Honors Theses

Date of Award

Spring 5-13-2023

Document Type

Undergraduate Thesis


Communication Sciences and Disorders

First Advisor

Gregory Snyder

Second Advisor

Toshikazu Ikuta

Third Advisor

Kristin Austin

Relational Format



Level 1 autism spectrum disorder (ASD) is a high-functioning neurodevelopmental disorder (Hodges et al., 2020; Hosseini & Molla, 2023). Several features of level 1 ASD negatively impact quality of life (QOL), and auditory sensitivity (specifically hyperacusis) is one of the most prevalent and disabling features (Danesh et al., 2015, 2021; Kuiper et al., 2019; Williams et al., 2021). Hyperacusis significantly impacts QOL in the level 1 ASD population, as current hyperacusis treatment strategies often result in various forms of social isolation (Adams et al., 2021; Danesh et al., 2015; Neave-DiToro et al., 2021).

However, Flare Audio markets a product (“Calmer”) that may address hyperacusis in a novel and effective manner (Calmer®, 2022). Calmer is a small silicone ear insert that alters resonance within the ear canal to dampen sound in the frequency range in which humans are most sensitive. The manufacturer of Calmer claims to have success improving QOL for those with hearing sensitivities, specifically including those with ASD and hyperacusis (Calmer®, 2022). Therefore, this research evaluates Flare Audio’s Calmer insert as a novel management for Hyperacusis in level 1 ASD to improve QOL by limiting exposure to agitating stimuli without sacrificing social connectedness.

This three-week pilot study measures the real-world efficacy of using Calmer during the activities of daily living. Participants included 12 adults who self-reported Hyperacusis and a diagnosis of level 1 ASD. Each participant was shipped a pair of Calmer inserts, which were worn for a minimum of three hours per day for three weeks. Data was gathered through a Qualtrics survey at the conclusion of the three-week trial period, and this survey assessed participants’ overall experience with Calmer.

Results reveal that 66% of participant users reported improved QOL measures when wearing Calmer, and 83% reported improvement in their sound tolerance problem when wearing Calmer. However, 33% of participants reported their QOL either “stayed the same” or was “somewhat worse” when wearing Calmer due to tactile sensitivity, product fit, a need for higher decibel protection, and product comfortability. Specifically, 58% of participants reported that wearing Calmer was uncomfortable, making Calmer’s comfortability a prevalent difficulty experienced among participants.

Data suggest that Calmer has the potential to manage hyperacusis for many with level 1 ASD effectively. While traditional treatment strategies may result in social isolation, some participants reported Calmer yielded efficacious results without social isolation. Considering themes among participants, Calmer may be optimal for those without tactile sensitivity who are commonly exposed to agitating sounds. Those who had positive experiences with Calmer reported a significant improvement in QOL when wearing this device. However, tactile sensitivity, social isolation, or a need for higher decibel protection may lessen the likelihood of success with Calmer inserts. Further research is warranted to expand external validity.

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Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Available for download on Saturday, May 02, 2026