1. Autism Insights
O r i g inal R e s e a r c h
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Effectiveness of Auditory Integration Therapy in Autism
Spectrum Disorders—Prospective Study
Laila Y. Al-Ayadhi12 Abdul Majeed Al-Drees12 and Ahmed M. Al-Arfaj3
1Autism Research and Treatment Center (ART Center) Al-Amodi Autism Research Chair. 2Department of Physiology
Faculty of Medicine King Saud University Riyadh Saudi Arabia. 3Department of ENT Faculty of Medicine King Saud
University Riyadh Saudi Arabia. Corresponding author email: [email protected]
Abstract
Objectives: To determine the effectiveness of auditory integration training (AIT) in people with Autism Spectrum Disorders (ASD).
Method: Seventy two subjects with ASD aged up to 17 years old (70 male and 2 females) were recruited for the study. All subjects
were screened by Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and assessed by CARS (Childhood Autism Rat-
ing Scale). Pre-intervention scores and post-intervention (3 and 6 months) scores were calculated for each child using CARS Social
Responsiveness Scale (SRS) and the Autism Treatment Evaluation Checklist (ATEC). Auditory integration training was performed
over 2 week 30 minutes twice a day.
Results: All subjects demonstrated improvement 3 and 6 months following the AIT. ASD subject showed 22% and 26% percentage
improvement in SRS scoring 3 and 6 months respectively following the AIT intervention. Those changes were attributed to statistically
significant changes in social awareness social cognition and social communication. Similar results were achieved with the ATEC check
list: ASD subject showed 19.5% and 22.5% improvement 3 and 6 months following the AIT intervention respectively. Those changes
are due to statistically significant (P 0.05) improvement in speech communication and sociability only.
Conclusions: The results of this study support the therapeutic effects of auditory integration training on social awareness social cogni-
tion and social communication as well as speech and communication.
Keywords: autism spectrum disorders auditory integration therapy
Autism Insights 2013:5 13–20
doi: 10.4137/AUI.S11463
This article is available from http://www.la-press.com.
© the author(s) publisher and licensee Libertas Academica Ltd.
This is an open access article published under the Creative Commons CC-BY-NC 3.0 license.
Autism Insights 2013:5 13
Al-Ayadhi et al
Introduction
Autism Spectrum Disorders (ASDs) are complex neu-
rodevelopmental behavioral disorders with an onset
prior to the 36th month. ASDs are characterized by
impairment of social contact and communication as
well as restricted and repetitive interest and behaviors.
Other characteristics include sensory dysfunction
inappropriate laughing and giggling little or no eye
contact apparent insensitivity to pain preference to
be alone and many others.1 Recent epidemiologi-
cal studies suggested that autism might affect one in
150 American children. The prevalence of ASD has
increased dramatically over the last few years and it
cannot be attributed completely to improved diagnos-
tic techniques and increased awareness.1
Sensory processing disorder (SPD) is relatively
common among children with ASD ranging from
40% to 80% in American children.2 Sensory integra-
tion (SI) theory was originally developed by Ayres
and focused on neurological processing of sensory
information. In ASD the SI dysfunction manifest as
difficulty in regulating responses to sensations and
specific stimuli. Individuals with ASD may use self-
stimulation to compensate for limited sensory input
or to avoid over stimulation.3–6 This suggests poor
SI in the central nervous system and could explain
the impairments in attention and arousal.27 SI inter-
vention is a type of intervention designed to provide
controlled sensory experiences in order to elicit an
adaptive motor response.2 The administered sensory
input must be in accordance with the child’s needs
and is characterized by an emphasis on sensory stim-
ulation active participation of the client and involve-
ment of client-directed activities.
Auditory hypersensitivity is a common finding in
ASD. Interventions to overcome variations in audi-
tory sensitivity in people with ASD have been devel-
oped and are collectively called auditory integration
therapy (AIT). Berard’s method of AIT was first
developed in France in 1982. Berard postulated that
abnormal sensitivity or insensitivity to certain fre-
quencies of sound waves regardless of overall hear-
ing ability was associated with a range of behavior
and learning problems and that his technique of AIT
would bring about a “re-education” of the hearing
process.89
Thus the aim of the current project is to test the
effectiveness of AIT in reducing ASD symptoms.
14
Materials and Methods
Patients
All subjects participated in the study were recruited
from the Autism Research and Treatment Center (ART
Center) at King Saud University King Khalid Univer-
sity Hospital. Seventy two ASD subjects 2 girls and
70 boys (ages ranging from 3 to 17 years old) were
assessed for participation and enrolled in the study.
All children were screened and assessed by psycholo-
gist and pediatrician using the Diagnostic and Statisti-
cal Manual of Mental Disorders 4th Edition DSM-IV
and Childhood Autism Rating Scale (CARS). Chil-
dren with a history of seizure disorder were excluded
from the study. Written consent was obtained from the
parents of each subject according to the guidelines of
the ethical committee of King Khalid Hospital King
Saud University Riyadh Saudi Arabia. During the
study period children were not allowed to begin any
new therapies or stop any current therapies including
medications and supplements.
Clinical outcome measures
All measurement was carried out by a qualified psy-
chologists. Pre-intervention scores and post-inter-
vention (3 and 6 months) scores were calculated for
each child using CARS Social Responsiveness Scale
(SRS) and the Autism Treatment Evaluation Check-
list (ATEC). The SRS is a validated test of interper-
sonal behavior communication and stereotypical
traits in autism.10 It consists of five subscales: social
awareness social cognition social communication
social motivation and autistic mannerisms. The SRS
measures the degree of social impairments in autistic
children and is suitable for assessing treatment out-
comes. In this study a total raw score was obtained
and raw scores
