A True Story: A Hate-Love Relationship

I conducted AIT on a young teenager with autism. This was something that his parent was uncertain about doing -- she just couldn't believe it might really help. I'd known her through my autism work for a while and had been talking to her about AIT on and off for about two years! She finally decided to give it a try.

About half-way through the AIT, his side effects started in. He was a boy who need LOTS of deep pressure and proprioceptive input (input to the joints and muscles to help you understand where your body is). As such, he was inclined to hand-flap, throw himself onto the sofa, wrestle with his dad and brother, and clench his muscles. This behaviour started to get really bad during his treatments. It was all I could do to convince him to sit still enough to keep his headphones on. I typically put a headband over the headphones, so a good deal of movement still won't result in the headphones falling off, but he was really active! He was giddy a lot of the time, and this was occurring at home, as well.

About 5 days after the AIT was done, I received a text message from his mother: "Dena, what have you done to my son?! I am NOT a fan of AIT!" Fortunately for me, the text got "lost in space," and I didn't receive it for several days. I let it sit for another day, wondering what I should say to reassure her that this, too, shall pass.

The next day (about 1-1/2 weeks after he'd finished AIT), I got another text from her: "Dena, he is AMAZING! His teachers are raving about how well he's paying attention in school, he's listening so well at home, he's like a different child! THANK YOU! I love AIT!"

Two months later, when he was faced with his biggest school challenge yet -- a new class, a new teacher, new friends -- he flew through it with ease, amazing everyone yet again!

A True Story: Like Clockwork

Several years ago, I conducted AIT for my secretary's son. It was wonderfully successful; my secretary reported that her son was much more social than in the past, happier, easier to get along with, did what he was told at home and at school much quicker and without complaints. She didn't notice any temporary side effects during or after AIT.

About 5 weeks after we finished, I was speaking to a new client on the phone about AIT. When she asked if there were side effects, I explained to her about the predictable "rough spots" after AIT -- those one or two days when children are often irritable and out of sorts that crop up one week, one month, and 3 months after AIT is completed.

When I finished my conversation, my secretary turned to me and said, "I heard what you said to her and I forgot all about that! My son was in a really bad mood, one day last week. He was just angry at everyone, and he couldn't explain why. It was all the more noticeable because he hadn't been that way since the AIT -- it used to be a regular occurrence, but I hadn't seen him in such a foul mood in ages." We looked at the calendar and guess what we found.... That day was exactly one month after he finished his AIT!

It really is like clockwork!

Side effects, if any, are minimal & temporary

Many people worry about whether there are any side effect resulting from AIT. Berard-type AIT is the gentlest type of AIT available. Because there is no "sitting" on a single frequency, and the ears are given ample time to rest, side effects are rarely seen.

When there are side effects, these are only temporary and typically wear off within a week after the treatment cycle has ended.

The most common side effect is an increase in sensory dysfunction. Many kids who have auditory processing disorders and/or hypersensitivity to sounds have other related issues -- sensory integration dysfunction of one or more types. These SI issues include a need to move (for example, bounce, rock, jump, hand-flap, etc.), a need for deep pressure (hugs, wrestling, hanging out in the bath or shower), and more.

Because the auditory sensory system is being adjusted, all the other sensory systems will also be adjusted. This shows up first as an increase in the sensory needs, and typically starts in the 2nd half of the treatment cycle. It lasts for up to two weeks total (in other words, for about a week after the sessions are finished), then settles down to levels that are lower than they were before AIT.

One week after you finish AIT, it is common to have a difficult day or two. "Difficult" may mean being out of sorts, ornery, irritable, or something else that's not the norm. There may be
a repeat of this a month after AIT is done, and again 3 months after the end of AIT, with this episode lasting as much as a week. Many people do NOT have this irritability, but when it does occur, it is at these intervals, like clockwork.

Confirming your suspicions through an audiogramme

Audiogrammes are simple hearing tests used regularly by audiologists. I remember, as a kid, that a visiting nurse would come in to our school every couple years to test all the students' hearing; I remember putting on the headphones, listening for the tone, and raising my right hand if I heard it in my right ear, my left if I heard it in the left ear.

Typically, an audiogramme is used to check for hearing loss and deafness. As such, the test is conducted as a "spot-check." In other words, not every frequency is tested, and they only test for hearing within the typical range of hearing. This tells them IF you can hear, not HOW you hear.

A complete audiogramme will show HOW you hear. The audiogramme is plotted on two graphs, one for the left ear, one for the right ear. The vertical axis represents the decibels (volume) at which a tone is heard, and the horizontal axis represents the different frequencies we can hear. Normal, perfect hearing appears on the graph as two straight horizontal lines placed somewhere between 0-10 decibels. In other words, the quietest volume at which each frequency was heard was the same decibel, and was somewhere between 0 and 10 decibels, which is considered normal for humans.

