There is broad consensus in both national and international frameworks that promoting inclusion in education should serve as both a guiding principle and an aspirational goal for all students (United Nations, 2007, 2023; UNESCO, 1994). Inclusive education values all students by providing equitable, high-quality learning experiences while avoiding the marginalization of learners in mainstream settings (Subban et al., 2023). Instead of requiring individuals to adapt to a given environment, inclusive education focuses on adapting the environment to meet the diverse needs of students (Hardy & Woodcock, 2015).

However, research highlights challenges in including students with neurodevelopmental conditions, such as autism, in mainstream schools, exposing a gap between the policy intentions of inclusion and its practical implementation (Bölte et al., 2021; Roberts & Simpson, 2015). School staff report feeling inadequately prepared to teach autistic students, and the implementation of inclusive practices and routines remains limited (Bölte et al., 2021). 

Sensory processing differences have been consistently reported among autistic individuals (Kirby et al., 2021; Poulsen et al., 2024) and are recognized as a core feature of autism (American Psychiatric Association, 2013). Among these, auditory sensory differences are the most prevalent (Carson et al., 2022; O’Connor, 2012; Williams, Suzman et al., 2021). Hyperacusis, which frequently co-occurs with autism (Williams, Suzman et al., 2021), is an auditory disorder characterized by heightened sensitivity or reduced tolerance to sounds that typically do not bother most people (Williams, He et al., 2021). Everyday sounds can be perceived as overwhelming, intense, frightening, unpleasant, or even painful (Aazh et al., 2016; Tyler et al., 2014), causing distress and impairment. This can lead to avoidance of certain environments and interactions, reduced participation in meaningful activities, and performance-impairing distractibility, all of which negatively impact overall quality of life (Bendo et al., 2024; Pfeiffer et al., 2019). These challenges are particularly relevant in school environments, which are often characterized by disruptive noise levels.

To manage sound sensitivity, autistic students often use noise-cancelling headphones (NCH) in their daily school life. As an inclusive adaptation, NCH can help reduce sound discomfort, potentially lowering stress and anxiety while improving participation and attention (Pfeiffer et al., 2019; Zanin et al., 2024). However, research also raises concerns about their use, including the risk of missing important information, reduced social interaction, stigma, and increased hypersensitivity to sound (Kulawiak, 2021; Neave-DiToro et al., 2021).

Despite the widespread use of NCH in schools for many autistic students, there is a lack empirical research to justify proper use, and the current body of research does not meet the standards for evidence-based practice (Kulawiak, 2021; Neave-DiToro et al., 2021). There is also a lack of clear guidelines and recommendations for the use of NCH for autistic students in schools, making it challenging for school staff to implement them in ways that support inclusive practices.

This study aims to explore the competencies and perceptions of school professionals and other relevant stakeholders regarding the use of NCH for autistic students in schools. Specifically, it seeks to understand their awareness of NCH and their perspectives on its potential benefits and drawbacks in the school context. Given the limited research in this area alongside the widespread use of NCH, expanding knowledge is essential to prevent uncritical use and support evidence-based decisions and guidelines for future practice.

Research Question:

What are the competencies, awareness, and perceptions of school professionals and other relevant stakeholders regarding the use of noise-cancelling headphones for autistic students in schools?

This study employs a quantitative methodological approach, utilizing a survey for data collection. With permission from the authors, we have incorporated large sections of a research-based survey developed and implemented in a study by Neave-DiToro and colleagues (2021). In addition to adapting the questionnaire to the Norwegian context, we have expanded certain sections. Specifically, we have added a separate section for professionals working in support systems around schools, such as the Educational-Psychological Service and the Child and Adolescent Psychiatry Outpatient Clinic. Furthermore, the survey places greater emphasis on diagnostic procedures and guidelines for addressing auditory sensory difficulties in autistic children and adolescents, as well as professionals' self-reported levels of expertise in this area. In addition to demographic variables, the questionnaire covers key areas that assess professionals' perceptions and knowledge of how autistic students manage sound in school, the use of NCH, and the potential benefits and drawbacks of such use within the school context. The questionnaire also examines the extent to which auditory sensory differences in autistic children and adolescents are considered during the diagnostic assessment for autism, how these differences are assessed, and what guidelines exist for such evaluations. The questionnaire is semi-structured and combines both closed and open-ended questions. Participants in this study will include all school staff who work with or have worked with autistic students. This will not only include teachers and special education teachers but also encompass the entire support system around the student, such as social workers, speech therapists, occupational therapists, and teaching assistants. Additionally, the survey targets staff in diagnostic units and school support systems, including the Child and Adolescent Psychiatry Outpatient Clinic and the Educational-Psychological Service. The digital survey will be distributed through key contacts in schools and other relevant units, as well as through social media.

