Auditory integration training
Encyclopedia
Auditory integration training (AIT) is a procedure pioneered in France by Guy Bérard, who promoted it as a cure for clinical depression
and suicidal tendencies
, along with what he said were very positive results for dyslexia
and autism
, although there has been very little empirical evidence regarding this notion.
It typically involves 20 half-hour sessions over 10 days listening to specially filtered and modulated music. It was used in the early 1990s as a treatment for autism; it has been promoted as a treatment for ADHD, depression, and a wide variety of other disorders. AIT has not met scientific standards for efficacy that would justify its use as a treatment for any condition.
The American Academy of Pediatrics
and three other professional organizations consider it an experimental procedure. The New York State Department of Health
recommends that it not be used to treat young children with autism. The U.S. Food and Drug Administration (FDA) has banned the Audiokinetron, the original device used to perform AIT, from importation into the U.S. due to lack of evidence of medical benefit. The American Speech-Language-Hearing Association
has concluded that AIT has not met scientific standards for safety.
(oversensitive hearing), which are said to cause discomfort and confusion in persons suffering from learning disabilities, including autism spectrum disorders. These hypersensitivities are believed to interfere with a child’s attention, comprehension, and ability to learn.
The training typically involves the child attending two 30-minute sessions per day, separated by a minimum of three hours, for ten consecutive working days. The child listens via headphones to a program of specially filtered and modulated music with wide frequency range. The program is modified for each child with certain frequencies of sound filtered using an electronic device, which randomly switches between low- and high-pass filtering for random durations between 1/4 and 2 seconds. The filtering device also varies the sound's intensity, creating a modulated
effect. The volume is set as loud as possible without causing discomfort. If the listener has shown unusual sensitivities to certain frequencies, these may be filtered out additionally.
The original device for delivering this training, the Audiokinetron or Ears Education and Retraining System (EERS), was banned by the U.S. Food and Drug Administration
from importation into the U.S. due to lack of evidence of medical benefit. Although no AIT device has been approved for marketing as a medical device by the FDA, devices used only to aid education are not subject to FDA regulation. Several other unapproved devices are now used to deliver AIT; one example is the Digital Auditory Aerobics (DAA) system, which replaced the Audiokinetron in the U.S., and which contains 20 half-hour CDs containing the output of the banned Audiokinetron, thus getting around the banned use of the original device.
Most AIT practitioners are speech-language pathologists or audiologists and occupational therapist; other practitioners include , psychologists, physicians, social workers, and teachers. No operator training is required for the DAA. However, the lack of proven benefit to clients has led the American Speech-Language-Hearing Association
to warn its members that they may be found in violation of ASHA's Code of Ethics if they provide AIT services.
s of AIT found insufficient evidence to support its use; no significant adverse effects were reported.
Several professional organizations state that AIT should be considered experimental: these include the American Academy of Audiology, the American Speech-Language-Hearing Association
, the American Academy of Pediatrics, and the Educational Audiology Association. After reviewing the available research, the New York State Department of Health concluded that AIT's efficacy had not been shown, and recommended that it not be used to treat young children with autism.
book provided wide publicity to AIT in the English-speaking world. By 1994, over 10,000 U.S. children and adults had received training, at a cost of around US$1000 to US$1300 each, and AIT became a multimillion dollar industry.
AIT gained popularity in the early 1990s, supported by anecdotal evidence and promising but small trials. Preliminary research included such methodological flaws as lack of statistical power, lack of blinding, or lack of a control group. Later larger and better controlled studies failed to bear out the promise of AIT. The use of AIT is not supported outside of research protocols.
Clinical depression
Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...
and suicidal tendencies
Suicidal tendencies
Suicidal tendencies is the propensity for a person to have suicidal ideation or to make suicide attempts. It may also refer to:* Suicidal Tendencies, a band that was founded in Venice, Los Angeles, California, in 1981 by the leader and only permanent member, singer Mike Muir* Suicide, the act of a...
, along with what he said were very positive results for dyslexia
Dyslexia
Dyslexia is a very broad term defining a learning disability that impairs a person's fluency or comprehension accuracy in being able to read, and which can manifest itself as a difficulty with phonological awareness, phonological decoding, orthographic coding, auditory short-term memory, or rapid...
and autism
Autism
Autism is a disorder of neural development characterized by impaired social interaction and communication, and by restricted and repetitive behavior. These signs all begin before a child is three years old. Autism affects information processing in the brain by altering how nerve cells and their...
, although there has been very little empirical evidence regarding this notion.
It typically involves 20 half-hour sessions over 10 days listening to specially filtered and modulated music. It was used in the early 1990s as a treatment for autism; it has been promoted as a treatment for ADHD, depression, and a wide variety of other disorders. AIT has not met scientific standards for efficacy that would justify its use as a treatment for any condition.
