What is Auditory Integration Training(AIT) ？
AIT (Berard type) is by far the most empirically supported listening therapy. It it the listening of modulated music through headphone to improve conditions as a result of auditory processing problems. These problems include poor attention, poor understanding and response to speech, sound sensitivity as well as learning problems.
What are the auditory processing problems?
Auditory processing problems arise when the brain process of incoming sound vibration into meaningful sounds is distorted for some reason. This would lead to the problem of focusing as well as decoding sound information, thus leading to poor attention, receptive and expressive language abilities.
Issues as a result of sound processing problems:
- attention deficit
- delay speech development
- poor receptive and expressive speech
- poor reading and writing skills
- poor academic performance
- phobic/strange reaction to sound
Who are the suitable candidates for AIT?
AIT could have benefit to the following groups of people(age 3 or above):
Autism Spectrum Disorder
Attention Deficit/Hyperactivity Disorder
Delay speech development
Central Auditory Processing Disorder
How effective is AIT?
We have provided AIT since 1994. In this more than 20 years of clinical experience, we have found that around 70% of those who have received AIT have improved in their deficit conditions and 20% improved very significantly.
How is AIT done?
The client is require to wear headphone to listen to modulated music at the Centre. The schedule is two 30-minute sessions per day with at least 3 hours apart. The course lasts for 10 day in two consecutive weeks with the weekend
“I am reasonably certain that it(AIT) does work.”- Bernard Rimland (1928-2006), Founder of Autism Research Institute
“…There was a direct rather than indirect connection between poor hearing and disruptive classroom behavior, …variations in hearing dysfunction …were associated with many behavior and learning problems, including hyperactivity(過動症)and dyslexia(閱讀困難症) .” – Dr. Guy Berard.
AIT is invented by the late French ENT doctor Guy Berard in the 60’s in a small French town Annecy. He gathered that a faulty hearing system could cause a lot of emotional, social, learning and behavioral issues, and therefore, he invented his unique modulated music to strengthening the auditory system to remedy those conditions. In his practice in Annecy, he had treated primarily people with dyslexia with very promising results.
In 1977, an American girl Gerogiana with autism, at the age of 10, was taken by her mother Annabelle to receive AIT in Annecy. AIT had caused dramatic improvements on her behaviorally and emotionally. She is now leading a normal life, having her own family and career. Her story was presented in her mother’s book “The Sound of Miracle” which was excerpted and published in “The Reader’s Digest” in January 1991, thus caused widespread attention and publicity. The father of Georgiana, Peter Stehli has then established the Georgiana Institute and invited Dr. Guy Berard to train up practitioners in USA.
The late former Director of Autism Research Institute, Dr. Bernard Rimland and the current Director of Autism Research Institute have done a large scale research on the effect of AIT in 1993. They published the report in May, 1994 that indicated the positive outcome in the autistic population. The research had 445 subjects with ASD aged from 4 to 41 (average age around 10). They had assessment on their behavioral as well as listening problems before, after, and each month after AIT for nine months. The result indicated that they had significant improvements after AIT and that continued for nine months.
A summary of 28 research reports on AIT, 23 (82%) of them indicated positive outcomes.
Sound processing problems can take many forms. The followings are the most come forms.
The most observable one is over sensitivity to sound. Some individuals might also have phobic reaction to certain sounds that make them avoid noisy environment or covering their ears. AIT had completely cured this problem in Georgiana’s case.
The second common sound processing problem is inability to focus on the sound source. Their brain is not able to suppress irrelevant environmental sounds like the normal brain would do automatically. As a result, they would exhibit attention problems, thus leading to problems in social interaction and difficulty in learning situation.
Another form would be the inability to process fast changing sound. As speech sounds require very speedy processing to decode their meaning, those who cannot process fast changing sounds would have difficulty in reading and writing.
Any body who is 3 years or older is suitable for AIT and research has indicated that age has no effect on the treatment outcome. However, considering the positive effect in early training, our suggestion is to receive AIT as early as possible.
We would test headphone wearing during the initial consultation to see if the client is able to proceed with the treatment. For the relatively few people who might not be able to wear headphone largely due to tactile defensiveness around the head, parents are advised to do headphone training at home. The Centre has ample experience in engaging the client so that the listening can last for 30 minutes.
If the client’s condition has improved after the first AIT, we would recommend for him/her to repeat another course after 6 months’ time. However, if there is no improvement, it is not recommended to do a second time.
AIT’s effect would not be affected by concurrent therapy. However, owing to the following reasons, it is advisable to stop concurrent training, or a least not to add in more trainings:
– It is not desirable to receive AIT when the client is tired which could be the result of running back and forth from therapy.
– It is hard to tell whether the progress, if there is, is the result of AIT or other therapy. Thus, making it difficult to recommend a 2nd AIT.
– It is not desirable to have spent the fee on a treatment that you would not tell for sure whether it has an effect.
The first 5 days is most critical period without interruption. If the client is sick during the first week, AIT has to re-start again on another day for the whole 2-week course. If the client is sick during the 2nd week, our normal practice is to re-take the missing sessions in the following day(s) after the scheduled days.
Our Centre Director Mr. Pang had received AIT training from the Georgiana Institute and has started providing AIT in Hong Kong in 1994. The no. of clients who has received AIT is over 500 now and most of them are children. The equipment that we are using is the Digital Auditory Aerobic system which is developed by the Georgiana Institute.
Our AIT system:
Digital Auditory Aerobic (DAA) system
NAD C315BEE Stereo Integrated Amplifier
Cambridge Audio 340C Compact Disc Player
Beyerdynamic DT250 headphone
10. Why does Wikipedia say that AIT is not effective? The information in Wikipedia regarding the lack of scientific evidence and safety is largely misleading. The references in Wikipedia have failed to cite the two well constructed control experiments that document the effectiveness of AIT. They are:
1. Auditory Integration Training: A Pilot Study Bernard Rimland and Stephen M. Edelson. Journal of Autism and Developmental Disorders , 1995, 25, 61-70.
2. Auditory Integration Training: A Double-Blind Study of Behavioral, Electro-Physiological, and Audiometric Effects in Autistic Subjects . S.M. Edelson, E. Arin, M. Bauman, S.E. Lukas, J. H. Rudy, M. Sholar, and B. Rimland. Focus on Autism and Other Developmental Disabilities , 1999, 14, 73-81.
Regarding the safety issue, where it is true that Audiokinetron is not being approved by the FDA for the reason that its application was filed under a medical device at the time. But it was just a mistake to file it as a medical device which was the reason for FDA’s disapproval. While all AIT machines are not intended to be medical in nature, they serve to enhance an educational function which is primarily sound processing in nature. The 2nd generation AIT machine, the Digital Audio Aerobic (DAA) system is not a medical device and therefore not subjected to FDA’s jurisdiction.
AIT is a very safe treatment. The reason that it does not meet scientific standards for safety for some is that it is being assessed in a standard which it does not belong to. When a sleeping pill required very stringent scrutiny to maintain its safety standard to improve sleep, drinking milk to improve sleep should be placed under an entirely different criteria for its safety concern.