Volume 3 Number 4, 1996

Georgie Receives Auditory Integration Training a Second Time
Georgiana Thomas, whose childhood was described in her mother’s book, Sound of a Miracle, and highlighted in several national television programs, recently received auditory integration training (AIT) a second time. As many of you know, she was 11 years old when she received AIT from Dr. Guy Berard in Annecy, France. While receiving AIT in Annecy, Georgie felt a gradual improvement in her hearing during each day of the listening sessions. Some of the changes she attributes to AIT include: a decrease in hypersensitivity to noise and distractibility, and an improvement in concentration.

At age 30, Georgie decided to receive AIT again; and this time, she received AIT at the Center for the Study of Autism in Beaverton, Oregon. Georgie stated that she also benefited from the second set of AIT listening sessions, but the changes were not as dramatic as when she first received AIT. She believes the primary change was an increase in overall calmness, (i.e., she felt more relaxed), but she did not know whether there were any other benefits.

An often asked question regarding AIT is whether a person will benefit from a second set of listening sessions. While Georgie’s experience shows a slight benefit after a second set of listening sessions, benefit of repeated AIT sessions can only truly be answered by conducting empirical studies assessing this issue.

In case you would like to know what Georgie is up to these days, she is married and lives in Corvallis, Oregon. She has been working hard on her art career and often does portraits and caricatures at local, county and state fairs and festivals. Georgie also travels throughout the country speaking at many AIT practitioner-sponsored conferences. Within the next month or two, she plans to establish her own Web site on the Internet which will display many of her artworks.

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`People In Motion’ Sparks More AIT Attention
The Public Broadcasting System (PBS) aired a one-hour program in March, 1996 called “Breaking the Silence Barrier’ and included a discussion of auditory integration training (AIT). The television program was one part of a three- part series titled `People in Motion’ and was produced by Gail Freedman. The series highlights creative technological advances for people with various disabilities.

The segment on autism focused on AIT, Temple Grandin’s `Hug Box’ and Mark Rimland’s use of a computer to paint elaborate pictures. The AIT portion of the program included children receiving AIT and interviews with parents before and following AIT.

For several weeks following the program, the Society for Auditory Integration Training (SAIT) received numerous telephone calls, letters, and email messages requesting information about AIT. In addition, SAIT’s web site on the Internet received a large number of `hits.’

Many local PBS stations will re-broadcast a program if there are viewer requests that they do so.

An informative viewer’s guide about the series can be obtained by writing to: People in Motion-Second Season, Viewer’s Guide, P.O. Box 245, Little Falls, NJ 07424-9876.

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Food and Drug Administration Update
In the last issue of The Sound Connection (Vol. 3, No.3, 1996), we reported that the Food and Drug Administration (FDA) had denied BGC Enterprises’ application to reclassify the Audio Effects Generator from a Class III to a Class II medical device. BGC Enterprises is working on an appeal to change the classification of the device; and the SAPP Corporation is currently reviewing their options on importing their devices to the United States.

Agents from the FDA recently visited an AIT practitioner in Virginia, but no adverse action was taken with respect to her practice of AIT.

Our office has been in contact with many practitioners throughout the country. Some are continuing the practice of AIT and do not view the FDA’s ruling as a obstacle since the federal FDA office is primarily concerned with the manufacture, distribution, and inter-state transportation of these devices (see The Sound Connection, Vol. 1, No. 3, 1994; Vol. 1, No. 4, 1994; Vol. 3, No. 3). Other practitioners have decided to stop offering AIT for a variety of reasons, such as liability and licensing issues or simply due to a lack of clients.

We will continue to keep SAIT members posted on the status of the FDA’s rulings concerning AIT devices.

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AIT Effectiveness: Not a Placebo Effect
A recent issue of The Advocate, the quarterly newsletter of the Autism Society of America, included an article critical of AIT. The following “Letter to the Editor,” written by Drs. Bernard Rimland and Stephen M. Edelson, was submitted to The Advocate in response to the article.

