Volume 9 Number 2, 2002

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Re-Organization of SAIT
Last December, 2001, the Board of Directors for the Society for Auditory Intervention Techniques (SAIT) passed a motion to change SAIT from a membership-fee based organization to a non-fee, Internet organization. This change will allow us to concentrate our efforts on our web site and, as a result, we will be able to inform many more people about the exciting developments in the field of auditory interventions.

New articles on auditory-based interventions will be posted on the Internet rather than published in The Sound Connection. Additionally, professionals and parents can join SAIT’s email list. They will receive an email whenever new articles are posted on SAIT’s web site (www.sait.org) and when there is important information to share. You can sign up for this free service on SAIT’s web site (look for the link: “Join SAIT’s email list”).

SAIT members will receive several more mailings this year. The listing of practitioners will be removed from SAIT’s web site when our liability insurance expires. This will be in April/May, 2002. A link will then be directed to the Autism Research Institute’s web site (www.autismresearchinstitute.com) which lists all-known AIT practitioners.

We hope this re-organization of SAIT will allow us to continue our efforts to present important and relevant information about auditory-based interventions to parents and professionals throughout the world.

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Inaccurate Information on AIT Published by the National Research Council
The National Research Council (NRC) recently published a book, Educating Children with Autism (2001), which contains disgracefully inaccurate information about auditory integration training (AIT). The book can also be read, free-of-charge, on the Internet (www.nap.edu and search the word ‘autism’). The section on AIT is located on pages 99 and 100.

The book falsely states regarding AIT: “… in general studies have not supported either its theoretical basis or the specificity of its effectiveness” (page 100). Edelson and Rimland recently wrote a review paper on AIT. The review paper found 23 studies to have reported improvement, 3 studies to have reported no improvement, and 2 studies to have reported equivocal results. The review paper has been posted on SAIT’s web site (www.sait.org).

There are many other problems with this very biased NRC report. A 1994 paper by Gravel is falsely cited: “A recent review noted that for children treated with auditory integration therapy, objective electrophysiologic measures failed to demonstrate differences in hearing sensitivity between children with autism and controls, thereby questioning the overall premise of auditory integration therapy” (p. 100). Gravel’s paper was actually an “opinion” paper; she did not report any research data nor did she review any studies using electrophysiologic measures to examine hearing sensitivity. Gravel did cite studies investigating other auditory issues, such as deafness, distortions in hearing and auditory processing. However, the statement that she cited studies showing no differences in hearing sensitivity in autism was simply not true.

The chapter also states “More recent studies noted no differences in responses to auditory integration training therapy in children with autism or controls (Best and Miln, 1997; Gillberg et al., 1997)” (page 100). The Best and Miln (1997) report was actually an unpublished review paper on AIT and contained no research data. The Gillberg et al. (1997) study was an open-clinical trial study of only 9 children, with no control group. Gillberg et al. (1998) acknowledged one year later that there may have been improvement as a result of AIT in their 1997 study. This was not mentioned in the NRC report. A study by Bettison (1996) was also discussed, but there was no mention of the many inherent problems with this study.

The book mentioned only one published study supporting AIT (Rimland & Edelson, 1995) and ignored the Rimland and Edelson (1994) paper involving 445 autistic children and the double-blind placebo study involving electrophysiological measures (Edelson et al., 1999). All three of these studies were among the 23 which showed positive results. The Edelson et al. (1999) study documented dramatic improvements using electrophysiological measures as well as significant improvements in behavior. The other 20 studies showing positive results were also ignored.

Unfortunately, the publication of the book may serve to dissuade parents from trying a very safe, non-intrusive and potentially effective intervention with their autistic children.

We hope our readers will inform parents and professionals about the NRC’s false statements regarding AIT if they are asked about it.

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News and Notes
Georgiana and Tom Thomas are proud parents of a new baby girl, Hannah Elizabeth. She was born on December 29, 2001. We extend our heartfelt congratulations to Georgie and Tom, and to Hannah’s grandparents, Annabel and Peter Stehli.

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Rosalie Seymour, a speech therapist and audiologist in Ireland, was recently named as director of the International Association of Berard Practitioners, an AIT organization based in Antwerp, Belgium. Ms. Seymour is also conducting a research study on the efficacy of AIT.

