Berard Auditory Integration Training: New perspectives from the international scene provide insight into functional outcomes
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BÉRARD AUDITORY INTEGRATION TRAINING New perspectives from the international scene provide insight into functional outcomes
Terrie Silverman, M.S. T. Silverman Training & Consultation Sally Brockett, M.S. Director, IDEA Training Center
Agenda • Seeking the Root Cause • Hearing, Listening, Processing • Problems Affecting Hearing • Problems Affecting Listening • Addressing the Problems • Results from Around the World • Resources
Does This Sound Familiar?
• Covers ears/fingers in ears •Hears sounds before others •Resists brushing teeth, hair cuts •Has delays in language development •Poor phonics and reading comprehension •Easily distracted by background noise •Can not follow verbal directions •Has a short attention span •Poor handwriting, spelling
Cognitive Skills
Hierarchy of Development Writing
Perceptual Skills Language Fine Motor Coordination Gross Motor Coordination Innate Reflexes
Imagination Spelling Visualization Reading Self-Esteem Arithmetic Capacity for abstract thought and reasoning Organization Speech & Attention Visual Perception Speech & Language Eye-Hand Coordination Controlled Oculomotor Bilateral Integration Balance Motor Planning Tactile Comfort Sucking Muscle Tone Auditory Tactile Vestibular Concentration Auditory Perception
Visual-Motor Integration Lateralization Body Percept Eye Movements Gravitational Security Oral Motor Visual Kinesthetic Proprioceptive Inflammation Allergies Structure
Basic Sensory Channels Physiological Reactions
Nutrient Deficiencies Immune System Malfunction Chemical Sensitivities
I know he hears, so why doesn’t he answer? Hearing is an unconscious
transmission of sound to the brain Listening is active focusing or tuning into sound Processing is the ability to interpret or attach meaning to the auditory stimulus
Poor Transmission of Sounds
Ear wax – may block transmission in the outer ear canal Ear infection/fluid – may block transmission in the middle
ear
Negative Eustachian tube pressure - decreases quality of sound transmission
Ear Check - Middle Ear Monitor
• Indicates the likelihood of middle ear fluid • Assists parents in determining when to seek medical attention • For home and school
Potential Causes of Problems
Medications Exposure to excessive noise Imbalances in biochemistry: toxins, deficiencies Illnesses that affect the auditory system Head trauma: falls, whiplash
10
40 30 0 10
125
20
60 250 500 750
1000 1500
50
2000
3000
4000
6000 8000
Audio Test
Right Ear
10 40 60 50 20 30 0 10
125
Left Ear
250 500 750
1000 1500
2000
3000
4000
6000 8000
10 10
40 40 20 30 0 10 30 60 50 0 10
125 125
20
After AIT
Before AIT
60 250 500 750
1000 1500
50 250 500 750
1000 1500
2000
3000
4000
6000 8000
2000
3000
4000
6000 8000
Right Ear
10
10
40
20
40 30
20
60
50
30
0 10
Audio Tests
60
50
0 10
125
125
Left Ear
250 500 750
1000 1500
250 500 750
1000 1500
(ADHD)
2000 2000
3000
4000
6000 8000
3000
4000
6000 8000
10
40 30 0 10
20
60
50
10
40 30 0 10
125 125
20
Before AIT
500 750
1000 1500
2000
3000
4000
6000
8000
After AIT
60 250 250 500 750
1000 1500
50
2000
3000
4000
6000 8000
Right Ear
10 40 60 50 20 30 0 10
10
40 30
20
Left Ear
Audio Tests (Autism)
60
50
0 10
125
125
250 500 750
1000 1500
250 500 750
1000 1500
2000
3000
4000
6000 8000
2000
3000
4000
6000 8000
Hearing Quality / Learning Ability Study
Maria Vega, Sp. Ed., Spain
Age - Years Number of Students Typical Learning Difficulties Predicted By Listening Test 6 – 11 60 30 30 93.1 % 12 - 16 50 36 14 92.9 % 16 - 18 48 29 19 94.7 %
Problems Affecting Listening
Hypersensitivity: hearing with more intensity. Causes distractibility, distortions Delayed Response Time: Slow processing of signals. May miss parts of words, hears bits and pieces. Uncoordinated Hearing: each ear hears differently. Causes confusion, misunderstanding
Problems Affecting Listening
Selectivity: difficulty hearing pitch relationships, and understanding tone of voice/emotions. May not sing on tune. Laterality: lack of dominant ear to process all frequencies. Causes delay in processing sounds, problems with sequencing, spelling.
