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Sound sensitivity and hearing loss is a curious relationship. One would think that an individual with hearing loss would have a higher tolerance for loud sounds, but often it’s quite the opposite—noises from loud to even normal decibel ranges can become a nuisance. Especially when the brain gets involved, which is, of course, how we all process sound; one can experience either ‘recruitment’ or ‘hyperacusis’, both separate mechanisms of sensitivity.

In honor of Autism Awareness Month this April, it’s an excellent time to talk about not only sound sensitivity in general, but also how autism can even further complicate the delicate and complex relationship of hearing loss and the presence of sound sensitivity. And additionally, how hearing aids can help individuals strategize a solution to said sensitivity in virtually all cases.

What is Recruitment?

Recruitment pertaining to the hearing system is the process of healthy hair cells suddenly and forcefully reacting to sound in the presence of dying cells surrounding them. In other words, they are ‘recruited’ by your brain to pick up the slack of damaged cells (via age or noise exposure) and as a result create sounds that can be painful and uncomfortable. This is why some individuals with hearing loss will be in conversation and may be struggling to hear well, only to have the person they’re speaking with speak louder and that may be experienced as a shout.

What is Hyperacusis?

Hyperacusis, or sensitivity to sound, is different than recruitment in that hearing loss doesn’t necessarily need to be present. There is no medical consensus on how exactly it develops, but it has been associated with physical trauma to the central auditory system. Hyperacusis, by definition, literally means ‘excess hearing’. Sounds otherwise normal to most—running water, crunching leaves, chewing, etc.—may be excruciating for an individual experiencing hyperacusis.

How Does Autism Affect Sound Sensitivity?

Sensory problems and autism go hand in hand, including sensitivity to sound. Already predisposed to abnormal auditory sensory responses, the medical community has found a growing correlation with autism and hyperacusis. In one 2015 study, researchers found a prevalence of 18% to 69% of hyperacusis among children with autism spectrum disorder.

How Can Hearing Aids Help?

The good news is that in combination with cognitive behavioral therapies to reduce the mental burden and biological response to sound sensitivity, hearing aids are an excellent tool in strategizing a way to level out an individual’s hearing needs. In the case of recruitment, hearing devices can be used to compress bothersome frequency ranges, while hyperacusis sufferers can utilize masking noise features to desensitize themselves to their respective sound thresholds.

Are you experiencing symptoms related to sound sensitivity? You may benefit from a hearing test and consultation. Contact Precision Hearing at 352-765-8008 to schedule an appointment. Or, learn more about your hearing health by visiting


 Danesh AA, Lang D, Kaf W, Andreassen WD, Scott J, Eshraghi AA. Tinnitus and hyperacusis in autism spectrum disorders with emphasis on high functioning individuals diagnosed with Asperger’s Syndrome. Int J Pediatr Otorhinolaryngol 79: 1683–1688, 2015. doi:10.1016/j.ijporl.2015.07.024

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