Discussion For Professionals Concerning the Practice
of Berard Auditory Integration Training
Contact Us
Complete
On-line AIT Checklist
by Rosalie
Seymour, SLP/A, Berard AIT Practitioner
An editorial to all members of
the profession of speech, language and hearing pathology concerning the practice
of Auditory Integration Training - Berard AIT Method.
It has come to the attention of
worldwide Berard Auditory Integration Professionals that there are some misconceptions
about the nature, scope and proper place of this method of auditory training,
known as Berard
AIT. This letter is my attempt
to inform, in the interest of scientific inquiry, and also to ensure the
best welfare of those who could benefit from this method.
Since its arrival in South Africa, first in Cape Town,
and subsequently countrywide, this new form of listening skills training
enjoyed much interest, and has been discussed formally and informally
by members of the profession, speech therapists and audiologists alike.
Frequently for many professionals the first inkling of its existence has
come in the form of patients making enquiry about it, or reports of outcomes
of Auditory Integration Training
on children already in therapy.
Misinforming The Public About Auditory
Integration Training
There has, however, been an alarming trend within
the profession, according to reports by members of the public, and as
observed through the actions of the professional Associations for speech
and hearing, to be misinformed about AIT and indeed even to resist becoming informed,
and to blatantly misinform their patients and other members of the public
about AIT.
It is of course natural, if not laudable, behavior to
resist new developments. The “scientific” approach is all
too often interpreted as being equal to the “conservative”
approach, and it can easily happen that “scientists” will
resist change, even to the point of persecuting the agent of change.
Ours is one of the caring professions that strive to
maintain the highest standards in service provision to our clients. This
high standard must not only encompass the use of treatments that are proven
to be effective and do no harm, but we must also maintain a high standard
of professionalism and ethical behavior towards clients and colleagues
alike.
Tensions will be inevitable in the pursuit of this ideal.
For example, a therapist may be dedicated to “the Scientific Approach”,
but in practice may have to consider using an “unscientific”
intervention for the greatest benefit of a particular client. In such
a case, what should the ethically superior, professional choice be? Should
one remain with the less promising but “scientific” intervention,
or does one do that which holds the most promise of benefit to the client?
Scientific Evidence for Auditory Integration
Training
Fortunately, the majority of the members of this
profession would answer that the best interest of the client is paramount
- we must do what is effective, to the utmost of our power.
The
thorough professional understands that self-service, even service of the
“club” or “Association”, must never be placed
before service to the individual client:- to do this would be the sure
road to malpractice.
In any case, David Eddy, Professor of Health Policy and
Management at Duke University, USA, as reported in the British Medical
Journal of October 1991, pointed out that ”only about 15% of
medical interventions are supported by solid scientific evidence”.
While he encourages research to improve this situation, he does not advocate
that doctors stop providing those other “unscientific” interventions.
We, as members of this profession, are no better
off than the medical profession in the percentage portion of “scientific”
against “experientially useful” activities. In our practice
we do not advocate that these other interventions “should not be
done” simply because they are "non-scientific”!
But having said this, there are leaders and policy-makers
in our profession who have chosen to adopt this very attitude, that AIT ‘should not be done’ on the basis
that it is purportedly ‘unscientific’! This was my experience
in South Africa, where the chairperson of the professional board voiced
this opinion and forced various actions as a consequence, leaving the
question to be answered – why would AITbe singled out for this imbalanced treatment?
(refer to the statements in “Shoutt” and the Health Professions
Bulletin of South Africa, stating that only health professionals should
do AIT,
and that in the providing of this service they should not charge a fee,
since it is still “entirely investigational”.
Why the bias?
As Dr. Jane Madell, Audiologist and professor
of clinical otolaryngology in the USA, and contributing author
in “Clinical Audiology” asks: “Why should it
AIT be held up to different standards than other
clinical treatments?” She advocates continuing offering AIT as a clinical option, while continuing to collect
data - just as we do with all other current interventions. (ASHA, winter
1997).
Negative Rumors by ASHA About Auditory
Integration Training
However, we find our South Africa Association (SASLHA),
and Professional Board attempting to have us believe AIT merits some “special attention”.
Perhaps there is a genuine concern that it might cause harm? There is
a persistent rumor spread by many long-standing members of the profession
that AIT
can “damage” ones hearing, and they have stated to members
of the public that published research has proven this allegation!
Another rum our is that there is no research to support
the claims of benefit made by practitioners of AIT. It is even rumored that the research proves
that AIT
“does harm”, can cause epilepsy, even paranoia, and is extremely
painful!