However, people with auditory processing disorders will have mountain ranges on their graphs, instead of straight lines. AND, the mountain ranges are different mountain ranges -- they don't overlap one another. This means that the quietest the person hears (for example) the 1 kHz tone in the left ear is 5 dB, and 10 dB in the right ear, and the quietest he hears the 2 kHz tone in the left ear is 15 dB, and 5 dB in the right ear.

Someone with hypersensitivity to sounds may hear many frequencies relatively normally, but there might be one or two frequencies that are heard at -5 dB or -10 dB -- below the point at which people can normally hear! Or, they may have Uncomfortable Loudness Levels (ULL) that are quite low. In other words, he may find a frequency to be painful at only 40 dB, whereas we don't normally find sounds painful until they're over 85 dB.

If you want to confirm your suspicions that you or your child has hypersensitivities to one or more frequencies or an auditory processing disorder, ask your audiologist to conduct a complete audiogramme, testing ALL frequencies, testing down to -10dB, and testing ULL's.

A checklist to help you decide whether AIT will help

Here's a checklist to help you determine if AIT is right for you. If you answer "yes" to even three of these items, then AIT will likely help.

1. Is there a history of hearing loss?
2. Is there a history of chronic ear infections?
3. Is there a diagnosis of Central Auditory Processing Disorder?
4. Does s/he listen to directions only 50% of the time or less?
5. Does s/he have difficulty listening carefully to directions, often needing them repeated?
6. Does s/he say "Huh?" or "What?" at least 5 times per day?
7. Is s/he unable to attend to auditory stimuli for more than a few seconds?
8. Does s/he have a short attention span of
1. 0-2 minutes?
2. 2-5 minutes?
3. 5-15 minutes?
9. Does s/he daydream? Does his/her attention drift? Is s/he not "with it" at times?
10. Is s/he easily distracted by background sounds?
11. Does s/he startle easily in response to unexpected sounds?
12. Does s/he cover his/her ears and complain that sounds are objectionable?
13. Does s/he respond to certain sounds with wide-open eyes and flared nostrils?
14. Does s/he have difficulty with phonics?
15. Does s/he experience difficulty with sound discrimination?
16. Does s/he forget what is said after only a few minutes?
17. Does s/he forget simple routines from day to day?
18. Does s/he display problems recalling what was heard last week/month/year?
19. Does s/he have difficulty recalling a sequence that has been heard?
20. Does s/he experience difficulty following auditory directions?
21. Does s/he frequently misunderstand what has been said?
22. Does s/he have poor verbal concepts (a poor vocabularly) for his age?
23. Does s/he learn poorly through verbal instructions?
24. Does s/he have a noted language problem (morphology/syntax/vocabulary/phonology)?
25. Does s/he have an articulation/phonology problem?
26. Does s/he have difficulty relating what s/he has heard to what s/he has seen?
27. Does s/he lack motivation to learn?
28. Does s/he display slow or delayed response to verbal stimuli?
29. Does s/he demonstrate below average performance in one or more academic areas?

You can confirm your suspicions that your child needs AIT through an audiogramme.

A True Story: O says hello

"O," a young boy with autism, came to me for AIT because he seemed to be lost in his own world, listening to something only he could hear. Communication is so difficult for him... he has to REALLY want something before he'll use the language he's learned. We did the AIT without having any idea what would come of it. For me, I always wonder, 'Will I get to see the changes? Or will I be gone before they manifest in his language or behaviour?'

I watched O get dropped off at school each morning, and his father would say goodbye to him, then wait for O to say, "Goodbye, Daddy." "Goodbye" generally came quickly enough, although it would be said without looking at his father. "Daddy" was much less likely to come. He'd guess a name at random. Then he'd wait for a prompt. When his father would say, "D...," he'd try a familiar name that began with "D," then another, until he finally guessed "Daddy." The same routine would take place again in the afternoon, when his father came to pick him up and waited for the greeting of, "Hi, Daddy." This was heart-breaking to watch, since I knew the family had worked with him on his greetings for years already!

On our 9th day of AIT, his father came in, and O immediately greeted him with "Hi!" as he looked at his father. When he was prompted, "Hi, who?" he thought a moment, then answered, "Daddy." When he was told to say goodbye to us all, he looked straight at me and said, "Goodbye." Again, a prompt was given: "D..." He quickly said, "Dena." No guesses, no waiting for minutes at a time until he answered, and no talking to the table/wall/door. He answered quickly, easily, and looked straight at me. WOW! Did I imagine that?

No, I didn't. The next day, I got laughter and joy from him all day long -- much different from the sad, disconnected boy I had been seeing the previous days. And when he said goodbye to me, it was with a quick turn to look at me, an easy, "Goodbye, Dena," a big smile, and then he turned and skipped away.

Does my heart good.