In his recent (May-June, 1996) review of several studies on the therapeutic use of sound stimuli as a treatment modality for cognitively handicapped children, Charles A. Amenta dismissed the reported effectiveness of Berard-type Auditory Integration Training (AIT) as attributable to placebo effects. That is, he asserts that the positive findings are merely the result of positive expectations or wishful thinking by the parents. That is not the case.

We have conducted three carefully designed and executed experimental evaluations of AIT. In two of the studies placebo effects were precluded by the use of double-blind/control group procedures. The results of all three of our studies were clearly positive, thus supporting the favorable evaluations of AIT rendered by the majority of parents of autistic children treated with AIT.

Readers who wish to receive summaries of the 12 studies of AIT completed to- date, including the three conducted by us, are welcome to request them from the Autism Research Institute (4182 Adams Avenue, San Diego, CA 92116). Please include a self-addressed, stamped envelope.

We also wish to comment on a related development: The May, 1996 issue of the American Journal of Speech and Language Pathology published a rather pointless study in which the authors reported having tested the maximum sound output of one of the AudioKinetron devices designed by Dr. Guy Berard. They claimed that the volume of the music it played could be adjusted to be too loud and that extended exposure to such excessive loudness could be damaging to hearing. Had the researchers gone into any K-Mart, Woolworth or Wal-Mart in the country and picked a CD or cassette player at random, they would have gotten the same results-almost any music player can be set to play too loudly, if one wishes. How do you make sure that the AudioKinetron is not being played too loudly? You listen to the music to make sure that it is being played at a comfortable level. You keep the child’s hands away from the volume control unless you trust the child’s judgment to adjust the volume appropriately. If you bang someone on the head with an AIT device, or with a cassette player from K-Mart, you could hurt them. Does that mean the devices are dangerous? Of course not!-the devices were being used inappropriately. So also is playing the devices too loudly inappropriate use. The bottom line: whenever anyone, in this case Dr. Berard, tries to make progress, he/she will be plagued by critics and naysayers. Parents should use their own intelligence and critical thinking and not be unduly influenced by detractors.

We have conducted research, and monitored the research of others, on the effectiveness of AIT for five years. We are confident that it is a very safe procedure and that it is quite helpful to a substantial majority of the autistic children and adults on whom it is used. As researchers, we have no financial incentive to favor AIT.

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PRACTITIONER’S FORUM
The AIT practitioner in my area sets filters by making a recording of the child’s voice (a sonogram) and analyzing the sounds. It is claimed that this is superior to other methods. Please comment.

It is just someone’s theory-one of many-until it is supported empirically. There are many ideas out there that could be tried, but the question is: Does it work? The way to determine if it works is through carefully designed research studies. The only way that has been scientifically tested and reported with AIT is to set filters based on an audiogram.

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Healing Music
Auditory integration training (AIT) generally involves listening to filtered music for 10 hours over a 10- to 20-day period. Besides AIT, there are extensive sets of compact discs and audiotapes commercially available which provide music to reduce symptoms such as anxiety and stress. These discs and audiotapes present various pulses or frequencies to the listener which are intended to influence brain wave activity.

People in the field of `healing music’ or `music therapy’ point to the historical and cultural importance of listening to specific sounds. For example, music has often been thought of as a source of healing and meditation. Such music includes: meditation gongs, mantras, spiritual chanting, Tibetan singing bowls, and tribal drum beats. Many people feel that certain types of singing and/or listening to music encourage the healing process by calming or relaxing an individual’s nervous system. (One theory of AIT states that AIT may simply provide a calming effect; see The Sound Connection, Vol. 3, No. 3, 1996). Some of the claims include a reduction of blood pressure, stress, headaches, insomnia, and anxiety; and improvement in balance, immune system response, blood circulation, mood, and emotions.

One type of healing music is entrainment. This is the process of using music to `entrain’ or influence brain waves. A popular form of entrainment which has been used by many families with an autistic child is Rhythmic Entrainment Intervention which involves listening to drum beat rhythms (see The Sound Connection, Vol. 3, No. 2, 1995).

