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The Failure of the Elder Study: Why Auditory Integration Training Failed Experts?
Auditory Integration Training (AIT) is a treatment method pioneered by French doctor Guy Bérard. Berard advocates that AIT can treat clinical depression and suicidal tendencies, and claims to have very positive effects on conditions such as dyslexia and autism. However, these claims lack sufficient empirical support. AIT training typically involves 20 half-hour consultations over 10 days, listening to specially filtered and modulated music. In the early 1990s, AIT was used as a treatment for autism, and was later promoted to treat attention deficit hyperactivity disorder (ADHD), depression, and a variety of other disorders.
AIT fails to meet scientific standards to demonstrate its effectiveness as a treatment for any condition.
The American Academy of Pediatrics and three other professional organizations consider it an experimental procedure. According to the New York State Department of Public Health, AIT should not be used to treat young children with autism. Due to a lack of evidence of medical benefit, the U.S. Food and Drug Administration (FDA) has banned the import of the Audiokinetron, the device originally used to perform AIT. The American Speech-Language-Hearing Association (ASHA) has also confirmed that AIT does not meet scientific safety standards.
Training plan
Auditory integration training is designed to address sensory issues such as auditory distortion and hypersensitive hearing. Among them, allergic hearing is understood as excessive sensitivity to sound. These sensitivities are thought to affect the ability to focus, understand and learn in people with learning disabilities, including those with autism spectrum disorder. AIT training programs typically require children to attend two 30-minute sessions per day, separated by at least three hours, over ten working days. During this time, children listen through headphones to a specially filtered and modulated piece of music that covers a wide range of frequencies. For each child's unique situation, the sounds of certain frequencies in the music are adjusted, that is, the bass and treble filters are randomly switched, and the duration varies between 1/4 and 2 seconds.
Due to a lack of evidence-based benefits to clients, the American Speech-Language-Hearing Association has warned its members that they may be violating ASHA's Code of Ethics if they provide AIT services.
While AIT's various equipment is not FDA-cleared, equipment specifically intended for use in education is not regulated by the FDA. However, many unapproved devices are still used to perform AIT, such as the Digital Auditory Aerobics (DAA) system that replaced the Audiokinetron, which contained 20 half-hour CDs of banned Audiokinetron sources. This enables it to bypass the ban on original devices. Most AIT practitioners are speech therapists, audiologists, or occupational therapists, but there are also other practitioners such as psychologists, doctors, social workers, and teachers. No operator training is required when running the DAA.
Insufficient power and evidence base
A systematic review of randomized controlled trials of AIT found insufficient evidence to support its use and no major adverse effects were reported. Several professional organizations have stated that AIT should be considered experimental, including the American Academy of Audiology, the American Speech-Language-Hearing Association, the American Academy of Pediatrics, and the Society for Educational Audiology. After reviewing the available research, the New York State Department of Public Health concluded that AIT has not been shown to be effective and recommended that it should not be used to treat young children with autism.
Historical background
Berard's Audition Égale Compportement was the first book about AIT, and Annabel Stehli's The Sound of Miracles tells the story of her daughter, an autistic A girl with autism received AIT treatment, and AIT was widely publicized in the English-speaking world. By 1994, more than 10,000 children and adults in the United States had received AIT training at a cost of approximately $1,000 to $1,300, and AIT had grown into a multi-million dollar industry. Alfred Tomatis, a French otolaryngologist, conducted research on hearing loss and discovered a connection between hearing and speech, which became the basis of his auditory stimulation method.
Although AIT became popular in the early 1990s due to humane evidence and small-scale trials, subsequent larger, better-controlled studies failed to verify AIT's expected effects. In fact, the use of AIT is not supported by the scientific community, so should we continue to invest time and resources in this treatment method in the absence of an empirical basis?