AIT can result in a great variety of improvements

Every person's benefits vary from everyone else's. This depends partly on the client's starting point. For example, does he speak or not? Is he distractable or not? Is his eye contact good, moderate, or poor? However, here is a list of things that are commonly seen resulting from AIT. Your child (or you) may experience some or many of these changes, or maybe experience something else that's not on the list.

• improved social behaviour
• increased attention
• reduced sensitivity to sound
• follows instructions better
• improved eye contact
• decreased irritability
• happier
• calms himself more quickly
• improved speech skills
• decreased echolalia
• clearer articulation
• improved sleeping habits
• more willing to interact with others
• improved auditory comprehension
• increased length of utterance
• increased independence
• decreased impulsivity

If there is a specific change that you hope to gain and you don't see it on the list, email me at denapage@gmail.com and I'll tell you if it's something that AIT might achieve.

What is Auditory Integration Therapy?

Auditory Integration Therapy, or AIT, is a sound-and-music therapy that improves the way the ears work together. It involves listening to music over headphones in a clinic setting for one half-hour in the morning and another half hour in the afternoon (at least three hours apart to allow the ears time to rest). These sessions are held every day for 10 days in a row, or 10 days within a two-week period (e.g., 5 days on, 2 days off, 5 days on). The equipment allows for more than one person to be treated simultaneously; however, in my practice, the client listens on his own, or possibly with a parent or sibling, but never with a stranger. Although some practitioners will pair strangers up to listen together, I feel this is unfair to the clients who may not be comfortable with one another.

The music that you listen to is digitally modulated so that it jumps around from frequency to frequency over a wide range of decibels. This forces the small muscles and moving bones in the ears to work hard to grab the sounds, constantly moving -- sort of like aerobics for the inner ear! At the end of the 10 days, the ears have improved their ability to process sounds sufficiently so that you are hearing the world differently.

AIT has two benefits:

1. It decreases hypersensitivity to sound. This improvement can quite consistently be seen before the treatment cycle is complete; in fact, it seems that, for most people, the 7th day is the "magic" day, the day in which the changes are first noted. That's the day that children can tolerate you using the dishwasher/blender/lawn mower or whatever noisy item used to send them running away in fear.
2. It improves auditory processing. This change occurs more gradually. The reason for this is two-fold. First, the changes that take place in the ear result in the person having to relearn the once-familiar in his world. For example, if he used to hear the word "fork" as "for," he now needs to relearn that the proper word for a tined eating utensil is "fork." He also has to learn that "for" is still the correct word to use when saying "this is for you," or "I am four years old." This can take some time. Secondly, the changes from AIT occur not only in the ear; AIT also stimulates cell-growth in the brain. Obviously, cell-growth isn't spontaneous, so changes resulting from this growth may occur gradually. Changes in auditory processing can be seen as early as a few days after AIT begins, and as late as 3 months after the completion of AIT.
   

About Auditory Integration Therapy - a brief history

Auditory Integration Therapy is not a new therapy. Many therapies don't become "mainstream" until they've been around for decades, because it takes that long for the research to prove it works, and for people to begin to hear about it, spread the word, and try it for themselves.

AIT has been around since the 1950's, when Alfred Tomatis developed the original system to treat hearing irregularities common to children with autism. That original therapy (still in use today) used recorded music and the recorded voice of the mother, since Dr. Tomatis felt that the hearing had not developed properly when the infant was in the womb. His patients listen to this music through headphones for two hours per day, for a minimum of three weeks at a time, and they repeat this treatment frequently. Some of the theory behind this original therapy was sound, while other parts were not. So one of Tomatis's students, Guy Berard, took the basic therapy and improved upon it.

Dr. Berard spent 20 years researching and refining his work, and developed a "perfect" protocol. His therapy technique involves listening to music that jumps around through all the frequencies over a range of decibels for one-half hour, twice a day, for ten days. This therapy forces the ear to work harder than it does normally, exercising the inner ear, so that it becomes more efficient at processing sound quickly.

In the late 1970's, Annabel Stehli's daughter, Georgie, recovered from extremely hypersensitive hearing following treatment with Dr. Berard. Annabel then began her life's work to spread the word about Auditory Integration Therapy. Because Georgie had been diagnosed with autism, AIT's introduction was made to the autism world.

It is now recognised that AIT can help a wide range of people with a variety of hearing-related problems. It helps people with autism, Attention Deficit Disorder (ADD), Attention Deficit/Hyperactive Disorder (ADHD), dyslexia, some people with anxiety disorders (where there is a connection to hypersensitive hearing) and some forms of depression. It also helps people who are struggling with language development -- either learning a 2nd language or the otherwise typically developing "late talker".

Recent developments in auditory integration therapies have brought about home-based versions of AIT. While these seem to be effective to some extent, the results are not as successful as Berard's AIT, nor is there research proving effectiveness yet. More on this in "How AIT works."