Autism and sound sensitivity

A different way of processing sound

Autism is a difference in how a person experiences and relates to the world, not an illness to be fixed. Part of that difference is often sensory. The National Autistic Society explains that autistic people can be much more, or much less, sensitive to sensory input than non-autistic people, and that this happens in how the brain processes information, not because anything is wrong with the ears themselves.

Sensitivity is not always the same. Someone might love loud music at a gig yet find an unexpected alarm startling and overwhelming. Tolerance can also drop when a person is tired, stressed, unwell or has been masking for a long time.

How common is it?

Very common. The National Autistic Society notes that research puts the share of autistic people with sensory processing differences of any kind somewhere between 53% and 95%. For sound specifically, a 2021 meta-analysis pooled 67 studies and estimated that:

Most of the studies involved children, with an average age of around eight, so the picture for adults is less complete. Even so, the authors concluded that most autistic people experience reduced sound tolerance at some point in their lives.

Hyperacusis, misophonia or something else?

Researchers often use the umbrella term “decreased sound tolerance”. A 2021 review argued that it is really several different experiences that can look similar from the outside:

• Hyperacusis: everyday sounds seem far too loud, or even painful. See what is hyperacusis?
• Misophonia: strong anger or disgust at particular sounds, such as chewing. See hyperacusis vs misophonia.
• Phonophobia: a fear of certain sounds or of sound happening. See phonophobia.

These can overlap. In one survey of adults who reported sound sensitivity, clinically relevant hyperacusis and misophonia were both more common in the autistic group. Across everyone in that study, more severe hyperacusis went along with higher anxiety, low mood and poorer quality of life, which is a good reason to take it seriously and seek support when it gets in the way.

Sensory overload

Sensory overload is when there is simply too much input to process. It is not a clinical term, but autistic people use it to describe what happens when triggers pile up. Common sound triggers include loud voices, humming electronics, sirens and background chatter in a busy office or school hall. Signs can include going quiet, stimming, pacing, trouble focusing, or strong reactions such as crying or leaving.

If someone is overloaded: turn off what you can, or help them move somewhere quieter. Keep talking to a minimum, don't try to stop stimming unless they are at risk of harm, and give them time and space to recover.

Practical, respectful strategies

Make environments more predictable

• Keep a sensory diary to spot triggers, good and bad times of day, and what helps recovery.
• Say what to expect before going somewhere busy or noisy, such as a shopping centre.
• Have a quiet space at home, school or work that the person can go to without having to explain.
• Believe the person. Avoiding a sound is not the same as disliking it, and forcing exposure to known triggers can be distressing and painful.

Headphones and ear defenders

Noise-cancelling headphones and ear defenders are one of the most widely used tools. In interviews, parents and teachers said noise-attenuating headphones helped children take part more at home, at school and out in the community, and many children learned to predict when they needed them and ask.

There is a balance to strike, though. The National Autistic Society notes that using them a lot may increase sensitivity over time, and that avoidance can be a “double-edged sword”. A recent paper on autistic students made a similar point: headphones can help, but work best with a plan tailored to the individual. Our guide to earplugs and hyperacusis explains why constant protection can backfire.

Professional help

If sound sensitivity is constant and affecting daily life, two kinds of professional are worth knowing about:

• Occupational therapists can carry out a sensory assessment and suggest adjustments, sensory diets or other approaches. The evidence for sensory therapies is mixed, so any plan should put the autistic person at the centre and be reviewed regularly.
• Audiologists can check hearing and assess and manage hyperacusis, including through sound therapy and counselling. See how hyperacusis is diagnosed.

The goal is not to make someone less autistic. It is to give them more choice about where they can go and how comfortable they feel there. For children, see our guide to hyperacusis in children, and for everyday ideas, living with hyperacusis.