrate or function well during classroom time. Untreated, the disorder can get worse.

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    Diagnosis and Treatment

    More often than not, misophonia goes undiagnosed. The majority of doctors are unaware of the condition. Help for the disorder usually is initiated when a parent or teacher recognizes the symptoms.

    A diagnosis is made through evaluation of the person's feelings when exposed to sounds. The best treatment approach is one that is performed by an audiologist and a psychiatrist. The audiologist treats the patient with tinnitus retraining therapy, a therapy that uses sound generators or broadband signal generators to desensitize the person to the sounds that bother them. An audiologist also works to reprogram the auditory processing center of the brain by teaching the patient to associate the sounds with pleasant feelings. A psychiatrist treats any underlying psychological conditions like OCD or anxiety, and helps the person develop coping methods to use when bothered by sounds. Treatment can last anywhere from six months to eighteen months.

    As treatment progresses, the person is encouraged to gradually discontinue the use of earplugs if they are using them. Ironically, continued use of earplugs only makes the person more sensitive to sounds. Unfortunately, until treatment is successful, earplugs are often a necessity for the person. Without them, their anxiety levels may be extremely high.

    Teachers and parents can assist students by helping them to avoid exposure to the sounds that bother them. For example, if the sound of chewing bothers the student, the teacher should allow the student to eat their lunch in the classroom, library, or another quiet place where they will not be exposed to chewing. Another way that both teachers and parents can help the student is to offer verbal support. Most people do not understand misophonia. For the student, having a teacher or parent who verbally understands and shows compassion towards them, is a comforting relief.

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    Additional Reading

    The Similarities Between Misophonia and Sensory Processing Disorder: Is There a Link?: http://www.healthguideinfo.com/neurological-disorders/p100641/
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    Helpful Resources

    List of audiologists who offer tinnitus retraining therapy: http://www.tinnitus-pjj.com/referral.html

    Misophonia Treatment Provider: http://www.audiologyonline.com/articles/pf_article_detail.asp?article_id=291

    Misophonia Support Group - The group is located in the U.K. but it has an online message board for people in all locations - http://www.meetup.com/Sound-Sensitivity/

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    References

    Jastreboff, Pawel J.; Hazell, Johnathan W. P.; Tinnitus Retraining Therapy: Implementing the Neuropsyiological Model; Cambridge University Press; 2004