- Sharda Ramlackhan M.A.

"Input" from Dr. Guy Berard
Findings of Unexpected Change after AIT

The aim of AIT is to correct hearing problems, and as you know, I have found that certain speific hearing problems, such as distortions, lack of selectivity, dyslaterally, painful hearing, delay in response time, peaks of hypersensitive hearing, etc. could contribute to learning disabilities, autism, and various behaviour problems which are typically labelled by specialists according to the existing symptoms.

I used to ask my parents to give me a detailed report of their condition three months after the end of the treatment. I was sometimes surprised to be informed, in addition to the concerns relevant to the problems for which they had been treated, that some unexpected responses had occurred:

Sight: Several patients told me that their sight had changed, generally improved, and that they had to change their glasses, by reducing the necessary diopters. An explanation can be proposed in thinking that with the brain cells of sight being very close to those of hearing, AIT mat increase the blood circulation in this area. The vision cells could not take advantage of this physiological situation. This is just an opinion, not scientific assertion.

Hand Dominance: Left hand dominance changing to right handedness was sometimes indicated; and the opinion expressed previously can be suggested for this change as well. I used to tell my trainess the story of a mother who was anxious because her daughter was left-handed. I was treating this girl for her learning disabilites, and her mother used to inform me of the improvement at school; but she continually complained about the persistence of the left hand dominance. All of a sudden, six months after the end of AIT, she phoned me, excited and enthusiastic: "Dr. Berard, my daughter has become right handed during the night ! She asked me why I had put her teacup with the handle ob the left side, and this seemed wrong to her ! " Maybe the connections between the billions of synapses was modifying everyday, according to the sounds of the environment, until the moment when the last contact was established at the place for the left brain to control the right hand.

As I have always indicated, the aim of AIT is to correct hearing problems. AIT should not be considered to change conditions such as vision, hand dominance, or other problems. Practitioners of AIT will observe some other responses at times; and if these are noted frequently, it would be good to share these observations with SAIT.

AIT: How Old is Old Enough ?

One of many yet-to-be answered questions is how old is old enough to begin AIT ? Guy Berard's position has been that, to be on the safe and conservative side, AIT should not be ordinarily given before age 4 years. Some authorities on hearing and child development agree, suggesting that the auditory system is too immature in younger children. Additionally there is concern that young children may not effectively protest to a loud, and possibly painful stimulus.

Pressure toward dropping the age limit to 3 years has been mounting from both parents and practitioners, who point to the advantages of early intervention. Some have used AIT with children as young as two years of age. As he has learned with apparent positive results with some 3 year olds and in the absence of known negative or adverse results. Dr. Berard has reconsidered; and he now feels that 3 years may be a suitable age (personal communication, 5/4/95).

Whatever the trainees age, extreme care should be taken to ensure that the volume is well below the EPA and OSHA noise exposure limits-in all cases-and that AIT devices be checked frequently to prevent excessive loudness-never above 85 dB. This caution is especially important for young children since EPA and OSHA limits have been determined for adults and not for children.

Until a safe age limit and volume level are established, practitioners who give AIT to young children should proceed cautiously.

Theories of Auditiory Integration Training

Some theories on why auditory integration training works for some individuals. The theories can be classified in different ways, such as those explaining a reduction in auditory peaks, a reduction in sound sensitivity, and an increase in attention as well as postulating changes in the middle ear, inner ear, brainstem, and mid-brain.

Reduction in peaks through Filtering:

Guy Berard: 'Reduction in Peaks due to a decrease in stimulation." During the AIT listening sessions, filters are used to dampen those frequencies whic hthe person hears too well. Dr. Berard theorizes that filtering will reduce the sensitivity due to the lack of stimulation to certain areas of the cochlea and/ or the brain during the listening sessions. Furthermose, those area(s) of the cochlea and/or the brain which are not filtered recieve intense stimulation; and this stimulation causes a slight improvement in hearing.

Thus the peak frequencies are slightly reduced because of a lack of stimulation, and non-pea frequencies are slightly improved because of stimulation. The end result is a relatively straight line.

Stephen Edelson: 'Reduction in peaks due to lateral inhibition'. This theory is actually an extension of Berard's theory of reducing auditory peaks using filters. One phenomenon that occurs throughout our sensory system is neural inhibition, in which soem neurons, when stimulated, inhibit the activation of other neurons. In addition, a phenomenon called 'lateral inhibition' occurs when a stimulated area inhibits an adjacent area which is not receiving stimulation.

Since the filtered frequencies are not stimulating certain portions of the cochlea and/or part(s) of the brain, stimulation of the adjacent, non-sensitive, (non filtered) areas may be laterally inhibiting, and possibly conditioning, the sensitive filtered area(s). Thus, sensitive areas are inhibited by the adjacent, non-sensitive areas.

AIT study: Children improve markedly

A new study from Ireland concludes that auditory integration therapy concludes that auditory integration therapy (AIT) is "well worth exploring" as a treatment for autistic children.

Mark Morgan Brown used AIT with two autistic children, a five year old boy and his three year old sister. Intended to reduce sound oversensitivity and other autistic symptoms, AIT involves having subjects listen to electronically modified music through headphones. Each child participated in two half hour sessions per day, for 10 consecutive days. Followups were conductd three and six months after the therapy.

Brown says that the two children showed marked improvement in a number of autistic symptoms following therapy. The boy became calmer, less sensitive to sound, and less "switched off", and his language skills and eye contact improved. Brown notes that before AIT the boy had to be kept separated from his sister because of his aggression toward her, but "he now interacts with her and recognizes her as part of his family." Interestingly he lost one peculiar skil, the ability to tear pages in an unusualy precise manner.

(Editor's note: The loss of "savant" skills is not uncommon in autistic children who suddenly make strides in normal skills.)

The girl also improved significantly, interacting more with others and growing more confident. Her balance and eye contact improved and she began making more types of sounds. In addition she learned to eat solid foods, something she was unable to do before the therapy.

"Before the intervention", Brown says, "[the girl] became physically sick when she heard loud mechanical sounds such as motorbikes and roadwork drills. During the last two days of the training, she was able to cope with the loud noises of various airplanes flying closely overhead at the local air show. She was also able to cope with the visual and auditory stimulation of the large crowds at this show and for the first time ever, turned her head to look at it... noises of interest in the crowds."

Brown notes that his study was not controlled, and that other factors could have influenced the children's improvement. However he notes that most of their behavioural changes began during the therapy, and that their spurt in improvement following AIT therapy was far greater than any of their previous gains.

- from : "Auditory integration training and autism: two case studies," Mark Morgan Brown, British Journal of Occupational Therapy, Volume 62, No. 1, January 1999, pp. 13-18.

Address: Mark Morgan Brown, Arderry, Corawallen PO, Via Cavan, County Leitrim, Republic of Ireland.

A Statement

The validity of Auditory Integration Training as a treatment for individuals with hypersensitive hearing remains an unanswered question in the minds of many professionals, individuals with autism and their families. It would appear that it's effectiveness in helping children with autism can only be evaluated on an individual basis. On a positive note, it is a relatively inexpensive treatment in terms of money and time committment and it would appear to be harmless even if unsuccessful in bringing about the possible changes that have been reported by individuals such as Georgie Stehli.

Neil Walker, Manager of Resource Services,
The Geneva Centre, Toronto
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