Volume 7 Number 3, 2000
Digital Auditory Aerobics (DAA). The Georgiana Institute, Inc. recently announced that practitioners no longer need to attend a training seminar to learn to conduct AIT sessions using the DAA. Practitioners are sent a manual that provides instructions on how to use the DAA equipment. Additionally, practitioners now have the option to lease the DAA. The telephone number for the Georgiana Institute is: (860) 355- 1545.
BGC Audio Tone Enhancer/Trainer. Although the BGC device is no longer manufactured, Ed Horton, who has worked with BGC Enterprises in the past, has several BGC devices for sale. Mr. Horton can also service BGC devices. His telephone number in San Diego, California is: (619) 281-9608.
The conference opened with Dr. Dirk Goetschalckx, director of Voluntas and a board member of IABP. Dr. Goetschalckx described the services provided through the Voluntas organization. When initially founded, Voluntas provided hydrotherapy but soon expanded to include physical therapy, speech therapy, Berard AIT, parent counseling and home therapeutic programs. Activities for clients are also arranged for weekends and school vacations. Comprehensive evaluations of the clients include background medical and developmental history, physical examination of the client, sensorimotor evaluation including gross and fine motor development, speech/language, visual system, auditory system and development of dominance. Based on all of the information compiled, a therapeutic program is designed and training provided. Extensive communication and follow-up with the families is also an important part of this program.
Dr. Guy Berard presented a brief historical overview describing the development of his method. He expressed concern about the recent data published by Oliver Mudford and his colleagues in England, noting that the AudioKinetron was not used for this study. He believes that in order to study the efficacy of Berard AIT, it is necessary to use a Berard approved device. Berard stated that he wants his method to continue to be available even if it is through use of a device other than the AudioKinetron as long as it is effective. Readers will be pleased to hear that he continues to enjoy his many sports activities and hobbies. His wonderful sense of humor and quick wit continues to entertain all who gather to hear him speak.
Dr. John Unruh is president of IABP and founder of the Center of Neurological Rehabilitation, which focuses on treating the causes, rather than symptoms of disorders. Dr. Unruh spoke about his experiences with the Berard method of AIT and clients who had received Tomatis training. Dr. Unruh stated that he began to see significant differences in the results between Tomatis and Berard methods of AIT as increasing numbers of clients participated in Berard AIT. Based on these observations, he has become a strong advocate for the Berard method. Dr. Unruh discussed the inefficient development of the nervous system as a cause of many developmental disorders and learning differences, stating that as many as 65% of people have nervous systems that are not properly developed. The Moro reflex in children and adults with attention deficit disorder (ADD) is frequently not fully suppressed. This interferes with their ability to develop appropriate filtering skills, a widely recognized problem in ADD. Since the nervous system develops based on environmental input, inappropriate functioning can often be improved with the proper environmental input. Dr. Unruh believes that AIT is often one of the appropriate sources of input.
Dr. Paul Deltenre holds a specialty in neurology and the rehabilitation of the neurological, auditory and visual handicaps. He is the director of the Evoked Potentials Department of the Children’s Hospital in Brussels. Dr. Deltenre spoke about the physiological mechanisms of auditory perception.
Dr. Roland DeBeuckelaer is the Director of IABP, Speech/Language Pathologist in Neurological Rehabilitation at the Brugmann University Hospital in Brussels and is responsible for program and evaluation at the Voluntas Consultation Center. Dr. DeBeuckelaer discussed the behavioral responses observed at several intervals during and following AIT. He noted that initially, young children may seem scared, angry, aggressive nervous and resistant, while older individuals seem to accept the headphones better but do show nervousness and anxiety. After two weeks of AIT, clients begin showing increased language performance; improved eye contact and coordination, increased socialization and independence, improved motor coordination and gait. Some may demonstrate aggression and crying, but sound sensitivity has usually decreased. Three months after AIT, many clients show an increase in sound imitation and improved articulation, better concentration and increased alertness, quicker responses to directions and questions, improvements in socialization and school performance. Dr. DeBeuckelaer commented that the more reaction seen during and after AIT, the better the prognosis. He stated that providing AIT early in the intervention program could save a lot of time.
