Frequently Asked Questions Concerning Auditory Integration Training
Following are frequently asked questions about auditory integration training (AIT), along with SAIT’s response to each one. Please let us know if there are additional questions you would like answered.
Who is a good candidate for AIT?
We do not yet have a profile of those individuals who would benefit most from AIT. We initially thought people similar to Annabel Stehli’s daughter, Georgie, would be most likely to benefit. Ms. Stehli’s book, The Sound of a Miracle, detailed how Georgie benefited from receiving AIT. Georgie was high-functioning, verbal, and very sound-sensitive. After receiving AIT, her sensitivity was eliminated; and her overall behavior improved. However, several research studies as well as many reports from parents show that people who are not similar to Georgie also do benefit from AIT.
Drs. Rimland and Edelson (1994) studied the effects of AIT on 445 autistic children and adults. They used a variety of statistical techniques to determine a profile of those who improved as a result of AIT. Although these researchers documented a reduction in sound sensitivity and an improvement in behavior, they did not see any relationship between age, language ability, configuration of the audiogram, and degree of autism. They did find that low functioning individuals improved behaviorally more than high functioning individuals.
Given these findings, the current answer to the question, “Who is a good candidate for AIT?” seems to be “we don’t know.” As with most interventions, not everyone benefits from AIT. However, given the noninvasiveness of this intervention, it may be worthwhile for interested individuals to see if AIT may be beneficial.
If a Person Cannot Be Tested Audiometrically, Can He/She Still Receive AIT?
The AIT music is processed in two ways. In one way, termed ‘modulation,’ low and high frequency portions of the sound spectrum are attenuated at random. The second way involves using narrow-band filters to dampen specific frequencies in the sound spectrum. These frequencies, referred to as ‘auditory peaks,’ are those which are heard much better than their adjacent frequencies. An audiotest is often given to an individual prior to AIT to determine if he/she has auditory peaks in his/her hearing. If one or more peaks are evident, then narrow-band filters may be used during the AIT listening sessions to lower the volume of sound at those frequencies. In cases in which a person cannot perform reliably on an audiotest, filters are not recommended, but the music is still modulated throughout the 10 hours of listening. Dr. Guy Berard, the pioneer of AIT, has often stated that it is better to use no filters than the wrong filters. He states that narrow-band filters are often not necessary for people with autism and related disorders.
The use of behavioral observations and sound field testing to obtain an audiogram for AIT is also not recommended by Dr. Berard. Behavioral observations may not be sufficiently reliable to determine the precise point at which the person begins to hear sounds, and this minimal threshold level is the point that needs to be measured. Sound field testing provides the results for only the better ear.
There are a few practitioners who feel they can determine the necessary filters by analyzing a person’s speech patterns, and others who feel they can determine filters by using an Otoacoustic Emissions Test. At the present time, there is no scientific support for either of these two methods.
What is the Minimum Age to Receive AIT?
How old is old enough to begin AIT? In the past, Guy Berard’s position has been that, to be on the safe and conservative side, AIT should not ordinarily be given before age 4 years. Some authorities on hearing and child development agree, suggesting that the auditory system is too immature in younger children. Additionally, there is concern that young children may not effectively protest if the music is inadvertently played too loudly.
Pressure toward dropping the age limit to 3 years has been mounting from both parents and practitioners, who point to the potential advantages of early intervention. Some have used AIT with children as young as 2 years of age. After he learned of apparent positive results with some 3 year olds with no known negative or adverse results, Dr. Berard has reconsidered; and he now feels that 3 years may be a suitable age (personal communication, 5/4/95).
Whatever the trainee’s age, extreme care should be taken to ensure that the volume is well below the EPA and OSHA noise exposure limits-in all cases-and that AIT devices be checked frequently to prevent excessive loudness. The output should never go above 85 dB. This caution is especially important for young children, since EPA and OSHA limits have been determined for adults and not for children.
Until a safe age limit and volume level are established, practitioners who give AIT to young children should proceed very cautiously.
Why Should the Listener Not Wear Headphones After Receiving AIT?
Dr. Guy Berard states that people should not wear headphones to listen to music after receiving AIT. He argues that the ear cannot defend itself against very loud sounds. Basically, sound is energy; and when a lot of energy (i.e., music) is placed in a short and narrow tube (i.e., the ear canal), it will work the ear drum, middle ear, and inner ear excessively.
According to Berard, if a person wears headphones to listen to music after receiving AIT, his/her hearing may return to where it was prior to receiving AIT. There have also been several clinical case reports of individuals who experienced a sudden loss of gain after wearing headphones. Berard believes that it is acceptable to listen to speech at a low to moderate level using headphones.
Why are people offering AIT when there is no research to support its efficacy?
There is research on AIT which supports its efficacy. We are aware of 28 studies which have investigated the effectiveness of AIT. Twenty three of these studies have indicated improvement in people with autism and learning disabilities after receiving AIT. The Autism Research Institute in San Diego distributes a summary of these research studies. Click here to visit their web site.
Does AIT reduce sound sensitivity by causing some form of hearing damage?
There is no evidence at all to support the idea that AIT is effective by inducing hearing damage. In fact, Drs. Bernard Rimland and Stephen Edelson analyzed the audiograms from 199 people who received AIT. They documented a significant decrease in sound sensitivity and a slight improvement in hearing. (The slight improvement in hearing may have been due to familiarity with the testing situation and/or the audiologist.) Of course, AIT devices, like any other devices using audiotape or compact discs, can be misused by adjusting them to play too loudly. The Society for Auditory Integration Training has often urged AIT practitioners to calibrate their equipment to make sure that the output level of these devices does not exceed 85 dBA.
How can a person be sure that an AIT practitioner is following the standard AIT procedure developed by Dr. Guy Berard?
Some practitioners have chosen to depart from the basic procedure developed by Dr. Guy Berard during his several decades of clinical experience. Some do tell parents of the changes while others do not. SAIT advises parents to do their `homework,’ by learning as much as they can about the procedure. SAIT provides parents and professionals a list of questions to ask practitioners as well as information about the basic procedure. Most of this information on this website and through the Internet at https://berardait.wpengine.com. Parents can obtain a list of Berard AIT Practitioners at https://berardait.wpengine.com/PracList.htm.
Has the Food and Drug Administration (FDA) classified the AIT devices as harmful?
No, the FDA has not classified AIT devices as harmful. Any device for which there are claims that it will improve or cure a condition is automatically labeled a `medical device’ by the FDA. Recently, the FDA clarified their position regarding AIT devices. That is, as long as AIT devices are not promoted as ‘medical devices,’ then the FDA does not have jurisdiction over them.
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