Auditory Impact of AIT | AIT & Learning | AIT & Autism
AIT & Sensory Dysfunction | AIT & Depression | AIT Research | AIT Theories
Auditory Impact of AIT
Some specific auditory problems that may be helped by AIT include: auditory hyper and hypo-sensitivity, auditory distortions, confused pitch relationships, delayed response and auditory laterality.
Auditory hypersensitivity causes the listener to hear certain frequencies with much more intensity than the others, making it difficult to attend to the target sound (such as a teacher or parent’s voice). It is often referred to as an auditory figure-ground problem and contributes to distractibility and comprehension difficulties.
Auditory hypo-sensitivity causes the person to hear certain frequencies with less intensity than the neighbouring frequencies, but not to the extreme of a hearing impairment. When this happens, words may become distorted or sound like another word, causing confusion for the listener. The listener must figure out which work was intended (mostly by context) or remain confused and not understand the message.
Confused pitch relationships, where high/low pitches are not processed correctly, may cause the same word spoken by someone with a high pitched voice to sound different from the same word spoken in a low-pitched voice. This may cause confusion to the listener. Also, individuals with confused pitch relationships may not enjoy music, or have great difficulty singing on tune.
Delayed response indicates that it takes more time for the sound signal to register. As speech flows rapidly from a speaker to a listener, a listener with delayed response cannot receive and process the message quickly enough. By the time the person has received and understood the beginning of the sentence, too many other words have been transmitted without sufficient time for processing. The message becomes a jumble of sounds and bits of words that cannot be organized by the listener. As a result the listener becomes frustrated and gives up listening.
Auditory laterality refers to which ear is dominant at a given frequency. It is preferable to have either the right ear or both ears as dominant, rather than a mix of the left and right ears. When people have mixed auditory laterality there may be a slight delay in the reception of sounds transmitted by the left ear. This delay can cause distortion of the word because sounds may not be received in the proper sequence by the speech/language center in the brain. Auditory processing may be slow and comprehension may be poor.
AIT & Learning
All of these auditory problems contribute to cognitive fatigue and variable performance, which is so common among individuals with learning disabilities and ADHD/ADD. These people must expend much energy trying to decode or translate the scrambled and distorted messages they receive. Their performance will depend upon the amount of energy, interest and motivation they have at any given time. Other variables, such as voice quality, pitch and rate of speech delivery of the speaker, background noises and visual cues also impact the performance of these individuals.
Through its effects on the hearing and sensory system, AIT can positively impact learning and behaviour issues such as reading (including dyslexia) and spelling, following instructions and cooperating with requests, work consistency, mental and emotional fatigue, and social interactions.
Reading and writing difficulties occur when groups of sounds are not perceived accurately and rapidly Reading requires the rapid decoding and comprehension of written words. In order to read words of an alphabetic language such as English, children must know that written spellings systematically represent spoken sounds, and be able to correctly perceive these spoken sounds. When decoding words is laborious and inefficient, the reader cannot remember what he has read and bring meaning to the content. Spelling requires many of the same skills used in reading, but in a reverse process. Just as in reading, this process involves listening to the sounds, either internally or externally, but includes visualizing the letters in the proper spatial sequence. Without the capability to link the letters and sounds together quickly and correctly, sequencing letters will be difficult. Even the physical act of writing can be made more difficult if there are disturbances in the vestibular system; the coordination needed for handwriting and other actions can be lacking, making schoolwork and even greater chore.
Verbal directions will be understood more easily and rapidly when efficient listening abilities are fully developed. This allows responding without further questions. Children, who appear to be more cooperative and obedient, may actually be more able to comprehend what they have been asked to do.
Efficient listening skills will also impact on the consistency of school work performance. Variations may arise due to the level of fatigue at the time the work is done. Poor listening abilities mean that it is harder to interpret the world: not unlike having to constantly translate everything from a foreign language. The listener becomes tired and may “tune out” for a while in order to rest, or simply stop trying to complete work. The constant work of listening and understanding everything around them can cause a great deal of fatigue, even physically (I have been exhausted after an intense lecture, or a long study session!). When one can listen efficiently, it is easy to know what the speaker is saying, without having to think about it, and to perform the assigned work without undue stress because what is needed is understandable.
Good listening abilities are also a social advantage. An inability to focus on the conversation and tune out background noises can cause some people to become socially isolated as they withdraw from a source of discomfort. They also may withdraw due to their inability to quickly understand the conversation and be an active participant. The sensory system may be overloaded, causing anxiety and stress that may only be relieved by seeking a less stimulating and confusing environment. Being overwhelmed, or fatigued by the effort of decoding the speech around him, a person will have a harder time maintaining (or even beginning) comfortable social interactions. When listening skills are trained to be efficient, people often demonstrate more appropriate social relationships.
