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Chan KH, Baker A, Gilbert D, Tong S, Rinaldi J, Cypers S, Zhu A, Schoenborn A. The Impact of Mental Health Symptoms in Children With Tinnitus and Misophonia: A Multi-disciplinary Approach. Clin Pediatr (Phila) 2024; 63:1146-1153. [PMID: 37932925 DOI: 10.1177/00099228231211155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Tinnitus and misophonia are important "sound annoyance" disorders in pediatric otolaryngology and audiology practices. There is scant published literature to suggest increased anxiety and depression symptoms in these disorders. This study aimed at assessing the clinical characteristics of these 2 disorders and their prevalence in mental health-related symptoms in a 2-year retrospective chart review of a multi-disciplinary (otolaryngology, audiology, and psychology) clinic cohort. Analyses were based on 54 (tinnitus = 33 and misophonia = 21) children consisting of 19 males and 35 females with a mean age (standard deviation) of 14.3 (3.0) years. The entire cohort was negatively affected by diagnosis-based symptom severity instruments as assessed by Tinnitus Functional Index and Amsterdam Misophonia Scale. Both subgroups exhibited elevated anxiety and depression symptoms in psychometric instruments as assessed by Screen for Child Anxiety Related Emotional Disorders and Short Mood and Feelings Questionnaire. Evidence-based management of these disorders is lacking, and clinical trials are needed.
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Affiliation(s)
- Kenny H Chan
- Department of Otolaryngology, School of Medicine, University of Colorado, Aurora, CO, USA
- Department of Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA
| | - Amanda Baker
- Department of Audiology, Speech and Learning, Children's Hospital Colorado, Aurora, CO, USA
| | - Deborah Gilbert
- Department of Otolaryngology, School of Medicine, University of Colorado, Aurora, CO, USA
- Department of Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA
| | - Suhong Tong
- Research Institute, Children's Hospital Colorado, Aurora, CO, USA
| | - Julie Rinaldi
- Department of Psychiatry, School of Medicine, University of Colorado, Aurora, CO, USA
| | - Scott Cypers
- Department of Psychiatry, School of Medicine, University of Colorado, Aurora, CO, USA
| | - Austin Zhu
- Department of Otolaryngology, School of Medicine, University of Colorado, Aurora, CO, USA
- Department of Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA
| | - Alyssa Schoenborn
- Department of Audiology, Speech and Learning, Children's Hospital Colorado, Aurora, CO, USA
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Balk SJ, Bochner RE, Ramdhanie MA, Reilly BK. Preventing Excessive Noise Exposure in Infants, Children, and Adolescents. Pediatrics 2023; 152:e2023063752. [PMID: 37864407 DOI: 10.1542/peds.2023-063752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 10/22/2023] Open
Abstract
Noise affects people of all ages. Noise-induced hearing loss, a major problem for adults, is also a problem for young people. Sensorineural hearing loss is usually irreversible. Environmental noise, such as traffic noise, can affect learning, physiologic parameters, sleep, and quality of life. Children and adolescents have unique vulnerabilities. Infants and young children must rely on adults to remove them from noisy situations; children may not recognize hazardous noise exposures; teenagers often do not understand consequences of high exposure to music from personal listening devices or attending concerts and dances. Personal listening devices are increasingly used, even by small children. Environmental noise has disproportionate effects on underserved communities. This statement and its accompanying technical report review common sources and effects of noise as well as specific pediatric exposures. Because noise exposure often starts in infancy and effects are cumulative, more attention to noise in everyday activities is needed starting early in life. Pediatricians can potentially lessen harms by raising awareness of children's specific vulnerabilities to noise. Safer listening is possible. Noise exposure is underrecognized as a serious public health issue in the United States. Greater awareness of noise hazards is needed at a societal level.
