Auditory (sound) processing training may not improve reading, spoken language, or attention in children with autism.
The author of this article compared 6 studies of auditory training program for children with auditory processing problems. Children with autism may also have auditory processing problems. They may have good hearing but have trouble processing sound input. The author said that commercial auditory training programs can be helpful for improving auditory processing. Nonspeech training and simple speech training were helpful. However, reading, spoken language, or attention were not improved. The author also said that there are few well-controlled studies on this subject, and some poorly-designed studies may be misleading.
Autism Therapy: auditory integration training (AIT)
definition of auditory integration training: Non-biologic alternative therapy for autism involving repeated exposure to sounds.
No Factsheets to Display
- Current Opinion in Neurology, by McArthur, GM, published in 2009, summarized Oct 6, 2009
- British Medical Journal Clinical Evidence, by Parr, J., published in 2007, summarized Sep 11, 2009
There are many therapy options for people with autism, and some of them are supported by scientific evidence indicating that they may be likely to help.
This review article summarizes published scientific studies of how well different autism therapies might work. The article lists 29 therapy options in four categories. There are "early multidisciplinary interventions" that include applied behavioral analysis (ABA) and social stories. The other categories are dietary interventions, drug therapy, and non-drug treatments like auditory integration training and chelation therapy. The therapies listed as "likely to be beneficial"include: ABA, Autism Pre-school Programme, Child's Talk, More than Words, Picture Exchange Communication System (PECS), and methylphenidate for hyperactivity. Other therapies are listed as "unknown effectiveness" or "trade off between benefits and harms."
- Pediatric Annals, by Schechtman, MA, published in 2007, summarized Dec 11, 2008
Many parents use scientifically unproven therapies to help their children with autism.
This article reviews a few therapies that are used to treat autism (vitamins, sensory integration therapy, facilitated communication, auditory integration therapy, hyperbaric oxygen therapy, and others). The author states that while some treatments can improve autism in many children, the above therapies have not been proven to work in research studies. Vitamin therapy includes vitamins A, C, B6-magnesium complex, folic acid, and B12. Sensory integration therapy is designed to help children learn to process the input from their senses. Facilitated communication involves having a person guide the child with autism as he or she talks through a computer.
- Research in Autism Spectrum Disorders, by Devlin, S., Healy O., Leader G., and Reed P., published in 2008, summarized Dec 4, 2008
ABA therapy may be able to improve problem behaviors that happen in response to noise.
As many as 40% of children with autism do not like noise and respond to noise with problem behavior. Despite this fact, few studies have looked at treating the response to noise as a way of treating problem behaviors in people with autism. This case study described a child with autism who had a bad response to music and was treated with applied behavior analysis (ABA) therapy. The authors noted that it was very hard to find the real cause (establishing operation) of the problem behavior. The authors describe other therapy approaches that might have worked such as teaching the child to walk away from the music.
Is Bal-A-Vis-X a Potential Therapy for Autism?
May 21, 2012Bill Hubert, an English teacher in Kansas, has created a series of 300 balance, auditory, and visual exercises – Bal-A-Vis-X. In the article from the NewStraitsTimes in Malaysia, the reporter explains how Bal-A-Vis-X works with kids with autism and other learning difficulties. She interviews parents and teachers who have tried the process. Bal-A-Vis-X exercises use sandbags or racquet balls to improve upon a child’s natural rhythm and balance, by focusing on touch, sound, and sight. The rhythm of exercises is steady and increases in complexity. Hasanah Hassan, a Malaysian kinesiologist, explained, “Two children partner each other. Here they learn to coordinate the hands and feet movements while watching the sandbags being passed from one to another. We start with a pattern that ensures success because that will result in good self-esteem and the desire to do more.” Any teacher or parent can be trained in the Bal-A-Vis-X program.