AIT is an important educationally related service, as these example of the connections between success in learning and optimal listening abilities illustrate. And while AIT will not miraculously make a poor reader a great reader overnight, it can remove the obstacles that were in the way before and smooth the road so that progress can be rapid
AIT & Sensory Dysfunction
The way we process all the information presented to our senses affects how we are able to interact with the world around us. If just not processing sound can impact all areas of behavior, what happens when the processing of the other senses is not quite right either? The senses are intimately interconnected. The smell of a dish affects its taste. Color can alter our moods. Motion can trigger memory. And more. When other forms of sensory dysfunction are present, Auditory Integration Training can be beneficial for more than just the auditory problems. Theories as to how this can happen are outlined in the section on AIT Theories, but it is not hard to envision how changing the processing of one sense can, domino-like, change others. Research has found there to be significant changes in Tactile Hyper- & Hyposensitivity, Vestibular Hyper- & Hyposensitivity after AIT. Anecdotal reports describe shifts in all areas of perception, from smell to touch to vision to taste. People have also noticed improvements with digestive problems.
AIT is also very complementary with any Sensory Integration Therapy that a person may already be working with, and can increase the rate of improvement dramatically in many cases.
AIT & Autism
The link between Auditory Integration Training and improvements in autistic people was dramatically noted in Annabel Stehli’s book The Sound of a Miracle. As she told the remarkable story of her daughter Georgiana's life; from the diagnosis of autism and time spent in harsh instiutions, to her experiences with AIT in France with Dr. Berard, and her subsequent improvements that allowed her to go to school and college, and eventually found "The Georgiana Institute" to offer support and help to others in the position she was in; Annabel Stehli brought hope to many families who had suffered as hers had. The attention it drew to AIT was instrumental in getting research initiated in North America, and created a demand for AIT that led to Dr. Berard training practitioners from the U.S. and Canada. She further illustrated the benefits of AIT in Dancing in the Rain, which compiled stories from many families who had experiences similar to hers with AIT.
There have been a number of studies regarding AIT and its effectiveness for the autistic community, a summary them is given in our section on AIT Research. Most impressive is the study by Dr. Bernard Rimland and Stephen Edelson, which same as there involved over 400 subjects and had measurably positive results. Behavioral questionnaire measures indicated a sharp reduction in problem behaviors, starting one month following the AIT listening sessions. These changes remained stable throughout the entire 9 moths of post-AIT evaluations. Lower functioning autistic individuals displayed significantly greater relative improvement than higher functioning autistic people. No negative effects were noted in this, or in any, research study on AIT.
Dr. Berard noted that the most important, the main auditory disorder found in autistic clients is painful hearing, which is always mentioned by parents or others who know the client. While it may not always be possible to obtain an accurate audiogram from an autistic client, painful hearing is an indicator that AIT could be useful in increasing tolerance to sound, and improvement can be expected even without the fine tuning that the audiogram results allow.
The exception is in cases of actual hyperacusis, which differs from hypersensitive hearing in that it usually involves the entire spectrum of sounds as opposed to specific frequencies; there is a collapsed tolerance to normal environmental sounds that is debilitating in many cases. AIT is not indicated when there is hyperacusis. Nor is it appropriate in cases involving recruitment hearing loss. The audiologist’s exam rules out either of these possibilities before beginning AIT.
AIT & Depression
Dr. Berard found that hyperaudition on specific frequencies always results in the same identifiable problem. This suggested that our perception of sound might produce effects in other cerebral areas and in other parts of the body, than just in the areas that control our auditory environment. Among other correlations between specific frequencies and physical conditions, Dr. Berard identified auditory peaks at 2,000 Hz and 8,000 Hz in the left ear in patients reporting depression and suicidal tendencies. The right brain is the center of negative emotion linked to mental imagery, and it is the side of the brain which will be affected by any disturbances of the left ear. He then found that the elimination of these areas of hyperacute hearing resulted in improvements in behavior and emotional state. His experience with over 200 patients was that 93% were cured after the first course of auditory training, and 4.7% were healed after two or three courses. Dr. Berard does not suggest that all psychoses and neuroses can be cured by otolaryngology! But he does feel that AIT is a tool that can help educational psychologists treat the problems of dyslexia and learning disorders, and psychiatrists faced with difficulty in stabilizing behavior by the usual methods; that it is a supplement to existing techniques that should not be overlooked.
