More information from Dr. Edelson
Written by Stephen M. Edelson, Ph.D.
Center for the Study of Autism, Salem, Oregon
Auditory integration training (AIT) was developed by Guy Berard in Annecy, France to help
people with auditory processing problems. According to Dr. Berard, processing problems may occur if one hears some
sound frequencies much better than other frequencies. For example, a person may be hypersensitive to the
frequencies 2,000 and 8,000 Hertz, but hear all the other frequencies in the spectrum at a normal level. The
frequencies to which a person is hypersensitive are referred to as 'auditory peaks,' and these peaks take on the
appearance of a mountain range in one's audiogram.
AIT is accomplished by a device which randomly selec! ts
high and low frequencies from a music source (a cassette or CD player), and then sends these sounds via headphones
to the trainee. In addition, if the trainee has auditory peaks in his/her hearing (as evident from an audiogram),
those frequencies are filtered out completely (blocked out) or partially (stressed at only a low level) from the
music. The trainee receives AIT twice a day, each time for 1/2 hour, for ten days. During the first five hours of
AIT, the sound level for both ears is equal. For those individuals who have speech and language impairments, the
sound level is reduced in the left ear after five hours of training. Since the right ear is connected more directly
to the left hemisphere than the right hemisphere, and since the left hemisphere is responsible for processing
speech and language, Dr. Berard believes that a higher sound level in the right ear will stimulate the left
An audiotest is conducted prior to the first listening session to ! determine whether the person
has auditory peaks; a second audiotest is given after five hours of listening to determine whether the auditory
peaks are still present and whether new peaks have developed; and a third audiotest is given after the completion
of the listening sessions. According to Dr. Berard, after completion of the program, all frequencies should be
perceived equally well; and the person should no longer have peaks in his/her hearing.
One caution: As Dr.
Berard informed us and as we have noted independently, some people exhibit unexpected behavioral problems during
the 10-day AIT period, such as agitation, hyperactivity, and rapid mood swings. Similar problems are reported for
more traditional forms of sensory integration therapy. We are unsure of the reasons for these behaviors. One
explanation is that these behaviors are occurring as a direct result of receiving AIT. However, it is also possible
that these problems may be a result of changes in the person's eating patterns and activity level during the 10-day
period. We hav! e noticed that parents often coax their son/daughter with candy and junk food so they will sit
quietly during the listening sessions. To support this observation, we observed such problems in both those
individuals who received AIT and those who received a placebo in our pilot study on AIT. At this point in time, we
do not have enough data to determine which, if either, of these explanations is correct.
Based on our own
experience, and our conversations with Dr. Cecile Wuarin, the psychologist who worked with Dr. Berard, we feel that
parents/caretakers should receive pre- and after-care consultation so they will be made aware of and be able to
deal constructively with possible changes they may see in their son/daughter. For example, one possible change is
an increase in attention span. If a person has a short attention span, it may be easy to redirect him/her away from
a toy or task. However, if the person's attention span increases, he/she may become more stubborn and ! more
difficult to redirect because his/her attention span is much longer. Other behavioral changes may include an
increase in emotional behavior (e.g., anger, crying, reacting to other people crying), independence (e.g., leaving
an area without permission), and social growth (e.g., increased interaction). We agree with Dr. Wuarin when she
states that if the trainee changes, the family must also change in how they perceive and interact with their
son/daughter. This failure to change is evident when a parent reports that their son/daughter is "on their
nerves" because they are not acting the way they used to act. One goal of AIT is to get them "to
act" more adaptively and age-appropriately. Recognition of this is essential (e.g., an 18-year-old who wants
to go to bed at 11 P.M. instead of her current bedtime of 8 P.M.). In general, we believe that since understanding
and working effectively with autistic people is much different than understanding and working with people with
other disorders (e.g., mental retardation), pre- a! nd after-care consultation should be handled by professionals
who have experience working with autistic individuals.
At the present time, we do not know exactly how AIT may
affect a person's behavior. One possible explanation is that AIT is actually conditioning the person to shift
his/her attention more easily. Dr. Eric Courchesne of Children's Hospital in San Diego has recently found that
autistic individuals have much difficulty shifting his/her attention from one stimulus to another stimulus. Since
high and low frequency sounds are sent randomly to the trainee, AIT may be teaching the person how to shift his/her
attention more rapidly and effortlessly; as a result, they may be better able to attend and thus understand the
contingencies related to sounds and movement (e.g., hand gestures). Another possible explanation relates to the
fact that autistic people are often described as "tuning out" others in their environment. By sending
high and low frequency s! ounds randomly, the person cannot anticipate the sounds; and thus, he/she cannot tune
them out. As a result, they are, in effect, being trained to "tune in." If one or both of these
explanations are correct, then it is possible that individuals who do not have auditory peaks may also benefit from
AIT. Finally, it is possible that the person starts to perceive sounds, especially speech, more clearly; and as a
result, he/she will be better able to learn relationships between a sound and a behavior, object, action, and
event. Even though all three explanations listed above are hypothetical, they do suggest how a person may possibly
benefit from receiving AIT.
Click here to visit The Society for
Auditory Integration Techniques' Internet Web site.
The Autism Research Institute distributes an information packet on auditory integration training.
Click here to learn how to obtain this packet.
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