AUDITORY INTEGRATION THERAPYBY CAITLIN LABARBERA & JESSICA KAY

CALDWELL COLLEGEABA 553 ASSESSING AUTISM INTERVENTIONS

WHAT IS AUDITORY INTEGRATION THERAPY?

Treatment used to help hypersensitive hearing and hearing distortions

Hypersensitive hearing = confusion and discomfort

Interferes with child’s attention Treatment gives the ear an aerobic workout

Retrains the ear’s response to sound

WHAT IS AUDITORY INTEGRATION THERAPY?

Child listens to 20 half hour sessions of music Music is selected by therapist Treatment is modulated by child Electronic device randomly switches

frequencies and durations Treatment needs to take place over 10

consecutive days http://

www.youtube.com/watch?v=MhTOUD4yB34&feature=related

WHAT IS AUDITORY INTEGRATION THERAPY?

Audiokinetron-> BANNED from US because it lacked medical benefit

Not FDA approved However, several unapproved

devices are still used -> Digital Audio Aerobics & Earducator

As long as device is solely used for educational purposes, it does not come under FDA regulations

HOW IS MUSIC SELECTED?

Any instrumental music that has Variety of tone & orchestral richness

Usually suggest Mozart and Bach Reggae Aggressive music (even if the child does not

like it) Music should vary from session to session Writing, reading, eating, watching TV, ect.

NOT ALLOWED DURING SESSION Listening to music through headphones after

AIT is not allowed

WHAT DO TO IF THE CHILD BECOMES ILL

Less than 1 week continue where you left off

More than 1 week begin full 10 day course all over gain

If illness is an ear infection stop AIT immediately

WHAT DOES AIT CLAIM TO DO?

Reduces or eliminates signs and symptoms associated with Autism spectrum disorders, central

auditory processing disorder, speech and language disorders, sensory issues, dyslexia, PDD, and ADD.

WHAT DOES AIT CLAIM TO DO?

Sensory issues and hypersensitivity will diminish

Speech and language improvement Fewer “overloads” Less “self-stimming” behaviors Behavior and learning improvements Improvements in mood and social skills Improvements in hearing, taste, smell, touch,

coordination, processing information, and handwriting

WHAT DOES AIT CLAIM TO DO?

Anyone 3 years and older can benefit Helps re-train the auditory system

and normalize brain functioning 75-80% see positive results Allows individual to utilize other

therapies more effectively

WHO STARTED AUDITORY INTEGRATION THERAPY?

Started by Guy Berard in 1950’s

Medical doctor in France Initially used to treat

hearing loss Realized that other abilities

such as attentive listening and concentration improved after treatment

Treated 8,000 clients “Hearing Equals Behavior”

WHO STARTED AIT?

Started to gain recognition with publication of “The Sound of a Miracle” by Annabel Stehli

Georgiana Stehli -> autism & hyperacute hearing

Was able to be integrated into mainstream after AIT

Now a speaker and worker at an Autism center

WHO STARTED AIT?

“Hearing equals behavior” -> how we hear plays a significant role in how we behave and learn

Prior to this, professionals focused on diagnosing and treating hearing loss rather than how the individual perceives auditory stimulation

Dr Bernard Rimland Director of Autism Research

Institute By 1998, 28 studies completed.

82% demonstrated positive effects

Below are the clinical outcomes, reproduced from Dr. Berard's clinical practice and documented in his book

"Hearing Equals Behavior":

Number of Ear, Nose and Throat Clients Dr. Guy Berard Treated in Total

8,000

Number Assessed as LIKELY to Benefit from Auditory Integration Training 2,300

Presenting with Dyslexia Very Positive ResultsNoticeable Partial ImprovementNo Change

1,850 76% 24%0%

Presenting with Depression and Suicidal Tendencies Cured After First Treatment

233 93%

Presenting with Autism Significant Modification of Behavior and Lost Fear of NoiseComplete Cure

48 47 1

WHO STARTED AIT?

Other listening programs begin to develop Bill Clark Method, Tomatis Method

Presently AIT is available in 28 countries

Seminars are presented all around the world and in different languages

New “research” continues to suggest the benefits to AIT

http://www.youtube.com/watch?v=zLp22g-FeFs

AUDITORY INTEGRATION THERAPY?