Read original article: Bounce Balls and Toss Sandbags for Better Grades
Auditory Integration Training as Therapy for Autism
Feb 15, 2012A speech and language pathologist in Kuwait has begun using auditory integrations training (AIT) for his students with autism at Dasman Model School and Khalifa School. Mamoun Aburas was interviewed for this article and discussed how he saw improvements in speech and attention span. Aburas explained that AIT is an, "intervention programme designed to correct or improve auditory hypersensitivity, distortions and delays in the signals that interfere with an individual’s ability to process auditory information normally." AIT, which is still considered an alternative therapy, presents music through a machine called an Earducator. This machine helps balance the music so that children are hearing sound at the same way in each ear. The music used must cover a wide range of frequencies and have a good tempo and beat. Some of the music Aburas favors includes Bob Marley, Hall & Oates, Bryan Adams and Chris De Burgh. He is pleased that more parents in Kuwait are getting involved in their children's treatment and that autism is not seen as too much of a stigma.
Read original article: Music Used to Help Special Children
Auditory-Motor Mapping Training (AAMT) is a recently researched therapy that shows music may help communication skills in children with autism. Catherine Wan, PhD, a researcher in the Music and Neuroimaging Laboratory of Beth Deaconess Medical Center’s Department of Neurology, explains that AAMT uses “singing (intonation) and motor activities to strengthen a network of brain regions that is thought to be abnormal in children with autism.” The researchers based their study on another similar therapy, Melodic Intonation Therapy that was successful in helping stroke victims recover their speech. The children involved in the AAMT study showed increased communication during the treatment as well as at home.
Read original article: Research Shows New Therapy Helps Nonverbal Children with Autism to Say First Words
Dr. Gina Diaz-Cembrano recently opened the I Listen Enhancement Center for Maximum Learning in the Philippines. Although a dentist by training, Gina felt teaching preschool was a better way to help families who had children with autism and other developmental issues such as ADHD. The center uses the Tomatis Method. Gina explains, “The Tomatis method re-trains the listening system by using electronically modified music and language to re-educate, stimulate and improve the way in which we process auditory information.” Children with learning disabilities often have difficulty in communication and social interaction, the Tomatis methods attempts to increase listening skills, communication, and memory and attention. Gina has seen that Tomatis worked well with other therapies including occupational therapy, sensory integration, and speech therapy.
Read original article: All Ears for the Tomatis Method
Please comment on auditory integration training (AIT) or other autism therapy topics.
Synonyms for auditory integration training (AIT) include: AIT, audio, audiologist, audiology, auditory, auditory brainstem response, auditory input, auditory integration, auditory integration therapy, auditory integration training, auditory processing, auditory therapy
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Free Sound Therapy Home Programme
Jan 21, 2010 by AnonymousDr. Alfred Tomatis, a French otolaryngologist, is recognised as the modern day originator of sound or music therapy. In the early 1950's he developed an effective therapy method using altered music to treat conditions such as auditory processing disorder, dyslexia, attention deficit disorder and autism. Another French doctor, Dr. Guy Bérard, developed a similar method, Auditory Integration Training (AIT), which has found many followers in the USA. From personal experience I know that many clients report improvements in understanding, speech, balance, behaviour and emotional well-being after just two or three weeks of daily sound therapy.
Sensory Activation Solutions (SAS) is an organisation with Centres in the U.K. and Turkey that provides a unique service for children and adults that face learning or developmental difficulties. When the established educational, psychological or medical services fail to provide adequate support, the SAS methodology often can provide practical solutions that result in noticeable improvements in daily life.
You may be interested to check out their Free Sound Therapy Home Programme. Their Auditory Activation Method builds on the pioneering work of Dr. Tomatis and Dr. Bérard and has been specifically developed with the aim to improve sensory processing, interhemispheric integration and cognitive functioning. It has helped many children and adults with a wide range of difficulties, ranging from dyslexia and attention deficit/hyperactivity disorder to sensory processing disorders and autism. It is not a cure or medical intervention, but a structured training programme that can help alleviate some of the debilitating effects that these conditions can have on speech and physical ability, daily behaviour, emotional well-being and educational or work performance.
There is no catch, it's absolutely free and most importantly often effective. Check it out at: http://www.sascentre.com/uk/uk_free.html.
