How Children Develop Misophonia

Misophonia is understood to develop through an experiential process known as conditioning. Conditioning is a process by which a reflex reaction is acquired in response to a predictable or repeating stimulus. This is an automatic human process and is not something that can be intentionally initiated or prevented. The process involves pairing a stimulus with an emotional or physical state. The stimulus may be any repeating sound. Eating sounds are the most common, but triggers may also include breathing sounds, muffled voices through walls, typing, certain consonant sounds (such as “s”), or other repetitive noises.

In The neurophysiological approach to misophonia: theory and treatment, Drs. Pawel and Margaret Jastreboff write, "Patients with misophonia could not control internal emotional reactions (even when fully realizing that these reactions are disproportionate to benign sounds evoking them), suggesting that subconscious, conditioned reflexes linking the auditory system with other systems in the brain are the core mechanisms of misophonia." This perspective supports the view that misophonia develops through experience rather than arising solely from a brain defect or genetic abnormality.

Two Common Patterns in Children Who Develop Misophonia

Based on clinical observations, Dozier has identified two general patterns among children who develop misophonia.

Type 1: The Compliant and Sensitive Child

The first pattern involves children who are cooperative, caring, and emotionally attuned to others. These children are often sensitive to the emotional states of parents or caregivers. They may not outwardly express distress, but they internalize emotional tension in their environment.

One adult patient described the development of her first misophonia trigger during childhood. She was highly sensitive to her father’s emotional reactions, and her brother frequently smacked while eating. At the dinner table, the father would reprimand the brother, which caused distress for the patient. Although the reprimands would temporarily stop the behavior, the smacking would resume. Over time, the sound of smacking became associated with emotional distress. Later, even in calm situations—such as breakfast, when the father was not present—the sound alone triggered the distress response. This pairing of sound and emotional state led to the development of a misophonic reflex.

After misophonia develops, children in this group may become demanding about triggers and may exhibit emotional outbursts. This behavior is a common characteristic of misophonia and does not indicate a different underlying pattern.

Type 2: The Strong-Willed and Emotionally Reactive Child

The second pattern involves children who are strong-willed, emotionally reactive, and often driven by a heightened sense of fairness. These children may experience frequent emotional conflict related to daily routines, limits, or interactions with siblings.

One example involved a 10-year-old girl who developed a misophonia trigger related to her younger brother’s crunching sounds at the dinner table. The siblings frequently argued, particularly around perceived staring and teasing. During these conflicts, the child experienced intense emotional arousal while hearing repetitive eating sounds. Over time, the sound became associated with muscle tension in her arms, shoulders, and legs—muscle groups that were activated during emotional confrontations. Once the reflex developed, the sound alone produced an immediate physical reaction, described as feeling similar to an electrical jolt in the muscles.

Observational Survey of Child Patterns

In an informal observational survey conducted by Dozier via a Facebook group, parents were asked whether their child with misophonia fit one of two general patterns:

1. Well-behaved, conscientious, cooperative children who appear emotionally stable

2. Strong-willed children who become upset easily and express strong emotional demands

Of the 36 responses received, 21 identified with the first pattern, 13 with the second, and 2 with both. These responses were consistent with broader clinical observations.

Sensory Processing Sensitivity as a Contributing Factor

A third group may include children with sensory processing differences, such as sensory over-responsiveness. These children may be sensitive not only to sound, but also to clothing textures, tags, light, or other sensory input. Because these children experience distress more frequently, they may have increased opportunities for pairing distress with repeating sounds. This pattern has also been noted in research literature and may contribute to the development of misophonia.

How the First Misophonia Trigger Develops

Both primary patterns involve exposure to emotional or physical distress. Sensitive children may experience distress through empathy or anxiety, while strong-willed children may generate distress through frequent emotional conflict. In both cases, misophonia develops when a repeating sound becomes paired with a distressed state. The sound itself becomes a trigger that automatically evokes the associated physical and emotional response.

Is Misophonia Caused by Genetics or Environment?

Current understanding suggests that misophonia develops through both genetic predisposition and environmental experience. Genetics likely influence whether a child exhibits traits associated with the first or second pattern, as well as sensory processing differences. However, environmental experiences play a critical role in whether misophonia develops. Some children with calm temperaments—shaped by both genetics and environment—appear unlikely to develop misophonia.

Importantly, misophonia does not appear to be a purely genetic condition that activates automatically at a certain age. This is supported by numerous cases in which misophonia first appears in adulthood.