The most common approach to this form of healing music is based on the idea of sonic entrainment in which one’s brain waves naturally `lock on’ or become `in synch’ with certain pulses or frequencies. In some cases, the pulses are presented rather rapidly to activate or capture the person’s attention and are gradually slowed down to `lock on’ the brain waves to a specific frequency. There are four basic categories of frequencies with corresponding music sources used to entrain the brain to:

Delta: 0.1 KHz to 3 KHz. These are considered slow waves and are associated with deep relaxation.

Theta: 3 KHz to 7 KHz. These are associated with visualization, meditation, REM (dream) sleep, and creativity.

Alpha: 7 KHz to 13 KHz: These are associated with an alert and focused state of mind.

Beta: 13 KHz and above: These are the fastest waves and are associated with a normal, waking state and attention.

Another concept of healing music is that it may `disrupt’ the system by providing music which creates tension within the nervous system. It is theorized that the nervous system is not functioning properly, and this leads to disharmony within the entire body. By creating a state of disarray in the nervous system, it is thought that it will eventually re-organize itself in a more organized and functional manner.

Many bookstores and record stores provide information on healing music. There are many audiotapes, compact discs, and written materials associated with various methods of healing music.

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Retiring: Dr. Guy Berard
Retiring. What does that mean exactly? Ten years ago, when I was 70, I began to think about my future since I was planning to stop my clinical activities within 4 years. I collected ideas about retiring by looking at my older friends who had already retired.

— Some of my friends were having a wonderful time fishing or hunting, playing the sports they liked, traveling in France or foreign countries around the world, reading books, and going to shows. Days and weeks were too short to succeed in doing everything. They looked very happy, explaining that they should have retired sooner to take better advantage of their life.

— At the opposite extreme, the others appeared completely lost. They had no daily program to follow, patients to counsel, nothing to do except look forward to the time for lunch, dinner, and bed.quickly becoming depressed.

— In the middle, the most successful ones had scheduled what should be done each day, mixing harmoniously some medical activities, entertainment, and sport.

While I was trying to make a choice, life took care of my future. Because I did not want to see the method that I created and applied successfully to thousands of patients fade away, I built a device which was easy to use-the AudioKinetron.

I also developed a waiting list of travel projects which included skin diving in the warm oceans and skiing in the Rocky Mountains.

Meanwhile, my first activities were focused on teaching my method, either to groups of 20 trainees in the U.S. or to groups of three people in my villa-that I continue now. There are approximately 250 individuals throughout the world who practice my method, in America and Europe, Hong Kong, Korea, Philippines, South Africa, Australia, and Malaysia.

This network is now well-established, and a large part of my time is devoted to the constant correspondence, usually by fax, with my trainees. They sometimes ask me for advice for special cases; and in other cases, they send me information concerning some discovery that they made during their work. This part is very important to me because the experience of these 250 people, who have applied my method to several thousands cases, is very helpful to me. This information, coming from so many different people, is more instructive to me than that which I collected myself because they diminish the risk of relying too much on my own feeling and personal thoughts.

Besides these activities, I am working with people who are translating my French book, Audition Egale Comportement (Hearing Equals Behavior), into Portuguese, Spanish, German, and maybe Korean.

At the same time, I am following closely the research concerning everything about autism, especially the studies on dyslexia and depression. [Editor’s note: there is indication that there is an increased prevalence of dyslexia and depression in families of autistic children.]

The conclusion is that “RETIRING” means the only vacation I could take until now is 10 days in 6 years with my wife! And, probably, I will take some time to shed tears for not getting to my “waiting list” of planned entertainment activities.

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Auditory Stimulation Compact Disc Available
The Society for Auditory Integration Training (SAIT) expresses no opinion on the efficacy of the EASe discs nor does SAIT express an opinion on whether the discs are subject to any regulation.

Vision Audio Inc. recently began selling “EASe” compact discs, to provide therapeutic auditory stimulation to children with autism and related disorders. EASe, which stands for Electronic Auditory Stimulation effect, was developed by Bill Mueller, President of Vision Audio Inc., to offer an inexpensive and easily accessible way for children to obtain auditory stimulation treatments. The discs sell for $79.00.