Neurofeedback
Dec 28, 2007 by Anonymouswww.neurofeedback.org
What is Neurofeedback? (taken with permission from http://www.thebrainlabs.com/neurofeedback.shtml)
Neurofeedback uses sophisticated computer technology to train the brain. While there are different forms of neurofeedback (as discussed below), the most traditional form is known as EEG Biofeedback. In EEG Biofeedback, a child plays video/computer games with his/her brainwaves. During a typical session, EEG electrodes are placed on the scalp and/or ear lobe(s). These sensors only measure a child's brainwaves; no electrical current enters the brain. The information/brainwaves that are read by these sensors are fed to a computer that converts this information into gamelike (pacman game) displays that include visual and auditory feedback. An example of a typical set up is displayed below in Figure 1.
Figure 1
As a child learns to control and improve upon their brainwave patterns, their game score increases and they progress. The only way to succeed at the games is for a child to improve their brain and how it functions. Further examples are included below, including the game computer that the client sees in Figure 2 and the therapist computer that monitors the clients brain wave patterns in Figure 3.
Figure 2
Figure 3
As this is done over various sessions, a child's brain improves and their symptoms or problems reduce. There is also every reason to believe that if this is done over a long enough period of time that the changes that occur will be enduring. In addition to its' long-lasting effects, the other major advantage is the lack of significant side effects.
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What can Neurofeedback help?
Given that this therapy helps people to control and change their brainwaves, EEG biofeedback can potentially help with any problems that can be influenced by brainwaves. This would include almost anything controlled by the brain including thinking abilities, motoric responses, behavioral, emotional, and social difficulties.
Table 1 shows the types of conditions/diagnoses for which Neurofeedback has been shown to be helpful. The number of research studies verifying its' impact is also presented.
Table 1
A simple review of the data in Table 1 shows that Neurofeedback is considered effective for some Seizure Disorders and Attention Deficit Hyperactivity Disorder. In fact, at least three research studies (Fuchs et al., 2003; Monastra et al., 2002; Rossiter & LaVaque, 1995) have now shown that EEG biofeedback is equivalent in its' effectiveness as compared to stimulant medications for the treatment of ADHD symptoms, but without the side effects and with a greater duration of lasting effects.
While Neurofeedback has also been shown to be effective for other conditions observed in children, such as Traumatic Brain Injury, there are clearly conditions in which much more work and research is needed. These would include Learning Disabilities, Stroke and especially Tourette's Syndrome and Autistic Disorders.
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What are the different types of Neurofeedback?
There are three major forms of Neurofeedback. These are:
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What is EEG Biofeedback?
Clearly, the most well known and first form of Neurofeedback is EEG Biofeedback. It was first discovered in the late 1960's and early 1970's that individuals could learn to control their own brain waves when provided feedback about them and that this information could be used to minimize or control seizures. It was later found that EEG Biofeedback could be used to treat Attention Deficit Hyperactivity Disorder and other developmental conditions or problems.
The typical EEG Biofeedback session has been described and shown above. Typically, EEG Biofeedback is done with three electrodes arranged in a monopolar pattern. This means that one electrodes is placed on the scalp at a clinically significant location and the other two are placed at relatively neutral sites (e.g., earlobes). With these electrodes in place various EEG frequencies are rewarded and others inhibited. This occurs via the visual and/or auditory feedback received, often via a computer screen and image. For example, it is common to reward low beta frequencies (often associated with focused, calm thought processes) and inhibit lower frequency ranges (delta, theta), which are often associated with distraction, fatigue, etc. When these conditions are met, for example, the pacman will move rapidly through a maze. Following similar processes, brainwave patterns are shaped over time toward a client's therapeutic improvement.
EEG biofeedback can be performed in a monopolar fashion at any of at least 19 electrode sites. Alternatively, some therapists chose to use bipolar montage or arrangement. In such a pattern, there are now two electrodes placed on the scalp and one on one ear. Now, brainwave patterns are shaped between theses two electrode sites or so it is theorized. Possible electrode placements and sites are expansive given that there are at least 19 locations and two electrode pairing combinations.
