Hyperacusis in children: The Edinburgh experience

Objectives: This study aimed to determine the factors associated with hyperacusis in children referred to an audiology-led paediatric hyperacusis clinic in a Paediatric tertiary centre. It also aimed to identify current management strategies in paediatric hyperacusis and their outcomes. Methods: Retrospective cohort study conducted by case note and AuditBase^® review over a 5-year period (March 2010 to March 2015) in a tertiary Paediatric ENT and Audiology service. Results: 412 children were referred with hyperacusis during the 5-year period. All children were assessed and managed within a dedicated Paediatric hyperacusis clinic. Median age at referral was 7 years. 76% were boys (n = 313). On average, children were sensitive to 6 identifiable sound stimuli at presentation (range 1–20). 82% complained of sensitivity to noise from household appliances and hand dryers. 60% had a background history of autistic spectrum disorder (ASD), followed by attention deficit hyperactivity disorder (ADHD) and other neurodevelopmental problems. In 91% management comprised behavioural therapy and provision of a 'sound-ball’ (Wellcare^® Naturcare Relaxation Therapy Ball) to take home. Of these, 25% did not attend their first review appointment. A further 25% were considered to have sufficient symptom improvement to permit discharge after a single clinic review. Only 2% of children required more than 3 review sessions before achieving resolution of symptoms. Conclusions: In our paediatric cohort, hyperacusis is more common in boys and in those children with ASD. A combined treatment approach with behavioural therapy and the provision of a sound-ball has a very high success rate in our experience.