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Affiliation(s)
- Sophie J Balk
- Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York
| | - Risa E Bochner
- Department of Pediatrics, New York City Health and Hospitals Harlem, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | | | - Brian K Reilly
- Otolaryngology and Pediatrics, George Washington University Medical School, Children's National Hospital, Washington, District of Columbia
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Balk SJ, Bochner RE, Ramdhanie MA, Reilly BK. Preventing Excessive Noise Exposure in Infants, Children, and Adolescents. Pediatrics 2023; 152:e2023063753. [PMID: 37864408 DOI: 10.1542/peds.2023-063753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 10/22/2023] Open
Abstract
Noise exposure is a major cause of hearing loss in adults. Yet, noise affects people of all ages, and noise-induced hearing loss is also a problem for young people. Sensorineural hearing loss caused by noise and other toxic exposures is usually irreversible. Environmental noise, such as traffic noise, can affect learning, physiologic parameters, and quality of life. Children and adolescents have unique vulnerabilities to noise. Children may be exposed beginning in NICUs and well-baby nurseries, at home, at school, in their neighborhoods, and in recreational settings. Personal listening devices are increasingly used, even by small children. Infants and young children cannot remove themselves from noisy situations and must rely on adults to do so, children may not recognize hazardous noise exposures, and teenagers generally do not understand the consequences of high exposure to music from personal listening devices or attending concerts and dances. Environmental noise exposure has disproportionate effects on underserved communities. In this report and the accompanying policy statement, common sources of noise and effects on hearing at different life stages are reviewed. Noise-abatement interventions in various settings are discussed. Because noise exposure often starts in infancy and its effects result mainly from cumulative exposure to loud noise over long periods of time, more attention is needed to its presence in everyday activities starting early in life. Listening to music and attending dances, concerts, and celebratory and other events are sources of joy, pleasure, and relaxation for many people. These situations, however, often result in potentially harmful noise exposures. Pediatricians can potentially lessen exposures, including promotion of safer listening, by raising awareness in parents, children, and teenagers. Noise exposure is underrecognized as a serious public health issue in the United States, with exposure limits enforceable only in workplaces and not for the general public, including children and adolescents. Greater awareness of noise hazards is needed at a societal level.
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Affiliation(s)
- Sophie J Balk
- Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York
| | - Risa E Bochner
- Department of Pediatrics, New York City Health and Hospitals Harlem, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | | | - Brian K Reilly
- Otolaryngology and Pediatrics, George Washington University Medical School, Children's National Hospital, Washington, District of Columbia
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Pérez-Crespo L, Essers E, Foraster M, Ambrós A, Tiemeier H, Guxens M. Outdoor residential noise exposure and sleep in preadolescents from two European birth cohorts. ENVIRONMENTAL RESEARCH 2023; 225:115502. [PMID: 36805354 DOI: 10.1016/j.envres.2023.115502] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 01/19/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To examine whether outdoor residential exposure to annual average road traffic and multiple (i.e., road traffic, railway, aircraft, industry) noise levels is related with preadolescents' sleep using maternal-reported and wrist-actigraphy data in two European birth cohorts. METHODS This cross-sectional study used data of 1245 preadolescents from the Dutch Generation R Study and 232 from the Spanish INMA-Sabadell cohort with a mean age of 12.3 years old. We used noise maps to assess average outdoor road traffic and multiple noise levels (day-evening-night noise indicator, LDEN) at each child's residential address for the year before the sleep assessment. Sleep disturbances were reported by mothers through the Sleep Disturbance Scale for Children and objectively recorded using GeneActiv wrist-actigraphy during seven subsequent days. Linear and Poisson regression models adjusted for several potential confounding variables were performed. RESULTS The mean (SD) exposure to road traffic noise was 53.2 dB (7.3) in the Generation R Study and 61.3 dB (5.9) in the INMA-Sabadell cohort. Exposure to road traffic was related with reduced total sleep time and longer wake after sleep onset (e.g. -3.62 min (95%CI -6.87; -0.37) and 6.88 min (95%CI 1.15; 12.61) per an increase of 10 dB in road traffic noise, respectively) collected by wrist-actigraphy. We observed no association between road traffic exposure and maternal-reported sleep disturbances. Results were similar for multiple noise exposure. CONCLUSIONS These findings indicate that sleep may be compromised for preadolescents living in areas highly exposed to outdoor residential noise. Future studies using longitudinal designs to further explore these associations during the different stages of sleep development across childhood and adolescence are warranted. Also, wrist-actigraphy measurements which provide more accurate information and may be complementary to the parental- and self-reported data should be considered.