Lastly, there is an advanced form of EEG biofeedback referred to as coherence training. Coherence training is done with two separate channels of EEG (3 electrodes times 2 for a total of 6 electrodes). Each electrode grouping is arranged in a monopolar fashion. There are then two electrodes on each earlobe and two electrodes on the scalp. The purpose of coherence training is to facilitate "communication" between two specific brain regions.
EEG biofeedback conducted with either monopolar or bipolar setups seeks to focus on the amplitude or magnitude of various EEG frequencies, encouraging some and discouraging others. Monopolar arrangements seek such changes over one particular location, while bipolar setups seek changes between two sites (theoretically speaking). The training of specific locations and EEG frequencies then becomes of critical importance. EEG frequencies are described in cycles per second and reflect the speed of processing at a particular brain region. The following table is a representation of common frequency ranges, their names and associated features.
Typically, EEG biofeedback seeks to encourage some frequency ranges and discourage others. As a result, the neurofeedback therapist is left to choose the type of training, where on the brain to train and what frequency ranges to reward or inhibit. Discussed below are some issues related to these choices and approaches to neurofeedback.
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What is Stimulation-Driven EEG Biofeedback?
The two most popular forms of enhanced or stimulation-driven neurofeedback are LENS and the Roshi. LENS, or Low Energy Neurofeedback System, uses a very low power electromagnetic field to carry feedback to the person receiving it. This signal seeks to change this persons' brainwaves in subtle ways. The goal is often to alter to dominant brainwave frequency so as to make it more powerful. The result may be increased self-regulation and skills.
The Roshi is also an enhanced form of neurofeedback. In its' many incarnations, Roshi involved light stimulation that emulates a normally fluctuating EEG signal and its' many frequency variations. This tends to "push" the person more towards normalcy than they would be otherwise.
There is some evidence to suggest that these forms of enhanced neurofeedback can be helpful, especially in complex cases.
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What is Hemoencephalography?
Hemoencephalography or HEG refers to brain blood flow, its' measurement, and use as a neurofeedback application. This is a completely unique form of neurofeedback that is separate and different than EEG Biofeedback.
The originator of this technique, Hershel Toomim, developed a technology referred to as Near Infrared HEG or nirHEG. This measurement and biofeedback device is housed in a headband, which contains a light source and two optodes. Infrared lights are flickered alternating between 660 and 850 nm. The absorption of these lights, and a ratio of the same, received at the optodes is a calculation of cerebral oxygenation. This is used in the form of feedback to allow the client to enhance their brain's functions.
Another form of HEG has also been developed by Jeffrey Carmen. This form, entitled Passive Infrared HEG or pirHEG, uses an infrared lense that serves as a brain thermometer and measures temperature and inferred cerebral metabolism. This may also be used as a form of neurofeedback to aide in the enhancement and regulation of brain functions.
HEG is somewhat limited in that it doesn't see through hair. However, it has the advantage of being insensitive to artifacts such as muscle tension or eye blinks which may interfere with EEG biofeedback. As a result, HEG may be particularly useful of neurofeedback of frontal lobe or system dysfunction.
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What types of assessments can help Neurofeedback?
Now that we know there are various form of Neurofeedback that could be applied to many different problems and brain regions, how does one decide what to do and where? Believe it or not, there are some within the field that believe that all people can be treated the same way or with the same protocol. This is not our approach. In our clinical practice, we individually tailor and Neurofeedback protocol to an individual's particular problems or symptoms and, importantly, the identifiable regions of brain dysfunction that related to these symptoms.
The following is a possible list of ways in which Neurofeedback could be tailored for an individual:
About Reading and nonverbal/low-communicating people with autism
Aug 1, 2007 by dankohnIt seems likely that many if not most nonverbal or low-communicating children with autism can read by the time they are six or seven, sometimes earlier – even when no one has taught them and even when no one knows they can read. I have observed this time and again and professionals who work with nonverbal children/people with autism using literacy based methods have confirmed this observation. It is hard to imagine the concept at first - that a person could know how to read and yet not know how to communicate, but it turns out that it is probably somewhat common in this population.
Recently a member posted on my community forum (www.strangeson.com) about reading and how colorful picture books kept her child’s visual interest. I thought I would share a few thoughts on this and in particular differentiate between a child/person’s visual interest and auditory interest in books.