The American Speech, Language and hearing Association has concluded that AIT is not scientifically sound

Warns practitioners that they violate ethics code if providing services

HOW TO BECOME AN AIT PRACTITIONER

Fill out online application Trainings in New Haven, CT Trainings include lectures, discussions, and

hands on work with equipment

http://www.ideatrainingcenter.com/ait-seminars.shtml

HOW TO BECOME AN AIT PRACTITIONER

Must meet one of the following criteria: Hold a Master’s degree is speech/language

pathology, audiology, special education or related field

Hold a current license as a registered occupational therapist, physical therapist or psychologist

Hold a doctoral degree in medicine or related field

Hold a bachelor’s degree in a related field with on the job experience

Seminar fee is $2,000

RESULTS

RESULTS

RESULTS

HOW TO BECOME AN AIT PRACTITIONER

The four day seminar includes workshops Client intake and evaluations Audio testing requirements AIT procedures (selecting music) Parent consultation Research studies Overview of other sound practices

"One of the most practical and functional seminars I’ve ever attended. I really feel like I could start tomorrow and feel pretty confident!"

WHAT DOES A SESSION LOOK LIKE?

The current Berard Auditory Integration Training (Berard AIT) protocol requires that a Participant listen to modulated music on device developed for Berard AIT, using high quality headphones for a total of ten (10) hours, over 10 (or 12) consecutive days under the supervision of a professional trained AIT Practitioner.

WHAT DOES A SESSION LOOK LIKE?

Child listens to specific musicPreforms fine motor and gross motor skills

Preforms memory skills

http://www.youtube.com/watch?v=XfBPqshEahE

“Music washes away from the soul the dust of everyday life.” - ~  Berthold Auerbach

QUALIFYING CHECK LISTS

The AIT Checklist is extensive on-line form with 76 questions that is made available for use to public by the AIT Institute.

Used by parent to help determine candidacy for possible AIT services.

It includes several questions per category. Questions include typing in a field, 'Yes' or 'No' type questions, or selection type questions.

QUALIFYING CHECK LISTS

The 76 questions in the AIT Checklist are in these categories, in this order:

General Information & Medical Background Bio-Medical Issues Response To Sound Stimulus Attention and Focus Issues Behavioral Issues Speech and Language Other Areas of Concern (you can specify

answers in detail)

EXAMPLE QUESTIONS

http://www.aitinstitute.org/survey/checklist.php

COST OF BERARD AUDITORY INTEGRATION TRAINING (BERARD AIT)

The cost for Auditory Integration Training sessions typically ranges between $1,200 to $2,000

Any required audiological tests are usually completed at an additional, separate fee.

Auditory Integration Training is considered to be an educational intervention not a medical intervention.

IS THERE SCIENCE?Is there research?

http://www.aitinstitute.org/ait_faq.htm

RESEARCH

Aberrant Behavior Checklist (ABC 1)- is a symptom checklist for assessing problem behaviors of children and adults with mental retardation at home, in residential facilities, educational settings, and work training centers.

Fisher’s Auditory Problems Checklist (FAPC), http://www.abcfl.com/fisher.pdf

Conner’s Parent Rating Scales (CPRS) is a popular research and clinical tool for obtaining parental reports of childhood behavior problems

OCULAR MOVEMENTS AMONG INDIVIDUALS WITH AUTISM PRE- AND POST-AUDITORY INTEGRATION TRAINING - 1993BY: MARGARET P. CREEDON IN COLLABORATION WITH STEPHEN M. EDELSON AND JANICE E. SCHARRE

Open-clinical study

Tracking Visual movements and a visual reflex

22 individuals with autism, ages 6 to 13 years

Individuals completed the 10 day program

FINDINGS

Significant improvements were seen in horizontal tracking immediately following AIT and in both horizontal and vertical tracking three months post AIT.

No changes were seen in visual reflex

DATA COLLECTION AND FINDINGS

Parents completed the FAPC and the ABC-1 , prior to, immediately following, and three months after AIT.

The FAPC indicated significant improvement at 3 months post-AIT

The ABC-1 indicated significant improvement both immediately following and 3 months post-AIT.

WEAKNESS WITHIN THE STUDY

No control group

No placebo Group

Individuals were also receiving various interventions, some including ABA

Not a blind study

Parents completed surveys/checklists

THE EFFECTS OF AUDITORY INTEGRATION TRAINING IN AUTISM BERNARD RIMLAND AND STEPHEN M. EDELSONAMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY , 1994, 5, 16-24.

Open-clinical research design.

445 autistic subjects in the study, with ages ranging from 4 to 41 years.

