Wednesday, July 13, 2011

Listening Therapy

Kim Wombles
kwomblescountering.blogspot.com
www.science20.com/science_autism_spectrum_disorders

Parents are always looking for new treatments to help their children with autism; it can be daunting to keep up with the multitude of new therapies constantly popping up on the internet, many with similar sounding names. There are several different “listening therapies” or auditory integrative training programs available online promising relief for autism symptoms. According to Sinha, Silove, Wheeler, and Williams (2006), “treatments to overcome variations in auditory sensitivity commonly encountered in people with autism have been developed and are collectively called auditory integration therapies. They include auditory integration training (AIT), the Tomatis method and Samonas sound therapy.”

Listening (or sound) therapies fall within the category of auditory training programs. Database searches show no results for any scientific investigation on specific programs available online, such the Lollipop Listening Therapy, Tomatis, or EASe, and there is limited research into auditory integration training for reducing autistic behaviors and issues.

The lack of research into the newer programs and the American Academy of Pediatrics’ recommendation to not use auditory integrative training has not stopped these programs from being popular ones for parents and therapists to use, as the abundance of sites relating to listening therapy, sound therapy, and auditory integration training attest. In 1998, The American Academy of Pediatrics issued a blanket rejection of both auditory integration training and facilitated communication which it reaffirmed in 2006. The AAP’s conclusion reads: “Their use does not appear warranted at this time, except within research protocols.” Much like facilitated communication has been made over into supported typing, all appearances indicate that listening therapy is auditory integrative training rebooted.

Sinha et al.’s 2006 attempted meta-analysis of auditory integrative training concludes with this warning: “AIT continues to be practised worldwide,30 despite evidence that shows it to be still an experimental treatment at best, and one which may be only available at a considerable cost to the family.”

Even without this research to rely on, parents can evaluate these programs by looking for a series of red flags that indicate a potential problem:
  1. Does the program promise to recover your child from autism?
  2. Are the total costs hidden?
  3. Do you have to buy special headphones and special equipment?
  4. Is the program prohibitively expensive?
  5. What evidence do they offer? (website articles and testimonials do not count as good evidence)
Traditional occupational or speech therapists may offer the program as part of their routine therapies, making it appear to be legitimate and evidence-based. While it can be hard to say no to a therapy, if the therapist is pushing the purchase of the items related to AIT, then parents should strongly consider opting out. With little to no evidence that this works and with the AAP’s recommendation that based on the science at hand it not be used, parents might want to think very carefully before pursuing this option.

The reality is that the therapy is in use by therapists, and parents are exposed to these kinds of therapies without ever being informed of the legitimacy or the quality of the evidence for the treatments. It's not just auditory integrative training or facilitated communication. It's sensory integration training and rapid prompting method, and so on. Not all of these can cause harm, but at best they are wild goose chases, and drains of income and time. Parents are in a no-win situation here, inundated with more and more information, with new therapies, with hopes, dreams, and promises.

In the end, parents must make the best decisions they can with the information they can find. With far too many treatments and therapies just a google search away, the demands on parents to make informed, practical decisions for their children is a daunting task.

Sources
American Academy of Pediatrics (2010). Auditory integration training and facilitated communication for autism policy statement. Retrieved July 8, 2011 at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;102/2/431.

Sinha, Y., Silove, N., Wheeler, D., & Williams, K. (2006). Auditory integration training and other sound therapies for autism spectrum disorders: A systematic review. Archives of Disease in Childhood, 91, 1018-1022. http://adc.bmj.com/content/91/12/1018.full.pdf