Volume 4 Number 1, 1996
The ABC broadcast was aired on September 24, 1996 and focused on the Tomatis method. The Tomatis practitioner, Valerie DeJean, who works in Bethesda, Maryland, made many claims about the effectiveness of the Tomatis method, even though there is no scientific evidence to support its efficacy. The narrator said the Tomatis method required 62 hours over a period of weeks, and that over 1,000 autistic children had been treated with this method. (Drs. Rimland and Edelson wrote a paper in 1991 comparing the Berard AIT method to the Tomatis method. If you would like to obtain a free copy, send a self-addressed stamped envelope to the Autism Research Institute, 4182 Adams Avenue, San Diego, CA 92116, U.S.A. Please include 55 cents postage.)
We also want to thank former Board member Jenness Roth for her contributions to SAIT during her term on the Board.
The new Board has elected Officers for a one-year term. The Officers are: Stephen M. Edelson, Ph.D., President; Sally Brockett, M.S., Vice-President; Cherri Saltzman, Secretary; and Elizabeth Gerlach, Treasurer.
Like the other senses in the body, the auditory sensory system is very adaptable and can change given the appropriate stimuli and structure. During the AIT listening sessions, the auditory system is stimulated in such a way as to place it in a state of flux, disarray, or chaos. After the completion of the listening sessions, the auditory system reorganizes itself, typically in a more natural, structured and functional manner.
One implication of Dr. Kaplan’s theory would be the possibility of post- treatment in which exposure to structured sounds may re-organize the auditory system more efficiently. This would include exposure to speech and language as well as listening to certain styles of music. Gregorian Chants and music written by Mozart would be appropriate because they are well-organized and very structured.
Although we may not realize it, critical periods for language development occur well before the baby begins to babble, jargon and finally say the first words. The newborn’s brain begins making dedicated connections in the auditory cortex when the baby hears a phoneme (smallest units of sound, such as /p/, /s/) over and over. By six months, a Swedish baby will have different connections than a Japanese baby. By 12 months, infant babbling has acquired the sound of the infant’s own language and he/she is unable to discriminate sounds not heard in his/her language.
Once these basic connections are established, the infant is ready to turn sounds into words. When babies hear a lot of words spoken, they learn language faster; and repeated exposure to words will have a significant impact on language development. When babies suffer from chronic ear infections, the brain may not “hear” sounds clearly and may fail to create distinct circuitry for distinguishing sounds. This can lead to language-based learning disabilities which may interfere with reading and spelling.
The Newsweek article also noted an interesting relationship exists between math and music. A study conducted by Gordon Shaw of UC Irvine found that 19 preschoolers dramatically improved their performance on spatial reasoning tasks when given piano or singing lessons for 8 months, compared to children who did not receive the lessons. It is suspected that when children exercise cortical neurons by listening to classical music, they are also strengthening circuits used for math. It is recommended that parents sing songs with children and play structured, melodic music. If a child shows any musical aptitude, start lessons at an early age. Few concert-level performers begin playing later than age 10.
Selection of narrow-band filters for the AIT listening sessions depends on the amplitude (or height) of an auditory peak(s) as well as its relation to adjacent frequencies. This is determined by using an air conduction hearing test. The audiogram, which is a graphic representation of one’s hearing, shows how well a person can hear frequencies at various levels. It does not indicate which frequencies are perceived as painful. According to Dr. Guy Berard and other audiologists, frequencies in which a person hears too well are not necessarily those frequencies which are perceived as painful. For Georgie, sounds were not perceived as painful; she simply heard sounds too well. Thus, when narrow- band filters are used during the AIT listening sessions, those frequencies which are heard hyperacutely are filtered, and not those frequencies which are painful.
Methods. Eighty subjects, who had a diagnosis of either autism or Asperger’s Syndrome, participated in this study. The age range was 4 to 16 years. The research design involved a blind procedure in which half received AIT and half received a placebo (the same, but unprocessed, music). Assessments were conducted one, three, and six months following the listening sessions. Parents completed the Autism Behavior Checklist, the Developmental Behaviour Checklist, a Sensory Problems Questionnaire, and a Sound Sensitivity Questionnaire (SSQ). The AIT device used in the study was the Audio Tone Enhancer/Trainer.
Results. The only statistically significant difference between the two groups, using the SSQ, was at the one-month assessment period in which subjects in the AIT group were reported to be less sound sensitive than those in the placebo group; however, there were no differences between the two groups at the three and six month assessment periods.
Overall, the results showed a decrease in sound sensitivity for those in the AIT group and those in the placebo group. There were no differences found for any of the other behavioral measures.
Conclusion. The investigator concluded that listening to music in a structured situation may lead to a decrease in sound sensitivity. [However, when improvement is observed in both the experimental and placebo groups, this trend is often attributed to maturation of the subjects rather than improvement due to the intervention being evaluated.]
Comments. SAIT has been tracking this study for several years. A careful analysis of the measures used in this study, especially the SSQ, raises questions about the validity of the reported findings. The SSQ was used to measure the subjects’ sensitivity to sounds; and a summary score, which was used in the statistical analysis, was derived by summing the responses to various questions.