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Drs. Dana Boatman and Barry Gordon of Johns Hopkins University recently received a grant to develop a series of assessments tests to study auditory processing problems in autism. The aim of the study is to determine whether autistic children hear sounds normally and whether the sounds are then processed normally.

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Dr. Timothy Roberts of UC San Francisco recently received a grant to study neurological changes in autistic children while hearing sounds. Dr. Roberts will study the electrical activity of the brain using Magnetoencephalography (similar to an EEG). Dr. Roberts speculates that the problem may be an inability to process the actual speech sound.

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Outcome Results Published on Cognitive Concepts’ Earobics Program
In a much anticipated and long awaited report, Cognitive Concepts released the research findings on their Earobics program. Close to 13,000 students participated in the study, and these students were enrolled in schools in four different states–Illinois, Kentucky, Texas, and Virginia. Earobics consists of a set of computer tasks that are designed to improve early literacy skills, such as phonemic awareness, spelling, and early reading/writing. A summary of their findings is listed below.

Chicago, Illinois. More than 12,000 students, ranging from pre-kindergarten to third grade, participated in this study. Many of the students were enrolled in ESL classrooms. A control group was not utilized in this study.

Students participated in the Earobics program three times a week, and each session lasted approximately 20-minutes. Assessments were conducted before and at the end of a 10- to 12-week program. Pre- and post testing indicated statistically significant improvements in the following grade categories:

Pre-kindergarten students

      — phonological awareness, language, listening, auditory sequential memory skills, and concepts of print.

Kindergarten students — phonological awareness, receptive vocabulary, auditory sequential memory, auditory memory for words, and ‘invented spelling skills.’

First grade students — phonological awareness, identifying letter sounds, decoding nonsense words, and spelling.

Second grade students — phonological awareness, spelling, identifying the sounds of words, decoding nonsense words, and non-sequential auditory memory skills.

Third grade students — phonological awareness, identifying letter sounds, decoding nonsense words, and spelling.

Houston, Texas. This study investigated the efficacy of the Earobics Literacy Launch program. A total of 16 kindergarten students participated in this program, and they were from ‘socio-economically underpriviledged’ families. The students participated in the program three to five times a week, for approximately 20 minutes a session. There was no control group for comparison.

Various assessment tests were given to the children including letter identification, concepts of print, word recognition, writing vocabulary, and dictation. The tests were given prior to the program, at mid-year, and at the end of the year.

The greatest amount of improvement for the students was during the first half of the year. Mid-year assessments indicated statistically significant improvements in all five areas. There were also improvements at the end of the year in four of the five areas (concepts of print, word recognition, writing vocabulary, dictation). There was a non-significant improvement on ‘letter identification,’ but the authors interpreted this finding as a ‘ceiling effect’ (i.e., there was no more room for improvement). Additionally, students were evaluated on how well they could read text, but this skill was assessed initially at mid-year and at the end of the year. There was also a statistically significant improvement in this area as well.

Newport News, Virginia. A total of 585 kindergarten students participated in a study on the Earobics program. There were 292 students in the experimental (Earobics) group and 293 students in the control group. Both groups received instruction in phonemic awareness for 12 weeks; however, students in the control group did not use the Earobics computer software nor other Earobics materials. Those students who were assigned to the experimental group received Earobics instruction at least three times a week, and each session lasted about 20 minutes. The Phonemic Awareness Screening test was administered to all students prior to and following the program.

A comparison of the pre- and post-assessment tests indicated statistically significant improvements for those who used the Earobics software as compared to the control group. These improvements included: identification of initial and final sounds in a word, identification of rhyming words, and an increased ability to blend phonemes into words, and segment words into syllables and phonemes.

Owensboro, Kentucky. A total of 66 kindergarten and 60 first grade students participated in the study. The kindergarten students received 24 weeks of instruction, and the first grade students received 15 weeks of instruction. Students worked with the Earobics program three times a week, and each session lasted approximately 20 minutes. The Phonemic Awareness Screening Test was given to students before and after the completion of the Earobics program. There was no control group for comparison purposes.

The results for the kindergarten students indicated dramatic improvements in several areas of phonemic awareness. This included: representing phonemes with letters, matching initial sounds, and counting phonemes. The results from the first grader students indicated improvements in counting phonemes, comparing word lengths, and representing phonemes with letters.

