Comparative Study of AIT Devices
The Earducator and Audiokinetron
By Sally Brockett, M.S. Director, IDEA Training Center
2 May 2001
Auditory Integration Training (AIT) is an intervention that uses specially modulated and filtered music to retrain an individual's ability to process sound input. Dr. Guy Berard, a French ear, nose and throat (ENT) doctor, developed the Berard method of AIT in the 1960's (Berard, 1993). He and other qualified instructors have trained practitioners to provide the intervention internationally and there are now over three hundred Berard AIT practitioners worldwide. The benefits of AIT are well documented with over 22 papers published (Edelson and Rimland, 2001).
The intervention was first provided in the US in 1991. A French-made device known as the Audiokinetron was developed by Dr. Berard and is in wide use around the world. A second device, the BGC, was made in the US to emulate the French device. A study by Rimland and Edelson (1994) showed the benefit of both devices to be roughly equivalent. In 1993 the US Food and Drug Administration (FDA) took the position that both devices were "medical devices" and subject to FDA regulation based on claims by manufacturers and practitioners that use of AIT would "improve a human condition". These devices became unavailable in the US as importation, manufacture and interstate transportation were prohibited and their use was limited. The FDA has recently stated that if used solely for educational purposes, new AIT devices would not fall within their jurisdiction and therefore could be used in the US. (Munzner,1999).
In 1997, an AIT device known as the Earducator was developed in South Africa in collaboration with Dr. Berard. The Earducator has since been used by about 17 practitioners in South Africa and anecdotal reports by parents, caregivers, educators and practitioners indicate that good educational benefits were produced. Unfortunately, no studies comparing the relative benefits of the Earducator and the Audiokinetron were done in South Africa. This study was conducted in order to validate the benefits of the Earducator (compared with the Audiokinetron) and, if successful, pave the way for introduction into the US.
A study using the Earducator was developed to compare results with the Audiokinetron.
The study population consisted of individuals diagnosed with autism, learning
disabilities and attention deficit disorder (ADD) who were already planning
to have AIT. These subjects ranged in age from 3 years to 20 years. There were
a total of 22 children, 21 boys and 1 girl, but no questionnaires were completed
for 3 of the participants.
The individuals were randomly assigned to use either the Earducator or the Audiokinetron. Three qualified practitioners of the Berard Method of AIT were used in different parts of the country to ensure that generalized results were obtained. The practitioners participating in the study were Sally Brockett in North Haven, Connecticut, Carole Swick, Huffman, Texas and Rose Marie Davis, Buena Park, California. These practitioners selected the monitoring tests appropriate for each individual, however all subjects were monitored with the Aberrant Behavior Checklist. The tests were administered immediately prior to starting AIT, and at 1 month, 3 months and 6 months after receiving AIT. This evaluation schedule has shown that the benefit over time is progressive through at least six months.
AIT sessions were scheduled between April and August 2000 at the three training centers. Participants were advised of the study and consented to participate without knowing whether the Audiokinetron or the Earducator would be used. Most participants completed baseline and follow-up evaluations.
Since a large body of educationally related data has been previously acquired using the Audiokinetron, the limited sample data from the study could be compared to determine if the trends were consistent. Earlier data collected at the IDEA Training Center by Sally Brockett is typical of results reported by other practitioners and provides a reliable baseline for comparison.
The study procedure obtained baseline data for each individual in the study using relevant rating forms. AIT was then provided following the method of Dr. Berard. The individuals first had listening evaluations and ear/hearing health evaluations performed by an audiologist immediately prior to the start of listening sessions. The individuals then listened to specially modulated and filtered music from either the Earducator or Audiokinetron for two 30 minute sessions per day separated by at least 3 hours, for a total of 10 hours of listening within a 12 day period. At the mid-point of the listening, a second listening evaluation was performed by the audiologist and used to make adjustment to filters or volume. At completion of 10 listening hours, a third listening evaluation was performed.
Many practitioners have used the Aberrant Behavior Checklist (ABC) as an evaluation
of AIT's effectiveness. A total of 19 children completed the baseline and follow-up
questionnaires with 11 using the Earducator and 8 using the Audiokinetron. The
median score results from the study show very good agreement with the larger
data set. The differences observed are to be expected with the relatively small
sample size of the study and since median scores are presented.
The Attention Deficit Disorders (ADD) Evaluation Scale was also used to compare the effectiveness of the Earducator with the Audiokinetron. In the study, data was obtained for three individuals who used the Earducator and is compared to prior data with 22 individuals that used the Audiokinetron. Again, the trend of the mean results of the Earducator data agrees well with the Audiokinetron. The 22 individuals that used the Audiokinetron had an average percentile gain of 23 points (from 30th percentile to the 53rd percentile). The individuals on the Earducator showed a slightly larger gain of 26 points (from the 25th percentile to the 51st), although this difference may not be significant due to the small sample size.
As with the earlier South African experience, the anecdotal reports from individuals, parents, educators and caregivers of Earducator users in the study were positive and consistent with that of Audiokinetron users. During the AIT training period and throughout the follow-up period, comments and feedback were consistent with that received from earlier studies using the Audiokinetron.
This study showed that the Earducator seems to be equivalent to the Audiokinetron in producing educational benefits for AIT recipients when evaluated by the ABC and ADD evaluation tools discussed above. Based on these results, practitioners and AIT clients should have confidence that the Earducator produces significant educational benefit. Further study using the Earducator with larger populations is recommended. A variety of evaluation tools should be employed to further identify and document educational benefits of AIT using the Earducator.
Berard, Guy. Hearing Equals Behavior. Keats Publishing, Inc., 1993
Edelson and Rimland. "Summaries and Critiques of Research on Auditory Integration Training: January ,1993 - May, 2001: 28 Reports". Autism Research Institute, 2001.
Rimland and Edelson . "The Effects of Auditory Integration Training in Autism." American Journal of Speech-Language Pathology, 1994, 5, 16-24.
Munzner, Robert F. Letter printed in The Sound Connection, Quarterly Newsletter
of the Society for Auditory Intervention Techniques, Vol. 6, No.3, 1999