Document Type

Capstone Project

Publication Date

Fall 10-18-2021

First Advisor

Antony Joseph, MA., Au.D., Ph.D., ABAC, CCC-A, CPS/A, F-NAP


Misophonia, Hyperacusis, Tinnitus, Sound Intolerance, Gradual Desensitization, Pediatric, Disorders of Sound Intolerance


Speech Pathology and Audiology


Introduction: Misophonia is a rare disorder affecting approximately one in 1,500 people, of which, a small percentage are pediatric patients. Misophonia is characterized by the dislike of an explicit sound in a specific context. Treatment for misophonia includes a four-step program that can be modified for pediatrics. Case Presentation: A young female presented to the clinic with a significant distressed reaction when in the presence of specific sounds that included chewing, clicking pens, and loud music bass tones. Discussion: Treatment of misophonia is comparable to a care-plan for both tinnitus and hyperacusis. For this case, a four-step approach was used for treatment that entailed listening to something enjoyable, allowing a trusted adult to control the volume of an enjoyable sound, participating in enjoyable activities, and gradually becoming desensitized to bothersome sounds. Conclusion: Additional misophonia research in young populations is needed in order to develop treatment programs that may be individualized.

Introduction: Hyperacusis affects approximately 1 in 50,000 individuals, so it is classified as a rare disorder. Hyperacusis is clinically indicated by a sensitivity to moderate sounds that can lead to physical pain or discomfort, and it co-occurs commonly with tinnitus. Case Presentation: An older adult presented to the clinic with intolerance to loud sound that included music played in her church, the voices of children, and booming laughter. She frequently donned circumaural headphones in noisy listening environments to self-prevent falling into a pattern of avoidance behavior. Discussion: Treatment of hyperacusis has a strong foundation in counseling and may be accompanied by a four-step approach that is comparable to treatment for tinnitus and misophonia. The goal of this four-step approach is to target sounds that are perceived as too loud and train the affected individual to become more tolerant. Conclusion: Testing and treatment for hyperacusis is comparable to that of individuals affected by tinnitus, as it has been hypothesized that cochlear cell damage may be responsible for these disorders. Nevertheless, there is a need for a test battery specific to hyperacusis in order to differentiate other disorders of sound tolerance.