 |
January 2011 |
MESSAGE: OAR! A Little Bit Louder NowBy Jim Sack, OAR Chairman
Most people my age remember well the classic oldie, Shout, recorded first by the Isley Brothers in 1959. In the song, the singer tells his girl how good she is for him, so good that it makes him want to shout. As the song nears its end, he starts a refrain “a little bit softer now,” repeating it several times, each time more softly, until he’s almost whispering. Then he brings it back up switching to “A little bit louder now” rising literally to a shout by the end. What does rock and roll history have to do with OAR, you might well ask. Last month, Lori Lapin Jones, our new vice chairwoman, wrote an excellent piece that answered the question, “What does OAR do?” She ended it by saying: “As OAR enters its tenth year, we proudly look back on our accomplishments and contributions, we dedicate our focus on the present, and we enthusiastically plan for even greater work in the future. And we do so quietly!” Like Lori, I appreciate OAR’s selfless approach to everything it does. OAR acts out of purpose, not promotion. But perhaps we go about things too quietly? In that vein, one of my foremost goals in 2011 is for OAR to make more meaningful and louder noise. Or, following the Isley Brothers’ lead, it’s time for OAR to get “a little bit louder now.” Let me explain. First, let me assure you that none of OAR’s hallmark traits and work ethic will change. Our staff, Board and Scientific Council will continue to roll up their sleeves and keep chopping wood, as the saying goes, each day. Take care of the details. Strive for excellence. People first. What I do expect to change, however, is OAR’s reach in its delivery of quality resources to the autism community. We’ll do that by creating “noise” in four significant ways: Push information and resources to the community. Lori said last month OAR “publishes topical guides for families.” We do that and more. Too many of those guides, however, sit idly in the warehouse, mainly due to OAR’s lack of reach. That is where our new director of programs and community outreach, Allison Gilmour comes in. Her mission in life is to get OAR’s resources into the hands of those who can use them, and she has the green light to open up the warehouse to do that. To that end, she has already put more resource guides in the hands of consumers in four months than we did in the previous year. Now that’s noise, a little bit louder. Take our conference on the road and build partnerships. After our conference last October, we did some hard analysis and reflection. We fielded another great line up of speakers thanks to Peter Gerhardt’s efforts, and the conference again earned high marks from all who attended. But only 200 people attended, getting premier education and information at a cost of more than $50,000 and countless hours in planning and preparation by OAR’s staff. Instead of holding our own conference, we are offering to support other autism conferences with an “OAR Research/Research to Practice” track consistent with the host organization’s theme and focus. We have just agreed in concept to partner first with Milestones in Cleveland, Ohio, for its June 21 conference , then with Autism New Jersey for its conference on October 13-14 in Atlantic City, NJ. Through these initial trials of the road model, OAR will have successfully provided its educational value to six times as many people at 40 percent of the cost. That’s bang for the buck both ways. A little bit louder now. Reevaluate and re-tool the information program. With the advent and popularity of Facebook, Twitter, and whatever will come next, we are re-evaluating our information program, which has been largely built around this monthly e-newsletter and the Web site. Already both our RUN FOR AUTISM and research and programs staff are tweeting and adapting social media to OAR’s communication strategy and mission daily. In 2011, look for that to increase, expect to see a major change to The OARacle, and watch as we transform the Web site in the course of the year, making the wealth of information there more readily accessible. The end result is that we will deliver evidence-based information to more and more families than ever before. A little bit louder now. Launch a major new project. For years, dating back to OAR’s beginning, we have envisioned undertaking a major demonstration project, a collaborative effort between OAR and other interested organizations or agencies that that would address a quality-of-life issue in a substantive and practical way. We are examining ideas that revolve around adults with autism: housing, employment, and supports for living as independently as they are able. We are past the envisioning stage. Now it’s time to act. At our next meeting of the Board of Directors, we will introduce a two-year project plan and budget of $100,000 to launch the first initiative. Before that, we will be soliciting recommendations on the focus of this first project from the Scientific Council and members of OAR’s Board. I expect that OAR will make a major announcement about this by April. A little bit louder now! In sum, our tenth year is going to be one of continuing change with an emphasis on delivering information and resources to parents, teachers, and the autism community in ways and on a scale that OAR has not done before. While we will do our work quietly in the manner Lori Lapin Jones described, the quality of that work will speak, perhaps even shout, ever more loudly that OAR is truly coming into its own as a force of good with respect to research, practice, high quality information, and quality of life for those on the autism spectrum and their families. Shout. A little bit louder now! OAR NewsResearch and Scholarship Applications Go Online 2011 opens with a new first for OAR. OAR has created an online application system for its Applied Research Grant, Graduate Research Grant, and Schwallie Family Scholarship programs. This new system creates an easier and more convenient process for applicants, streamlines the process for reviewers and OAR staff, and is more environmentally friendly. Applicants for all three competitions can fill out forms on OAR’s Web site and upload all supporting documents. After signing up by entering an e-mail address and creating a password, users can complete the application at their own pace. Partially completed applications can be saved and accessed at a later date, up to the deadline. Once finished, users submit their applications and will receive prompt confirmation. Here’s a quick recap of the three programs: Graduate Research Competition - Due March 4, 2011 Applied Research Competition – Pre-proposals due April 1, 2011 Schwallie Family Scholarship - Due April 29, 2011
For more information, visit www.researchautism.org/news/otherevents/scholarship.asp.
