Misophonia is a difficult condition at any age, but especially for children who have not developed self-regulation and coping skills to handle aversive incidents.  For example, a child will cry if they stub their toe, but an adult will not.  Every misophonic trigger is an aversive incident, though usually less aversive that stubbing your toe.  Still, it is common for children to be very upset and have some form of explosive outburst when triggered, especially in a safe environment, such as at home.

There are a limited number of treatments and management techniques for misophonia for children age 9 and under.  These are described on MisophoniaInstitute.org and on MisophoniaTreatment.com.  The common management techniques for young children include:

• Reducing exposure to triggers
  • Avoiding trigger situations
  • Adding background noise
  • Using headphones and noise apps
• Reducing the sensitivity to trigger sounds
  • Improving overall health
  • Getting enough sleep
  • Positive activities
  • Counterconditioning (Trigger Tamer) but only for a few specific triggers
  • Improving general mood and cooperation

Improving general mood and cooperation

I have found that there are a significant number of children with misophonia who have difficulty with emotional regulation and cooperation/compliance in non-misophonia areas of life.  Children often have conflict with parents over issues like getting ready in the morning, eating, use of electronics (especially stopping), transitions, bedtime, chores, homework, or hygiene.  It may be that a child will do what he needs to do, but only when the parent nags him to do it.  There may also be conflict with siblings.

This conflict contributes to a general poor mood (especially when misophonia issues are added).  Most adults I work with have agreed that when they are in a good mood, their misophonia bothers them less.  This is true for children also.  But what is to be done to change a child’s mood?  How do you make a child more compliant, or a good looser at games?  The answer is warm, positive behavioral parenting skills.  It is also referred to a behavior modification.

Behavior modification is much more than simply using praise and rewards, though these are definitely a part of it.  Behavior modification is a planned way to address child behavior issues that increases the child’s skill of doing the appropriate behavior, motivates the child to willing engage in the behavior, and interactions with parents that strengthen the relationship.  As a behavior scientist and parenting coach, my primary work with families is to help every member of the family be happier.  Because of the behavior science foundation for these skills, they are predictably successful.

The process is not to convince the child that they need to behave better.  Talk does not easily change behavior.  The process is for the adults to meet each week and make a plan to teach and motivate better behavior in a specific situation.  When the child engages and behaves well, she enjoys the positive reward and also experiences positive feelings.  At first, the child behaves appropriately just for the reward.  We start with a “shallow” behavior change, but over the course of a few months, the behavior change becomes “deep” and lasting.  What starts is eliminating conflict over the bedtime routine ends up with a whole new pattern of cooperation and positive interaction between parents and child.  The child feels better because she is behaving well.  She feels better because the negative interactions with parents are greatly reduced.  And best of all, concerning misophonia, because she is feeling and behaving better, the impact of their misophonia is reduced.

So for children age 9 years and under, I recommend that parents engage in a positive behavior modification process with a parenting coach and behavior expert.  I am such an expert, and have been working as a behavioral parenting coach for the past 10 years.  (This is how I became involved with misophonia).  It is the most enjoyable work for me, and I work with individuals worldwide thanks to the great communication available with internet video chat.