Hyperacusis: Hearing Impairments in School Aged Children

Hyperacusis is a rare disorder that causes a person to have a reduced tolerance to sound. Noises that are not normally perceived as loud by the general population, are perceived as loud by a person who has hyperacusis. Exposure to sounds can cause the person to experience physical pain sensations in the ears. Hyperacusis can be caused by head trauma or ear trauma. It is also relatively common in autistic children and children with Williams Syndrome. In rare instances, hyperacusis can occur for unknown reasons in the absence of an injury or other medical condition. This article discusses hyperacusis that occurs for unknown reasons.

Hyperacusis is not caused by abnormalities in the ear. People with hyperacusis can have normal ears without any detectable hearing loss. The exact cause of hyperacusis is still being studied and is believed to have multiple possible causes. A popular theory is that the disorder stems from a central processing problem in the brain. While the ear picks up sounds normally, the brain does not process the sound normally. Hearing is a two step process. First the ear picks up a sound. Then the brain processes the sound. In the case of hyperacusis, the ear picks up the sound normally while the brain perceives the sound abnormally.

Hyperacusis in the Classroom

Hyperacusis can occur in children of any age. The disorder often goes undiagnosed for many years. Children may not know how to express their condition. A feeling of embarrassment may deter them from seeking help. A child's extreme sensitivity to noise is often not understood by peers, teachers or parents. Doctors who do not have experience in hyperacusis may not know to look for the disorder. When the results of hearing tests come out normal, doctors sometimes wrongly assume that the hearing sensitivity is purely a psychiatric condition.

Severe cases of hyperacusis can be a debilitating condition. Children with the disorder may try to avoid certain noises. The children often cover their ears with their hands or wear ear plugs to try to mask sounds. Concentration in the classroom is difficult for these children due to sound sensitivities. It is common for children with hyperacusis to develop phonophobia, which is a fear of sounds.


Because hyperacusis is not caused by abnormalities in the ears, diagnosis is primarily made by evaluating symptoms. The most successful method of treatment for hyperacusis is tinnitus retraining therapy. The goal of tinnitus retraining therapy for hyperacusis patients is to desensitize the brain to noises. An audiologist fits the patient with white noise generators. The white noise generators are devices that fit in the ears like hearing aids. The noise generators have volume controls that can be adjusted by the patient. At first the noise generated by the devices are perceived as loud by the patient. After wearing them for a while, the sound generated from them becomes barely audible to the patient, as they are desensitized to the sound. When this happens, the patient uses the volume controls to increase the level of sound. Once the patient is able to wear the devices with the sound adjusted to a certain high level, as determined by the audiologist, use of the white noise generators can be gradually discontinued. Tinnitus retraining therapy treatment can last anywhere from six months to eighteen months.

While the child undergoes tinnitus retraining therapy, teachers and parents can help decrease anxiety levels by helping the child avoid noisy situation. Teachers can arrange for the student to sit in the library or another quiet place when noise levels are causing the hyperacusis student problems. During treatment, the child may continue to wear ear plugs during times that they are not wearing their noise generators. Towards the end of treatment the audiologist will encourage the child to gradually reduce reliance on the ear plugs. Counseling can be beneficial in children who have developed phonophobia.


The Hyperacusis Network is an informative site on hyperacusis that contains a message board that allows you to interact with those affected by hyperacusis. The Tinnitus and Hyperacusis Centre explains tinnitus retraining therapy and its application for the treatment of hyperacusis.

This post is part of the series: Rare Hearing Disorders in the General Education Classroom – Hyperacusis and Misophonia

This article is a two part series on two rare and often misunderstood hearing disorders that can affect children.
  1. What Is Hyperacusis?