Join Us at the Casino for Fun and Fundraising Please join OAR staff and friends for a Casino Night Benefit for OAR on Saturday, February 26 at the home of Theresa and Christopher Waddell in Arlington, Va. This is the second year the Waddells have opened their doors to bring together members of the autism community for a night of stress-free fun and games. The Waddells have two children on the autism spectrum and have been active with OAR, ASA-Northern Virginia and the autism community for years. Together, they have competed in RUN FOR AUTISM events from the 10K to the marathon, in Philadelphia, San Antonio, New York City, and Washington, DC. All gaming is for fun only, but there will be a 50/50 raffle as well as live and silent auctions. Champagne and desserts will be served. Contributions of any amount will be accepted at the door. Please RSVP to Allison Gilmour at 703-243-9762 or agilmour@researchautism.org by February 23. In order to make this event an even bigger success than last year, OAR is looking for in-kind donations to offer as auction items as well as “experienced” volunteers to be blackjack, roulette, and craps dealers. If you or anyone you know are interested in helping, please contact agilmour@researchautism.org. Read the details at www.researchautism.org/news/otherevents/CasinoNight.asp
December always seems to bring in one or more special donations. Some earn that distinction for the dollar amount of the gift, others by the story or sentiment behind the contribution. OAR received one in the latter category a few weeks ago from 8-year old Logan, who lives in Abilene, Texas. Logan’s handwritten note and his generous donation of five quarters makes his gift one of the truly most memorable in OAR’s nine years. “I would like to help the kids with Autism,” he wrote. “This is $ one and twenty-five ¢. Love, Logan” His mother or father wrote on the envelope, “Logan is 8 years old and wanted to help.” Logan, you have helped more than you will know! The spirit of your heartfelt and generous gift will be with us throughout the year as we too work to “help the kids with autism.” Since Logan did not include his last name, this stands for posterity simply as Logan’s Gift. OAR hopes that the word of this public sharing of his generosity will somehow find its way to Logan where he lives in Abilene. Well done, and thank you, Logan.
OAR is currently accepting applications for participants in the summer 2011 internship program and welcomes interest from undergraduate students seeking to apply academic experience in a real-world setting all while helping a good cause. Participants will gain work experience in a nonprofit organization and learn about autism and autism research in the process. This year’s interns will work on a variety of projects, including the writing of a new Life Journey through Autism guidebook, adding resources to the Operation Autism Web site, managing social media, writing research summaries, and supporting the planning and fundraising efforts of the RUN FOR AUTISM. To learn more about internships and the application process please visit www.researchautism.org/about/internships/index.asp.
The RUN FOR AUTISM is also sharing their news and stories. Follow @RUN_for_AUTISM and like www.facebook.com/runforautism to stay in the know. We can’t wait to hear from you!
As OAR expands its outreach and delivery of resources in 2011, it is seeking to expand its list of authors and contributors to The OARacle by building a bank of people who would like to submit articles for publication. OAR invites people with autism, parents or siblings of people with autism, clinicians, and educators to submit first person or “how to” articles (750 words or less) related to autism, research, or research to practice. If interested, contact Alyssa Kruszyna at 703-243-9717 or akruszyna@researchautism.org. News from the RUN FOR AUTISMOAR Launches Early Registration for Fall Races Join OAR and its RUN FOR AUTISM for OAR’s landmark fall events—the Bank of America Chicago Marathon on October 9 and the Marine Corps Marathon on October 30. OAR is excited to share the opportunity to register for these sell-out races before official registration opens. The Chicago Marathon is the pinnacle of achievement for elite athletes and everyday runners alike. Runners take to the streets of the Windy City and wind through beautiful, historic, lively neighborhoods. RUN FOR AUTISM participants will experience a first-class race and a first-class weekend. OAR treats its team to a Runners’ Recognition Dinner at Harry Caray’s and provides race day hospitality at its Charity Village tent. Join the RUN FOR AUTISM—Chicago team today; runners who purchase their race entry through OAR before February 14 or before the race sells out (whichever occurs first) will pay last year’s entry price of $135 and commit to a fundraising minimum of $600. Contact run@researchautism.org for more information. Just three weeks after Chicago, OAR’s RUN FOR AUTISM – Washington, DC team will be hitting the streets of our nation’s capitol in the 36th annual Marine Corps Marathon. Arguably one of the most inspiring marathon courses in the country, “The People’s Marathon” includes such highlights as the National Mall, Jefferson, Lincoln, FDR, Korean War and Vietnam Veterans memorials. The final stretch challenges runners with an incline that builds up to a patriotic finish in front of the Iwo Jima Memorial and a finishers chute lined with uniformed Marines. OORAH! OAR runners will enjoy a Runners’ Recognition Dinner the night before the race, as well as OAR’s customary Charity Village hospitality and finish line celebration on race day. Sign up for the RUN FOR AUTISM – Washington, DC team now; the first 20 registrants will receive half off their entry fee, bringing the cost down to only $45! Runners purchasing their entry through OAR will commit to a $600 fundraising minimum. Contact run@researchautism.org for the details.