Dr. Wayne Kirby presently serves as Professor of Music at the University of North Carolina at Asheville. Recent research efforts have focused on the effects of sound and music on the human brain. Dr. Kirby presented data from his recent study “The Effects of Auditory Integration Training on Children Diagnosed with Attention Deficit/Hyperactivity Disorder: A Pilot Study”. Using the hypothesis that AD/HD children will show increased auditory vigilance three months after AIT, Dr. Kirby measured attention and impulsivity with the Auditory Continuous Performance Test (ACPT). The musical stimulation was limited to specially engineered classical music selections which were somewhat different from that typically used in AIT. At three months post AIT, the control group showed no improvements relative to inattention and total errors. There was slight, though insignificant, improvement in impulsivity. The experimental group showed significant improvements in regard to impulsivity and inattention and a significant reduction in total errors. This pilot study included a small number of subjects, 10 children; and Dr. Kirby suggests that these results may provide the groundwork for a larger, longer term study on the effects of AIT. However, based upon this study, Dr. Kirby concludes that AIT significantly enhanced the educational potential of these children with AD/HD. The abstract from Dr. Kirby’s research paper is presented in this issue, see pages 4 and 5.
Sally Brockett, M.S. is Director of the IDEA Training Center in North Haven, Connecticut. Trained by Dr. Berard in 1991, Ms. Brockett has been providing AIT and educational consultation to individuals with a variety of educationally related disabilities. Dr. Berard has approved Ms. Brockett as a professional instructor of his method. Ms. Brockett’s presentation focused on AIT Aftercare, “Often Misunderstood and Overlooked.” Aftercare may be defined as training and counseling in peripheral information on AIT and in the intervention techniques to facilitate the individual’s adjustment and manage behavioral reactions. Proper provision of aftercare can significantly improve the long-term results of AIT. Ms. Brockett stressed the fact that aftercare actually begins during the initial orientation and preparation phases of AIT and continues throughout the training sessions and the following period of adjustment. Information should be shared about use of medications, which may be ototoxic, any history of chronic ear infections, avoidance of headphones after AIT and noise exposure. The family should also receive consultation in techniques that can facilitate the listener’s adjustment to changes that may be expected as a result of AIT. Other aspects of aftercare include a plan to monitor progress and changes that may occur, as well as the training of new skills and retraining of skills that are poorly developed. Thus, aftercare is a comprehensive and critical component of AIT that must be thoroughly understood and well implemented. When this occurs, the entire AIT process is enhanced and greater success will be achieved.
Professor of Music, University of North Carolina at Asheville
The purpose of this pilot study was to examine the effects of the Berard Method of Auditory Integration Training on children diagnosed with Attention Deficit/Hyperactivity Disorder. This double blind study included ten children between the ages of six and eleven. The children were randomly assigned to either the experimental group or the control group. The five children in the experimental group listened to classical music that was electronically processed to facilitate modulation by the AudioKinetron, an electronic device developed by French physician, Guy Berard, M.D. The five other children constituting the control group, listened to the same music without any special processing or modulation.
Prior to commencement of the listening sessions, a licensed audiologist was instructed by the investigator to complete an audiogram on all the children using examination parameters recommended by Guy Berard, M.D. The investigator then administered the Auditory Continuous Performance Test (ACPT) by Robert W. Keith, Ph.D. to all subjects. The ACPT is an auditory vigilance test used to diagnose AD/HD in children between the ages six and eleven by detecting the presence of auditory attention deficits. This test yields performance scores based on several parameters, including impulsivity and inattention–the two main parameters which were the focus of this study. Following the audiometric examinations, the investigator made notch-filtering recommendations for all experimental subjects consistent with the Berard protocol. The appropriate auditory stimuli were administered to both groups over the first ten half-hour sessions. Audiometric examinations were administered to all subjects at the end of ten sessions for the purpose of resetting of filters for the experimental subjects, as necessary. Final audiometric examinations were administered to all subjects after all twenty half-hour sessions had been completed. The author then administered the ACPT examination of each subject. Three-month follow-up audiometric and auditory vigilance examinations were also administered. The author hypothesized that, at the end of three months, the experimental group would show a significant improvement in auditory attention and that the control group would not.
Comparisons from pre-experiment scores to scores obtained three months after the listening sessions indicated the following. The control subjects showed no improvements when their three months post experiment performances were compared to their pre-experiment scores relative to impulsivity, inattention and total errors. The experimental subjects showed statistically significant improvement in all areas when their pre- and three months post-experiment scores were compared with regard to impulsivity, inattention and total errors. The two group’s scores, which were obtained immediately before the listening sessions, were compared to those obtained three months after the listening sessions. These analyses showed that the experimental group had improved performance relative to the control group. When the scores of the two groups were compared, the experimental group’s performance was analyzed as follows. Impulsivity errors were diminished by a significant, but statistically unreliable, amount; inattention scores improved, though not significantly (this analysis was unreliable due to the number of tied scores). However, the total number of errors had decreased by a statistically significant amount.
