Transitional Intervention for Hyperacusis in Autism

Aided Modified Continuous Contour Test

Sound intensity (dB SPL) corresponding to a judgment of "loud, but okay" for continuous speech as measured in the modified continuous contour test (Aided MCCT) during aided listening (i.e., while wearing study hearing aid devices) in the test ear (TE). In this trial, the TE is the participant's ear with the poorest pre-treatment sound tolerance. This measure was chosen to maximize validity, reliability, and utility relative to available alternative outcomes. The continuous speech stimulus used to evaluate loudness perception is a 16-second passage known as the "Carrot Story" that is spoken by a female talker with neutral accent and widely used in hearing aid prescriptive fittings. The passage features a broad sampling of the speech sounds in the English language and has a long-term average spectral shape (LTASS) that matches average vocal effort. The passage is delivered in sound field via the loudspeaker built into a clinical hearing instrument test system.

Hyperacusis Questionnaire

The Hyperacusis Questionnaire is one of the earliest developed and most widely reported subjective tools for assessing supra-threshold auditory hypersensitivity in adults. It has been used both as a screening tool for hyperacusis and as an outcome measure of treatment-related change in hyperacusis severity. The HQ contains 14 items, each rated on a 4-point Likert scale with scores ranging from 0 (no) to 3 (yes, a lot). The total scoring range spans from 0 to 42 with attentional, social, and emotional subscales. Aazh and Moore (2017) proposed an HQ global score ≥ 22 as a cutoff indicator of a LH condition, with greater scores indicative of a greater problem.

Questionnaire on Hypersensitivity to Sound (GÜF)

The GÜF is a tool developed and validated in adult tinnitus patients. In this study, we will use the translation of the questionnaire from the original German to English. The GÜF was designed to evaluate subjective distress and annoyance associated with hypersensitivity to sound using 16 items, each rated on a 4-point Likert scale with scores ranging from 0 (never correct) to 3 (always correct). The GÜF total score range spans from 0 to 45, with four levels of distress (mild to severe) and three subscales (cognitive reactions to hyperacusis; actional/somatic behavior; and emotional reaction to external noises).

Tampa Scale of Hyperacusis

The Tampa Scale of Hyperacusis is an English version of the Tampa Scale for Kinesiophobia modified for Hyperacusis. The questionnaire was originally developed as a 17-item index of excessive, irrational, and debilitating fear of movement, physical activity, and fear avoidance related to (re)injury in chronic pain patients with musculoskeletal disorders. It was adapted for use as a subjective tool to assess pain of suffering due to sound exposure in adults. We have translated their Swedish version for use with English-speaking hyperacusis patients. It has 17-items and uses a 4-point response scale with scores ranging from 1 (strongly disagree) to 4 (strongly agree). Higher scores indicate hyperacusis of greater severity; the cutoff for a clinically meaningful condition is ≥ 37.

Tinnitus Questionnaire

The Tinnitus Questionnaire is a 52-item questionnaire designed to establish tinnitus severity, a condition that is highly co-morbid with Loudness Hyperacusis. It consists of 52 items scored on a three-point Likert scale (0, 1, 2). The questions are grouped into five subscales: psychological distress, intrusiveness, hearing difficulties, sleep disturbances, and somatic complaints. This was the primary outcome measure in our successful Phase III NIH-sponsored clinical trial that investigated the efficacy of Tinnitus Retraining Therapy. The TQ was chosen for its excellent validity and generalizability properties. Higher TQ scores indicate greater tinnitus severity.