The data will be analysed and presented using both descriptive and inferential statistics. Descriptive statistics are first used to summarise and describe the data. Inferential statistics will then be used to draw possible conclusions from the sample to the population, to test hypotheses and to assess the statistical significance of the results. The results of this study are expected to shed light on professionals' awareness, competence, and perceptions of the use of NCH for autistic students in the school context, with particular focus on the potential benefits and drawbacks that such use may have in different settings within the school environment and how this can affect individual students. Additionally, the study will contribute to discussions on how NCH can be effectively implemented in practice and the considerations that should guide their use. Increased awareness and research in this field are essential for building a solid knowledge base. This is important due to the sparse research that exists in the field and will be of great importance to the field of practice. There is a need for research that can clarify recommendations and guidelines for the use of NCH in the school settings for autistic students who are affected by noise. Such research will help prevent uncritical use and support professionals in ensuring that they are using evidence-based practices.

Bölte, S., Leifler, E. & Borg, A. (2021). Inclusive practice for students with neurodevelopmental disorders in Sweden. Scandinavian Journal of Child and Adolescent Psychiatry and Psychology. 9(1), 9-15. https://doi.org/10.21307/sjcapp-2021-002 Hardy, I., & Woodcock, S. (2015). Inclusive education policies: discourses of difference, diversity and deficit. International Journal of Inclusive Education, 19(2), 141–164. https://doi.org/10.1080/13603116.2014.908965 Kirby, A. V., Bilder, D. A., Wiggins, L. D., Hughes, M. M., Davis, J., Hall‐Lande, J. A., Lee, L., McMahon, W. M., & Bakian, A. V. (2022). Sensory features in autism: Findings from a large population‐based surveillance system. Autism Research, 15(4), 751–760. https://doi.org/10.1002/aur.2670 Kulawiak, P. R., & Schussler, D. (2021). Academic benefits of wearing noise-cancelling headphones during class for typically developing students and students with special needs: A scoping review. Cogent Education, 8(1). https://doi.org/10.1080/2331186X.2021.1957530 Neave-DiToro, D., Fuse, A., & Bergen, M. (2021). Knowledge and Awareness of Ear Protection Devices for Sound Sensitivity by Individuals with Autism Spectrum Disorders. Language, Speech & Hearing Services in Schools, 52(1), 409–425. https://doi.org/10.1044/2020_LSHSS-19-00119 O’Connor, K. (2012). Auditory processing in autism spectrum disorder: A review. Neuroscience and Biobehavioral Reviews, 36(2), 836–854. https://doi.org/10.1016/j.neubiorev.2011.11.008 Pfeiffer, B., Erb, S. R., & Slugg, L. (2019). Impact of Noise-Attenuating Headphones on Participation in the Home, Community, and School for Children with Autism Spectrum Disorder. Physical & Occupational Therapy in Pediatrics, 39(1), 60–76. https://doi.org/10.1080/01942638.2018.1496963 Poulsen, R., Williams, Z., Dwyer, P., Pellicano, E., Sowman, P. F., & McAlpine, D. (2024). How auditory processing influences the autistic profile: A review. Autism Research, 17(12), 2452–2470. https://doi.org/10.1002/aur.3259 Subban, P., Bradford, B., Sharma, U., Loreman, T., Avramidis, E., Kullmann, H., Sahli Lozano, C., Romano, A., & Woodcock, S. (2023). Does it really take a village to raise a child? Reflections on the need for collective responsibility in inclusive education. European Journal of Special Needs Education, 38(2), 291–302. https://doi.org/10.1080/08856257.2022.2059632 Williams, Z. J., He, J. L., Cascio, C. J., & Woynaroski, T. G. (2021). A review of decreased sound tolerance in autism: Definitions, phenomenology, and potential mechanisms. Neuroscience & Biobehavioral Reviews/Neuroscience and Biobehavioral Reviews, 121, 1–17. https://doi.org/10.1016/j.neubiorev.2020.11.030 Zanin, J., Tomlin, D., & Rance, G. (2024). Effectiveness of Noise Cancelling Earbuds in Reducing Hearing and Auditory Attention Deficits in Children with Autism. Journal of Clinical Medicine, 13(16), 4786. https://doi.org/10.3390/jcm13164786