There are several ways a child/person you are working with can respond and relate to books. Visually stimulating types of books designed for very young children can capture visual attention and they can be fun and useful for keeping a child/person focused on a visual target (in this case the pictures in the book) and this can be used for social interaction as I will describe below.
For educational purposes on the other hand, we need to remember that many nonverbal children/people with autism are very reliant on their auditory system for learning. I remember asking Soma when I first met her, how she got the idea to read books aloud to Tito when he was little, even though he showed no outward sign of paying attention to her words much less understanding what she was reading. She called it “listening behavior” and explained that he could have left the room, but he never did. I realized when she told me that, that when my husband read Harry Potter aloud to the kids and Dov was running around the room, making sounds and stimming and acting like he was paying no attention – he never left the room either – and he could have. Most of us think that “listening behavior” consists of sitting quietly and attending to the pages of the book, but Soma taught me that not leaving the room was listening behavior too.
Later, when Dov began to communicate, it turned out he had been listening all along and he could answer all kinds of questions about Harry Potter from when his Dad used to read it aloud. You can read a few sentences or a paragraph of age-appropriate material, whether from a teen magazine or the newspaper or a book and then ask a question and use multiple choices to get the answer, then read some more. If the child/person stays in the room – you can be pretty sure he/she is listening, even if he/she displays none of the behaviors such as sitting quietly and looking at the pages.
It’s gotten to the point now that Dov knows it bothers me when he starts stimming too wildly while I am reading to him, and so when he does it I just stop reading mid-word and give him a quick look and he stops immediately – because he loves to listen to someone reading out loud! Then I resume reading immediately. Now Dov can sit for hours listening and answering questions and asking them too and I’m the one who usually tires out first.
But Dov also still loves to look at his favorite, visually exciting type of books with high contrast colors and designs, and sparkly illustrations; books for very young children. These kinds of books definitely still capture his visual attention and when he is paging through one of his favorite “visual” books, sometimes I take the opportunity to talk about the pictures with him, and discuss what he likes and why. Dov can spell out a word, phrase or sentences about the pictures in these books but in the beginning we often used multiple choice and even now, if he is tired or having a hard day, we might still use multiple choice sometimes.
An example of how you can use multiple choice with a picture book to turn visual fascination into communication, you could ask: “I see you like this page. What do you like about it?” then I quickly jot the choices on a clipboard: “the way it looks?”, “the way it feels?”, or “both” and “something else”. (I always include “something else”) If he/she chooses “the way it looks” you could ask: “What do you like about the way it looks?” and offer the choices: “the colors?”, “the sparkliness?”, and so on. You could also ask him/her to show you the part of the page he/she likes best (by pointing) and then talk about that, ask more questions, and so on. This is a fun activity and it gives you a chance to share something the child/person likes and have an interaction about it - which most kids/people with autism don’t get a chance to experience often enough. But it is also a completely different kind of activity than reading a book for the sake of learning about something and/or for the literary enjoyment.
Both kinds of activities are very valuable. Enjoy!
Best wishes, -Portia
Thomas' Story
Oct 16, 2006 by AnonymousMy almost four year-old son Thomas is a delightful child in so many ways. He can sing the alphabet song. He can recite entire scenes from movies he likes. He's got a great throwing arm. He shows lots of affection with hugs and kisses. He tries to ride our dog as if she were a horse. He does all of these things and so much more, despite being autistic.
He was diagnosed with autism at the age of three-and-a-half years with the help of both the staff at his developmental preschool and a neurologist. After I completed the Childhood Autism Rating Scale (CARS) with his neurologist, Thomas was placed at the moderate to severe end of the spectrum.
The journey to diagnosis was a long and frustrating one. Every time my husband (not me; I was in some degree of denial about Thomas' behavior) mentioned autism to any of Thomas' three therapists (speech, developmental, and occupational), they always replied that they were not qualified to make that kind of diagnosis, but they didn't think he was autistic. We got very tired of hearing that nobody was qualified to make a diagnosis, and since none of his therapists "thought" that he was autistic, we didn't see the need to seek the advice of a neurologist. I still wish that somebody would have had the guts to tell us that they suspected we were up against something very serious.
