Assessment and Treatment of Noise Hypersensitivity in a Teenager with Autism Spectrum Disorder: A Case Study
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ORIGINAL PAPER
Assessment and Treatment of Noise Hypersensitivity in a Teenager with Autism Spectrum Disorder: A Case Study Jill C. Fodstad1,2 · Stephanie A. Kerswill1 · Alexandra C. Kirsch3 · Ann Lagges1,2 · Jonathan Schmidt4,5
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Noise hypersensitivity is a poorly understood symptom of Autism Spectrum Disorder (ASD). For some, problem behaviors co-occur with the aversive noise. Limited literature exists on treating noise hypersensitivity; however, noise hypersensitivity may be related to a specific phobia. This case study utilizes modified Cognitive Behavioral Therapy (CBT) to address anxiety, avoidance, and problem behaviors evoked by noise in a teen with ASD and mild Intellectual Disability (ID). Using multi-method assessment and individualized treatment, problem behaviors reduced, and independent coping strategies use occurred. Successful desensitization supports the efficacy of modified CBT as a treatment for noise-related anxiety and problem behaviors in individuals with ASD and ID. Outcomes are discussed considering intervention difficulties for noise hypersensitivity in a complex and diverse population. Keywords Autism spectrum disorder · Cognitive behavior therapy · Systematic desensitization · Noise hypersensitivity · Problem behaviors · Anxiety Individuals diagnosed as having an Autism Spectrum Disorder (ASD) exhibit significant deficits in the areas of communication and socialization, as well as excesses in the areas of repetitive behaviors and circumscribed and intense interests (American Psychiatric Association 2013). One core symptom commonly reported, yet poorly understood, is sensory sensitivity, especially to noises. Sensory sensitivity is a pattern of atypical responses to information from the senses. Sensory sensitivities can be characterized as either hypersensitivity, an exaggerated response to sensory information, * Jill C. Fodstad [email protected] 1
Department of Psychiatry, Indiana University School of Medicine, 355 W. 16th St., Suite 4800, Indianapolis, IN 46202, USA
2
Indiana University Health Physicians, Indianapolis, USA
3
Department of Psychiatry and Behavioral Sciences, Northshore University HealthSystem, 2300 Lehigh Ave., Suite 215, Glenview, IL 60026, USA
4
Department of Psychiatry and Behavioral Sciences, Kennedy Krieger Institute, 707 North Broadway, Baltimore, MD 21205, USA
5
Johns Hopkins University School of Medicine, Baltimore, USA
or hyposensitivity, a less intense than expected response to sensory information (Baranek et al. 2006). It is well established that children with ASD commonly have hypersensitivity or hyposensitivity to noise stimuli (Baranek et al. 2006; Jones 2003); however, little is known about how best to assess and treat noise sensitivity. Over half of all individuals with ASD experience some form of sensory hypersensitivity (Baranek et al. 2006; Mazurek et al. 2013). Further, approximately 40% of children with ASD show signs of noise hypersensitivity,
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