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Affiliation(s)
- Laura Pérez-Crespo
- ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Spain
| | - Esmée Essers
- ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Maria Foraster
- ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Spain; PHAGEX Research Group, Blanquerna School of Health Science, Universitat Ramon Lull (URL), Barcelona, Spain
| | - Albert Ambrós
- ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Spain
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands; Department of Social and Behavioral Science, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Mònica Guxens
- ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
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Makani P, Koops EA, Pyott SJ, van Dijk P, Thioux M. Hyperacusis is associated with smaller gray matter volumes in the supplementary motor area. Neuroimage Clin 2023; 38:103425. [PMID: 37137255 PMCID: PMC10176058 DOI: 10.1016/j.nicl.2023.103425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/05/2023]
Abstract
Hyperacusis is a disorder in loudness perception characterized by increased sensitivity to ordinary environmental sounds and associated with otologic conditions, including hearing loss and tinnitus (the phantom perception of sound) as well as neurologic and neuropsychiatric conditions. Hyperacusis is believed to arise centrally in the brain; however, the underlying causes are unknown. To gain insight into differences in brain morphology associated with hyperacusis, we undertook a retrospective case-control study comparing whole-brain gray matter morphology in participants with sensorineural hearing loss and tinnitus who either scored above or below the threshold for hyperacusis based on a standard questionnaire. We found that participants reporting hyperacusis had smaller gray matter volumes and cortical sheet thicknesses in the right supplementary motor area (SMA), independent of anxiety, depression, tinnitus burden, or sex. In fact, the right SMA volumes extracted from an independently defined volume of interest could accurately classify participants. Finally, in a subset of participants where functional data were also available, we found that individuals with hyperacusis showed increased sound-evoked responses in the right SMA compared to individuals without hyperacusis. Given the role of the SMA in initiating motion, these results suggest that in hyperacusis the SMA is involved in a motor response to sounds.
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Affiliation(s)
- Punitkumar Makani
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, the Netherlands; Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, FA30, P.O. Box 196, 9700 AD Groningen, the Netherlands.
| | - Elouise A Koops
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, the Netherlands; Department of Radiology, Massachusetts General Hospital-Harvard Medical School, Boston, USA
| | - Sonja J Pyott
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, the Netherlands; Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, FA30, P.O. Box 196, 9700 AD Groningen, the Netherlands
| | - Pim van Dijk
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, the Netherlands; Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, FA30, P.O. Box 196, 9700 AD Groningen, the Netherlands
| | - Marc Thioux
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, the Netherlands; Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, FA30, P.O. Box 196, 9700 AD Groningen, the Netherlands
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Mednicoff SD, Barashy S, Gonzales D, Benning SD, Snyder JS, Hannon EE. Auditory affective processing, musicality, and the development of misophonic reactions. Front Neurosci 2022; 16:924806. [PMID: 36213735 PMCID: PMC9537735 DOI: 10.3389/fnins.2022.924806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 09/02/2022] [Indexed: 11/13/2022] Open
Abstract
Misophonia can be characterized both as a condition and as a negative affective experience. Misophonia is described as feeling irritation or disgust in response to hearing certain sounds, such as eating, drinking, gulping, and breathing. Although the earliest misophonic experiences are often described as occurring during childhood, relatively little is known about the developmental pathways that lead to individual variation in these experiences. This literature review discusses evidence of misophonic reactions during childhood and explores the possibility that early heightened sensitivities to both positive and negative sounds, such as to music, might indicate a vulnerability for misophonia and misophonic reactions. We will review when misophonia may develop, how it is distinguished from other auditory conditions (e.g., hyperacusis, phonophobia, or tinnitus), and how it relates to developmental disorders (e.g., autism spectrum disorder or Williams syndrome). Finally, we explore the possibility that children with heightened musicality could be more likely to experience misophonic reactions and develop misophonia.
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Potgieter I, Hoare DJ, Fackrell K. Hyperacusis in Children: A Thematic Analysis of Discussions in Online Forums. Am J Audiol 2022; 31:166-174. [PMID: 35130032 DOI: 10.1044/2021_aja-21-00137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Hyperacusis is commonly defined as reduced tolerance to everyday sounds leading to avoidance behavior and disrupting normal functioning. Hyperacusis is prevalent in children. However, the literature on the manifestation and impact of hyperacusis on children is scant. This qualitative study examined online discussion forums to understand the lived experiences of hyperacusis in children from a parent or carer perspective. METHOD Posts from publicly available online discussion forums were thematically analyzed. Online searching identified 219 potentially relevant conversation threads across 18 forums and involving 1,436 forum users. A total number of 170 eligible conversation threads, containing 1,834 messages, were used in the analysis. RESULTS Thematic analysis of the data generated six themes: personal and health information about the child, onset and prognosis, bothersome sounds and characteristics, reactions, coping strategies, and impact. Hyperacusis onset was associated with loud noise, physical trauma, or stress. Bothersome sounds were categorized in terms of appliances, vehicles, public places, nature, and very loud sounds. Children's reactions included panic, shaking, and screaming. Strategies to manage hyperacusis included ear defenders, building up tolerance, and school adaptations. Hyperacusis had an impact on various aspects of the child's life including academic performance and social development. CONCLUSIONS This is the first study to account for the lived experiences of children experiencing hyperacusis from a parent/carer perspective using online forum data. These findings expand on existing research on the manifestation of hyperacusis in children and provide a basis for further work improving clinical assessment and management.