The significance of these results must be cautiously viewed within the limitations of this pilot study. The study included a very small number of subjects. The group sizes, as well as the author’s hypothesis, influenced the choice to use a one-tailed analytical approach. Although the Wilcoxon and Mann-Whitney statistical tests are reliable indicators of statistical significance, the one-tailed approach yields a more liberal (by a factor of two) estimation of significance. The Auditory Continuous Performance Test is limited to measurement of auditory vigilance over the relatively short time span of approximately twelve minutes. The ACPT age range for which it has been scientifically validated limited the age of subjects. Medication taken by some subjects was a variable that may have influenced the performance of some subjects. The music used was limited to a specially engineered collection of classical music.
The author recommends that future studies include larger groups of experimental and control subjects. Larger groups would enable more reliable statistical analyses using two-tailed approaches with more conservative P-values. The reliability of the ACPT is validated for children between the ages of six and eleven. Studying a larger population of children beginning when they are in the six to seven year old age range, and following them until they are ten or eleven years old, would enable an evaluation of the longer term effects of AIT. The author suggests that the results of this pilot study may provide the groundwork for such a study.
The author concludes that Auditory Integration Training, as viewed within the context of this pilot study, significantly enhances the educational potential of children with Attention Deficit/Hyperactivity Disorder.
This paper was presented on January 27, 2000 at the First Annual Congress of the International Association of Berard Practitioners, Antwerp, Belgium
Copyright (c) 2000 by Wayne J. Kirby. All Rights Reserved.
SAIT professional members will soon be listed on SAIT’s web site (www.sait.org). Professional members were sent a form to complete in our last mailing. If you are a professional member and did not receive this form, please fax a note to us and we will send you a form to complete (fax: 503-363-9110).
The Autism Research Institute in San Diego plans to post a list of all-known AIT practitioners on their web site (www.autism.com/ari). Their list will include the practitioner’s status as a member of SAIT, although non-members who wish to be listed will be included.
SAIT is also organizing a Practitioner Information Packet. The packet will contain articles from past issues of The Sound Connection that provide information on AIT procedures. These articles will be based on the recommendations of Dr. Guy Berard and Bill Clark. The packet will be sent to SAIT professional members in the near future.
How Do You Work on Naming?
There are at least two processes involved. Getting the information in, i.e., “storage” and getting the information out, “retrieval.” Naming tasks are usually of two types, visual confrontation and responsive naming. In visual confrontation the client is shown a picture of an object and is expected to name the object. If the visual stimulus does not elicit a response, an auditory or gestural stimulus can be provided to help with recall. It is presumed that the name of the item is logged into long term storage and the problem is one of retrieval. In responsive naming, the client responds to a characteristic of the object, “What do you eat with?” I prefer to use the structure words (color, size, shape, etc.) from the Visualizing and Verbalizing for Language Comprehension Program (Bell, 1991) or describe functional characteristics for cueing. “I use a hammer to pound a ….”
How Do You Develop Naming Strategies?
Several types of cueing strategies to facilitate word recall are: phonetic cues, associative- semantic class cues, sentence completion, melodic stress cueing and multiple choice cueing (Wiig and Semel, 1984). Hedge (1994) describes the following cueing hierarchies:
What is this? It’s a …
“You write with a …”
“…. starts with a p….”
tap out syllables “ta-ble-cloth”
Silent Phonetic cues
Clinician begins to make the initial sound with articulators but without sound. Functional description
“It is something you read…”
Description and demonstration of action
Client describes the stimuli for naming and cues self: “I use it to write with. It’s a pen.”
Client demonstrates the function of the item. Gesture to cue the word.
Client matches word to the item
Client spells word, then says the word
Client writes the word, then says it
Presentation of a sound to evoke a name “meow”
Repeated trials. Client evokes the correct response through drill.
Of course naming single items is not the goal of communication. The goal is to convey ideas from one brain to another. There does however need to be a starting point, and single words can function as important communicative tools. Once single word naming is established and used for one of the purposes of communication, i.e. call attention, give information, and receive information the message can be extended to multiword messages with more meaning.
Source Health and Healing, Vol. 9, No. 8, Aug 1999, Newsletter by Dr. Julian Whitaker
Source Arch Otorhinolaryngol, Vol. 234, No. 2, 1982.