This blog has been designed to help people learn about effective, simple treatments for attention deficit disorder, autism, auditory processing disorders, dyslexia, and even challenges learning a new language.

Tuesday, August 14, 2007

A True Story: "Cured."

Nick came to me with hypersensitive hearing and a diagnosis of Autism Spectrum Disorder. His family was feeling fairly desperate because he hated his younger brother, and they didn't know how to cope with this.

From the start, I questioned whether ASD was an accurate diagnosis for him. He spoke a bit to fluidly, interactively, and flexibly for ASD to ring true. Still, there wasn't a better fit, and it ultimately didn't matter! He clearly was sensitive to sounds, so AIT was a good treatment option for him.

The parents had previously tried Samonis CD's with Nick, but he couldn't tolerate listening to them for even a few seconds! The speech therapist who had recommended that treatment persisted with it, then suggested that if he couldn't tolerate these CD's for even a few moments, there was no way he'd tolerate 30 minutes of Berard-type AIT!

But he did. From the very first day, he had no problem listening to the music. Why? Because our system eases the ears into it by starting off very quietly and gradually building to full volume. Also, and probably more relevant in this case, the CD's we use treat all frequencies simultaneously, jumping around from one to the next, so that there's no resting on uncomfortable frequencies. This makes it much easier for people to tolerate than the discs that focus on a single frequencies, as in the case with Samonis.

As he was receiving AIT, I had the opportunity to get to know his wonderful parents, and admire their commitment to find whatever treatment was necessary to help their son. They spoke with such sadness about the way Nick treated his brother, who was about 2 at the time. When the toddler would come in the room, Nick would run out of the room. When the toddler would talk, Nick would scream. When the toddler would cry, Nick would hit him. And perhaps the most heartbreaking part... the toddler adored his big brother and wanted to play with him all the time!

On the 7th day of AIT, the family came in to me for their 2nd session with big news! The parents reported that Nick had asked to play with his brother! For the first time ever! And they did! They played together, without fighting, hitting, or screaming! At long last!!!

The parents continued to see Nick improve by leaps and bounds. Within months, he was reassessed and found to no longer merit a diagnosis! Did he overcome autism? Or was it something less severe than autism, a more straightforward acute hyperacousis? I can't say for certain. BUT, I can say this for certain: He was an unhappy little boy who couldn't enjoy even the little things in life before AIT. Now, he races into life, living fully and with joy. And you can't tell, from watching him, that he ever had a day's struggle in his life!

Nick's story can be found in the book, "Sound of Falling Snow: Stories of Recovery from Autism and Related Conditions," edited by Annabel Stehli. To order this book, call 1-860-355-1545.

A True Story: C speaks out

C is a non-verbal boy with autism. He is considered "very challenging" to his family and therapists, because he has a host of anti-social behaviours (e.g., drinking from the sink spigot, picking his nose), and although he is a beautiful child to look at, there's always a wildness in his eyes that can be expressed with a giant leap out of his chair and a slap across your face. Still, there's something there that people love... a hint of the intelligence within him.

C did Auditory Integration Therapy with me twice. The first time was because he was so obviously hypersensitive to ... well, everything! If someone cried, if the heater clicked on, if someone was singing downstairs, he'd get upset, scream, cry, hit, scratch, and kick.

His first few sessions of AIT were tough. We had to hold his hands down and his headphones on so that he wouldn't throw the headphones off. This is not unusual -- many kids with autism don't like to try new things because they're unpredictable, and therefore scary. Also, he has a pattern of reacting to unwanted things with a violent edge, so his aggressive behaviour at the start was not atypical for him; we had planned for it.

After the 2nd day, though, things started to mellow for him. He fussed for only the first 10 minutes, then only the first 5 minutes, then for only 30 seconds, and finally just a grunt of protest when the headphones were being put on. And then, one day, he came in, reached for the headphones, and tried to put them on himself! By halfway through the cycle, he was a model client, with the exception of when there was a frequency/decibel combination on the music that was difficult for him to deal with. But since these occurred only very briefly, he'd simply cry out once, then settle down again for more listening. [This occurs when we can't get an audiogramme done, which is common for children with autism. We can't filter out uncomfortable peaks. It's not dangerous, just uncomfortable.]

