Volume 5 Number 2, 1997

SAIT: New Focus, New Name
The Society for Auditory Integration Training (SAIT) has shifted gears and has broadened its focus to include other auditory interventions. During the past few years, several new auditory-based interventions have become available to people with various auditory problems, such as sound sensitivity, central auditory processing problems, and difficulties distinguishing between speech sounds. At the same time, professionals have begun to acknowledge the importance of audition and its relationship to information processing and behavior (See article on the Rockville, Maryland conference on pages 2 & 3.)

During several meetings, SAIT’s Board of Directors have discussed the importance of including other auditory interventions into the domain of SAIT. In November, 1997, the following motion was introduced: “Expand the focus of SAIT to include additional auditory-based interventions for people with autism spectrum disorder, learning disabilities, developmental disabilities, and related disorders.” This motion was approved by the Board. During the meeting, the Board also changed the name of the organization to the Society for Auditory Intervention Techniques (note: we’re keeping the same initials). The name of SAIT’s newsletter, The Sound Connection, will stay the same since this wording still conveys the theme of SAIT.

The Sound Connection has published articles on many of these auditory- based interventions, including the use of computerized learning programs (e.g., Fast ForWord, Train Time), Rhythmic Entrainment Intervention (REI), the Tomatis method, and variations of the Berard AIT method (BGC’s Audio Tone Enhancer/Trainer, EASe Disc). Additionally, SAIT has received many letters and emails from professionals and parents requesting additional information about these techniques. Thus, we feel that SAIT’s enlarged focus will better meet the needs of our members as well as other professionals and parents.

Given SAIT’s new direction, we will provide members additional information regarding the various auditory-based interventions. This information will include: description of the method, theories/explanations, research, and criticisms. Since many SAIT members are practitioners, we will also include information on training and background credentials which are required to provide these services. These articles will allow us to develop a substantial body of resources for parents to use when making informed decisions.

Please note: SAIT will continue to keep members informed of any new developments in the area of AIT. We have received international recognition for our contribution to the field of AIT, and we do not plan to neglect our initial mission.

The next issue of The Sound Connection will have a slightly different format. We hope our members will embrace SAIT’s new direction, and we hope this change will take us along a very exciting and important pathway.

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Book Review: The Mozart Effect
The power of Mozart’s music made news in the early 1990’s after a study at the Center for the Neurobiology of Learning and Memory reported improvements in concentration and spatial-temporal reasoning. Although we enjoy listening to music, few of us are fully aware of its impact. It can be stimulating, overstimulating or even invasive. It also produces mental and physical effects. These effects are explored in-depth by Don Campbell in his recently published book, The Mozart Effect.

Campbell discusses the variety of ways music can be used to deal with pain and anxiety producing situations. It was interesting to read his technique for using the voice to mask severe pain. He recommends making a high ee sound, stating that the high ee or ay sounds release sharp pains and can help the person to let go of inner anger and torment. These sounds may trigger an endorphin release that will mask the pain for a while. Many children with autism frequently make a high ee sound; perhaps this is a reason for it.

The correct choice of music is important if you wish to mask the unpleasant sounds and feelings associated with certain activities. For example, during dental work, the sounds that reverberate through the jaw and bones can be reduced with quiet Baroque music. The popular music heard in waiting rooms usually will not accomplish this.

Music can also alter brain waves and therefore affect our level of awareness and balance between the two hemispheres. Music with 60 beats per minute can enhance alertness and general well-being as it shifts the brain waves from the beta range toward the alpha range. Studies have demonstrated that music can also affect respiration, pulse rate and blood pressure. Slowing the tempo of music can slow the breathing and heart beats, allowing the mind to calm down and enhance deeper thinking.

In the chapter on enhancing learning and creativity with music, Campbell discusses how music can be used to create an optimal learning environment and laments the vanishing funds for music and art education. Campbell notes that rhythm can aid memory, and information spoken in a rhythmic pattern will hold together as a unit for easier storage. Using the hands to clap and tap rhythms along the midline in front of us can synchronize the brain hemispheres. Using music and rhythm in this way integrates the creative right brain and the logical left brain, enabling us to find answers to our problems.

The Mozart Effect provides an excellent presentation of the many powers of music, with chapters that focus on health, education, rehabilitation and spiritual effects. It will be a valuable resource for anyone interested in the field of sound therapies. (Avon Books, NY, 1997, ISBN: 0-380-97418-5)

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Sound Therapies Highlighted at Conference
The Interdisciplinary Council on Developmental & Learning Disorders held its 1997 Conference on November 14-16 in Rockville, Maryland with close to 1400 participants. Drs. Stanley Greenspan and Ivar Lovaas opened the conference with presentations on intensive behavioral interventions for autistic spectrum disorders. The similarities and differences between these approaches were discussed.

