Auditory Dysfunction... Epecially Hyposensitivity (Auditory Processing)

by Angela
(Delaware, Ohio, USA)

I'd really like some more information on this.

My son, 4, has SPD and is seeing an OT. My daughter, 14 months- 12 months adjusted, has some issues with feeding related to sensory issues. She has other tactile sensory issues as well. They are all very mild and being treated by an OT (the OT is nearly ready to release her).

She also has some hearing issues. Her hearing tests are normal (an odd dip on the cochlear test, but not in the range of speech), EXCEPT for the reactions test (meaning she doesn't always respond to the sound by looking). The audiologists are sending her for an ABR because of suspected auditory neuropathy. I'm more inclined to believe it's a sensory issue, but I'm having difficulty finding information on auditory hyposensitivity. My son is hypersensitive to sounds, so I know what that looks like (my son is one of the hypo and hyper sensitive children, he fluctuates from one to the other, EXCEPT in hearing, steadily hyper).

I have read what I can online, and it's looking like Auditory Neuropathy, but I don't want to believe it. The two problems could be similar, with AN just having nerve impairment and SPD: AD not.

I just want to see some examples...

Please help a mom stay calm and sane while awaiting further testing on her daughter's hearing... I REALLY want to believe this isn't Auditory Neuropathy.

Since Auditory Neuropathy and Auditory Processing can overlap and/or be similar in symptomology (the less trained eye), I think it is important to get the answer as to which it is. I know that is what you are trying to do... but I hear the "fear" you feel about the Auditory Neuropathy diagnosis. I want to assure you, from what I know, whether it is AN or APD, it is "treatable"; especially discovering it so early in life!

You should really feel good about the fact that you are seeking diagnoses and treatment at such a young age. YOU knew, you trusted you gut, you fought and advocated for your daughter!

First, you can, of course, get a second opinion regarding the Auditory Neuropathy before you do any drastic treatments. For example, as we understood it (not knowing as much as you or others about Auditory Neuropathy), two treatments for AN are hearing aids or cochlear implants.

Hearing aids would be the least "intrusive"/"drastic" treatment of the two so that might be the best treatment to start with. UNLESS, the specialists recommend a different plan. And, as you may know, there is a great debate over which treatment is most effective... so research will be key.

BUT, here are some other thoughts. We know that true CAPD (Central Auditory Processing Disorder) cannot be officially diagnosed before age 8 using standardized testing. I KNOW you don't want to wait that long to find out if it is officially CAPD. We also know that there are programs that can be done by trained professionals (OT's and/or SLP's) before age 8 that may greatly increase any potential auditory processing deficits that may exist. So, this may be one route to pursue.

And, as for finding information on "hyposensitivity" to auditory input? You may find more if you look up "auditory processing" instead of hyposensitivity.

Since your daughter has been diagnosed with SPD, we feel it is appropriate to seek out an OT or SLP that is familiar with both SPD and Auditory Processing Therapies. The fact that other
processing issues have been identified, puts her "at risk" for possible auditory processing difficulties... with or without Auditory Neuropathy. Therefore, if we were you? We would try any and all auditory processing OT and Speech therapies to work through any of those issues first, THEN see what deficits still exist or are unresolved after this "less intensive" treatment (vs. the more invasive treatments such as cochlear implants).

I am not as familiar with the exact auditory processing therapies that can be done with children as young as your daughter. I do know with children a little older, programs such as Listening Therapy (Therapeutic Listening, The Listening Program, etc.), Fast Forward, and/or Earobics are used. We would recommend you talk to an experienced OT or SLP familiar with these, or other, programs to decide what could be used at your daughter's age. I would NOT recommend discharge from OT until this is evaluated further (or get a new OT).

Other ideas? Play some sound localization games with beepers, sound toys, timers, hideable sound sources, etc. And experiment with auditory processing in different environments to see if
background noises affect her. All that said, you will have to go with and accept the professionals opinions and diagnoses, as they are the experts on this (not me). But, also know second opinions can be good. And, we would recommend an OT and SLP for possible auditory processing therapies while pursuing or ruling out AN through the official testing.

Know that treatment is available whichever diagnosis comes. With the proper treatment based on an accurate diagnosis, things will be ok!

Any other readers have input, advice or information regarding auditory dysfunction (hyposensitivity) and/or auditory neuropathy?

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Dec 28, 2015
Auditory Hyper/Hyposensitivity
by: Older with Autism

I'm so glad you've found help for your children, you're doing really well :) It certainly seemed like auditory processing issues to me, as I experience issues with it myself. I'm in the boats of both your children, having hypersensitivity to background noise and hyposensitivity when people are talking to me. This makes it especially hard to work out what people are saying unless they have already gained my attention and I'm listening intently. A lot of people think I just don't listen but unless I realize someone is talking to me, a lot of it just goes in one ear and out the other. I also get sensory overload which is almost always due to background noise (and occasionally smells).