At the end of the 13th session (the typical turning point for hypersensitivity), he already showed signs of being more at ease. He was much less antsy, less likely to act out against a noise with a quick slap at the person closest to him. Over the next few days, he was responding a bit better in his school work, and he started to verbalise some of his favourite things. Amazing progress!

His performance in school and at home improved. He began learning to identify sight words, which he found much more interesting than letters and sounds. Amazingly, he started to repeat the word after it was said to him -- pretty astounding considering he was unable to imitate single sounds, which are supposed to be easier to produce!

A year later, his mother decided she wanted to see if she could get more out of him with another round of AIT. This time, although hypersensitivity wasn't totally resolved, he definitely wasn't as sensitive to environmental sounds as he had been. So this time, our hope was that we'd see more far-reaching changes.

C remembered the routine and, by the end of the first day, was keeping his headphones on without assistance. He happily sat and looked at toy catalogues, played with magnetic letters, and read out loud the names of his favourite things. He only fussed after about 22 minutes, which is when most kids start getting bored and ready to go home, and then was easily redirected to a new activity.

A week after AIT, I got a message from one of his teachers: "C is talking so much! He asked me, today, to take a shower [part of his daily living skill training], he's asking for new foods, he's using two-word phrases all the time, now, and an occasional full sentence! It's amazing!"

He's not so non-verbal, now!

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Is Modi'in too far for a daily commute for you?

Modi'in is centrally located between Jerusalem and Tel Aviv, and is a short drive from many popular towns. However, it may still be too far from you to make the daily realistic.

Don't worry -- there are options!

You can arrange a therapy cycle in your area. For a minimum of 4 clients (maximum of 8), I will travel to your area. There is an additional fee to cover my travel expenses (lodging, food, travel), but since this is spread amongst the whole group, it is less expensive than your own travel expenses if you choose to stay in Modi'in for two weeks. It also allows you to have the therapy during the school year without your child having to miss out on school or you having to take vacation time from work.

If you'd like to arrange a therapy cycle, I can come to your area and give a presentation (in English) on AIT and who it benefits. This should be scheduled approximately 6-8 weeks prior to the targeted cycle date. Inviting teachers, principals, sayats, speech therapists, occupational therapists, and any other professionals, in addition to parents of children with autism, ADD, ADHD and Dyslexia will increase your chance of building a group of 4-8 clients quickly.

I will help you with this as much as possible.

Alternatively, if you want to come to Modi'in, turn it into a vacation. There are some self-catering rooms in Modi'in (simple bedroom/kitchenette arrangements) that are very affordable, year-round. During August and September, there are often whole houses for rent.

For out-of-towners, I can adjust your schedule so that you have a long stretch between sessions. For example, instead of being treated at 8:30 and 13:30 every day, we can schedule you for 8:30 and 17:30 for some or all of the days. This way you can take a day trip somewhere.

Where? How about the beach? Or Old City. Or Ben Shemen Forest. Or take a tour at Neot Kedumim Biblical Forest. Or Luna Park. Or Action Park. Or the Monkey Park. Or Jerusalem Zoo. Or visit an old friend who lives just that bit too far to see regularly. Or, just go to one of Modi'in's beautiful parks and play on the swings and slides.

There's loads to do within a short drive, bus trip, or train ride of Modi'in. Bring the whole family and have fun!

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What is hypersensitivity like in real life?

Same two questions. First, let me explain that we use the word "hypersensitive," but we mean in most cases, "painful." Imagine you're sitting peacefully on your sofa, reading a book, when someone comes into the room without you realising and turns on the computer. The computer's volume had been accidentally turned up very loud the night before, so when the computer boots up, the welcome greeting jingle is LOUD!! How high did you jump? How fast is your heart beating??

Okay... you calm yourself down and go outside for a bit. You're immersed in your book again, when suddenly, your neighbour starts his mower, inches from where you're sitting! How high this time? How fast is it beating?