"To claim to have cured hyperactivity or dyslexia, widely regarded as “emotional” or “mental” conditions, simply by training the ear to be either more or less responsive to particular sound frequencies seems on the face of it implausible and extravagant. However, thirty years of clinical work, research and follow-up on more than 2,100 patients and study of more than 8,000 auditory cases, verifies the claim. Of the 1,850 learning/behavior problems patients, three-quarters showed very positive results and the remainder demonstrated noticeable partial improvement; none failed to show some benefit." - Dr. Guy Berard
Of 28 published research studies, most focused on the autistic population, 23 found there to be observable positive responses to AIT. None of the 28 studies found there to be any negative effects from AIT. Researchers Stephen M. Edelson, Ph.D. and Bernard Rimland, Ph.D. summarize this research as “The balance of the evidence clearly favors AIT as a useful intervention, especially in autism”. For a link to the full text of their summary of AIT research, visit our Links & Resources page.
Educational researcher and Berard Practitioner, Sally Brockett, conducted a pilot study of children with identified sensory integration difficulties. Her results indicated statistically significant changes in the areas of vestibular hypersensitivity, play interactions, tactile hyposensitivity and self regulation. There were also measurable changes in the areas of vestibular hyposensitivity, tactile hypersensitivity and poor tactile discrimination. You can see Ms. Brockett’s full report through our Links & Resources page.
While there have not been any physiologically based studies on why AIT works, the observation of practitioners and scientists over the past 30 years have yielded a number of hypotheses on the topic. They range from the purely physical aspect of retraining the ear, to addressing the more subtle and unexpected response people have shown after AIT over the decades. Here is a summary of four primary theories:
CVS Theory by Sally Brockett
The cerebellar-vestibular system (CVS) is the sensory-motor processing center of the brain. It is responsible for the integration and processing of all sensory information (including hearing, vision, taste, and smell), coordination voluntary and involuntary motor movements (including eye movements), and controlling the sense of balance, direction, time and rhythm. It also regulates anxiety. Vestibular stimulation and rotation have been reported to open the door for further remediation when there is an impairment in the sensory channels, even when nothing else has worked. AIT may be one other method of providing stimulation to the CVS to help reorganize a dysfunctional system through specially designed, vibrating sound waves. The CVS theory provides a reason why so many changes occur with AIT that on the surface do not appear to be related to the auditory system, or specifically, the flattening of the audiogram pattern. It explains why individuals report that they can taste and smell things better and are no longer tactilely defensive. It also supports parents’ and teachers’ claims that children exhibit better balance, motor coordination and handwriting. It also accounts for improved eye contact, eye-hand coordination and eye alignment.
Dr. Melvin Kaplan has suggested that the auditory system is organized in a dysfunctional and unstructured manner in some people with developmental disorders. Similar to the other senses in the body, the auditory sensory system is very adaptable and can change given the appropriate stimuli and structure. During the AIT listening session, the auditory system reorganizes itself in a more natural, structured and functional manner. One implication of Dr. Kaplan’s theory would be the possibility of post-treatment in which exposure to structured sounds may re-organize the auditory system more efficiently. This would include exposure to speech and language as well as listening to certain styles of music.
Reduction in peaks due to a decrease in stimulation
Dr. Berard theorizes that filtering out frequencies which the person hears “too well” will reduce sensitivity due to the lack of stimulation in certain areas of the cochlea and/or the brain during the listening sessions. Furthermore, those areas(s) of the cochlea and/or brain which are not filtered receive intense stimulation; and this stimulation causes a slight improvement in hearing.
Theories related to the middle ear
Two theories focus on the role of the middle ear in explaining how individuals may benefit from receiving AIT. One is that muscle tension is not adequate for proper functioning of the middle ear. AIT listening sessions exercise and strengthen the muscles in the middle ear, which then lease to the correct amount of muscle tension and efficient sound transmission. A second theory postulates that the tensor tympani muscle and the stapedius muscle are no longer working together to form the acoustic reflex. This may result from a trauma to the middle ear, such as a middle ear infection. By listening to very stimulating, modulated music, the two muscles are given a “work out”, and as a result, they start to work together to form the acoustic reflex.
While the re-education of the ear results in changes in the perception of sound, and may impact many other related areas of learning development, AIT does not profess to treat or cure any form of disease or physical/psychological disability. Clients with medical concerns should consult their doctor or other healthcare practitioner before engaging in any program.