Prevalence of Decreased Sound Tolerance (Hyperacusis) in Individuals With Autism Spectrum Disorder: A Meta-Analysis.

Every included study looked at people at a single point in time, so the paper cannot show whether sound sensitivity improves or worsens as a person grows up. The rise into adolescence and fall afterwards comes from comparing different people of different ages, not from following anyone over time. The studies disagreed enormously with one another and most of that disagreement was not explained by anything the authors measured, so the pooled figure is a rough average rather than a precise estimate for any one clinic. The authors could not tell how severe the symptoms were, so it is not known how many people have sound sensitivity bad enough to need clinical help. Only 8 estimates came from behavioural or objective testing, too few to test what influenced those results. Many studies used broad parent-report screening items, which may have counted misophonia, phonophobia or trouble concentrating in background noise as hyperacusis. Studies of autistic adults were scarce (6 samples), and the authors extracted only autistic samples, so they could not compare how much more common this is in autism than in the general population.

Do not read the pooled prevalence as the number of your autistic clients who need treatment for hyperacusis. The studies disagreed widely with one another, symptom severity was not measured, and most of the pooled figure comes from parent-report screening items that may also pick up other sound-related complaints such as misophonia. Objective testing in the few studies that used it gave lower estimates.