Evanna has always been sensitive to environmental stimuli. In the NICU, she required a calm, quiet, low light environment and gentle, slow handling. Add noise, light, or a nurse who "gets it done" and she would be stressed, irritable, and crying.
As she's gotten older, her tolerance for loud sounds has improved. She will comment, "Loud," when she hears certain noises like a nearby train or a low flying plane overhead. But generally, she tolerates sound fine.
One exception is the skating rink. Once a month, we join our homeschool group at the skating rink. Josh and Maddie look forward to going; Evanna does not. So far, we've made it through the two hour session with distraction: I bring her tablet for her to watch her favorite TV shows or she watches me play some games and win tickets to get her a small prize.
This month's meet up didn't go so well. She immediately freaked out at the door. I managed to get her inside but couldn't distract her. We went into the closed party room to dampen the sound a little, but that only worked about fifteen minutes. We eventually retreated to the car to wait until the end of the session as I did not want to cut Maddie and Josh's day short. (They are great about tagging along to all of Evanna's stuff, so they deserve something for them too.)
We know that sensitivity to sound is common in people with hydrocephalus, a condition many with Spina Bifida have. Adults have described sensations in the shunt itself, an echoing sensation, nausea, anxiety, etc. So...
...we bought her noise canceling headphones. She even got to pick out the color. Hopefully, these will give her comfort in loud situations and allow her siblings to continue skating.