Go back inside. Calm down. Relax. OY!! What's that?! A helicopter is landing on your roof!! It's so loud, and you can't get away from the sound! Maybe if you sit in your closet with your hands over your ears, it'll be easier to tolerate....

Living with hypersensitive hearing can be very difficult. For the hypersensitive (aka hyperacute) person, an airplane in the sky can sound like the helicopter on your roof. The lawnmower down the street may sound like the one next to your ear. And every time the computer turns on, with the volume down low, it sounds as startling as did the one in our story. What's more, the list of things that could be perceived painfully loud goes on and on. And on. Washing machines, blenders, timers, garbage disposals, vacuum cleaners, hand dryers (in public restrooms), babies crying, people with high voices (young kids, women), certain songs, the air coming through an open window, people chewing, people snoring, people rustling the newspaper, and so many more.

Here are some signs to look for:
  • covering the ears
  • leaving the room
  • avoiding someone/something before they make noise
  • hitting babies
  • crying unexpectedly (if you tune in to the noises in the environment, you may notice something new in the background that might be overwhelmingly in the foreground for your child)
  • visually inspecting a room before entering
  • startles easily
  • complains of things and voices being too loud
  • hides in enclosed spaces
  • turns off fluorescent lights (which hum)
  • alerts to new noises, such as the refrigerator fan or heater turning on

What are auditory processing problems like in real life?

This question actual is two different questions: What is it like to live with auditory processing problems? and What should I be looking for?

The first, first. Living with auditory processing problems is a constant challenge. If you're reading this blog to help your child or other loved one, I'll let you in on a secret... it's no fun to be your child! He (she) wishes to have an easy life like "everyone else."

A person with problems processing auditory input has to work hard to hear every word. Have you ever been listening to a lecturer who drones monotonously, or one who whispers, or one who uses such long, technical words that every word he utters has to be interpreted before you can understand it? How do you feel after listening to him for an hour? ... That's how it feels to have an auditory processing problem, only all the time!

And how did you cope with this? Did you start to whisper to your neighbour? Close your eyes for a short nap? Leave, just to stretch your legs and get a breath of fresh air? Stare out the window? ... Hmm ... it's starting to sound familiar, isn't it?

For those of you who have had to learn a new language as an adult, you'll have experienced a very normal auditory processing problem: not understanding the new vocabulary. However, the symptoms and experience are the same as the dysfunctional variety: you can't understand every word, you have to listen very carefully, you have to extrapolate by the bits you heard and understood, you tune out from time to time to take a mental rest, and you (maybe) feel foolish when you're trying to get information from someone and simply can't make it make sense. Exactly the same experience as that of a person with auditory processing problem with one major difference: When learning a new language, you can put it away for a while and speak in your native tongue with your family and friends, picking and choosing when you use the new language and when you ask, "Do you speak English?" If you have an auditory processing problem, you can never turn away from it for a break!

So, what should you look for in your child? Kids are clever, so they can always come up with new coping strategies, so there's no such thing as a comprehensive list. But here's a pretty good start:
  • Says "huh" or "what" then answers your question without needing you to repeat it
  • Looks at you blankly for a moment before responding
  • Talks loudly (to drown out the background noise that he can't actually push into the background)
  • Whispers (because it sounds so loud to his own ears)
  • Complains that the TV or radio is too loud or not loud enough -- this may change from song to song or show to show.
  • Doesn't like a baby or someone with a high voice for no apparent reason.
  • Afraid to enter new places
  • Visually observes a room before entering
  • Is easily startled
  • Complains of being bored when you instinctively feel he hasn't tried or you know he hasn't been at it long enough to get bored
  • Calls something "dumb" as an excuse for not doing it, even though you know it should be his cup of tea.

