How Children Develop Misophonia

by Tom Dozier

Note:  The following is my opinion based on a number of children I worked with and comments of parents and adults with misphonia.

Misophonia develops through an experience process called “conditioning.”  It is a process where we develop (acquire) a reflex reaction to some predictable/repeating stimulus.  It is an automatic human process, and we cannot “make” a child do it or not do it.  The process consists of pairing a stimulus and a emotional/physical condition.  The stimulus can be any repeating sound.  The most common one is an eating sound, but it could also be a breathing sound, muffled voices through walls, typing, a consonant sound of your voice  (like “s”), or any other sound.

In an article about treating misophonia and other hearing conditions, Dr. Pawel and Margaret Jastreboff wrote that misophonia reactions, “are governed by the principles of conditioned reflexes, with the subconscious part of the brain playing a significant role.”  (The Jastreboffs proposed the name “misophonia” in 2002.)  I include this here as support for the idea that misophonia is developed through experience, and not something that just happens because of a brain defect or genetic condition.

Two Types of Kids Develop Misophonia

I have generally found that there are two types of children who develop misophonia.

“Type 1” Kids:  First, there is the compliant and sensitive child.  This child is cooperative, caring, and emotionally in tune with the feelings of others.  The child may not show any outward signs of being upset, but when mommy or daddy is upset, they are upset.

An adult patient told me her story of developing her first misophonia trigger.  She was sensitive to her father’s feelings, and her brother smacked when he ate.  At the dinner table, her father would reprimand her brother for smacking (which would distress her).  After a few minutes, the boy would be smacking again.  Hearing that sound was distressing to her because she knew her father didn’t like it.  So, at a later time, when she was calm (like breakfast) and father was not there, she heard the smacking sound and the misophonic reflex created the distress condition of the dinner table.  After the child develops misophonia, the child may become very demanding regarding the trigger and have emotional outbursts.  This is a common characteristic of misophonia.  It does not make him a “Type 2” kid.

“Type 2” Kids:  The second type of child to develop misophonia is the strong-willed, volatile, and a strong sense of fairness (though likely incorrect).  This child creates her own world of distress.  She may complain about bedtime, leaving the park, having to turn off the video game, or not getting to do something.  This child will often have conflict with a parent or sibling.

A 10-yr-old girl I worked with developed her misophonia trigger to her younger brother’s crunching at the dinner table.  They had a running battle of “stop staring at me.”  She would get upset and yell, he would argue and crunch, crunch, crunch (open mouth eating because he had a stopped up nose).  After the reflex developed, when she heard him crunch his food, her brain automatically jerked the muscles in her arms, shoulders, and legs, which she was tightening when she was fighting with him at the dinner table.  It was like she was getting tazered (zapped) in those muscles.

On a Facebook group post, I posed the following question.
I have observed that kids with miso generally fall into 2 classes.
#1. Well behaved, almost ideal kids. Very conscientious and cooperative. Seemingly stable emotionally.
#2. Strong-willed kids, who get upset easily, and make strong, emotional demands for what they want.
Would you say that your child fits #1, #2, or other (please specify)?

I got 36 responses – 21 for #1; 13 for #2; 2 for both.  I think this is pretty good agreement with my general observation.

“Type SPD” – Sensory Processing Disorder or Sensory Over-Responsiveness:  There does seem to be a 3rd group, which could either be Type 1 or Type 2 kids (or neither).  This are kids who have sensory sensitivities.  With these kids, sounds are more upsetting.  Clothing tags, clothes, shoes, or light may cause distress.  These kids simply have more times when they are distressed with a connection to repeating sounds.  This also seems to contribute to development of misophonia, and was pointed out in one research study.

Developing the First Misophonia Trigger

The reason that these two types of kids develop misophonia is because both types experience emotional/physical distress.  The #1 type kids may have distress from being sensitive to the feelings of others.  It is my guess that kids with anxiety or Obsessive Compulsive Disorder are type #1 kids, and these genetic conditions also create distress that could lead to misophonia.  Type #2 kids create their own emotional upheaval and distress.  Either way, it is the pairing of a distressed state and a repeating sound, especially when the repeating sound plays a part in the distress of the individual.

Is Misophonia Caused by Genetics or Environment (experience)?

The answer is “both.”  Genetics plays a large part in a child being a Type #1 or a Type #2.  Genetics is likely the sole or dominate cause of Sensory Processing Disorder.  But experience in the home also plays a critical part.  Some kids are extremely mellow.  This has both a genetic component and an experience component.  These mellow kids seem very unlikely to develop misophonia.  So we should not say that misophonia is caused by genetics or by environment.  It takes both.  What we can say is that misophonia is not simply a genetic condition, what turns on like a switch at a certain age.  We know this because there are many cases where misophonia does not begin until the person is an adult.

What’s a Parent To Do?

This is a difficult situation for you as a parent.  Others (or you) may say that your child is behaving like a brat.  It seems that your child should be able to just ignore the sound, but they don’t!  Maybe you think your child just wants to have power over the family.  Misophonia is a unique disorder where a common sound causes your child great distress.  Your child is not choosing to be bothered by the sound – being distressed by the sound is an involuntary, reflex reaction.

504 PlanIf you let the misophonia run its natural course, you should expect it to get progressively worse with time.  More trigger sounds will develop.  Visual triggers will develop.  Triggers often develop at school or with friends.  Once this happens, the misophonia can have a large, negative impact on your child’s life.

There are treatment options.  Some are expensive.  Some are difficult to implement.  No treatment works for every child.  But there are very important things that you can do to help your child with this condition.  There are things that can reduce the reactions.  There are treatments that have helped others.  So do what you can, as soon as you can.  The Misophonia Institute is here to help you understand your options and can help you find treatment providers that can help you.  Even though treatment and management of misophonia is difficult, there is hope because we are making steady progress on misophonia treatment, and more researchers are getting involved.