How Auditory Problems Affect Learning
• Sounds Cause Distractibility, Irritability, Stress • Difficulty with Processing Reduces Attention Span • Difficulty with Processing Reduces Memory • Timing Delays Distort the Message • Distortion of Speech Sounds Affects Phonics
Addressing the Problems
Berard Auditory Integration Training Requires listening to modulated music for 10 hrs. to stimulate reorganization of auditory system Neural Plasticity: allows the brain to reorganize when given novel stimulation with intensity and repetition. Creates new neural connections for a more efficient system
Bérard Protocol
• 30 minutes each session • 2 times per day w/ at least 3 hours in between • 3 years of age and older • Headphones • Limited Distractions • Provided directly (on-site) by the Berard practitioner
Bérard Protocol Berard AIT Equipment is evaluated and proven effective. Currently two devices are accepted: • Earducator • Audiokinetron
Berard Auditory Stimulation
Visual System
Auditory System
Vestibular System
Observed Benefits
Auditory Integration Attention Modulation Memory Sensory Integration Affective behavior Visual Motor Integration Visual Spatial Orientation Motor Planning Motor Coordination Oral-Motor Academic Learning
Results from Around the World
Berard protocol is easily replicable Practitioners in 27 countries obtain similar results when following the protocol and using Berard AIT devices
Sensory Dysfunction (Decrease)
Sensory Integration Checklist
100 80 60 40 20 0
Median Change (%)
79% Improvement
0
IDEA Training Center
2
4
Months
6
8
Sample Size = 14
Short Sensory Profile (SSP)
Change During 6 Months Post AIT N = 54
Pre AIT 6 Mo. Typical Performance Probable Difference Definite Difference 30% < 10% < 20% > 70% > 30% > 30% > 30% > 40% ~ 20% > Post AIT 1 Mo.
Attention Deficit Disorders Evaluation Scale
Percentile - Median
60 50 40 30 20
Gain of 24 Percentile Points
0
Months After AIT
2
4
N = 48
6
Test for Auditory Processing Disorders for Children (SCAN-C)
Percentile Scores Pre Post-AIT Filtered Words Figure Ground Competing Words Competing Sentences Composite Total Score 50 37 84 50 55 84 75 84 63 86
SCAN-A: Test for Auditory Processing Disorders in Adolescents and Adults
Percentile 90 80 70 60 50 40 30 20 10 0
Filtered Words Pre-AIT Figure Ground Competing Words Competin g Sentences 6 Mos. Post AIT Total Test
Results for 38 Year Old Male
IDEA Training Center April 2006
PHELPS Kindergarten Readiness Scale Pre/Post AIT Results 5 year old boy
Percentile Rank Pre AIT Post AIT Verbal Processing Perceptual Processing Auditory Processing Total Readiness Score 25 9 <1 3 75 50 91 77
Test of Problem Solving
Age Equivalent Scores Before AIT After AIT 7 yr. 8 yr. 4.4 5.10 6.5 5.11 6.6 5.1 5.10 6.11 6.5 6.6
Chronological Age: Explaining Inferences Determining Causes Negative Why Questions Determining Solutions Avoiding Problems
9 yr. 9.7 11.1 8.10 9.10 9.9
COLORING - 5 Year Old
Before AIT
After 6 days of AIT
Handwriting - 7 year old
Before AIT After 6 Days of AIT
Before AIT
Handwriting
6 Months After AIT
Doaa El Hadary, M.D., Egypt
Autism Treatment Effectiveness Checklist (ATEC)
4 Year Old Boy
