Volume 8 Number 3, 2001
The following information summarizes the presentations and discussions that focused on auditory integration training (AIT).
AIT Practitioner’s Meeting: Approximately 30 AIT practitioners met on Thursday evening, March 8 to participate in a discussion of AIT. Cindy Wilson, a pediatric audiologist and AIT practitioner, led the group. There was universal consensus that use of headphones for recreational purposes after AIT can undo or decrease the benefits that had been achieved. Virtually all practitioners caution parents about this matter.
Sally Brockett recommends that parents have the ‘no headphone’ stipulation written into their child’s IEP as a special modification or pre-caution. This makes the school accountable for its implementation within that environment. Practitioners have not reported problems with the therapeutic use of headphones, as with FastForWord, Therapeutic Listening, etc., after AIT, although this has not been clinically studied.
Practitioners shared concerns about the use of ototoxic medications and their impact on AIT improvements. There were reported instances of individuals losing the benefits that had been gained following use of these medications. There are a variety of medications that can have ototoxic side effects, and it is difficult to obtain this information. The Physicians Desk Reference can be helpful, and pharmacists are often knowledgeable. Specific drugs that were mentioned on several occasions include IV drip Ceclor (often used for surgeries) that may cause sound sensitivity, and Benadryl, an antihistamine used for allergic reactions, which may cause tinnitus, vertigo and acute labyrinthitis.
Sally Brockett provided information on the Earducator, the new Berard device. Clinical studies were completed this summer to determine whether performance of the Earducator was at least equal to that of the AudioKinetron. The data from this study indicates that the performance was quite similar.
Discussion also focused on the listener’s activities during the AIT listening sessions. Many practitioners request that the listener sit quietly and try to actively listen to the music. Occasional sips of water and certain types of food may be allowed if the child becomes restless. Other practitioners believe that some forms of sensory input during the listening sessions facilitate the AIT process, although there is no clinical data available yet. They permit use of thera-putty, thera-band, koosh balls as well as some movement activities. All practitioners discourage activities that engage the listener in highly cognitive tasks such as reading.
Most practitioners are requiring that audiologists conduct a hearing test prior to the AIT listening sessions. However some practitioners do their own testing. Some concern was expressed in regard to the Therapeutic Listening program since it does not require audiological evaluation.
Some practitioners commented on the Digital Auditory Aerobics’ comprehensive questionnaire as being very useful for monitoring progress and change. This is a rating scale completed by parents or caregivers as a baseline and then again during the follow-up period after AIT.
Booster sessions (2-3 days of AIT after the 10-day session has been completed) were discussed, and some practitioners who attended the meeting were aware of others who still provide these sessions. Dr. Guy Berard has stated that booster sessions are not recommended. If AIT is repeated, which it can be, the complete 10-day session should be provided after a period of time appropriate for the individual case. In fact, many practitioners reported that clients often choose to do more that one set of AIT listening sessions, and most show improvement with each set of sessions. Once improvement is no longer seen, AIT need not be continued, unless there is a future relapse due to illness, medications, trauma, etc.
The meeting concluded with practitioners in agreement that it was very productive to be able to meet together and discuss AIT. Although there are some variations in the way individuals conduct their practices, it was helpful to share ideas. All practitioners have been impressed with the value of AIT and the positive results so often achieved.
Jane Madell, Ph.D. “AIT for Toddlers.” Jane Madell presented her method of AIT to the conference attendess, which varies somewhat from Dr. Berard’s method. She emphasized the importance of an audiological evaluation to determine if auditory function is normal. She determines eligibility for AIT based on the following auditory criteria: (1) auditory attention disorder, (2) auditory processing disorder, and (3) sound tolerance. The age of the listener is not limited to three years and older, but he/she must be able to wear headphones. Dr. Madell reported significant improvements have been achieved in toddlers and preschoolers. Clients are monitored following AIT and may receive additional sessions or other interventions if auditory function continues to be a concern.
Sally Brockett, M.S. “Aftercare: Often Overlooked and Misunderstood.” Sally Brockett presented information on aftercare, a critical component of AIT that can impact on the long-term results of AIT. The presentation focused on issues such as ototoxic medications, reteaching of skills, facilitating the adjustment to changes that may occur and use of headphones after AIT.
