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"Helping you to help your ADD ADHD child"by Anthony Kane, MD
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Auditory Integration Training
What is Auditory Integration TrainingAuditory integration training (AIT) was developed by French otolaryngologist Guy Berard, in order to treat auditory processing problems. Berard claims that abnormal auditory processing results when there is discrepancies in how well someone hears different sound frequencies. For example, a person may be hypersensitive to the frequencies 2,000 and 8,000 Hertz, but hear all the other frequencies normally. Berard developed Auditory Integration Training as a way to reduce sensitivity to specific sound frequencies.
What Does Auditory Integration Training Treat
ADHDSome researchers feel that many children who are diagnosed with ADHD actually have a central auditory processing disorder. This condition is particularly common if the child has other sensory integration disorders, such as touch sensitivity. AIT seems to help improve attention span deficits, to correct poor auditory discrimination skills, and to improve the ability to follow directions, all of which are common problems in an ADD ADHD child.
Sound SensitivityAIT was created to reduce sound sensitivity and improve language discrimination.
DyslexiaDyslexia is usually thought of as a visual disorder. However, recent physiological findings indicate that the auditory processing system may be a major contributor to dyslexia. Brain studies of dyslexic people show a decrease in neurons on the left side of the medial geniculate nucleus, one of the central components of the auditory system. Interestingly, it is this part of the brain that processes fast-changing sounds. As we shall discuss, AIT focuses on training the child to improve his discrimination of this type of sound.
Vestibular Processing DysfunctionThe vestibular processing system is integrally related to the auditory processing system. AIT seems to improve vestibular dysfunction. In fact, some researchers feel that the presence of vestibular dysfunction is a good predictor that AIT will be successful.
Reading ProblemsIn order to read, children must know that letter combinations represent spoken sounds. A child must be able to grasp the sounds that a combination of letters represents in order to read an unfamiliar word. For example, he must understand the ‘at’ sound in order to read ‘cat’ or ‘bat’ correctly. A child who has an auditory perceptual problem may not be able to read because he is not able to hear the ‘at’ sound properly.
AIT often enhances listening skills and the ability to perceive sounds more accurately. This may enable the child to hear the spoken sounds more clearly. Thus, the basic auditory perceptual skills involved in reading may be improved through AIT.
Speech ComprehensionOne often-overlooked reason for learning difficulties is that the child cannot understand the teacher’s words. Many children have problems with hearing a message and then actively, correctly, and quickly, interpreting the meaning. The first step of speech comprehension depends upon the ability to receive the sounds. Children with auditory integration deficits have difficulty with this task. AIT may be a way of correcting this problem.
Thought OrganizationWe think verbally. We organize and process our thoughts through the use of an inner dialogue. Some children with a verbal deficit also have problems with their own inner dialogue. It is thought that AIT can enhance the child's ability to organize and sequence his thoughts by improving his own inner dialogue.
Behavior ImprovementBehavioral problems are often a result of a misunderstanding. Frequently children misbehave because they didn’t understand what it was they were told to do. I address this problem in How to Improve Your Child’s Behavior.
If the child has an auditory processing deficit he may not understand instructions. Adults will view this child as a behavior problem. The child thinks he was doing what he was asked, but finds this does not make his parents happy. He may eventually give up on ever pleasing his parents. This makes sense. From his point of view there is no relationship between listening to his parents and satisfying them. Why should be bother to try?
Since AIT helps the child to understand the spoken word, he will now have a better chance of understanding what it is that he is being asked to do. The child will appear to be more cooperative and obedient simply because he will now understand what he has been asked to do. This improvement will be reflected in school as well as at home.
Improved School PerformanceWhen a child understands the words that the teacher is saying he will do better in school. This is not hard to understand.
However, there is more than that. Children with auditory processing problems have great inconsistencies in their work. This variance in performance is due to the child’s level of fatigue. A child who has auditory dysfunction has to work harder to comprehend the spoken word. His experience is similar to one who is learning in a foreign language where he has to translate what he hears into words that he understands. This is tiring and as a result these children tune out frequently in order to rest.
Improved Social SkillsChildren with normal auditory integration have a social advantage. Because they have difficulty focusing on tuning out background noises, children with speech comprehension problems tend to withdraw socially. AIT can help a child with his listening skills so that he will not be overwhelmed by the sounds of his environment. This helps the child do better with social relationships.
Calming EffectOne of the most frequently reported changes as a result of AIT is an overall calmness in the listener. Some changes described include better sleep, an increase in attention span, a decrease in anxiety, and a decrease in hyperactivity.
How Auditory Integration Training WorksAuditory processing deficits seem to result from a defect in the brain stem’s reticular activating system. This is the area of the brain that regulates information from the auditory and vestibular systems, selectively focusing on certain types of sensory inputs while inhibiting others.
The unpredictable, modulated music used in AIT stimulates the reticular activating system. Because the vestibular system is also integrated in this part of the brain, the unique sounds used in AIT also may be capable of producing improvements in posture, balance, and spatial orientation.
AIT works by allowing a sound sensitive child to adapt to the sounds. Adaptation is a built-in mechanism, which after continued exposure to a stimulus reduces the perception of that stimulus. AIT trains the child to filter out unimportant sounds so that he can focus on what is important. This results in better sound discrimination.
How Auditory Integration Training is DoneUsing a cassette or CD player, the child listens to music that has been specially processed. If the child has certain frequencies of auditory sensitivity, these frequencies are dampened or filtered out.
The training takes place twice a day, each time for 1/2 hour, over a ten-day period. During the first five hours of training, each ear receives the same sound level input. For children with a speech or hearing impairment, the sound level is reduced in the left ear during the second five hours of training. The left hemisphere is responsible for processing speech and language. Since the right ear is connected more directly to the left hemisphere, Dr. Berard believes that a higher sound level in the right ear will stimulate the left hemisphere.
An audiogram is conducted prior to the first listening session to determine whether the person has auditory sensitivity. After the first five hours, the child gets a second audiogram to determine if the sensitivities are still present and whether new sensitivities have developed. A final audiogram is given after the completion of the listening sessions. The goal of the training is that all frequencies should be perceived equally well and the sensitivities should be eliminated.
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Anthony Kane, MD
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