Areas Speech/Communication Sociability Sensory/Cognitive Health/Physical/ Behavior Total Scores Pre-AIT 26 35 29 54 144 Post-AIT (1 yr.) 10 11 18 22 61 % Change 62 69 38 59 58
Isamar Gonzalez, M.S. Audiologist: Puerto Rico Aberrant Behavior Checklist
5 Year Old Boy
Areas Irritability Lethargy Stereotypy Hyperactivity Inappropriate Speech Pre-AIT 27 14 8 30 3 Post-AIT (2 mo.) 11 6 1 17 2 % Change 59 57 87 43 63
Isamar Gonzalez, M.S., Audiologist: Puerto Rico Autism Treatment Effectiveness Checklist (ATEC)
5 Year Old Boy
Areas Speech/Communication Sociability Sensory/Cognitive Health/Physical/ Behavior Total Scores Pre-AIT 16 14 7 25 62 Post-AIT (2 mo) 6 15 4 13 38 % Change 62 -7 43 48 39
Berard’s Method Center, Antalya, Turkey
Lars Persson, Berard AIT Practitioner
Date of Study: 2005 – 2006 Number of Subjects: 52 Age Range: 8 – 18 yrs.
Functioning Level: normal, or with minor attention/ concentration difficulty, placement in regular education program. Data: Baseline rating form, repeated at 6 months post-AIT
Items 1. Evaluate your ability to maintain focus on a task of your choice 2. Evaluate your ability to maintain focus on a task choosen by your teacher 3. Evaluate your state of alert getting started on a task 4. Evaluate your motivation performing tasks/ solving problems 5. Evaluate your working memory 6. Evaluate your long term memory
% change 15 92 61 42 64 37
Items 7. Evaluate your stress level at tests/exams (reversed scale) 8. Evaluate your self confidence 51 9. Evaluate your determination, will power and endurance 10. Evaluate anxieties, fears, feelings of insecurity (reversed scale) 11. Evaluate your sleeping situation 12 Evaluate your distractability by back ground sounds when performing tasks (reversed scale) Total improvement, mean value on 12 variables:
% Change 180
71 76 81 108 73%
Summary of 28 AIT Studies
op P
Autism ADHD CAPD Mixed Populations Animals (chicks)
lat u
ion
os P
13 4 2 2 2
e tiv i
Am
2 0 0 0 0
b
uo ig
us
ue Q
1 0 1 1 0
tio s
ble na
Visit berardaitwebsite.com/sait for details
Resources
AIT for You – Terrie Silverman, M.S. Speech Pathology, Board of Directors for Berard AIT International Society, Member of Autism Society of America, Developmental Delay Resources. www.aitforyou.com IDEA Training Center – Sally Brockett, M.S. Berard AIT Instructor/Practitioner, Special Ed Consultant, Founder and President of Berard AIT International Society, Member of Autism Society of America, Developmental Delay Resources www.IdeaTrainingCenter.com
Resources • Dr. Guy Bérard
• Hearing Equals Behavior
• Books by Annabel Stehli:
• Sound of a Miracle • Dancing in the Rain • Sound of Falling Snow
Resources
Official Berard AIT Website www.berardaitwebsite.com International List of Berard AIT Practitioners www.berardaitwebsite.com/PracList.htm Berard AIT International Society www.berardaitwebsite.com/BAITIS.htm Dr. Guy Berard: www.drguyberard.com Official Website for the Earducator www.earducator.com Autism Research Institute www.autism.com
Resources
EarCheck Middle Ear Monitor Information www.earcheck.com Ototoxicity Information hearinglosshelp.com/articles/ototoxicupheaval.htm hearinglosshelp.com/articles/ototoxicaudiology.htm
Documented Results
Berard AIT efficiently produces positive functional outcomes
Berard AIT Improves Quality of Life!
