I created this song to help people better understand misophonia.

It’s not about volume. It’s not about being dramatic or picky. It’s about how certain soft sounds (breathing, chewing, clicking, whispering) can feel physically threatening to someone whose brain can’t filter them out. These sounds bypass logic and go straight to the nervous system.

Misophonia can quietly unravel relationships. It creates guilt, distance, and frustration in families that care deeply but don’t know how to bridge the disconnect. You can’t see it. You can’t measure it. But it’s real. And it affects how people live, work, sleep, and connect with others.

This song is one person’s way of making that invisible experience visible.

Of saying, “You’re not alone.” And maybe, “Now you get it.”

“The softer the sound, the harder it sticks. The quieter it is, the louder it hits.”

Please feel free to listen and share. Especially with someone who’s trying to understand.

I know my views aren’t always politically correct.

I ramble sometimes, because I’m human, not AI. So instead of juggling every point someone raised, I’m focusing on one.

I’m walking the track using speech-to-text right now. This is all me. No AI. Or at least, it was until I ran into the 8000-character limit. That’s when I asked AI to help me shorten it. Not to rewrite it, just to fit it into the box.

Eventually, I gave up and turned it into a full-fledged post.

You may not agree with me, and that’s okay. I agreed with parts of what was said too. But I want to talk about ASL and interpreting, which I care deeply about.

Since we’re already in uncomfortable territory, I’ll bring up another one: Cued Speech.

I was a certified ASL interpreter. I grew up in the Deaf community and attended Gallaudet for two years. I know how human interpretation works, and how often it fails. Many interpreters shouldn’t be interpreting. Some lack the linguistic or cognitive skills, and most DHH students don’t know what they’re missing, so they can’t speak up.

It’s like asking someone to raise their hand if they didn’t hear a beep. How would they know?

They only realize there’s a problem when something important gets misunderstood. But even then, how do they know whether the error came from the interpreter or their own processing?

Sometimes, yes, AI adds things I don’t love. Sometimes it sounds off. But I edit. I shape it. I make it mine. And while I do that, I think about the cost. The electricity. The water. The footprint. I don’t feel great about it. But I also think about all the years I was locked out of my own words.

One example? Those long dashes. Em dashes. AI loves them. It litters them throughout everything. I’ve trained myself to spot them instantly, because I know the second someone sees one, they’ll assume the whole piece was written by a machine. I spend a ridiculous amount of time just trying to clean them out. Not because I care that much about punctuation, but because I know how quickly people use those tiny signals to write me off.

And honestly, it reminds me of how people listen to autistic speech. That slightly robotic cadence. The pauses that don’t follow the usual rhythm. The flatness. Not everyone has it, but some do, and when you do, people notice. I see it in my son. I hear it in some of the kids I work with. It’s a giveaway. A tell. And once people hear it, they decide. You’re different. You’re probably autistic. You’re marked as disabled. And that mark follows you whether you want it to or not.

Before we found our rhythm, it was chaos. literal hell, as my nearly 12-year-old AuDHD/APD son Zack put it. “all hell was breaking loose. The house was in terrible shape. Nobody was doing anything they were supposed to.” And he wasn’t wrong.

We were stuck in a loop of yelling, pushing, begging him to do anything other than watch TV. Some days, we were even shutting off the screen remotely just to force a reaction. It wasn’t working. And none of it felt good. Not for me, not for Zack, not for anyone in the house.

That’s when we found the Joon app and started experimenting with a point-based token system. Just a trial, just to see. Within a week, we were surprised. Within a month, we were sold. (Later, we changed to a different app called "Privilege Points" due to more flexibility and a better yearly cost.)

Zack now earns points for everything from unloading the dishwasher to taking risks on scary amusement park rides. Before he can do anything else, he needs to complete 40 points’ worth of chores. To earn screen time before 6 PM, he has to hit 200 points. If it’s after 6, it’s 100. It’s simple math with powerful meaning.

"Honestly," Zack said, "it works incredibly well. And it’s super consensual. I know what I need to do, and it’s not like someone’s yelling at me to get it done. I just do it." He added, "If I quit the system, I just go back to being told what to do and not getting anything I want. So I’d rather work the system."

Today I recorded a podcast with a homeschool mom who is a virtual occupational therapist and fellow neurodivergent parent. I had heard her name before as a thoughtful advocate in the neurodivergent parenting community. She was sent to me by another professional, Amy Bodkin, an AuDHD educational psychologist and fellow podcaster, who has run into multiple parents of my other patients.

Why We Were Talking

We spent the first part of the podcast talking about auditory processing difficulties, also called functional listening difficulties and their impact on daily life, particularly in homeschool families and households where neurodivergence and sensory sensitivity are everyday realities. The host, a homeschool mom and virtual occupational therapist, had invited me to speak on her show, her podcast, to help parents better understand how listening difficulties can shape behavior, attention, emotional regulation, and even relationships.

As she shared her story... how her daughter’s low-gain hearing aids had changed their home life, I began to piece things together. The off-screen selective-mute child in our early sessions. The fatigue. The trial of devices. The sudden shift in sleep and connection. It was all there.

