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: ayadh2@gmail.com

   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
```