Hyperacusis in children: signs and how to help

Is it normal for a child to be sensitive to noise?

The NHS notes that children are often more sensitive to loud noises than adults, so a toddler who covers their ears at fireworks is not unusual. Hyperacusis is different: ordinary, everyday sounds feel too loud, uncomfortable or even painful, and the reaction gets in the way of daily life. It is not rare. Studies of children and young people aged 5 to 19 put it at somewhere between 3.2% and 17.1%, depending on how it was measured.

How it can show

Young children often cannot explain what they hear, so ASHA advises that they may show it through actions and emotions instead, such as covering their ears or crying. A review of research on children with hyperacusis found:

• Covering the ears was the most common reaction, followed by crying, screaming or becoming upset or aggressive.
• Household appliances such as vacuum cleaners, blenders and hand dryers were frequent triggers.
• School sounds came up often: the bell, fire alarm tests, music lessons, busy corridors and dinner halls.
• Avoidance was common in older children, for example skipping parties, avoiding public toilets because of hand dryers or spending break in a quiet room.
• Wearing ear protection for long stretches, sometimes all day.

Younger children were less likely to cope by themselves. Instead, their families tended to limit outings to avoid upset, which is why the biggest impact was often on getting out of the house, social events and school.

Possible links

Glue ear and middle ear problems

The NHS says some children may become more sensitive to noise after having glue ear, where the middle ear fills with fluid. In one UK audiology clinic, nearly half of the children seen for hyperacusis had an active middle ear problem, most often glue ear, and the most common age at presentation was 3 to 4.

Autism and other neurodevelopmental conditions

Hyperacusis is more common in autistic children. In a paediatric hyperacusis clinic in Edinburgh, 60% of the 412 children referred over five years were autistic, and ADHD was also common. The National Autistic Society describes how sounds other people barely notice can cause discomfort and even pain. There is more in our guide to autism and sound sensitivity.

Sound sensitivity can also come with tinnitus, or look like fear of particular sounds (phonophobia) or strong dislike of certain sounds (misophonia).

When to see a GP

The NHS advises seeing a GP if everyday noises feel too loud or painful. It is worth going if the sensitivity is stopping your child from joining in at school, at parties or on family outings. The GP can check the ears and refer your child to a hearing specialist (audiologist).

Get help sooner if there are red flags. Ask for an urgent GP appointment or contact NHS 111 if your child has sudden hearing loss, hearing that has got worse over days or weeks, or hearing loss with earache or discharge from the ear. Ear pain from sound should always be checked by a doctor.

What assessment looks like for children

There is no single test for hyperacusis (see how hyperacusis is diagnosed). For children, an audiologist usually starts by checking hearing and the middle ear. The tests depend on age:

Specialists also ask about which sounds bother your child and how they react, and may use questionnaires, observation or careful checks of which sound levels feel uncomfortable. Researchers point out that very few assessment and treatment methods have been designed and tested specifically for children yet.

Gentle ways to help

Keep some sound around

Quiet can feel like relief, but steady, low-level background sound helps the hearing system settle. The Edinburgh clinic mostly combined behavioural therapy with a small relaxing sound device to use at home, and the team reported good results. Read more in our guides to sound therapy and pink noise vs white noise.

Use ear defenders for loud moments, not all day

ASHA advises against wearing hearing protection when sound levels are safe, because avoiding sound can make the ears more sensitive. The National Autistic Society makes the same point about ear defenders and noise-cancelling headphones. Save them for genuinely loud events. Our guide to earplugs and hyperacusis explains why.

Prepare for loud events

• Tell your child what to expect before a party, match or shopping trip.
• Agree a quiet spot they can go to, and a signal for when they need a break.
• Keep a simple diary of triggers and what helps, to spot patterns over time.

Work with school

Share what you know with the class teacher or SENCo. Useful adjustments can include a warning before fire alarm tests, a quieter place to eat or spend break, and a calm space to recover. The aim is to help your child take part, rather than step back from things. CBT-based approaches can help older children with the worry that often grows around sound.

Stay calm and take your child's experience seriously. For the wider picture, see hyperacusis treatment and living with hyperacusis.