I'm 18 and had a load of early intervention when I was little, so a lot of my autism related issues I can manage by myself, or internalize them and deal with them later/when I get home. I'm starting to think I need help with my auditory processing though but I am very aware that services for ASD children are just that... for children. Are there any services that I could look for that aren't aimed at children?

Mar 23, 2009
You Are Not Alone
by: Kathy

From the age of 2 until now (age 7), my son has gone from a diagnosis of auditory neuropathy to moderate hearing loss to autism. He wore hearing aids for a year, and did really well with his language while taking auditory verbal therapy. When the hearing loss diagnosis was changed to autism, we relied solely on the OT, ST, and ABT from the school system.

I am thinking more and more that we need to work on settling down his sensory system thru OT directed at SPD and biomedical interventions, but I am having a hard time making sense of it all. We just finished AIT. I am looking forward to improvements in his attention over the next few months. I am glad that you have gotten help for your children early.

Mar 05, 2009
More Updates
by: Mom

I decided to come and update this again. I'm sure someone else is bound to have these questions at some point, and our story may help them.

Who would have thought that a hypersensitivity could look so much like hyposensitivity?? Certainly not me.

My daughter has been doing so well! The brushing protocol helped her with her tactile sensitivities a great deal!! After we completed the intensive part of the program, we transferred her to an OT clinic that specializes in SPD. There we found out that she really is hypersensitive to sound, but instead of reacting outwardly, she reacts inwardly by shutting down and thus LOOKS like she's hyposensitive! Apparently, the clinic has seen this before. They started her on Listening Therapy and we've seen massive strides in how often she totally shuts down! It's amazing and wonderful.

She now also has a pair of sound muting headphones that she calls (her speech has taken off now that we know the problem and can avoid her becoming overwhelmed too often!) "pink ears."

My baby talks up a storm. Even when her hearing shuts down she will still talk, but she sounds funny then. Like her voice changed or muted a bit. When she shuts down, she relies on sign to understand the people around her, but she seems to be able to read lips pretty well too. Sometimes she gets confused, but she does better than anybody would ever expect of a 2.5 year old.

As she is now 2.5 we are getting ready to begin the process of transferring her to the school district. We know our chances of getting the school to see SPD as a disability is slim. They generally don't unless the child shows a delay in fine motor skills. My little one shows no delays anymore. She's ahead in many things. We all know this is because of our continued effort to avoid loud sounds...but she is still "deaf" without touch to attract her attention in the car, or if a train goes by, or I try to drive with the windows open...or any time there is too much "white noise" including a fan or the furnace.

I can only imagine how her hearing would be after a bus ride...or being on the playground with a bunch of kids...

I believe that if I can make the school understand how substantially she is affected when she shuts down they would see the problem, how it would clearly affect her development and learning, and therefore help preemptively. I have to believe that. Otherwise we will have to wait until she's so substantially affected that even the school cannot deny there is a problem.

Also, as a side update, my son was diagnosed not too long ago with Autism. I guess it didn't really come as a surprise, but it was still hard to hear. We had been fighting for professionals to recognize that something was different for so long that it came as a surprise when someone not only agreed with us, but gave him a diagnosis (after full testing).

Oct 23, 2008
by: Anonymous

Please have your child checked for Autism as she has one of the symptoms of it... God Bless

May 11, 2008
Final Answer - Sensory
by: Mom

My daughter's hearing has been determined to be related to her sensory issues.

Her hearing fluctuates from unresponsive without touch to perfectly normal.

Her ABR came back perfectly normal, but her hearing test was totally unresponsive, and another one was fine.

After much journaling we (her OT, SLP, and I) have been able to determine that her eating issues, tactile sensitivities, and hearing all coincide. Generally when her hearing is poor she is more willing to eat and explore sensory media, and her speech development stagnates (also unwilling/able to participate in therapy). When her hearing is good her other sensory issues become very apparent, BUT her speech begins to develop and she is able to participate in her therapy sessions.

There are also times where her tactile sensitivities are overboard (every little thing causes her to get upset and shake and cry) and during those times her hearing will often be extremely poor. This caused us some problems when trying to find a pattern in the journal, but in the end we were able to figure out that she was just so far overloaded that she shut down anything else coming in.

At this time, we are preparing to start her on a brushing protocol. I'm dreading the stress it will cause her, but I am extremely hopeful that it will help regulate her system enough that her speech development can get back on track.

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