Early Development of the Method
Although many people are just becoming aware of Berard auditory integration training (AIT), this program was initially developed in the 1950s in Annecy, France by Dr. Guy Berard, an Ear, Nose and Throat (ENT) physician. In Dr. Berard’s earliest years of practice, his AIT program was used primarily to assist in certain cases of hearing impairment. However, with his discovery that learning related skills and abilities, such as attentive listening, concentration, auditory discrimination and memory skills, often improved following his AIT program, this intervention is now noted for its use as an educationally related intervention.
Dr. Berard cites many accounts of clients who have reported improvements after completing his AIT program. Some report that their ability to remember information such as telephone numbers, or verbal directions is better, or they are able to understand language even in a room filled with background noise, such as a restaurant. Others, who were sound sensitive, are much more comfortable in their environment and no longer suffer from the anxiety of unexpected, irritating noises.
This method of rebalancing the auditory system developed gradually as Dr. Berard worked in his clinic, making adjustments and changes as he constantly sought to improve his technique. He monitored his clients’ progress and made changes in the protocol based on clinical observations and client reports. His philosophy and approach to life was always based on “efficiency”. He strove to develop an efficient program, and he always took pride in working efficiently.
Public Awareness Expands
Berard AIT began to receive recognition as an intervention for behavior and learning difficulties with the publication of the book, The Sound of a Miracle in 1991. This book chronicles the story of Annabel Stehli’s daughter, Georgianna, who progressed slowly, but dramatically after receiving Berard AIT at the age of eleven. Georgie, who had been placed in Childville, a New York residential placement for children with severe autism, was gradually integrated into the mainstream community following Berard AIT and intensive teaching provided initially by her mother. In 1991, the publication of Annabel’s book, The Sound of a Miracle, quickly grabbed public attention. Parents, especially those with children on the autism spectrum, began seeking this intervention for their own children.
Annabel dedicated herself to promoting AIT with a passion. As a parent of a child who had been labeled autistic, she easily connected with other parents and often presented very inspiring talks for parent support groups. She was featured on television and radio talk shows, motivating parents to seek out this program for their own child.
Dr. Berard’s book, Hearing Equals Behavior: Updated and Expanded meticulously describes his understanding of the auditory imbalances that interfere with efficient listening and learning. The first edition, Audition Egale Comportement, published in 1982, was written in French, so it was not until 1993, when the English translation became available, that professionals and parents in the English-speaking world could finally be introduced to the concept that how we hear plays a very significant role in how we behave and learn. Prior to this, the professional interest had been on diagnosing and treating hearing loss, rather than evaluating how the individual without hearing loss actually perceives the auditory stimulation. Unfortunately, even today, there are many professionals who are not aware that many individuals who are struggling with academics and behavioral problems, have auditory imbalances that interfere with effective listening and therefore are at a great disadvantage in the classroom and workplace. The 2011 edition of Dr. Berard’s book, Hearing Equals Behavior: Updated and Expanded, co-authored by Dr. Berard and Sally Brockett, will bring professionals and parents up to date on these auditory issues. This book contains the content from the 1993 edition, and updated information, including chapters on research, sensory integration and AIT, and the impact of Berard AIT on visual functions.
Scientific Research on the Method Begins
The late Dr. Bernard Rimland, who was Director of the Autism Research Institute at that time, was interested in Dr. Berard’s intervention and had encouraged Annabel to share her story of Georgie’s success. Since there had never been actual clinical research done on the Berard method, Dr. Rimland, and his assistant Dr. Stephen M. Edelson, organized research studies to document the effectiveness of the method. They recognized that without scientific studies, Berard AIT would not become accepted as a valid intervention for use with learning related problems. The publication of Annabel’s book, The Sound of a Miracle, and the research by Drs. Rimland and Edelson, were responsible for generating excitement about this method of balancing the auditory system that rapidly spread around the world. The ABC Network television show, 20/20, produced a program about the research sponsored by the Autism Research Institute, which inspired more professionals to become trained practitioners and to study this intervention.
The Rimland/Edelson studies focused on the autism population, but later studies by other researchers included subjects with attention deficit disorder (ADD), central auditory processing disorder (CAPD), and other disabilities. By 1998 there were 30 studies completed and 82% demonstrated positive effects from this intervention.
The Name AIT is Coined
Dr. Berard originally referred to his program as “auditory training” when he began training a few new practitioners in France. When it first became popular in the U.S., it quickly became apparent that this term would be confusing since “auditory trainer” was already in use to refer to the FM system used by those who had difficulty listening to the teacher’s voice in the classroom. During a meeting with Drs. Rimland and Edelson at a conference in St. Louis, Missouri, the new practitioners discussed forming a professional society and the use of the term “auditory training” was discussed. In order to differentiate between the two programs, Dr. Rimland recommended we use the term “auditory integration training” to refer to the Berard method. This term was agreed upon because it took into account the “integration” of the senses and processing that occurs with Berard AIT.