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Affiliation(s)
- Iskra Potgieter
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, United Kingdom
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, United Kingdom
| | - Derek J. Hoare
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, United Kingdom
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, United Kingdom
| | - Kathryn Fackrell
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, United Kingdom
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, United Kingdom
- Wessex Institute, University of Southampton, United Kingdom
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Essers E, Pérez-Crespo L, Foraster M, Ambrós A, Tiemeier H, Guxens M. Environmental noise exposure and emotional, aggressive, and attention-deficit/hyperactivity disorder-related symptoms in children from two European birth cohorts. ENVIRONMENT INTERNATIONAL 2022; 158:106946. [PMID: 34715431 DOI: 10.1016/j.envint.2021.106946] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/23/2021] [Accepted: 10/18/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Environmental noise exposure is increasing but limited research has been done on the association with emotional, aggressive, and attention-deficit/hyperactivity disorder (ADHD)-related symptoms in children. OBJECTIVE To analyze the association between prenatal and childhood environmental noise exposure and emotional, aggressive, and ADHD-related symptoms in children from two European birth cohorts. METHODS We included 534 children from the Spanish INMA-Sabadell Project and 7424 from the Dutch Generation R Study. Average 24 h noise exposure at the participants' home address during pregnancy and childhood periods were estimated using EU maps from road traffic noise and total noise (road, aircraft, railway, and industry). Symptom outcomes were assessed using validated questionnaires: Strengths and Difficulties Questionnaire, Child Behavioral Checklist, ADHD Criteria of Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition List, and Conner's Parent Rating Scale-Revised at 4, 7 and 9 years (INMA-Sabadell cohort) and 18 months, 3, 5, and 9 years (Generation R Study). Adjusted linear mixed models of prenatal and repeated childhood noise exposure with repeated symptom outcomes were run separately by cohort and overall estimates were combined with random-effects meta-analysis. RESULTS Average prenatal and childhood road traffic noise exposure levels were 61.3 (SD 6.1) and 61.7 (SD 5.8) for INMA-Sabadell and 54.6 (SD 7.9) and 51.6 (SD 7.1) for Generation R, respectively. Prenatal and childhood road traffic noise exposure were not associated with emotional, aggressive, or ADHD-related symptoms. No heterogeneity was observed between cohorts and results were comparable for total noise exposure. CONCLUSIONS No association was observed between prenatal or childhood road traffic or total noise exposure and symptom outcomes in children. Future studies should include a more comprehensive noise exposure assessment considering noise sensitivity and noise exposure at different settings such as work for pregnant women and school for children.
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Affiliation(s)
- Esmée Essers
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
| | - Laura Pérez-Crespo
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
| | - Maria Foraster
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; PHAGEX Research Group, Blanquerna School of Health Science, Universitat Ramon Lull (URL), Barcelona, Spain.
| | - Albert Ambrós
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre - Sophia Children's Hospital, Rotterdam, the Netherlands; Department of Social and Behavioral Science, Harvard T.H. Chan School of Public Health, Boston, USA.
| | - Mònica Guxens
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre - Sophia Children's Hospital, Rotterdam, the Netherlands.
