Autism & Developmental

Misophonia Symptoms in Autistic Adults.

Smit et al. (2026) · Journal of autism and developmental disorders 2026
★ The Verdict

Expect sound rage in autistic adults, treat sensory sensitivity as the lever.

✓ Read this if BCBAs serving autistic adults in clinic, day-program, or residential settings.
✗ Skip if Practitioners who work only with toddlers or clients without sound complaints.

01Research in Context

01

What this study did

Kaplan-Kahn et al. (2026) ran an online survey with autistic adults. They asked how often everyday sounds trigger anger or distress.

The team also measured general sensory sensitivity. They wanted to see if sound over-reactivity is part of wider sensory differences.

02

What they found

Autistic adults scored much higher on misophonia than typical adults. Females and people with extra diagnoses had the strongest scores.

Statistical tests showed sensory sensitivity partly explains the link. When the body reacts strongly to lights, textures, or smells, mouth sounds or pen clicks hit harder.

03

How this fits with other research

The result lines up with Ando et al. (1979). That older study showed maladaptive behaviors often stay put as autistic children grow. Misophonia looks like one more adult carry-over.

It also echoes Poppes et al. (2010). In profound ID, staff reported daily self-injury yet rated it "minor." Here, internal sound distress may be hidden too.

Fellinger et al. (2022) found poor language drove behavior problems in deaf adults. Likewise, Kaplan-Kahn et al. (2026) flag sensory channels, not IQ, as the risk point.

Finally, the paper extends Pitchford et al. (2019). That team called for harmonized adult tools. Measuring misophonia could now join the standard battery.

04

Why it matters

Screen every adult client for misophonia, especially women and those with anxiety or ADHD. Add two quick questions about rage at chewing or tapping to your intake. If scores are high, fold sound desensitization or headphone breaks into the behavior plan. Target broader sensory sensitivity first; it may dial down the trigger power of specific noises.

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Add a three-item misophonia checklist to your adult intake form and offer noise-canceling headphones during sessions.

02At a glance

Intervention
not applicable
Design
survey
Sample size
1050
Population
autism spectrum disorder
Finding
positive
Magnitude
medium

03Original abstract

PURPOSE: Misophonia is the adverse emotional reaction to everyday sounds (e.g., chewing or pen clicking). Since atypical sensory experiences are a key feature of autism, we investigated whether autistic individuals are more liable for experiencing misophonia symptoms. In addition, we explore the contribution of sensory sensitivity to misophonia symptoms in autism. METHODS: Autistic adults (N = 1050) filled out the Amsterdam Misophonia Scale-Revised (AMISOS-R), the Autism Spectrum Quotient (AQ-28), and the Sensory Processing Questionnaire (SPQ). Chi-square tests were applied to compare proportion of moderate or higher AMISOS-R scores over 20 to previously reported values in the extant literature. Next we modelled the quantitative level of AMISOS-R scores as function of AQ-28 with age, sex, and co-occurring disorders. Finally, we ran a mediation model adding SPQ as a mediator. RESULTS: Autistic people reported moderate to extreme levels of AMISOS-R in higher proportion than the general population. In particular autistic females and those with co-occurring disorders scored higher. In quantitative models, we found that autistic traits strongly predicted misophonia symptoms after correcting for multiple covariates. Both the hearing and vision subscales of the SPQ significantly mediated the effect. CONCLUSION: The increased level of misophonia symptoms in autism and the mediation analyses suggest that autistic traits and sensory sensitivity are factors to consider for a subset of misophonia sufferers, with possible consequences for their clinical interventions.

Journal of autism and developmental disorders, 2026 · doi:10.4103/indianjotol.indianjotol_117_23