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For more information on the Earobics program, call 888-328-8199; or visit their web site at: www.earobics.com

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PRACTITIONER’S FORUM: There are many different types of AIT devices available. Are they equally effective?
At the present time, there is very little research on whether or not the available AIT devices are equally effective. The AIT devices currently available include: the Digital Auditory Aerobics (DAA), the Earducator, the Electronic Auditory Stimulation Effect (EASe discs), and the Kirby Method of AIT. In addition, many practitioners are using the AudioKinetron and the BGC Audio Tone/Enhancer Trainer (ATET). These two AIT devices are no longer manufactured.

Not one of these devices is identical to another. The differences include: the music source, how the music is processed (i.e., modulated), and/or how auditory peaks are filtered (i.e., the width and depth of the narrow band filters). Dr. Guy Berard considers each one of these components critical to the AIT process.

There have been only two studies that have compared the effectiveness of AIT devices. Rimland and Edelson (1994) compared the AudioKinetron and the ATET to one another and found no differences between the two devices. Brockett (2001) recently compared the effects of the Earducator to the AudioKinetron and found no differences. Although there is some research indicating that the Kirby Method of AIT and the EASe method are effective, there is no evidence at the present time to indicate whether they are more, less, or equally effective in relation to the other AIT devices. We are not aware of any published research on the efficacy of the DAA device, although research is underway.

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Mozart Effect: Simply Activating the Brain?
The ‘Mozart Effect’ is very popular today and has turned into a big business. Much of the popularity of the ‘Mozart Effect’ is based on the publication of Don Campbell’s book, The Mozart Effect (1997), and Gordon Shaw’s recent book, Keeping Mozart in Mind (2000). Compact discs of Mozart music as well as other classical pieces for infants and children have sprung up in bookstores and record stores and are marketed to parents and educators as a method to improve a child’s intelligence.

The initial study, published in 1993, found that subjects who heard Mozart’s Sonata for Two Pianos in D Major scored higher on an I.Q. test than subjects who did not hear Mozart’s piece. This effect lasted approximately 10 to 15 minutes after listening to the music. There was little or no improvement on test scores after 15 minutes. Follow-up research has been rather mixed, with some studies reporting similar benefits whereas other studies have not been able to replicate the ‘Mozart Effect.’

There has been much discussion of the ‘Mozart Effect’ among music therapists as well as researchers in the field. There is growing consensus that listening to some forms of music are mentally stimulating, such as many of Mozart’s compositions. The music itself does not increase one’s intelligence; but rather, auditory stimulation heightens the brain’s ability to process information. As a result, the person may be more attentive while working on tasks such as an intelligence test. Additionally, after the music is turned off, it takes 10 to 15 minutes for the brain to ‘settle down.’ This interpretation would be consistent with the notion that many people work better (e.g., increased attention, concentration, motivation) when they listen to music in the background. (see related story below.) There is no solid evidence that passive listening to stimulating music can simply increase one’s intelligence.

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Mozart Music, Played in the Background, Improves Physiology, Behavior and Coordination
In a study by Anne Savan, students who were characterized as having behavioral and emotional problems showed improvements in physiology, behavior, and coordination while listening to Mozart music in the background In her study, ten boys, ages 11 and 12 years, listened to music written by Wolfgang Mozart while participating in a science lesson. Several physiological tests were utilized, such as blood pressure, body temperature and heart beat. The results indicated a decrease in all three measures while listening to the music. In addition, Savan reported improvements in behavior (i.e., reduction in aggression and frustration) and coordination.

Since the limbic system is one of the structures activated when listening to music and has some control over blood pressure, body temperature, and pulse rate, Savan speculated that the Mozart music may have stimulated the limbic system, which in turn, produced a chemical that slowed down the body’s metabolism.

Reference: Savan, A. (1999). The effect of background music on learning. Psychology of Music, 27, 138-146.

