Publication Date

Spring 2016

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Terea Giannetta

Second Advisor

Ruth Rosenblum

Third Advisor

Dian Baker


Therapeutic listening communication, Children with autism, Hyperasusis


Hyperacusis, or auditory hypersensitivity, is defined as abnormally sensitive hearing and in some cases an extreme sensitivity, where normally tolerated sounds are perceived as excessively, even painfully loud. This is a debilitating condition for children with autism, causing activity limitations and participation restrictions, also leading to peer isolation and habitual sound avoidance behaviors.

This research explores a means of modifying the auditory environment of a child with hyperacusis in a safe, effective way for the purpose of improving attention span and facilitating learning. The small pilot study (n=4) was a single-subject, multiple-baseline design, conducted with school-aged children in the special education classroom setting. The researcher and associate have designed, developed, constructed, and safety tested the electronic device used in the study; it combines existing sound therapies of white and pink noise generation, noise cancelling headphones, and receives wireless communication from the teacher(s), in a small, wearable package that allows individual preference in user control of the audio levels.

Research consisted of twelve classroom sessions, 15 to 30 minutes in length, with subjects wearing the device during normal classroom instruction. Some sessions added controlled levels of white or pink noise and some did not. Sensory and behavioral data for each child in the study was captured pre- and post-study from both the caregiver/parent and the teacher using the nationally recognized Sensory Profile 2™ tool. The researcher also observed each session, recording qualitative data about student behaviors and classroom interactions along with the physical aspects of wearing and functioning of the device.

Study results were compiled and found to be generally favorable; the study subjects overall showed varying amounts of improvement in attentiveness during classroom activity and interaction, while wearing of the device was readily accepted across all participants. Research results indicated where some improvements to the device could be made; teacher and parent comments were all positive and supportive of the concept. This study has shown the device may have a beneficial result toward the research objective and warrants further research on a larger scale.


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