The method, which has been termed `Transient Electronic Auditory Stimulation’ (TEAS), involves listening to the EASe compact discs through headphones. According to Mr. Mueller, over 300 hundred children worldwide have listened to the compact discs; and many parents have reported positive effects. However, there are no experimental studies which support the efficacy of these discs nor any studies establishing optimal length of listening.

The EASe disc which is currently being distributed is one-hour in length and contains 17 different audio tracks. Several more EASe discs are to be distributed in the future, according to Mr. Mueller.

The TEAS procedure raises several concerns:

1) TEAS resembles auditory integration training (AIT) in that the discs contain modulated music, but they do not contain narrow band filters. Mr. Mueller chose not to use narrow band filters because Rimland and Edelson’s 1994 study indicated that the use of filters during AIT may not be necessary for autistic individuals. However, Rimland and Edelson are reluctant to generalize their findings from this one study because their findings were dependent on the measures utilized in the study (see The SAIT Newsletter, Vol. 1, No. 3, 1994). In their study, Rimland and Edelson investigated sound sensitivity and behavioral problems and found improvement in both, but it is at least possible that filters may be necessary for other symptoms, such as attention, auditory processing, and speech/language. In addition, the Rimland and Edelson study included only people with autism.

2) The TEAS schedule differs from Dr. Guy Berard’s clinically derived procedure. Dr. Berard recommends twenty 30-minute listening sessions over a 10- to 20-day period; and says that a person should not receive more than 10 hours of AIT music over a 6- to 9-month period. Dr. Berard feels that a person will not benefit after more than 10 hours of AIT, and the person may exhibit both auditory and behavioral problems if more than 10 hours of AIT is given. In contrast, there is no set procedure for how long a person should listen to the EASe discs. According to the literature accompanying the discs, “The listening schedule is determined by you the parent.” The instructions state that AIT consists of 10 hours of listening; however, Mr. Mueller also states: “A group of over three hundred children have been listening to these discs thirty minutes a day for eight months, with no ill effects. You decide what is right for your child.” Please be aware that listening to the EASe discs for thirty minutes a day for 8 months totals to 120 hours. Mr. Mueller claims that there are no ill effects while listening to the EASe discs for an extended period of time; however, this has not been tested experimentally.

3) For those individuals who have speech and language problems, part of the AIT procedure involves lowering the volume level in the left ear by 30% after five hours of AIT, to stimulate left hemisphere function. Reducing the volume level in the left ear is not part of the TEAS method.

4) Prior to AIT, it is recommended that the listener’s ears are examined for possible problems, such as a middle ear infection and excessive wax. In addition, an attempt should be made to test a person’s hearing to determine if the person may have problems in the middle and inner ear. People using the EASe discs would not necessarily conduct an ear examination.

Mr. Mueller advises us that all proceeds from the EASe discs are donated to the Institutes for the Achievement of Human Potential in Philadelphia, Pennsylvania.

For more information about the EASe Discs, contact Vision Audio Inc. at 611 Anchor Drive, Joppa, MD 21085, telephone: (410) 679-1605.

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Chemical Causes of Sound Sensitivity
One of the reasons parents seek auditory integration training (AIT) for their child is their child’s reaction to certain sounds. However, some forms of sound sensitivity are a result of biochemical imbalances which may not be helped by AIT.

There is evidence that aspartame (or Nutrasweet), a popular artificial sweetener, may lead to hypersensitivity to sounds. Interestingly, many chewable vitamins for children use aspartame as a sweetener (Sesame Street vitamins do not). According to the Physicians’ Desk Reference (1995), one of the side-effects of the anti-convulsant drug Tegretol (Carbamazepine) is hyperacusis. Another side-effect of both aspartame and Tegretol is tinnitus (buzzing or ringing in the ears). As mentioned in a previous article in The Sound Connection (Vol. 2, No. 4, 1995), magnesium deficiency is also associated with sound sensitivity. Many people in the U.S. consume too little magnesium in their diets. Magnesium supplements of 100 to 300 mg. per day for children and 200 to 400 mg. per day for adults are safe and may help sound sensitivity.

Practitioners are advised to discuss possible biochemical causes of sound sensitivity with families prior to AIT so that families can make informed decisions regarding whether to receive AIT or to try other options to reduce sound sensitivity.