![]() This may account for the level of distress that some children experience and the ‘flight or fight’ or panic response. the limbic system and the amygdala, and are stimulated by somatosensory as well as auditory inputs. These pathways project to non-auditory areas of the brain, e.g. Children also use non-classical auditory pathways in loudness perception. There is development of the frontal cortex leading to a decreased susceptibility to interference from environmental stimuli. ![]() ![]() In parallel, there is development of the sensory gating process which allows us to inhibit distracting or unwanted auditory information. ![]() In young children, maturation of the auditory system leads to improving intensity discrimination. There may be different mechanisms underlying hyperacusis in children. Little wonder children don’t like them! “Anxiety in children can contribute to increased auditory gain and in turn to increased vigilance, exacerbating the hyperacusis.” While some definitions of hyperacusis refer to problems with everyday sounds, many of these sounds are really loud (see table). Common sounds which children find troublesome include that of vacuum cleaners, children screaming or playing, hand dryers, emergency sirens and alarms. Sounds which are loud, unpredictable in onset or duration, and over which the child has no control tend to be particularly problematic. Picture simulated from clinical experience of patients. It may also relate to different populations of children, with a higher prevalence in preschool children and children with developmental difficulties, including autistic spectrum disorder. This variability may relate to the variations in diagnosis. The reported prevalence of hyperacusis in children varies between 3.2% and 17.1%. For a few children, the reaction to loud sounds can range from distress to panic attacks which can last for considerable time after cessation of the troublesome sound. For most children, this usually lasts until the noise has stopped. In any noisy environment, it’s a common sight to see children holding their hands over their ears.
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