And then, mid-sentence, mid-moment, the connection suddenly snapped into place. I felt that immediate sense of familiarity, followed by the slow realization that I knew this family. It’s always a little embarrassing not to recognize a client, especially one whose family clearly made an impression. I see a lot of people, and I know how doctors can forget patients based on chart notes alone. But I take pride in seeing people as individuals, not numbers. I really try to meet them where they are. Still, I’ll admit that facial recognition has never been my strength. Back when I worked in a large corporate clinic, I relied on the receptionists to discreetly point out my patients in the waiting room because I often didn’t recognize them on sight. I’m usually better with names, so I was surprised I missed this one. It had only been a few months since I’d seen the mom, and only brief (visual) glimpses of the daughter during our sessions.

And the fact that we were reconnecting in real time, through a recorded conversation meant to help other parents, only underscored what we had both learned: auditory support isn’t just about sound, it’s about survival.

Reposting: A podcast I recorded with host and speech pathologist / neurodiversity specialist Gabriele Nicolet!

What if your child’s struggles with attention, language, or behavior weren’t about what they hear—but how their brain makes sense of it?

I’m joined by Dr. Rae Stout, audiologist and expert in auditory processing, to unpack the often-misunderstood world of Auditory Processing Disorder (APD). We dig into what APD actually is, why it’s so often missed or misdiagnosed, and how things like early ear infections and fluctuating hearing can impact learning, language, and even behavior. Dr. Rae shares eye-opening stories and makes the case for early intervention using low-gain hearing aids—even in kids without hearing loss.

Think about it this way. If you were trialing speech therapy or physical therapy, would you expect to know after two days whether it worked? Of course not. You’d expect a process. You’d expect to measure progress over time, based on how your body or your communication changes with practice and support. You’d listen to the person receiving therapy, and you’d value feedback from the people around them.

Hearing aids for APD are no different. They are not just devices. They are tools for reshaping how the brain interacts with sound. That takes time, consistent input, thoughtful adjustment, and partnership. And just like with therapy, the goal is growth. Not everyone who tries hearing aids will end up needing them long-term. But many choose to keep using them once they realize how much easier life feels with that added support.

I’ll never forget one teen I worked with who started using low-gain hearing aids at age 13. At first, he didn’t even realize how much he was missing. But over the course of that first year, everything started to shift. His focus, his stress levels, even how much energy he had left at the end of the school day. He wore the aids consistently, and by the time we retested him at 16, his auditory processing scores had dramatically improved. According to the well-known research audiologist who had originally tested him, he made more progress than any patient she had seen in the past three years. He no longer tested as having significant APD and didn’t need the hearing aids anymore. But he still chooses to wear them sometimes, especially in noisy environments. He's planning to bring them with him to university next year, figuring they’ll come in handy in large lectures or even at frat parties.

That’s what a good trial gives you. Not just numbers, but clarity. Not just answers, but options.

At the cognitive training center, I found myself nearly falling asleep while trying to keep up with the visual and auditory tasks that the kids and adults were doing, timed to the second. It was exhausting. The room was filled with motion, timers beeping, and the sharp clicks of multiple metronomes interacting in overlapping rhythms. There were no visual separations—just one large, open space echoing with layered sound. Voices, footsteps, and mechanical cues all competed for attention. Every surface reflected sound, and every corner demanded awareness. There was nowhere to rest your eyes, and no acoustic break to regroup.

The energy was intense. It was structured and purposeful, but unrelenting. And it made me realize just how much I’ve been compensating all these years. I struggle with memory, focus, and fatigue even in environments where I’m supposed to be the expert.

This mirrored the very challenges I see in my son and those I now recognize in myself. The desire for better focus. The fatigue after conversation. The inability to hold on to a thought while someone else is speaking. It helped me understand why I interrupt, why I lose the thread. When memory is fragile, it’s hard to wait your turn. You speak not to dominate, but because the idea might vanish if you don’t.

These aren’t just patient struggles. They are ours too. And seeing that in myself reminded me how essential it is to stay humble, stay curious, and look at our blind spots with compassion.

We are not lacking research because the tools do not work. We are lacking research because the system is not built to study interventions that must be personalized. That is why so many of us rely on clinical observation and interdisciplinary input. That is why parent reports and school feedback are often more telling than standardized scores. And that is why we continue to do this work, even when the literature is behind us rather than ahead of us.

What we are doing is not easy to measure. But it is not anecdotal. It is functional. It is repeatable. It is observable. And it is deeply rooted in the real-world needs of children who are struggling to access the world of sound, speech, and connection.

Don’t be afraid to ask.

I think it’s really important to be in continuous contact with your audiologist during a low-gain programmed hearing aid (LGHA) trial.

There is no universally accepted methodology of fitting these devices, and for that reason the implementation can vary enormously from clinician to clinician, as can the success rate. Many audiologists predominantly work with more traditional patients, and APD hearing aid fitting - that is fittings of hearing aids at low levels of amplification for individuals with normal hearing thresholds - are the exception rather than the norm.

We are all learning. It’s a constant learning process of how to do these kinds of fittings because there are no trainings nor accepted prescriptive targets. It is challenging to get enough power to make soft sounds audible and clear, medium sounds comfortable, and loud sounds non-disturbing and safe.

It is to be expected that the initial settings may not be ideal. They are just a rough draft. Just like in creating a sculpture, we have to chip away or add material until it is just right.