As a clinician who works with children who have tinnitus and hyperacusis (a lowered tolerance of everyday sounds), I’ve seen first-hand how children can be worried or have anxiety related to their conditions.

I’ve relished the opportunity to be able to research into this and understand how anxiety could be associated with tinnitus and hyperacusis.

There has not been much research done to understand how tinnitus or hyperacusis affect children’s mental health, and this was related to the research priorities identified by a partnership between the British Tinnitus Association and the Nottingham Hearing Biomedical Research Unit in 2013. So I was glad to be able to look into this further and understand how and why anxiety may be linked to the conditions in children and young people.

Our research study

The aim of our study at was to find out whether levels of anxiety were higher the more severe the tinnitus is in children and young people. Levels of anxiety were also compared in children with and without hyperacusis.

The study recruited 139 children attending Hearing Services at Sheffield Children’s Hospital in the 8-16 years age group. These included 98 children who had tinnitus, and 41 without tinnitus; 31 of these children had hyperacusis (with and without tinnitus).

The children and young people were each asked whether they had tinnitus, and if they had, they were asked to rate its severity if present, using 0-10 scales. They were also asked whether or not they suffered from hyperacusis which actually affected their day-to-day lifestyle.

The study participants were then asked to complete a short questionnaire specially designed to measure levels of anxiety in school-aged children- the State-Trait Anxiety Inventory for Children [Speilberger 1972].


All the data collected from the children and young people taking part were then analysed to see how anxiety was related to tinnitus, taking into account the presence or not of hyperacusis, and of other factors such as hearing levels, and age.

The study’s results showed that:

  • Levels of state and trait anxiety were higher in children and young people with tinnitus and/or hyperacusis than in children without. State anxiety reflects how the child was feeling specifically at the time in the clinic, whereas trait anxiety reflects the tendency to be anxious across different situations, in other words, a personality trait.

  • Tinnitus and hyperacusis are particularly associated with higher levels of trait anxiety in children and young people. Age and hearing levels did not significantly affect the levels of anxiety.

It is hoped that the results of this study will encourage those professionals working with children and young people with tinnitus and hyperacusis to not just focus on the ears and hearing but to consider that the children may also be quite anxious.

Clear explanations and reassurance about tinnitus, and introducing interventions such as counselling and relaxation techniques in the clinic may significantly ease a child’s anxieties, and hopefully prevent further exacerbation of tinnitus symptoms.

The study was supported by a grant from The British Tinnitus Association.



Hall DA et al. Identifying and Prioritizing Unmet Research Questions for People with Tinnitus: the James Lind Alliance Tinnitus Priority Setting Partnership. Clinical Investigation 3(1) 2013

Speilberger DC. Manual for the State-Trait Anxiety Inventory for Children, Palo Alto CA, Consulting Psychologist Press, 1972.

About the author

Samantha Lear is Lead Clinical Scientist in the Hearing Service department of Sheffield Children's NHS Foundation Trust.