Perhaps a quote from David Eddy will suffice in answer:
“Agreement of the experienced without evidence is a poor basis
for producing advice”. (Brit. Journal of Medicine, Oct 1991).
It would seem that there is a crushing lack of information
about the origin, claims of, and practice of Berard
AIT, and that the very people who could
be expected to know their facts are content to merely “form their
own opinion“ with a blithe disregard of the existence of these facts.
Dr. William Hay, quoted in A New Health Era, 1934, told
medical practitioners: “Facts have always discounted theory, and
always will; so get the facts for yourself and let others be satisfied
with unproven theory.”
There Are Many Scientific Studies About
AIT!
These
are the days of the information superhighway- information is so easily
accessible. Why the ignorance?
See 28 Critiques
of Scientific Studies on AIT by the Autism Research
Institute
There are facts about
AIT and there are rumors. There
are research results and case studies. Which should feed
the opinion of the professional? Is it really adequate that the position
statement concerning
AIT was drawn up without consultation and discussion with the
( then only) AITexpert in the country? Is it adequately professional to make “rulings”
concerning AIT
and its practice with no reference nor consultation with adequately informed
and trained parties? Surely the “scientifically-minded” professional
would answer “No!”
The “scientific method” requires
the observation of phenomena, collection of data, and the “publicly
observable events”. Should it not be asked why those very
people who want AIT crushed because it is “unscientific”, never once
visited the therapist who brought AIT into the country, to observe, investigate, question,
and otherwise inform themselves? What unusual “scientific”
behavior indeed!
It has by now become apparent to practitioners of Berard
AIT and also to its detractors, that the
attacks on this intervention has no factual basis. Nonetheless, experience
has shown that every vindication of Auditory
Integration Training only serves to inflame the vehemence of the attack
. As every objection is answered with fact, a new red herring is thrown
up. The letter printed in the Living and Loving of January 2000 was typical,
in which a speech therapist accused AIT practitioners of presenting it as “…a panacea for all ills…”
Let me here present a fact: No (South African)
Auditory Integration Training practitioner
has made such a claim. How odd of the professional therapist to have done
so in a public forum!
Berard Auditory Integration Training
(Berard Method) is an Absolutely Non-Medical Intervention
The American FDA has ruled that it has no jurisdiction
over it, as an educational or training issue.
Auditory
Integration Training is probably best understood
in the context of aerobics, passive exercise, massage, and such. Obviously
just as there are medical implications in physical exercise, in gym, even
in education, nobody would suggest that gym or education were medical
interventions!! Passive exercise can benefit the paralyzed as well as
the un-fit and flabby. So too, AIT can benefit a wide range of people, the functional
as well as the dysfunctional.
There are people with medical conditions
autism,
language disorder, Downs syndrome, etc. who also have poor listening
skills, and who could benefit from AIT. There are people in responsible jobs whose listening
skills could benefit from enhancement, and who seem to benefit from it
too. There are scholastic benefits possible, and wellness issues involved. But for all that, it is a common-domain
intervention. As with any such issue, the application needs special training
to properly perform it, but still it remains non-therapeutic in the medical
sense. AIT is an International entity, and in this arena
is held to be non-medical, and Dr.
Berard himself confirms its common-domain stature, and the International
Association of Berard Practitioners .
However, this does not mean that a therapist should be
barred from practicing it, after suitable training. After all in voice
therapy, techniques are used that are shared with other disciplines, medical
and also public speaking and singing:- who would suggest that a therapist
using these techniques should not charge a fee for her service? Should
a therapist also not charge for using the Auditory Discrimination in Depth
program, just because teachers also use it? or PECS, etc etc etc.
In stuttering therapy any number of techniques may be
selected by the speech therapist, some of which (relaxation techniques,
self-knowledge, re-scripting) are used by many others. Just because these
techniques are used by the therapist does not mean they are the sole domain
of the profession of speech therapy! And who would suggest that she should
not charge a fee for that portion of her time that the therapist uses
a “common domain” intervention? This has not been our practice
to-date - why are we being led to believe that we should single out AIT for such special consideration?
Did those who devised this statement really suppose
that they weren't clearly seen to be trying to “bury” Auditory
Integration Training? To what end? What could possibly be the motivation
in so strongly opposing this one out of any number of new auditory training
methods?
It is plain that certain actions by the Associations
and Professional Boards need examination, since they defy logic and explanation.
Perhaps it is time to call for accountability and transparency, in the
spirit of the climate in health care today. Above all we should call for
a re-evaluation of the actions of certain colleagues to determine IN TRUTH
whose interest was being served by these actions: the patient we have
in our care, or the agenda of vested self-interest that has no place in
the health professions, and certainly ought not to be elevated in our
midst.
| 
