Working with Hearing Sensitivity
Dear Kathie: "Chad is 5 years
old and ‘very' autistic and non-verbal. He covers his ears with his hands when
there is a loud noise, such as a fire alarm, or even when he anticipates a loud
noise, like a balloon that he thinks may pop. How can I help him, his classroom
teacher, and his parents? - Payton, speech-language pathologist
My Response: Using the hands to cover
one's ears is very common in children with autism spectrum disorder. Many
people think it's just weird or that the child is being difficult because he or
she will stop what they are doing and cover their ears immediately to a loud
sound or if they think one might happen, like in the case of the balloon
mentioned above. In actuality, these loud sounds often cause real pain to the person with autism. People
with autism react to certain pitches and tones, but often not to others. They
may not even react to people's voices. This can vary on a daily basis and across
environments. It will also depend on whether something extremely loud has
startled them in the past.
I
have seen children with autism cover their ears well into their teens. I have
seen parents keep their child away from family outings that they know will be full
of loud sounds. I have seen children wear heavy sets of headphones and they still
cover their ears with their hands. I have seen mothers stuff cotton plugs in
their child's ears. I have seen children cover their ears and scream to loud
sounds.
I do think there are some strategies we can implement
to assist these individuals so that the volume of the sound will induce less
fear and not startle them as much. We can even introduce some more socially
acceptable reactions to the sound. One word of advice, though: never pull the child's hands away from his
or her ears.
Strategies for Young Children
- I'm a huge believer
in early intervention. So the first time this behavior is reported or
observed, just know that it is going to reoccur.
- Ask this question
at the Individualized Education Plan (IEP) meeting: "Does Chad cover
his ears when he hears a loud noise?"
- Gradually
desensitize the child by using a variety of sounds on an iPad, a tape
recorder or a video. By using an iPad, the child can point and touch the
sound, thus empowering the child to take control of the sound. (Please refer
to the post "The
iPad Becomes a wePad for Autism".)
- Make it fun and
laugh at the sounds.
- Control the level
of the sounds on the iPad or device from soft to louder.
- Use the images provided
in the "A
Lesson in Volume Control" post. (You can use the Loud Meter for
children who are at that level of understanding.)
- Use self and
parallel talk such as:
- "The balloon might pop but it's OK."
- "I like the helicopter."
- "You hear a bear." (Say this after the child has
selected a picture of a bear on the iPad)
- "I think thunder is fun."
- Practice in front
of a mirror with the child covering and uncovering their ears with their
hands and use soft and loud sounds and self and parallel talk to make it
fun.
- Tell the school
office to give the classroom a heads up in the case of a fire drill so
that the teacher can let the child know about it ahead of time.
Again, never pull
the child's hands away from his or her ears.
Strategies for Teens and
Adults
- I hope by the time an
individual becomes a teenager or adult that they have been lucky enough to
have been given many of the strategies listed above. If so, they may have
outgrown the need to cover their ears through desensitization, practice
and simply by maturing.
- Shape their ear-covering
behavior through the use of a mirror and let them see for themselves how
they look to others
- Empower the individual
by letting them select a headset that is smaller and more socially
acceptable. Always check with the parents first.
- Show them and talk
about appropriate ways to escape certain offensive sounds
- For individuals
with high functioning autism or Asperger's syndrome, honesty is the best
answer. For example, you can say "Covering your ears with your hands draws
unnecessary attention." Let them know how it looks to others. ("Looking
at you, looking at me.")
- Watch for bullying
- it can be very subtle but very deadly.
This true with younger children as well.
Behavioral Change
It
takes persistence, consistency and a team to change this behavior. It may not
be easy but it is certainly worth the time and expertise of the SLP.
"Speech
pathologists make good things happen."