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Clarification of ‘Progressive Peaks’
Addendum to “Filtering Auditory Peaks Using the Berard Method of AIT,” The Sound Connection, 2000, Vol. 8, No. 1.
Sometimes the audiotest pattern shows a gradual rising slope that results in a peak. This is referred to as a ‘progressive peak’ and typically occurs in increments of 5 dB, although it could be greater. At first glance, the frequency may not seem to meet the criteria for filtering since there may not be a 10 dB difference from the immediate adjacent frequencies. For example, as stated in The Sound Connection (2000, Vol. 8, No. 1), filter selection for a secondary peak at 1000 Hz should have a minimum adjacent difference of 10 dB. However, a ‘progressive peak’ may be present and may need to be filtered. The size of the ‘progressive peak’ can be measured by using the points of the frequencies that mark the beginning and ending of the slopes as a base and the highest point as a peak.

Several examples are located on the Internet at: www.up-to-date.com/saitwebsite/progressive.pdf You will need Adobe Acrobat reader to view this page. You can download a free version of Adobe Acrobat at: http://www.adobe.com/products/acrobat/readstep.html

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New Speculations on the Cause of Sound Sensitivity
Many children with developmental disabilities, such as autism, Fragile X syndrome, and William’s Syndrome,suffer from sound sensitivity. The underlying reason for this problem is not understood. A recent study by Drs. Chen and Toth of Cornell University Medical College in New York provide some evidence that sound sensitivity may have a genetic cause. Their study examined genetically engineered mice who did not have the FMR-1 gene. The FMR-1 gene is inactive in people with Fragile X syndrome. These mice displayed unusually strong reactions to tones, and they were more likely to have seizures induced by sounds.

Dr. Karl Reichelt of the Pediatric Research Institute in Oslo, Norway hypothesizes that a defect in serotonin metabolism may be responsible for sound sensitivity in autism. Serotonin is a neurotransmitter related to arousal and inhibition; and it is known to be abnormal in many autistic individuals. Dr. Reichelt theorizes that there are relatively low levels of serotonin in the synaptic gap. [The synaptic gap is a small space between the neurons. Neurons are able to communicate with one another when one neuron, often referred to as the pre-synapse neuron, releases chemicals into the synaptic gap. Another neuron, referred to as the post-synapse neuron, is activated or inhibited when it receives (uptakes) the chemicals.] Dr. Reichelt suggests that there is an increased uptake of serotonin by the pre-synaptic neuron from the post-synaptic neuron, and this may be caused by a serotonin-uptake stimulating tripeptide. This tripeptide is related to the Reelin gene, a probable marker for autism. Consequently, there will be less serotonin in the synaptic gap, and this will lead to a hyposerotoninergic state and to problems in inhibiting stimulation in the central nervous system. For example, there would be little or no inhibition after sounds enter the central nervous system; and this would lead to sounds resounding and reverberating at full force in the brain.

Another possible cause of sound sensitivity is mercury poisoning. Many parents and professionals believe that the mercury preservative (i.e., thimerasol) used in many vaccines can cause autism. Research on mercury toxicity has clearly shown that it can cause sound sensitivity. We are hearing reports from parents whose children participated in a mercury detoxification program; and as a result, their sound sensitivity decreased or was eliminated. We have heard from a few parents whose children’s sound sensitivity increased slightly while receiving a mercury detoxification procedure. In these cases, the mercury may have been temporarily re-distributed to other places in the body.

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Listening versus Reading the Same Information
Researchers at Carnegie Mellon University recently examined differences in brain activity while subjects either heard or read identical sentences. A functional magnetic resonance imaging (fMRI) procedure was used to measure the electrical brain activity during these two tasks.

The findings showed more brainwave activity in the right hemisphere when the person was listening to the sentences as compared to reading the sentences. Second, there was more activation in a portion of Broca’s area, a major speech/language center, while listening to the sentences. According to the researchers, these results indicate a qualitative difference between these two ways of processing information.

Based on these findings, the researchers suggest that listening requires much more processing as well as more memory resources than when processing written text. That is, spoken words are only available for a short period of time and are held briefly in temporary memory storages. In contrast, when reading, a person can control how fast he/she processes the words; and written words can be considered an ‘external memory’ because the text can be re-read.

Reference: Michael, E.B., Keller, T.A., Carpenter, P.A., & Just, M.A. (2001). fMRI investigation of sentence comprehension by eye and by ear: modality fingerprints on cognitive processes. Human Brain Mapping, 13, 239-252.