Decreased Sound Tolerance in Autism: A Clinical-Phenomenological Study

Decreased sound tolerance (DST) is a common, yet understudied, sensory experience among individuals with autism. Beyond neurobiological or behavioral explanations, DST can be understood phenomenologically as a distinct mode of auditory being-in-the-world. This study examined how adults with autism experience, interpret, and inhabit their auditory world in situations where sound becomes overwhelming or invasive.

Eight adults with autism were recruited through social media and participated in in-depth semi-structured interviews focused on their experiences with DST. Participants had a prior clinical diagnosis of autism established by a neurologist or psychiatrist (in some cases supported by ADOS-2), which was subsequently verified by the research team according to DSM-5 criteria. The interview guide was designed to collect information about perception, informed by Karl Jaspers' clinical phenomenology and Maurice Merleau-Ponty's philosophy of perception as sensitizing frameworks. Data were analyzed using Amedeo Giorgi's method, which includes holistic reading, delineation of meaning units, transformation into phenomenological-psychological language, and eidetic synthesis.

Participants described DST as an embodied and relational shift in how sound was encountered. Certain sounds are experienced as intense, intrusive, or difficult to accommodate, affecting bodily attunement and ongoing activities. The phenomenon fluctuated with emotional state, fatigue, and contextual predictability and was often accompanied by physical exhaustion and a need to recalibrate through rest or withdrawal. Alongside these challenges, participants also reported moments of heightened clarity and attunement, revealing a distinctive way of perceiving and engaging with the auditory world.

DST in individuals with autism might be understood as a modification in the structure of embodied perception and auditory attunement, beyond a mere sensory alteration. From a phenomenological perspective, DST reflects a particular relational configuration with the auditory world that shapes embodiment, affectivity, and intersubjectivity. These findings contribute to the emerging phenomenological psychopathology of autism by describing how auditory experience can participate in the formation of lived presence and being with others.