The American Academy of Pediatrics
American Academy of Pediatrics
The American Academy of Pediatrics is the major professional association of pediatricians in the United States. The AAP was founded in 1930 by 35 pediatricians to address pediatric healthcare standards. It currently has 60,000 members in primary care and sub-specialist areas...
and three other professional organizations consider it an experimental procedure. The New York State Department of Health
New York State Department of Health
The New York State Department of Health, ', is the governmental body responsible for public health in the state of New York. The cabinet-level department is headed by the Health Commissioner, a position held since January 24, 2011 by Nirav R. Shah, M.D., M.P.H.....
recommends that it not be used to treat young children with autism. The U.S. Food and Drug Administration (FDA) has banned the Audiokinetron, the original device used to perform AIT, from importation into the U.S. due to lack of evidence of medical benefit. The American Speech-Language-Hearing Association
American Speech-Language-Hearing Association
The American Speech–Language–Hearing Association is a professional association for speech–language pathologists, audiologists, and speech, language, and hearing scientists in the United States and internationally...
has concluded that AIT has not met scientific standards for safety.
Training regimen
Auditory integration training (AIT) aims to address the sensory problems such as hearing distortions and hyperacusisHyperacusis
Hyperacusis is a health condition characterized by an over-sensitivity to certain frequency ranges of sound...
(oversensitive hearing), which are said to cause discomfort and confusion in persons suffering from learning disabilities, including autism spectrum disorders. These hypersensitivities are believed to interfere with a child’s attention, comprehension, and ability to learn.
The training typically involves the child attending two 30-minute sessions per day, separated by a minimum of three hours, for ten consecutive working days. The child listens via headphones to a program of specially filtered and modulated music with wide frequency range. The program is modified for each child with certain frequencies of sound filtered using an electronic device, which randomly switches between low- and high-pass filtering for random durations between 1/4 and 2 seconds. The filtering device also varies the sound's intensity, creating a modulated
Modulation
In electronics and telecommunications, modulation is the process of varying one or more properties of a high-frequency periodic waveform, called the carrier signal, with a modulating signal which typically contains information to be transmitted...
effect. The volume is set as loud as possible without causing discomfort. If the listener has shown unusual sensitivities to certain frequencies, these may be filtered out additionally.
The original device for delivering this training, the Audiokinetron or Ears Education and Retraining System (EERS), was banned by the U.S. Food and Drug Administration
Food and Drug Administration
The Food and Drug Administration is an agency of the United States Department of Health and Human Services, one of the United States federal executive departments...
from importation into the U.S. due to lack of evidence of medical benefit. Although no AIT device has been approved for marketing as a medical device by the FDA, devices used only to aid education are not subject to FDA regulation. Several other unapproved devices are now used to deliver AIT; one example is the Digital Auditory Aerobics (DAA) system, which replaced the Audiokinetron in the U.S., and which contains 20 half-hour CDs containing the output of the banned Audiokinetron, thus getting around the banned use of the original device.
Most AIT practitioners are speech-language pathologists or audiologists and occupational therapist; other practitioners include , psychologists, physicians, social workers, and teachers. No operator training is required for the DAA. However, the lack of proven benefit to clients has led the American Speech-Language-Hearing Association
American Speech-Language-Hearing Association
The American Speech–Language–Hearing Association is a professional association for speech–language pathologists, audiologists, and speech, language, and hearing scientists in the United States and internationally...
to warn its members that they may be found in violation of ASHA's Code of Ethics if they provide AIT services.
Insufficient efficacy and evidence basis
A systematic review of randomized controlled trialRandomized controlled trial
A randomized controlled trial is a type of scientific experiment - a form of clinical trial - most commonly used in testing the safety and efficacy or effectiveness of healthcare services or health technologies A randomized controlled trial (RCT) is a type of scientific experiment - a form of...
s of AIT found insufficient evidence to support its use; no significant adverse effects were reported.
Several professional organizations state that AIT should be considered experimental: these include the American Academy of Audiology, the American Speech-Language-Hearing Association
American Speech-Language-Hearing Association
The American Speech–Language–Hearing Association is a professional association for speech–language pathologists, audiologists, and speech, language, and hearing scientists in the United States and internationally...
, the American Academy of Pediatrics, and the Educational Audiology Association. After reviewing the available research, the New York State Department of Health concluded that AIT's efficacy had not been shown, and recommended that it not be used to treat young children with autism.
History
Guy Bérard's Audition Égale Comportement (English translation Hearing Equals Behavior) was the first book about AIT. Annabel Stehli's The Sound of a Miracle told the story of the author's daughter, an autistic girl who received AIT treatment from Bérard. The latter anecdotalAnecdote
An anecdote is a short and amusing or interesting story about a real incident or person. It may be as brief as the setting and provocation of a bon mot. An anecdote is always presented as based on a real incident involving actual persons, whether famous or not, usually in an identifiable place...
book provided wide publicity to AIT in the English-speaking world. By 1994, over 10,000 U.S. children and adults had received training, at a cost of around US$1000 to US$1300 each, and AIT became a multimillion dollar industry.
AIT gained popularity in the early 1990s, supported by anecdotal evidence and promising but small trials. Preliminary research included such methodological flaws as lack of statistical power, lack of blinding, or lack of a control group. Later larger and better controlled studies failed to bear out the promise of AIT. The use of AIT is not supported outside of research protocols.