Tinnitus and Autism Spectrum Disorder: Understanding the Link and Managing Sound Sensitivity

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that affects communication, social interaction, and behavior. It is estimated that 1 in 54 children in the United States has been identified with ASD, and cases have been increasing in recent years. 

Many people with ASD experience sound sensitivity, which can lead to conditions such as tinnitus. Fortunately, tinnitus symptoms can be managed to improve the individual’s quality of life and ability to function in noisy environments.

What Is Autism Spectrum Disorder?

Autism Spectrum Disorder (ASD) is a developmental disorder that affects communication, social interaction, and behavior. The term “spectrum” reflects the wide variation in symptoms and severity of the condition. 

The core symptoms of ASD include: 

• Difficulty with social interactions
• Difficulty communicating
• Repetitive behaviors or interests

Hypersensitivity To Sound Stimuli Makes Tinnitus And Hyperacusis More Likely

In addition to the core symptoms of ASD, many individuals also experience sensory sensitivities, including sound sensitivity. Auditory hypersensitivity (an increased sensitivity to sound stimuli) is a common feature of ASD. 

Because their auditory systems are more easily overstimulated, individuals with ASD are more likely to experience tinnitus (ringing of the ears) or hyperacusis (a distorted perception of sounds).

How Sound Sensitivity Affects People With ASD

Individuals with ASD often have difficulty processing sensory information, including sounds. Even ordinary, everyday sounds can be overwhelming and distressing for them. In some cases, this can lead to a sensory overload that causes anxiety, agitation, and other behavioral issues.

Sensory Overload

When an individual with ASD is exposed to too much sensory information at once (sounds, lights, smells, or touch) it can lead to a feeling of overwhelm and distress. Sensory overload can cause behavioral issues or a shutdown response, where the individual may withdraw and become non-responsive.

Hyperacusis

Compared to the general population, people with ASD often have an atypical perception of (or response to) sounds. For example, they may have an increased sensitivity to high-pitched or sudden noises, or a decreased tolerance for voices or traffic sounds. This can make it difficult for individuals with ASD to function in noisy environments, such as classrooms or public spaces.

Decreased Sound Tolerance

Some individuals with ASD may have decreased sound tolerance, which means that they are more easily disturbed by sounds that would not typically bother others. This can lead to tinnitus, a ringing or buzzing in the ears, or hyperacusis, a decreased tolerance for everyday sounds. These conditions can be distressing and impact quality of life.

Prevalence Of People Diagnosed With Autism Spectrum Disorder And Tinnitus/Hyperacusis

There is limited research on the prevalence of tinnitus and hyperacusis in individuals with ASD, but studies suggest that they may be more common in this population. One study found that up to 70% of children with ASD had sound sensitivity, and a significant portion of these children also had tinnitus and hyperacusis.

ASD Medications Can Have Tinnitus Side Effects

Many medications used to treat the core symptoms of ASD can have side effects, and tinnitus is one of them. It is important to discuss any potential side effects with a healthcare provider and weigh the risks and benefits of medication before starting treatment.

Some of the medications with the side effect of tinnitus include:

• Antipsychotics (risperidone and aripiprazole)
• Antidepressants (selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs)
• Anti-epileptic medications (carbamazepine and phenytoin)
• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin

Tinnitus And Hyperacusis Can Affect Anyone On The Autism Spectrum

People with high-functioning autism and Asperger’s syndrome are considered to be on the milder end of the autism spectrum. However, individuals with these diagnoses are just as likely to experience tinnitus and hyperacusis as those with more severe forms of ASD. 

The prevalence of these conditions highlights the importance of assessing and managing sound sensitivity in individuals across the spectrum.

Assessments For Tinnitus

When assessing tinnitus in individuals with ASD, it is important to rule out any underlying hearing loss or other auditory conditions that might be contributing to the tinnitus. This can be done through an audiological evaluation, which includes a hearing test and other assessments of the auditory system. 

Other assessments for tinnitus may include pitch matching, where the frequency of the tinnitus is matched to a tone played through headphones, and loudness matching, where the loudness of the tinnitus is matched to the volume of a tone played through headphones. 

Tinnitus questionnaires, such as the Tinnitus Handicap Inventory and/or Tinnitus Functional Index, may also be used to assess the impact of tinnitus on quality of life. In some cases, imaging, such as a high resolution CT scan or MRI may be necessary to rule out any underlying structural issues in the auditory system.

Tinnitus Management For People With ASD

There are a variety of approaches to managing tinnitus in individuals with ASD. It is important to work with a healthcare provider or audiologist to determine the most appropriate management approach based on the individual’s needs and preferences.

Some Of The Treatments Include: 

• Sound Enrichment Therapy: Providing background noise or music, also referred to as sound therapy, can help reduce the perception of tinnitus. 
• Cognitive Behavioral Therapy (CBT): This form of therapy is done by a licensed therapist and helps individuals change their thoughts and behaviors in response to tinnitus, which can reduce distress and improve quality of life. 
• Tinnitus Retraining Therapy (TRT): TRT is a specialized form of therapy that involves retraining the brain to habituate to the sound of tinnitus over time. 
• Alternative Therapies: Holistic therapies such as acupuncture may also be used to manage tinnitus in some cases. 

Not All People In The Autism Spectrum Will Experience Tinnitus

It is important to note that not all individuals with ASD will experience tinnitus or hyperacusis. However, for those who do, it can be a distressing and impactful experience. Early identification and management of sound sensitivity and tinnitus in individuals with ASD can help improve quality of life and reduce the impact these conditions have on normal daily activities.

Tinnitus And Autism Spectrum Disorder At A Glance

In conclusion, sound sensitivity, tinnitus, and hyperacusis are common in individuals with Autism Spectrum Disorder. While not all individuals with ASD will experience these conditions, it is important to assess and manage sound sensitivity in individuals across the spectrum. 

Some medications used to treat ASD can also cause tinnitus as a side effect, so healthcare professionals must carefully weigh the risks and benefits of medication before starting treatment. 

Audiological evaluations and tinnitus questionnaires can help identify and manage tinnitus in individuals with ASD. Treatment may include sound enrichment therapy, cognitive behavioral therapy, tinnitus retraining therapy, and alternative therapies such as acupuncture. 

Early identification and management of sound sensitivity and tinnitus in individuals with ASD can help improve quality of life and reduce the impact of these conditions on daily functioning.