Unfortunately, this term was not trademarked. As new listening programs evolved, the term was used by these programs as well and “AIT” has become a generic term to identify all different types of listening programs. In order to help distinguish Dr. Berard’s method from these others, Berard Practitioners now use “Berard AIT” instead of just AIT. However, it is still confusing for parents who may not realize that all AIT is not the same, and the research that applies to the Berard method does not apply to other methods.
Berard AIT in the U.S.
In April of 1992, Dr. Berard began coming to the U.S. to train new practitioners. Professional seminars were provided through the Georgiana Institute, organized by Peter and Annabel Stehli and held in Westport, Connecticut. Professionals from around the world gathered for training with Dr. Berard.
The advancement of Berard AIT was slowed in 1993 when the FDA investigated claims made that AIT could be used to treat conditions such as AD(H)D, autism, learning disabilities, etc. When claims are made to the effect that human conditions can be cured or treated with specific devices, or procedures, it is the responsibility of the FDA to assure that the equipment used for these medical treatments is safe. The FDA also labels equipment that is used for medical treatments as “medical devices” and the equipment then falls under the jurisdiction of the FDA. The Audiokinetron, the device used for Berard AIT at that time, became labeled as a medical device due to the nature of the claims that had been made. This meant that the Audiokinetron could no longer be imported or taken across state borders because it was not an FDA approved medical device. In order to become FDA approved, comprehensive FDA approved studies to demonstrate safety would have to be conducted. Due to the prohibitive costs, this type of study was not done.
Development of New AIT Devices
Following this event, there were many attempts to develop a device that would work effectively for providing Berard AIT as an educational intervention. Many of these attempts were unsuccessful. Eventually, a device called “Digital Auditory Aerobics” or “DAA”, was developed and became available. Upon questioning about FDA regulation, the FDA stated in a letter in 1999 that as long as a device is used solely for educational purposes, it does not come under FDA regulation. This means that devices used for training, learning and as an educational aid, do not need to go through the comprehensive research studies and be approved by the FDA.
Unfortunately, as of this writing, clinical research on the DAA device to document its effectiveness in producing beneficial changes has never been completed. Due to this lack of data, the DAA has not been accepted as a device for use with Berard AIT. However, in 2000, there was news of another device that had been developed in South Africa with the cooperation of Dr. Berard.
An international conference for Berard AIT Practitioners was held in Belgium in January, 2000, and Rosalie Seymour, a Berard AIT Practitioner from South Africa, announced the availability of the Earducator. Rosalie had facilitated the development of this device by engaging Mr. Tim Hagen, an electronics engineer, to replace the aging Audiokinetrons. Dr. Berard has been involved in the progress of its development through the years as refinements were made.
Since the Earducator had been used for several years in South Africa with anecdotal reports of success, Sally Brockett, arranged to bring it to the U.S. for a clinical comparison trial with the Audiokinetron. If it proved to be at least equally effective as the Audiokinetron in producing positive results with clients, it would then be accepted as a Berard AIT device for educational training. The Earducator was tested by 3 different Berard AIT practitioners at different sites across the U.S. When the data was compiled and analyzed, the results indicated comparable benefit between the two devices. Therefore, the Earducator was accepted and came into world wide use as an educational device for Berard AIT.
Listening Programs Derived from Berard AIT
Several years after the introduction of Berard AIT into the U.S., other listening programs began to emerge. Some of these, such as the BGC, or Bill Clark method, were quite similar to Berard AIT, but had deviations from his protocol and used different devices that had been developed. The BGC method uses a device that is a hybrid between the Berard device and the Tomatis device. This method follows the protocol of 2 thirty minute listening sessions for 10 days, but the filtering process is quite different from Dr. Berard’s method. The BGC was included in the research study conducted by Drs. Rimland and Edelson in 1994 and did produce beneficial results. So, while it is a proven technique, it is not Berard AIT.
The other listening programs that evolved require many hours of listening to the processed music. This is one of the elements that Dr. Berard worked so diligently to improve with his method. He wanted a program that was efficient in use of time and therefore, cost. He also wanted to minimize the number of hours of exposure to headphones. As an ENT, he understood the risks of headphone use and strove to keep his use of them for retraining the auditory system to a minimum. Since he did not believe ongoing exposure to headphones was in the best interests of the client, he designed his method to allow quick, efficient use of headphones, and then stopping use of them.
Berard AIT in the 21st Century
Berard AIT has expanded to countries around the world. It is available to people in more than 30 countries and continues to spread to new regions. Currently, there are Berard AIT Instructors in 14 countries and seminars for professionals are provided in several different languages. New research continues to document the benefits derived from this method, which currently is available for those as young as 3 years of age. There is no upper age limit since the brain is capable of reorganizing through neural plasticity until death.
As new understanding of the brain emerges, and new technologies develop, there may be changes in the Berard AIT protocol. New equipment may become available and adjustments may be made in the program. However, any changes must first undergo high quality, scientific study to measure whether the suggested change actually provides equal or greater benefit in terms of functional performance of the clients.
© Sally Brockett 2008