Research on the underlying central nervous system mechanisms associated with disorders of communication, relating, and learning was presented by Drs. Margaret Bauman, Edwin Cook, Jr., Jocelyne Bachevalier, and Diane Chugani. A fundamental theme throughout these discussions was the significant dysfunction of the auditory processing system in most children with developmental and learning disorders.

Saturday morning focused on new biomedical treatment approaches presented by Drs. Jeffrey Lewine, Roberto Tuchman, Michael Chez, Dr. Gerry Stefanatos, Andrew Zimmerman and Stephen Mott. The general focus was on the availability of biomedical treatments such as medications, (e.g., steroids), and in some cases surgery (such as for Landau Kleffner syndrome). In many cases, these treatments resulted in improvements in auditory abilities.

Saturday afternoon featured new interventions to enhance auditory processing, language, reading and learning. Paul Madaule spoke about the Tomatis method, Dr. Stephen Porges presented his research which used a modified AIT approach, Dr. Jane Madell provided an overview of her procedure for auditory integration training, and Dr. Michael Merzenich presented Fast ForWord. Dr. Joseph Torgesen and Dr. Judith Lauter also spoke on their research and approaches for auditory processing. The focus of these presentations was on the availability of less invasive alternatives directed at improving auditory processing that are also producing positive results.

On Sunday morning, Dr. Reuven Feuerstein provided a fascinating discussion on his intensive program at the International Center for the Enhancement of Learning potential in Jerusalem.

The concluding comments at the closing stressed that successful programming for individuals with developmental and learning disorders on the autistic spectrum are most successful when started early, must be intensive and may include a variety of approaches or treatments. However, these treatments must be based on the unique, individual needs of each child, with the professionals and family working together as a multidisciplinary team.

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Practitioner’s Forum
Does the length of the headphone cord affect the quality of output from the AIT device?

Opinions differ about the effect of cord length and the quality of sound. Some audio technicians state that the length is not as significant as the number of connections. Some of the intensity and frequency of the sound may be lost for every connection between the sound source and the headphone. Thus, each extension cord that is connected to the headphones would add two more connections. The difference in sound quality is most likely not significant enough that the listener would be able to detect it, but it would likely show up on sophisticated measurement devices.

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Update on Georgie’s Baby
One of the cover stories in the last issue of The Sound Connection was the announcement of Georgie’s baby girl, Rebecca. In a recent interview with Georgie, she informed us that Rebecca has blonde hair and blue eyes. She is very alert and quite sociable. She can also roll over, and she babbles constantly.

You can also visit Georgie’s web site at: http://www.autism.com/georgie/ which contains several of her paintings and drawings along with a photo of Rebecca.

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Train Time: A Computerized Educational Program
Train Time is a CD-ROM program designed to capture the learner’s attention and then teach various skills, such as auditory comprehension, reading, spelling, speech, problem solving, and attention skills. Train Time was developed by a speech pathologist for children or adults with receptive and expressive language difficulties and have a keen interest in trains.

The primary educational objective of Train Time is to gain attention. There are five different kinds of attention training addressed in this program: focused, sustained, selective, divided and alternating. Focused attention is the ability to acknowledge and respond to a multimodal stimulus. Sustained attention is the ability to maintain attention to auditory, tactile, or visual stimuli during repetitive and continuous activity.

Selective attention requires frontal lobe activation for maintaining a mental “set” in which one must activate and also inhibit responses based on the stimuli. Divided attention is the ability to respond to two or more stimuli simultaneously. This is the “pat your head, rub your stomach, listen, talk and chew gum” type of attention.

Alternating or shifting attention is the ability to move between tasks that have different rules. That is, one must hold the task instructions in mind while manipulating information. Train Time requires frontal lobe activation, activation of working memory, usually multimodal stimulus reception, and expression (i.e., vision, audition, etc.). The sensory association areas are also important in shifting attention because the stimuli in the real world often move quickly from one input mode to another.

The games used in Train Time were designed for individuals of all ages who have deficits in language and literacy. Children as young as three years have played some of the games, as well as teens and adults.

The games involve real pictures (full-color) and real speech (16-bit sound). There are eight different games in Train Time, and each game has levels of difficulty from easy to hard. These levels range from, “watch the screen” to “listen, watch, problem solve and respond.”