BÉRARD AUDITORY INTEGRATION TRAINING New perspectives from the international scene provide insight into functional outcomes
Terrie Silverman, M.S. T. Silverman Training & Consultation Sally Brockett, M.S. Director, IDEA Training Center
Agenda • Seeking the Root Cause • Hearing, Listening, Processing • Problems Affecting Hearing • Problems Affecting Listening • Addressing the Problems • Results from Around the World • Resources
Does This Sound Familiar?
• Covers ears/fingers in ears •Hears sounds before others •Resists brushing teeth, hair cuts •Has delays in language development •Poor phonics and reading comprehension •Easily distracted by background noise •Can not follow verbal directions •Has a short attention span •Poor handwriting, spelling
Cognitive Skills
Hierarchy of Development Writing
Perceptual Skills Language Fine Motor Coordination Gross Motor Coordination Innate Reflexes
Imagination Spelling Visualization Reading Self-Esteem Arithmetic Capacity for abstract thought and reasoning Organization Speech & Attention Visual Perception Speech & Language Eye-Hand Coordination Controlled Oculomotor Bilateral Integration Balance Motor Planning Tactile Comfort Sucking Muscle Tone Auditory Tactile Vestibular Concentration Auditory Perception
Visual-Motor Integration Lateralization Body Percept Eye Movements Gravitational Security Oral Motor Visual Kinesthetic Proprioceptive Inflammation Allergies Structure
Basic Sensory Channels Physiological Reactions
Nutrient Deficiencies Immune System Malfunction Chemical Sensitivities
I know he hears, so why doesn’t he answer? Hearing is an unconscious
transmission of sound to the brain Listening is active focusing or tuning into sound Processing is the ability to interpret or attach meaning to the auditory stimulus
Poor Transmission of Sounds
Ear wax – may block transmission in the outer ear canal Ear infection/fluid – may block transmission in the middle
ear
Negative Eustachian tube pressure - decreases quality of sound transmission
Ear Check - Middle Ear Monitor
• Indicates the likelihood of middle ear fluid • Assists parents in determining when to seek medical attention • For home and school
Potential Causes of Problems
Medications Exposure to excessive noise Imbalances in biochemistry: toxins, deficiencies Illnesses that affect the auditory system Head trauma: falls, whiplash
10
40 30 0 10
125
20
60 250 500 750
1000 1500
50
2000
3000
4000
6000 8000
Audio Test
Right Ear
10 40 60 50 20 30 0 10
125
Left Ear
250 500 750
1000 1500
2000
3000
4000
6000 8000
10 10
40 40 20 30 0 10 30 60 50 0 10
125 125
20
After AIT
Before AIT
60 250 500 750
1000 1500
50 250 500 750
1000 1500
2000
3000
4000
6000 8000
2000
3000
4000
6000 8000
Right Ear
10
10
40
20
40 30
20
60
50
30
0 10
Audio Tests
60
50
0 10
125
125
Left Ear
250 500 750
1000 1500
250 500 750
1000 1500
(ADHD)
2000 2000
3000
4000
6000 8000
3000
4000
6000 8000
10
40 30 0 10
20
60
50
10
40 30 0 10
125 125
20
Before AIT
500 750
1000 1500
2000
3000
4000
6000
8000
After AIT
60 250 250 500 750
1000 1500
50
2000
3000
4000
6000 8000
Right Ear
10 40 60 50 20 30 0 10
10
40 30
20
Left Ear
Audio Tests (Autism)
60
50
0 10
125
125
250 500 750
1000 1500
250 500 750
1000 1500
2000
3000
4000
6000 8000
2000
3000
4000
6000 8000
Hearing Quality / Learning Ability Study
Maria Vega, Sp. Ed., Spain
Age - Years Number of Students Typical Learning Difficulties Predicted By Listening Test 6 – 11 60 30 30 93.1 % 12 - 16 50 36 14 92.9 % 16 - 18 48 29 19 94.7 %
Problems Affecting Listening
Hypersensitivity: hearing with more intensity. Causes distractibility, distortions Delayed Response Time: Slow processing of signals. May miss parts of words, hears bits and pieces. Uncoordinated Hearing: each ear hears differently. Causes confusion, misunderstanding
Problems Affecting Listening
Selectivity: difficulty hearing pitch relationships, and understanding tone of voice/emotions. May not sing on tune. Laterality: lack of dominant ear to process all frequencies. Causes delay in processing sounds, problems with sequencing, spelling.