We had many concerns about his behavior. He crashed into me and my husband all the time, on purpose. He spent the winter of 2004 - 2005 rocking and bouncing his head on our couch cushions. He repeated everything that he heard, word for word, including identical intonation and inflection. He didn't seem very interested in playing with other kids, and when he did, he went about social interaction the wrong way. He would approach another child, a complete stranger, and either hit the child or hug them instead of saying "Hi." Transitions were also very difficult. Leaving the park must have been quite a spectacle as I strapped Thomas' neurologically typical and easy-going little sister into the back seat of the double stroller and then attempted to force Thomas into the front seat while he struggled as best he could to land a well-placed foot or fist in my face. It was enough to make me not want to take him out of the house anymore. I kept at it though, and it seems to be paying off.
Thomas left the Early Intervention program of therapies at the age of three and began school in January of 2006. He was only attending on Tuesdays and Thursdays for two-and-a-half hours in the morning. He was in a class of ten with all of the children displaying some degree of developmental disability or delay. He had good days and bad days, and because of the difficulty his teacher was having getting him to accept the school routine, she suggested that we switch Thomas to a five-day per week schedule. We'd talk more about that at his Individual Education Plan (IEP) meeting in May, she said.
I will never forget that meeting. It was on Tuesday, May 9th. Somehow I knew going in that it was not destined to be a "happy" meeting. My instinct was more right than I could have realized as I sat at the end of a long table filled with stacks of papers and Thomas' entire educational staff. Everyone took turns talking about Thomas' behavior, and very little of it seemed good. By the time the school social worker was talking (she was maybe the fourth person out of ten) I was in tears, my mind was in a haze and I could think of nothing but going home and crying for a long time. Unfortunately, the worst was still to come as everyone had finished talking and the social worker said, "All of this suggests autism to me. We'd like you to take him to a neurologist for a diagnosis." There was a quiet nod of assent from the other people at the table, and Thomas' teacher looked at her hands in her lap. Weeks later, I realized that it must be just as difficult for educators to go through those tough meetings as it is for the parents.
I did take Thomas to see his neurologist the very next week. His diagnosis was confirmed and he was allegedly moderate to severely autistic. I don't really agree with where Thomas' neurologist placed him on the spectrum, because he is at his absolute worst at the doctor's office, like most children.
After a long summer, Thomas started going to school five days every week on September 5th. He takes the bus each day and is doing a great job, so far. We're still working on transitions, and he has actually gotten a lot better recently with that. He seems to do better transitioning for everyone but me. (I still have a long, scabby scratch-mark on my face from a particularly nasty incident while leaving Chuck E. Cheese last Friday.) Thomas continues to have a lot of echolalic speech, but he seems to have good days and bad days with it. Of course, social interaction is a problem, but even that's been improving. Probably the most troublesome aspect of Thomas' behavior is that he is constantly seeking sensory input. He really hurts me and my husband sometimes by jumping on us and crashing into us when we're unprepared for it. The chiropractor bills are staggering. (Luckily, he abstains from jumping on his little sister.) If he's not getting enough auditory input, he makes the most irritating noises, like banging toys into walls or slamming doors. It's hard for me to try to redirect him instead of just taking toys away or taking doors off their hinges, so I try to remind myself that he's not making noise just to be obnoxious, he needs the input.
Parenting Thomas continues to be a struggle with small rewards throughout our day. Just this evening, I was whining to my husband because he got home very late from work and I was frazzled after a long day with the kids. Thomas didn't even look up from where he was playing at the sink to say to my husband, "Mommy is getting very sad, Daddy." Of course, I immediately stopped my moaning and started laughing. Through all of this, there are many small, bright moments of clarity in Thomas' behavior that make us laugh or smile. We treasure them all.
My husband and I are going to attend our first Autism Support Group meeting on Wednesday night. I'm not really sure what to expect, but I'm looking forward to exchanging information with other parents in our same situation. We're also about to hit potty training hard, after attending a workshop on the subject at the school last week, so I'm sure I'll have plenty to write about in the coming weeks.