The BBC article states that five NHS audiology departments reported an increase in young people being referred to audiologists for hearing issues—only to discover that their hearing tested within the acceptable range. Instead, the problem was the way in which their brains recognized, identified, and decoded sound, causing some audiologists to wonder whether the extensive use of ANC headphones was affecting listening and sound-processing skills.
Although the original article was based only on speculative anecdotal reports, subsequent articles by other outlets referenced the reporting as a study, research, or findings, which is not accurate. Brian Fligor, PhD, PASC, president and clinic director at Tobias & Battite Hearing Wellness, whom we’ve interviewed many times for our coverage on hearing health and safety, told me, “As a pediatric audiologist with specific expertise in the use of headphones, [I can say] there is no evidence APD can develop secondary to using any headphone, and certainly not active-noise-canceling (ANC) headphones.… APD is linked to auditory deprivation in children prior to developing spoken language, such as from chronic middle-ear fluid from untreated ear infections (though the link here is weak). The only adult-onset/adventitious onset of APD I know of is secondary to traumatic brain injury.”
Maria Pomponio, AuD, CCC-A, doctor of audiology at Stony Brook Medicine Speech and Hearing Department, agreed: “Regular headphones and noise-cancelling headphones are safe—as long as they’re [used] at an appropriate volume.”
Other experts I spoke to cautioned not to attribute causation where there may just be correlation. Audiologists may have noticed an increase in post-childhood APD diagnosis for any number of reasons.
“Oftentimes individuals develop compensatory strategies,” Courtney Baker, AuD, CCC-A, owner and principal audiologist at Hearing Brain Audiology, said. “For example, they may have an auditory processing disorder from a young age and be able to cope until they get into college, where listening environments are a lot more demanding. Then those prior strategies fail, prompting a whole audiology workup and a diagnosis of auditory processing disorder. Now, just because they went to college and the listening demands are harder doesn’t mean that that’s what gave them the auditory processing difficulties—they were likely there the whole time. It’s just that [the patients] were able to manage previously.” When the compensation strategies fail, the sudden awareness of listening difficulties might be disruptive and frightening enough to motivate people to seek a diagnosis.
Smart points to additional potential lifestyle factors, including time spent in isolation during the pandemic and changes in attention span due to digital devices. “There are so many other things that have been going on in the past five or six years … we can’t ignore the elephant in the room that is called ‘distracted brain.’ It’s like ‘I have trouble paying attention to something, even in quiet, if I’m thinking about something else or looking at my phone.’ And so I think it’s important to notice a pattern. I think it’s more important to investigate.”
Auditory processing disorder is also interconnected with many conditions where headphone use has been encouraged. Fligor pointed out that APD is associated with neurodiversity, including autism, ADHD, dyslexia, and other specific learning disabilities. And many people who experience auditory sensory overload—officially diagnosed or not—use headphones, earplugs, or hearing-protection earmuffs as a coping mechanism. In fact, headphones, in combination with a remote microphone for instructors, are commonly recommended for school-age children who struggle to focus due to auditory overstimulation.
Any device that covers the ears, if worn for long periods, can cause previously tolerable sounds to feel more intense when you remove it. This is especially true for people with hyperacusis, misophonia, or tinnitus. “Taking headphones off and then being unable to process is a jarring experience,” said Baker. “But it’s most likely the same type of experience as when people’s compensatory strategies fail.”
Regardless of the cause, for people who experience APD, the challenges of life in this sonically busy world remain. But help is available.
