Learning Objectives: To understand the factors associated with hyperacusis in children and to identify current management strategies and their outcomes.

Introduction: The current evidence on the benefit from counselling and sound therapy approaches in the management of children with hyperacusis remains poor.

Methods: Retrospective cohort study conducted by case note review over a 5 year period (March 2010-March 2015) in a Paediatric ENT/Audiology service.

Results: 412 children were referred with hyperacusis during the study period. All children were assessed and managed within a dedicated Paediatric hyperacusis clinic by a senior Paediatric Audiologist. Median age at referral was 7 years. 76% were boys. Hearing was normal in the majority of children (n = 407, 98.8%). Of the 5 children with hearing loss, 4 had mild CDHL secondary to OME and had bilateral grommet insertion for the condition; 1 had a profound unilateral SNHL. On average, children were sensitive to 6 identifiable sound stimuli at presentation (range 1–20). 82% complained of sensitivity to noise from household appliances. 60% had a background history of autistic spectrum disorder (ASD), followed by attention deficit hyperactivity disorder (ADHD) (8%) and other neurodevelopmental problems (3%). In 91%, management comprised behavioural therapy combined with provision of a sound-ball (Puretone relaxation therapy ball) for home use. Of these, 25% did not attend their first review. A further 25% were considered to have sufficient symptom improvement to permit discharge after a single clinic review. Only 2% of children required more than 3 review sessions before achieving resolution of symptoms. Only 1% were referred back to the service.

Conclusions: In our series hyperacusis is more common in boys and in children with ASD. A combined treatment approach with behavioural and a sound-ball therapy has a high success rate.