OAR has officially partnered with the Rite Aid Cleveland Marathon for the Rite Aid Cleveland 5K Presented by OAR to be held Saturday, May 14, 2011, as part of the 34th annual Rite Aid Cleveland Marathon race weekend events. As presenting charity of the 5K race, OAR will have naming rights for two years, gaining publicity in front of thousands of runners for its cause and RUN FOR AUTISM program, and will be listed on the marathon's marketing and promotional materials. In addition to the duties as presenting charity, OAR has set three goals to accomplish in each of the next two years: bring the greater Cleveland autism community together around the Rite Aid Cleveland Marathon, raise $30,000 to fund a research study, and open the door to greater support and collaboration between area autism organizations. “We are very excited to be the presenting charity for the 2011 and 2012 Rite Aid Cleveland 5K," says OAR Executive Director Mike Maloney. "Having a team of 300 runners in a single race will be a new record for our RUN FOR AUTISM program. It's only fitting that we break our record in the city of Cleveland where we have enjoyed so much support and success." In 2008, OAR had 11 runners in The Rite Aid Cleveland Marathon and associated races, raising over $4,000. That number increased to 72 runners raising over $31,000 in 2009. In 2010, 99 runners raised just short of $30,000. The money raised in Cleveland the last three years amounted to funding for two OAR research grants. The force behind OAR’s fundraising success is a team named “Running for OAR by the Shore,” a group of over 50 people comprised mainly of Lear North Elementary School teachers, school district personnel, parents, and friends from North Ridgeville, Ohio, who came together in support of OAR. Through the team’s efforts in 2009 and 2010, the group raised more than $30,000 to support OAR research. In recognition of that effort, OAR has honored “Running for OAR by the Shore” by designating the group as the sponsor of a new 2011 research study that began this month. After selecting the research study, Jessica Barwacz, team captain and 1st grade intervention specialist at Lear North Elementary, said, “It was such an incredible experience for us all to put in the countless hours to raise the money for OAR, and now we actually get to choose how we want to spend it! Thank you so much for this chance to really make a difference in the world of autism!
The events take place May 14 and 15, 2011. To register for any of the events or learn more, visit www.clevelandmarathon.com. To register for the RUN FOR AUTISM - Cleveland team, visit www.active.com/donate/runforautism11. News from the Autism CommunityAutism NOW Opens a National Resource and Information Center The Arc’s Autism NOW: The National Autism Resource and Information Center celebrated its opening on January 18. The Autism NOW Center has exciting goals to become a central location for information about autism. This project, funded by a $1.87 million grant from the Administration on Developmental Disabilities, will work with self-advocates and families to foster a community environment to provide resources about community-based services and evidence-based interventions. To create this new resource, The ARC partnered with Autism Society, the Autistic Self Advocacy Network, Self Advocates Becoming Empowered, and many other professional groups in the autism community. The center plans to use Regional Autism NOW Summits to promote the understanding and use of evidence-based research and best practices. Autism NOW has already begun a series of webinars to teach members of the community about other organizations. OAR is excited to present a webinar on February 1st at 2:00 p.m., EST. This brief overview of OAR goals, research, and projects will be followed by questions and answers. OAR looks forward to helping this new member of the autism community reach its goals. PerspectivesIt’s All about Resources and Research: Reflections from the OAR “Family”
With a background in special education, Allison Gilmour, director of programs and community outreach at OAR, understands the value OAR offers to the autism community. “OAR has so many wonderful resources for parents and educators that I want the community to know all about.” Gilmour taught high school students with autism and intellectual disabilities for three years in the Fairfax County, Va., public schools before coming to OAR. “As a former special education teacher, I know how little time professionals have to read about the newest research-based interventions. OAR gives people access to this information in easy to understand formats through The OARacle, Web site, and blog.” Through her work at OAR for the past six months, Gilmour has found a way to “combine my passion for research and supporting the autism community. I love being part of a group that helps get people resources and information. There is so much information and misinformation about autism out there; OAR teaches people how to figure out who to listen to.” For Gilmour, OAR’s greatest value lies in the people who support its mission. “They don’t take information at face value. They practice the skepticism that Dr. Zane wrote about in the November issue of The OARacle. They encourage us to think about why research is important. They are also some of the most dedicated parents, grandparents, and professionals. I love hearing everyone’s story- it encourages me to work even harder to get research-based materials to people.” Research 2011As a result of the 2010 Applied Research Grant competition, OAR approved seven new research