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Sunday, August 12, 2007

A True Story: A Family Affair

Here are a few snapshots of families with auditory processing problems:
Family 1. Mom has ADHD, talks loudly and quickly (probably to cover up uncomfortable background noise). The daughter has ADD, one son has autism, and a third child has pervasive developmental delay. All did well with AIT.
Family 2. Mom whispers (probably because her own voice hurts her ears), the oldest daughter panics when she's in a room with too many children (probably because she's hypersensitive to the frequencies voices are on), the son "mumbles," which is really a problem where he hears things improperly and therefore repeats it improperly.
Family 3. Dad is hypersensitive to "mouth noises," Mom gets irritable when there are more than 2 people talking simultaneously, and daughter has difficulty hearing foreground speech from amongst the background noise.

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Auditory processing problems are hereditary

We all are delighted when we see our best traits appear in our children. Our artistic eye, our keen intellect, our love of music... But sometimes, we pass on things we don't like. Our "unibrow," our tendency to be too skinny or too fat, or our poor math sense. Sensory issues fall into the 2nd category of things we wish we didn't pass on but did.

You may have started reading this website for your child, but discovered that you have a lot of the symptoms described in the checklist, too. Or maybe you've finally figured out why your spouse complains that you're talking too loud.

This also explains why it's not unusual for more than one child in your family to have similar problems, such as a daughter with ADD and a son with ADHD.

I can treat two family members simultaneously, and do so at a significant discount, so that you don't have to pick which one receives treatment first, which one needs it more -- a question you shouldn't have to ask!

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Protecting your ears, before, during, & after AIT

Your hearing is precious! You should always do everything you can to protect it! Especially after AIT, you should be protecting the investment you made in your hearing. Following these simple rules will ensure that your ears are not faced with unnecessary auditory assaults.
  • Do not use headphones for any reason other than therapeutic treatments (e.g., audiogrammes, additional listening therapies). Headphones feed the sound directly into your ear without any air operating as a buffer. This means the sound waves are more intense as they hit your ear drum. This can damage your hearing over time.
  • Do not view fireworks without protection (e.g., ear plugs).
  • Do not expose yourself to sustained loud noises (e.g., rock concerts, construction sites, etc.)
  • If something is loud and hurts your ears (such as a passing ambulance), protect yourself by covering your ears!

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Do's and Don'ts during AIT

Auditory Integration Therapy is a passive treatment. The only real requirement of the listener is, well, to listen! However, there are some do's and don't to keep in mind during your AIT sessions.

Do ...
... bring favourite toys, colouring books, and games to occupy your time. These toys should not make noise, though, so they don't compete with the AIT. We have toys in the office, but bring anything else that might pass the time more enjoyably.
... bring soft foods to nibble on, if you think hunger may be an issue.
... bring a bottle of water, as long as the bottle is contained (e.g., sippy cup or sports bottle, not open-mouth bottles) to minimize spillage.

Don't ...
... bring a book. Many people with auditory processing problems have learned to shut off their hearing in order to read. Thus, reading during AIT can interfere with the active listening.
... bring crunchy foods, as the crunch will interfere with listening.
... try to talk during AIT; you won't be able to hear my responses over the music. Save your questions for before or after your session.

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Monday, August 6, 2007

My daughter gets "topped up"

This is my daughter, Rivka. She's just started her 3rd AIT treatment. She loves doing it, and has been badgering me for the past 6 months to do it again! I had to explain to her (many times) that it's not safe to do it too quickly after the last session, she'd have to wait for summer.
She's delighted to be back in headphones, dancing to the music, and this year she has many more ballet moves under her belt, so it's a joy to watch her perform as she listens! Riv's wearing a headband, so if she gets a bit TOO into her dance routine and tosses her head, the headphones will stay on, no problem!
Last night, after a bit of dance, she coloured for a while. Tonight, though, when she got bored of dancing, she practiced writing Hebrew. I think she's eager to start back to school!
While listening to the music, you can do whatever you want to pass the time, with the exception of eating crunchy food, drinking, or reading. Reading is a no-no because many people with auditory processing disorders have learned to shut out all noise when focusing on reading, and this is counter-productive to actively listening to the music. Crunchy food interferes with the listening, and drinking is simply too high a risk to the equipment!
You can see the AIT equipment in the background. Nothing too scary!