How Auditory Problems Affect Learning
• Sounds Cause Distractibility, Irritability, Stress • Difficulty with Processing Reduces Attention Span • Difficulty with Processing Reduces Memory • Timing Delays Distort the Message • Distortion of Speech Sounds Affects Phonics
Addressing the Problems
Berard Auditory Integration Training Requires listening to modulated music for 10 hrs. to stimulate reorganization of auditory system Neural Plasticity: allows the brain to reorganize when given novel stimulation with intensity and repetition. Creates new neural connections for a more efficient system
Bérard Protocol
• 30 minutes each session • 2 times per day w/ at least 3 hours in between • 3 years of age and older • Headphones • Limited Distractions • Provided directly (on-site) by the Berard practitioner
Bérard Protocol Berard AIT Equipment is evaluated and proven effective. Currently two devices are accepted: • Earducator • Audiokinetron
Berard Auditory Stimulation
Visual System
Auditory System
Vestibular System
Observed Benefits
Auditory Integration Attention Modulation Memory Sensory Integration Affective behavior Visual Motor Integration Visual Spatial Orientation Motor Planning Motor Coordination Oral-Motor Academic Learning
Results from Around the World
Berard protocol is easily replicable Practitioners in 27 countries obtain similar results when following the protocol and using Berard AIT devices
Sensory Dysfunction (Decrease)
Sensory Integration Checklist
100 80 60 40 20 0
Median Change (%)
79% Improvement
0
IDEA Training Center
2
4
Months
6
8
Sample Size = 14
Short Sensory Profile (SSP)
Change During 6 Months Post AIT N = 54
Pre AIT 6 Mo. Typical Performance Probable Difference Definite Difference 30% < 10% < 20% > 70% > 30% > 30% > 30% > 40% ~ 20% > Post AIT 1 Mo.
Attention Deficit Disorders Evaluation Scale
Percentile - Median
60 50 40 30 20
Gain of 24 Percentile Points
0
Months After AIT
2
4
N = 48
6
Test for Auditory Processing Disorders for Children (SCAN-C)
Percentile Scores Pre Post-AIT Filtered Words Figure Ground Competing Words Competing Sentences Composite Total Score 50 37 84 50 55 84 75 84 63 86
SCAN-A: Test for Auditory Processing Disorders in Adolescents and Adults
Percentile 90 80 70 60 50 40 30 20 10 0
Filtered Words Pre-AIT Figure Ground Competing Words Competin g Sentences 6 Mos. Post AIT Total Test
Results for 38 Year Old Male
IDEA Training Center April 2006
PHELPS Kindergarten Readiness Scale Pre/Post AIT Results 5 year old boy
Percentile Rank Pre AIT Post AIT Verbal Processing Perceptual Processing Auditory Processing Total Readiness Score 25 9 <1 3 75 50 91 77
Test of Problem Solving
Age Equivalent Scores Before AIT After AIT 7 yr. 8 yr. 4.4 5.10 6.5 5.11 6.6 5.1 5.10 6.11 6.5 6.6
Chronological Age: Explaining Inferences Determining Causes Negative Why Questions Determining Solutions Avoiding Problems
9 yr. 9.7 11.1 8.10 9.10 9.9
COLORING - 5 Year Old
Before AIT
After 6 days of AIT
Handwriting - 7 year old
Before AIT After 6 Days of AIT
Before AIT
Handwriting
6 Months After AIT
Doaa El Hadary, M.D., Egypt
Autism Treatment Effectiveness Checklist (ATEC)
4 Year Old Boy
