بِمَعْنَى أَنَّ اللَّهَ تَعَالَى يَخْلُقُ الْإِدْرَاكَ فِي النَّفْسِ عِنْدَ ذَلِكَ
That is, God creates apprehension in the soul at that occurrence.
In the theological account, hearing occurs through divine creation of perception when the ordinary bodily conditions are present. “At the cause” does not grant the physical condition autonomous or necessary efficacy independent of God.
The presence of appropriate physical conditions matters in ordinary hearing. Their role as accustomed means is not denied; the claim concerns the ultimate source of the act of perception.
One must distinguish an account of sensory mechanisms from an account of metaphysical causal efficacy.