Testing Sound Sensitivity after AIT treatment

DATA COLLECTION

Analyses of the hearing tests conducted prior to, after 5 hours of listening, and after 10 hours of listening

Parents completed several different questionnaires on a monthly basis for 9 months. These included the ABC-1, CPRS, and the FAPC.

FINDINGS

A reduction in sound sensitivity was found, based on the presentation of pure tones prior to and immediately following the AIT sessions.

Hearing tests - showed hearing acuity to have improved slightly while the amount of variability within the audiogram decreased.

FINDINGS

Parents completed several different questionnaires on a monthly basis for 9 months. These included the ABC-1, CPRS, and the FAPC.

Parents questioners reported:

Sharp reduction in problem behaviors, starting one month following the AIT listening sessions.

These changes remained stable throughout the entire 9 months of post-AIT evaluations.

WEAKNESS WITHIN THE STUDY

No control group

No placebo group

Individual were also receiving various interventions, some including ABA

No blind observer

Parent completed questioners

POSITRON EMISSION TOMOGRAPHY MEASURE OF MODIFIED AUDITORY INTEGRATION THERAPY BY: JACQUELINE M. CIMORELLI AND MELANIE K. HIGHFILLCASE STUDY REPORTED IN ADVANCE FOR SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS, JUNE 26, 1995.

Single Subject - 8-year old male with mental retardation and autism

Investigated changes in brain functioning following AIT using Positron Emissions Test (PET) Scan technology.

DATA COLLECTION

PET scans were conducted prior to a second set of AIT listening sessions (baseline), one day after the listening sessions, and six months later.

RESULTS

The results at both the one-day and six-month follow-up evaluations indicated a normalization of brain wave activity, including a decrease in hyper-metabolism in the frontal lobe and an increase in activity in the occipital lobe.

WEAKNESS WITHIN THE STUDY

Only given to one subject

No control group or placebo group

A PET scan had not been given prior to the first set of AIT sessions

Individual was also receiving various interventions

PARENTAL PERCEPTIONS OF CHANGE FOLLOWING AIT FOR AUTISM BY DANA MONVILLE AND NICKOLA NELSON PAPER PRESENTED AT THE AMERICAN SPEECH-LANGUAGE-HEARING CONFERENCE, NEW ORLEANS, 1994.

A survey was mailed to 150 parents of children diagnosed with either autism or pervasive developmental disorder whose children had received AIT between 1991 and 1993.

DATA COLLECTED/RESULTS

40 parents (27%) responded to the survey.

25 (63%) reported an increase in attention span

25 (63%) reported a decrease in sound sensitivity

12 (30%) reported an increase in language.

4 parents (10%) reported an increase in tantrums and aggression.

WEAKNESS WITHIN THE STUDY

Only 27% responded to the survey Those who observed positive changes in their

children may have been likely to complete the survey than those who did not observe any changes.

Relied on parent opinion

Individual were also receiving various interventions, some including ABA

BERARD AIT CONCLUSION

WHAT HAPPENS AFTER BERARD AIT? Once the cause of the auditory

processing or hearing problems are corrected - such as hearing distortions, hypersensitive hearing, hyposensitive hearing, sound sensitivity - then other therapies and educational programs become more effective in producing changes that enable the individual to achieve a new level of success.

THE DAVIS CENTER – DISCLAIMER

Call The Davis Center at 862-251-4637 862-251-4637 to schedule an evaluation. Email npdunn@thedaviscenter.com. Sound-based therapies are not medical treatments. They do not cure or treat medical disease conditions. They work on supporting change in learning, development, and wellness. The Davis Center does not diagnose or prescribe for medical or psychological conditions; nor does it claim to prevent, treat, mitigate or cure such conditions; nor provide diagnosis, care, treatment or rehabilitation of individuals or apply medical, mental health or human development principles beyond the scope of professional practice. Copyright ©2009 thedaviscenter.com

OUR CONCLUSION There is no true valid scientific

research to support AIT findings.

The use of AIT should be avoided

Time and resources should be given to interventions that have valid and reliable research like ABA.

RESOURCES

Edelson, S. M. (2010). Aditory integration training. Retrieved from http://www.aithelps.com/autism_books.html

AIT Institute for Berard Auditory Integration (2011). What is berard autidory integration training? Retrieved from http://www.aitinstitute.org/

The Davis Center. (2009). Auditory intergration Retrieved from http://www.thedaviscenter.com/

IDEA Training Center (2011). Berard AIT. Retrieved from http://www.ideatrainingcenter.com/berard-ait.shtml

http://www.youtube.com/watch?v=XfBPqshEahE