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Williams ZJ, Suzman E, Woynaroski TG. Prevalence of Decreased Sound Tolerance (Hyperacusis) in Individuals With Autism Spectrum Disorder: A Meta-Analysis. Ear Hear 2021; 42:1137-1150. [PMID: 33577214 PMCID: PMC8349927 DOI: 10.1097/aud.0000000000001005] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Hyperacusis, defined as decreased tolerance to sound at levels that would not trouble most individuals, is frequently observed in individuals with autism spectrum disorder (ASD). Despite the functional impairment attributable to hyperacusis, little is known about its prevalence or natural history in the ASD population. The objective of this study was to conduct a systematic review and meta-analysis estimating the current and lifetime prevalence of hyperacusis in children, adolescents, and adults with ASD. By precisely estimating the burden of hyperacusis in the ASD population, the present study aims to enhance recognition of this particular symptom of ASD and highlight the need for additional research into the causes, prevention, and treatment of hyperacusis in persons on the spectrum. DESIGN We searched PubMed and ProQuest to identify peer-reviewed articles published in English after January 1993. We additionally performed targeted searches of Google Scholar and the gray literature, including studies published through May 2020. Eligible studies included at least 20 individuals with diagnosed ASD of any age and reported data from which the proportion of ASD individuals with current and/or lifetime hyperacusis could be derived. To account for multiple prevalence estimates derived from the same samples, we utilized three-level Bayesian random-effects meta-analyses to estimate the current and lifetime prevalence of hyperacusis. Bayesian meta-regression was used to assess potential moderators of current hyperacusis prevalence. To reduce heterogeneity due to varying definitions of hyperacusis, we performed a sensitivity analysis on the subset of studies that ascertained hyperacusis status using the Autism Diagnostic Interview-Revised (ADI-R), a structured parent interview. RESULTS A total of 7783 nonduplicate articles were screened, of which 67 were included in the review and synthesis. Hyperacusis status was ascertained in multiple ways across studies, with 60 articles employing interviews or questionnaires and seven using behavioral observations or objective measures. The mean (range) age of samples in the included studies was 7.88 years (1.00 to 34.89 years). The meta-analysis of interview/questionnaire measures (k(3) = 103, nASD = 13,093) estimated the current and lifetime prevalence of hyperacusis in ASD to be 41.42% (95% CrI, 37.23 to 45.84%) and 60.58% (50.37 to 69.76%), respectively. A sensitivity analysis restricted to prevalence estimates derived from the ADI-R (k(3) = 25, nASD = 5028) produced similar values. The estimate of current hyperacusis prevalence using objective/observational measures (k(3) = 8, nASD = 488) was 27.30% (14.92 to 46.31%). Heterogeneity in the full sample of interview/questionnaire measures was substantial but not significantly explained by any tested moderator. However, prevalence increased sharply with increasing age in studies using the ADI-R (BF10 = 93.10, R2Het = 0.692). CONCLUSIONS In this meta-analysis, we found a high prevalence of current and lifetime hyperacusis in individuals with ASD, with a majority of individuals on the autism spectrum experiencing hyperacusis at some point in their lives. The high prevalence of hyperacusis in individuals with ASD across the lifespan highlights the need for further research on sound tolerance in this population and the development of services and/or interventions to reduce the burden of this common symptom.
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Affiliation(s)
- Zachary J. Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN
| | - Evan Suzman
- Graduate Program in Biomedical Sciences, Vanderbilt University, Nashville, TN
| | - Tiffany G. Woynaroski
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN
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Danesh AA, Howery S, Aazh H, Kaf W, Eshraghi AA. Hyperacusis in Autism Spectrum Disorders. Audiol Res 2021; 11:547-556. [PMID: 34698068 PMCID: PMC8544234 DOI: 10.3390/audiolres11040049] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/30/2021] [Accepted: 10/06/2021] [Indexed: 11/30/2022] Open
Abstract
Hyperacusis is highly prevalent in the autism spectrum disorder (ASD) population. This auditory hypersensitivity can trigger pragmatically atypical reactions that may impact social and academic domains. Objective: The aim of this report is to describe the relationship between decreased sound tolerance disorders and the ASD population. Topics covered: The main topics discussed include (1) assessment and prevalence of hyperacusis in ASD; (2) etiology of hyperacusis in ASD; (3) treatment of hyperacusis in ASD. Conclusions: Knowledge of the assessment and treatment of decreased sound tolerance disorders within the ASD population is growing and changing.
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Affiliation(s)
- Ali A. Danesh
- Department of Communication Sciences and Disorders, Florida Atlantic University, Boca Raton, FL 33431, USA;
- Department of Integrated Medical Sciences, Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA
- Correspondence:
| | - Stephanie Howery
- Department of Communication Sciences and Disorders, Florida Atlantic University, Boca Raton, FL 33431, USA;
| | - Hashir Aazh
- Department of Audiology, Tinnitus and Hyperacusis Specialty Clinic, Royal Surrey Hospital, Guildford GU2 7XX, UK;
| | - Wafaa Kaf
- Communication Sciences and Disorders Department, Missouri State University, Springfield, MO 65897, USA;
| | - Adrien A. Eshraghi
- Department of Otolaryngology and Neurological Surgery, Miller School of Medicine, University of Miami, Miami, FL 33146, USA;
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