Ototoxic drugs may have side effects that can damage the auditory system. This includes drugs such as the aminoglyocide family of antibiotics, benadryl, and aspirin or salicylates. Since there are also many others, it is important for AIT practitioners and parents of children receiving AIT to be aware of the possibility of ototoxicity when given prescription medications.
Parents and practitioners also need to understand the benefits of reteaching skills following AIT since the individual may now perceive certain things differently. This applies especially to phonics as the person may hear sounds differently. Reteaching the letter/sound associations may improve spelling and reading skills. Organizational and study skills may also improve with direct teaching after AIT.
The presentation also provided information on helping the individual adjust to the changes with a minimal amount of disruption. Some helpful suggestions include using sensory integration activities such as deep pressure and joint compression to calm and integrate the system after the listening period. It is best to discuss these activities with the child’s OT in order to determine which activities may be most suitable for the individual. Use of well-structured music (Mozart and Gregorian chants played as background music) may also be helpful for reorganization.
Mrs. Brockett emphasized the need for practitioners to be certain parents understand that headphones should not be used following AIT, and that this is a lifelong commitment. This precaution can be written into a child’s IEP to assure that school staff are aware and adhere to the stipulation.
Laurie Ross-Brennan, M.S. “AIT and Language Development” spoke about the impact that AIT has on language abilities and shared information on some of the techniques that she uses. Her presentation included pre- and post-data from the Porch Index of Communication Ability in Children. Mrs. Ross-Brennan has seen consistently good results with pre/post testing with the Porch.
Mrs. Ross-Brennan reported that headbands can be used to hold the headphones securely on children. She also stated that many children have enjoyed listening while sitting in a video rocker chair. She has also found that sensory integration activities help with the reorganization and integration of AIT.
Julia Grenier, Ph.D. “Stimulating the Brain with AIT.” Dr. Grenier presented her theories on how AIT impacts the individual. Dr. Grenier hypothesized that AIT stimulates not only the auditory system but also the temporal lobes of the brain, which are connected to the visual system. She reported that in addition to well-known problems associated with temporal lobes, impairment also includes: disorder of selection, disorder of contextual use of information, poor long-term memory and changes in personality and emotions. Dr. Grenier also stated that AIT will help hypersensitivity in nearly every case.
Three practitioners at centers in Connecticut, Texas and California collaborated on the study. Participants were assigned at random to either the Earducator or the AudioKinetron; and the evaluators, the parents, were ‘blind’ to group assignment. A total of 19 children participated in the study.
Since many studies have utilized the Aberrant Behavior Checklist (ABC) to evaluate changes following AIT, this measurement tool was the primary method of assessment. The results indicated no statistical difference in the behavior of those who received the Earducator and those who received the AudioKinetron. Based on these findings, the Earducator was judged to perform at least as well as the AudioKinetron. As a result of this favorable outcome, the Earducator will be made available to qualified practitioners in the U.S. by June, 2001.
Sally Brockett has been approved by Dr. Guy Berard as a Certified Instructor, and she is now conducting Professional AIT training seminars in the application of Berard Educational AIT. For information on these four-day seminars or on the Earducator, call 203-234-7401 or visit the IDEA Training Center web site at www.ideatrainingcenter.com
SAIT has consistently held the position that if a practitioner, who claims to be following the Berard method, deviates from the method, the change and “rationale” should be explained to the client. SAIT has also provided articles in The Sound Connection and on its Internet web site to clarify certain issues that have been confusing to parents and practitioners. SAIT professional members can review this information on SAIT’s web site by accessing any of the previous issues of The Sound Connection (www.sait.org). We remind practitioners who state that they are providing Berard AIT to discuss any change in procedure with their clients and/or parents so they understand and can have a choice in the matter.
Practitioners who are interested in ordering a supply of Hearing Equals Behavior to have for sale in their offices should contact SAIT. Or, you may know of a bookstore or therapy center that would like to offer this book for sale if we can get the book reprinted. If a sufficient number of books can be ordered, Dr. Berard’s book may become available for purchase once again. Please e-mail SAIT at email@example.com to indicate your interest. We will contact you with price information and more details. [Please note our new email address for SAIT members: firstname.lastname@example.org]