The initial Train Time tasks focus on attention because attention can be considered the foundation of sensory information processing, conceptualization, and cognition. Literacy and comprehension are high order attention skills that need the association areas of visual, motor, sensory, language, and audition. These games are intended to teach children how to learn. This process begins with learning to coordinate the various areas in the brain. Learning and generalization of learning occurs when each area becomes coordinated with one another.

Other popular computer programs, such as Fast ForWord and Earobics, are focused primarily on auditory processing. Train Time contains games for auditory processing of speech and non-speech sounds as well as games for expressive language. The programs are complementary, but they do not substitute for one another.

Train Time is user friendly. The screen designs are large, clear, simple and usually self-explanatory. The manual describes one way to work with children using this software as a tool. The games work on a touch screen, mouse, or keyboard. Most three-year-olds can navigate their way around the games.

Train Time does not require any training seminar nor professional credentials. Train Time is produced and distributed by LocuTour. Other related software programs available through LocuTour are: Attention and Memory Vol. I and Articulation. For more information about these programs or to obtain a demonstration CD-ROM with all of these software programs, contact LocuTour at P.O. Box 15006, San Luis Obispo, CA 93406; telephone: (800) 777-3166; fax: (805) 543-6665; and email: locutour@aol.com

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Editorial: Loss of AIT Benefits: By Sally Brockett, M.S.
Among some of the controversial issues surrounding AIT is the question of loss of AIT benefits. Some people have questioned the lasting quality of AIT over the long term, since there are cases where the improvements seem to fade after a period of time, even though there are a large number of individuals who have maintained the improvements over many years.

Dr. Berard has consistently stated that certain experiences may “undo” or cause the loss of AIT benefits, including: illnesses that affect the auditory system, medications that have ototoxic side effects, exposure to loud noise, and listening to music with earphones. And indeed, parents have reported that these experiences have disrupted the improvements obtained. In all the cases I am familiar with, retraining with AIT has restored the benefits at least to some degree, and usually to the previous level.

Recently, based on a few individual cases, I have begun to rethink the possibilities involved with this phenomenon. At least in some cases, it may be that what appears to be a loss of benefits is caused by changes in the individual’s system. For example, when one child was treated with antibiotics, her extreme auditory hypersensitivity returned and language abilities deteriorated. Tests revealed that yeast levels were quite high at this time. Although retraining with AIT was considered, it was decided to wait until the child’s biochemistry was in better balance. As the child’s biochemistry improved and the yeast levels declined, the hypersensitivity also declined and the language abilities improved again. The child’s mother believes that perhaps the AIT benefits were really not lost but simply masked and inaccessible to the child during this period of unbalanced biochemistry.

It is important to consider all possibilities when clients seem to repeatedly “lose” the AIT benefits, especially when there is no obvious cause. It may be that retraining is needed; however, it may be best to consider why the training does not hold with this individual when it does hold for so many others. What might be different with this person and can adjustments be made so the system will be able to retain the AIT? If issues such as these are addressed, perhaps those who seem to consistently require retraining will improve and maintain lasting effects.

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Frequently Asked Questions: Dr. Guy Berard
During the teaching of my trainees, I always try to give them all the necessary information concerning:

— the way to do all the audiometric tests in order to know what information an individual is receiving from his sound environment-whether correct or distorted;

— the way to use the AudioKinetron-setting the device correctly according to the test results,

— and the way to apply AIT.

Although I have taught around 300 trainees up to now, I continue to sharpen my teaching skills when students ask me questions and afterwards by trainees confronted by special cases. Of course, I won’t discuss “special cases” in this article because they are specific and need particular answers taking into account all the data concerning the patient.

Otherwise, the usual questions are:

— Can we modify the number, the length, the space of time between the sessions? My answer is always NO, because I have already tested all the other ways, and the rules that I teach give the best results.

— Is it necessary to apply AIT with an appropriate volume? Yes, because the treatment is more efficient and because the AudioKinetron has an electronic system to eliminate problems such as trauma from sound. This is different from filtering the undesirable peaks of an audiogram.

— When can we repeat AIT? The rule is: ask the patient, or parents to keep you informed 3 months after the end of the training. If the result is not satisfactory, do another hearing test after 3 more months, and train again if necessary. You may apply AIT several times, every 6 months to one year as long as a positive result is obtained each time for autism, hearing loss, or dyslexia. But, generally, one AIT is enough.

— Are children allowed to play, read, draw during the sessions? No.

Now I can say that I have not received any general questions in a long time, probably because my trainees have assimilated my teaching well and I congratulate them for that.