Using Psychoacoustic Tasks and Multidimensional Questionnaires to Characterize Auditory Hyperreactivity in Autistic Young People

Prior studies of auditory hyperreactivity in autism have often not distinguished between different aspects of auditory sensory discomfort, such as hyperacusis and misophonia. The present study rigorously characterises multiple forms of auditory sensory hyperreactivity, using a mixture of laboratory-based psychoacoustic tasks and self- and caregiver-reported questionnaires, and examines group differences and relationships among different measures. 18 autistic and 22 comparison adolescents rated the pleasantness of conventionally-pleasant, conventionally-unpleasant, and misophonic trigger sounds at intensities of 50 through 80 dB SPL. They also provided hearing thresholds, loudness discomfort levels, and filled out a number of questionnaires; their caregivers completed additional questionnaires. Autistic participants rated conventionally-pleasant sounds as being more unpleasant at intensities of 60 through 80 dB, but overall loudness discomfort caused by pure tones did not significantly differ across groups, nor did ratings of common misophonic triggers appear to differ. Autistic participants nevertheless self-reported more auditory hyper-reactivity, including hyperacusis and misophonia. However, in the autism group, self-reported auditory hyper-reactivity scores were unexpectedly lower than caregiver-reported scores. Psychoacoustic task and some questionnaire-based measures of misophonia converged well, but hyperacusis measures did not converge well. Sound intolerance reportedly affected autistic participants’ quality of life. However, varied findings with different measures, such as ratings of pure tones versus conventionally-pleasant sounds, emphasise the complexity and seeming idiosyncrasy of sensory discomfort and distress in autism. Psychoacoustic sound rating tasks showed some convergence and some divergence with questionnaire measures, pointing to the importance of multimodal measurement.