Areas Speech/Communication Sociability Sensory/Cognitive Health/Physical/ Behavior Total Scores Pre-AIT 26 35 29 54 144 Post-AIT (1 yr.) 10 11 18 22 61 % Change 62 69 38 59 58
Isamar Gonzalez, M.S. Audiologist: Puerto Rico Aberrant Behavior Checklist
5 Year Old Boy
Areas Irritability Lethargy Stereotypy Hyperactivity Inappropriate Speech Pre-AIT 27 14 8 30 3 Post-AIT (2 mo.) 11 6 1 17 2 % Change 59 57 87 43 63
Isamar Gonzalez, M.S., Audiologist: Puerto Rico Autism Treatment Effectiveness Checklist (ATEC)
5 Year Old Boy
Areas Speech/Communication Sociability Sensory/Cognitive Health/Physical/ Behavior Total Scores Pre-AIT 16 14 7 25 62 Post-AIT (2 mo) 6 15 4 13 38 % Change 62 -7 43 48 39
Berard’s Method Center, Antalya, Turkey
Lars Persson, Berard AIT Practitioner
Date of Study: 2005 – 2006 Number of Subjects: 52 Age Range: 8 – 18 yrs.
Functioning Level: normal, or with minor attention/ concentration difficulty, placement in regular education program. Data: Baseline rating form, repeated at 6 months post-AIT
Items 1. Evaluate your ability to maintain focus on a task of your choice 2. Evaluate your ability to maintain focus on a task choosen by your teacher 3. Evaluate your state of alert getting started on a task 4. Evaluate your motivation performing tasks/ solving problems 5. Evaluate your working memory 6. Evaluate your long term memory
% change 15 92 61 42 64 37
Items 7. Evaluate your stress level at tests/exams (reversed scale) 8. Evaluate your self confidence 51 9. Evaluate your determination, will power and endurance 10. Evaluate anxieties, fears, feelings of insecurity (reversed scale) 11. Evaluate your sleeping situation 12 Evaluate your distractability by back ground sounds when performing tasks (reversed scale) Total improvement, mean value on 12 variables:
% Change 180
71 76 81 108 73%
Summary of 28 AIT Studies
op P
Autism ADHD CAPD Mixed Populations Animals (chicks)
lat u
ion
os P
13 4 2 2 2
e tiv i
Am
2 0 0 0 0
b
uo ig
us
ue Q
1 0 1 1 0
tio s
ble na
Visit berardaitwebsite.com/sait for details
Resources
AIT for You – Terrie Silverman, M.S. Speech Pathology, Board of Directors for Berard AIT International Society, Member of Autism Society of America, Developmental Delay Resources. www.aitforyou.com IDEA Training Center – Sally Brockett, M.S. Berard AIT Instructor/Practitioner, Special Ed Consultant, Founder and President of Berard AIT International Society, Member of Autism Society of America, Developmental Delay Resources www.IdeaTrainingCenter.com
Resources • Dr. Guy Bérard
• Hearing Equals Behavior
• Books by Annabel Stehli:
• Sound of a Miracle • Dancing in the Rain • Sound of Falling Snow
Resources
Official Berard AIT Website www.berardaitwebsite.com International List of Berard AIT Practitioners www.berardaitwebsite.com/PracList.htm Berard AIT International Society www.berardaitwebsite.com/BAITIS.htm Dr. Guy Berard: www.drguyberard.com Official Website for the Earducator www.earducator.com Autism Research Institute www.autism.com
Resources
EarCheck Middle Ear Monitor Information www.earcheck.com Ototoxicity Information hearinglosshelp.com/articles/ototoxicupheaval.htm hearinglosshelp.com/articles/ototoxicaudiology.htm
Documented Results
Berard AIT efficiently produces positive functional outcomes
Berard AIT Improves Quality of Life!
