Fulwood Audiology Clinic, Lancashire Teaching Hospitals NHS Foundation Trust, 4 Lytham Road, Fulwood, Preston, PR2 8JB, United Kingdom.
Fulwood Audiology Clinic, Lancashire Teaching Hospitals NHS Foundation Trust, 4 Lytham Road, Fulwood, Preston, PR2 8JB, United Kingdom.
Int J Pediatr Otorhinolaryngol. 2024 Nov;186:112119. doi: 10.1016/j.ijporl.2024.112119. Epub 2024 Sep 21.
Decreased sound tolerance (DST) is common in children with auditory processing disorder (APD). This study aimed to differentiate between hyperacusis and misophonia in children with APD.
A retrospective study evaluating outcomes of structured history and co-morbidity following Research Domain Criteria (RDoC) frame-work. Misophonia was considered as oversensitivity to eating/chewing sounds and hyperacusis as oversensitivity to other sounds.
Two hundred and seventy-nine children (160 males; 119 females), 6-16 year-olds with NVIQ ≥80, diagnosed with APD between January 2021 and December 2022.
One hundred and forty-three out of 279 children with APD had DST, of which 107 had hyperacusis (without misophonia) and 36 had misophonia. Misophonia co-existed with hyperacusis in 35 children (97 %), and in one child misophonia occurred without hyperacusis. Misophonia was prevalent in older children, in females, and those with tinnitus. Fear and being upset were predominant emotional responses in hyperacusis (without misophonia) while disgust and verbal abuse were prevalent in misophonia (with or without hyperacusis). Compared to children without DST, the hyperacusis (without misophonia) and misophonia (with or without hyperacusis) groups had significant higher prevalence of ADHD, anxiety, and language impairment. Educational difficulties were similar in APD irrespective of the presence or absence of DST. Despite higher tinnitus prevalence in misophonia (with or without hyperacusis) along with similar co-morbidities and educational difficulties in both hyperacusis (without misophonia) and misophonia (with or without hyperacusis), the misophonia (with or without hyperacusis) group surprisingly had less support at school which was reflected in fewer Education, Health and Care Plan (EHCP).
In APD misophonia mostly co-exists with hyperacusis, with differences in emotional responses, tinnitus prevalence, and gender distribution when compared to hyperacusis (without misophonia). Increase in awareness about misophonia is needed, as children with misophonia may have unidentified needs. Larger scale prospective study is required to clarify if misophonia evolves from hyperacusis, and to explore the factors underlying 'misophonia with hyperacusis' and 'misophonia without hyperacusis'. For clarity, DST studies need to specify if hyperacusis or misophonia co-existed when referring to hyperacusis or misophonia.
听觉处理障碍（APD）儿童中常见的声音耐受降低（DST）。本研究旨在区分 APD 儿童的听觉过敏和厌恶声症。
一项回顾性研究，根据研究领域标准（RDoC）框架评估结构化病史和合并症的结果。厌恶声症被认为是对进食/咀嚼声音的过度敏感，听觉过敏则是对其他声音的过度敏感。
2021 年 1 月至 2022 年 12 月间，279 名年龄在 6-16 岁、非言语智商（NVIQ）≥80、被诊断为 APD 的儿童，其中 160 名为男性，119 名为女性。
279 名 APD 儿童中有 143 名出现 DST，其中 107 名患有听觉过敏（无厌恶声症），36 名患有厌恶声症。35 名儿童（97%）同时患有厌恶声症和听觉过敏，1 名儿童仅患有厌恶声症。厌恶声症在年龄较大的儿童、女性和有耳鸣的儿童中更为常见。在听觉过敏（无厌恶声症）中，恐惧和不安是主要的情绪反应，而在厌恶声症（有或无听觉过敏）中，则是厌恶和言语虐待。与无 DST 的儿童相比，听觉过敏（无厌恶声症）和厌恶声症（有或无听觉过敏）组患 ADHD、焦虑和语言障碍的比例显著更高。APD 儿童的教育困难相似，无论是否存在 DST。尽管厌恶声症（有或无听觉过敏）的耳鸣患病率较高，且听觉过敏（无厌恶声症）和厌恶声症（有或无听觉过敏）的合并症和教育困难相似，但令人惊讶的是，厌恶声症（有或无听觉过敏）组在学校得到的支持较少，这反映在较少的教育、健康和关怀计划（EHCP）中。
在 APD 中，厌恶声症主要与听觉过敏共存，与听觉过敏（无厌恶声症）相比，在情绪反应、耳鸣患病率和性别分布方面存在差异。需要提高对厌恶声症的认识，因为有厌恶声症的儿童可能存在未被识别的需求。需要进行更大规模的前瞻性研究，以阐明厌恶声症是否由听觉过敏发展而来，并探讨“听觉过敏伴厌恶声症”和“听觉过敏不伴厌恶声症”背后的因素。为了清晰起见，当提及听觉过敏或厌恶声症时，DST 研究需要指明是否同时存在听觉过敏和厌恶声症。