1. The SSQ is a modified version of Dr. Bernard Rimland’s `Hearing Sensitivity Questionnaire’ (HSQ). The HSQ was simply an exploratory checklist designed to survey the prevalence of sound sensitivity in autism. At the present time, there are no studies supporting the validity of either the SSQ nor the HSQ. (This was stated in the Bettison article, on page 367.) Researchers have always stressed the importance of using both valid and reliable measures when conducting scientific investigations, especially when relying on questionnaires completed by parents.
2. It is unlikely that the SSQ summary score reflects sound sensitivity because it does not even have face validity (i.e., the appearance of being valid), a pre-requisite of any measurement tool. Some of the questions used in the analysis include: `#1. Have there been certain sounds which the person does not seem to hear?,’ `#7. Did the child seem particularly fixated on certain sounds?,’ and `#9. Did he/she chose to listen to TV/Radio/Tape etc. very loud.’ Interestingly, the statistical analysis of the SSQ included the question: `Has it ever been suspected that the person could NOT hear?,’ but this question was not listed in the article. One can easily dispute the appropriateness of these questions as reflecting sound sensitivity; and thus, question the validity of these results.
3. Several research studies which showed a decrease in behavioral problems as a result of AIT have utilized the Aberrant Behavior Checklist. Since the Bettison study did not employ this checklist, it is inappropriate to state that her results are inconsistent with previous research studies, since the questionnaires and checklists may be measuring different behaviors in the subjects.
Given these shortcomings, this study cannot be considered as demonstrating that AIT is an ineffective intervention for autistic individuals.
The statistics were related to telephone operators, translators, and musicians, and even though I cannot exactly quote the results now, I remember that the people whose hearing had been impaired through occupationally-related causes could obtain an official pension. Thus, it was officially recognized that wearing headphones to listen to speech or music could lead to some hearing damage. Afterwards I was asked by several lawyers to evaluate the percentage of hearing loss of these individuals. This percentage was very different for each person, probably because of differences in the physiological and physical resistance of each person.
If it was admitted that wearing headphones to listen to speech or music could lead to some damage to normal individuals, it is obvious that someone who had been treated with AIT, who had some problem of hearing, would be more sensitive to all hearing aggressions, including wearing headphones. This is the reason why I forbid the use of headphones, or at least, if people have to do this because of their work, to minimize the amount of time for this use.
What causes this hearing problem when headphones are used?
I have never read any official explanation, if one even exists, and have to suggest my own opinion.
Normally, when you hear sounds, such as music, talking, noises from your own behavior, songs of the birds, as well as thunderclaps, any kinds of engines or of explosions, they reach your tympanic drums after passing through a large quantity of atmosphere. This air works as a shock absorber to diminish the intensity of the impact on the eardrum.
However, when you are hearing sounds coming directly from the membrane of the headphone to your tympanic membrane, through the one square centimeter of air included in your outer ear canal, the impact is practically direct, without any possibility of easing this aggression.
This constant aggression is transmitted to the ossicles, then to the inner ear. This explains why many of people working with headphones have a trough, or drop on 4000 Hertz on their audiogram, similar to that of people working in noisy factories.
On the other hand, wearing headphones eliminates all the sounds coming from outside, increasing the sounds coming from your own body, your own voice, creating a sort of echo. This aspect of the problem is more important for people wearing earplugs placed directly in the outer ear canal close to the eardrum. Then there is no more air to help the vibration of the tympanic drum and all your own sounds lead directly to the cochlea and the brain, which is not satisfactory, physiologically or psychologically.
As soon as I became aware of the existence of walkmans, I warned officials of the danger of this type of device, for the same reason … in vain. Now the same officials are discovering this danger and giving precautions.
Participants were interested in the new compact disc that is now available for home listening sessions. Discussion focused on the differences between the two procedures. The article on maximum sound output of one Audiokinetron, which appeared in the May, 1996 issue of the American Journal of Speech and Language Pathology, was also a topic of discussion. Members expressed concern about the poor study design used in this project.
The first section presents 43 alternative therapies, with clear explanations of the treatments and for what conditions they may be used. Resources for finding help and additional recommended reading lists are provided.
The second section presents the health conditions and discuss what treatments are currently being used, along with resources for seeking help and recommended reading lists.
Autism is included in the health conditions section. Possible causes of autism are discussed, including viral infections, lead poisoning, food allergies, vaccinations, yeast infections and deficiencies of digestive enzymes. Treatments are presented and explained, including nutritional supplements, diet, auditory integration training, craniosacral therapy, and allergy therapy. The chapter on auditory integration training includes discussions of the Berard and Tomatis methods. This is an excellent section to share with your child’s physician, teachers and therapists to make them aware of the current theories and methods of treatment available.
Published in 1994, the book is presently available in bookstores or at discount clubs such as Sam’s, Price Club, Costco, etc. It is a worthwhile addition to any home health library.
Dr. Bernard Rimland felt that a better term was needed to describe Berard’s method. He realized that Berard’s method could be considered a form of sensory integration; and after much thought, he coined the phrase `Auditory Integration Training’ or `AIT.’ At the same time, a few practitioners started using the term `Auditory Enhancement Training’ to differentiate Berard’s method from the other form of `auditory training.’ This term is still used by some people today. Since the term `AIT’ is used by most professionals and families, we recommend that all practitioners use this term to avoid confusion.