studies for funding in 2011 for a total of $210,000. In each issue of The OARacle, OAR will provide a summary of one of these studies. This month features the study sponsored by “Running for OAR by the Shore,” a RUN team of the staff, parents, family, and friends of Lear North Elementary School in North Ridgeville, OH. Read more about their efforts in this month’s RUN FOR AUTISM News. Study: Outcomes of a Community Center-Based Program for Toddlers with Autism Spectrum Researchers: Sam Odom, Ph.D., director, Frank Porter Graham Child Development Institute and Connie Wong, Ph.D., postdoctoral research fellow, Frank Porter Graham Child Development Institute Purpose: To objectively evaluate a current center-based model of intervention so that families and professionals have access to practical information to make more fully informed choices in the education of young children with autism spectrum disorders (ASD). Why Is This Study Needed? This study will look at the effects of center-based interventions for toddlers with ASD. The first goal is to compare outcomes of young children with ASD who attended an existing, comprehensive 20 hour/week, center-based toddler program to other young children with ASD in the same community who did not attend the program by examining program and school records. The second goal is to explore child and family characteristics along with intervention approaches affecting optimal outcomes. The third and final aim is to examine family perceptions on their satisfaction with early intervention services received, reasons for selecting specific early intervention programs, and perspectives on home-based and/or center-based intervention programs for toddlers with ASD by collecting data from a survey and through semi-structured interviews with families. The results from the study will provide practical information to families in making educated treatment decisions for their toddlers recently diagnosed with ASD as well as to service providers in offering treatment recommendations related to center-based versus home-based programs and guiding intervention practices for individual children and families. Study Methodology In Brief Using records from the center, researchers will analyze and compare the developmental progress of children at the center compared to children who did not attend a center-based program. The second part of the study will be a survey of parents of participants in Phase 1. Researchers hope to survey at least 70 families, equally divided between those whose children did attend the center’s program and those who did not attend a center-based program. The survey will ask questions about the child’s program and services to date and the parents’ reasons for selecting the specific early intervention programs and why they chose center- or home-based programs for their child, in addition to obtaining demographic information. For Phase 3 of the study, the research team will conduct interviews with 30 to 40 families, again equally split, to get more in-depth information on parents’ decision on what intervention programs and services they chose and why and the results of those decisions. Research Team Before coming to FPG, Dr. Connie Wong was an assistant professor of early childhood special education in the Department of Teacher Education at Cleveland State University and was the principal investigator of an Autism Speaks-funded intervention project targeting the facilitation of joint attention and symbolic play in young children with ASD through classroom teachers. Furthermore, she travels regularly to California from FPG and collaborates regularly with Mr. Akstinas and several of the Orange County (Calif.) Department of Education school systems. Mr. Mark Akstinas is a school psychologist at the Interagency Assessment Centers (IAC) who facilitates the transition meetings to the IAC program as well as out to the preschool services with the various local school districts. He also presented the preliminary study of the IAC child outcomes with Dr. Wong at the International Meeting for Autism Research. Research Reviewby Allison Gilmour, Director, Programs and Community OutreachParents as Play Date Facilitators for Preschoolers With Autism Playing is not just fun for kids; it’s an important part of early development. As children mature, they progress from playing alone, to playing beside others, to actually interacting and playing with peers. Many children with autism, however, do not make the same progression or make it more slowly. They may line up toys or perform repetitive actions rather than play with toys in the ways typically developing children do. Many children with autism prefer to play alone and do not progress to actual interactive play. Research has shown that children with autism can learn to participate in reciprocal play through the use of interventions. These interventions that teach children how to play usually take place in therapy settings under the guidance of professionals. In “Parents as Play Date Facilitators for Preschoolers With Autism,” Stephanie Jull, MA, BCBA, and Pat Mirenda, PhD, BCBA, examined the usefulness of parents directing play dates to increase reciprocal play skills. Parents administering interventions in the home with their child’s peer has more social validity than skills taught in a therapy setting. Researchers trained two mothers to use previously studied strategies to facilitate successful play dates in their young children with autism. Play interactions were taped so that the parents could be rated on use of facilitating strategies while the children were rated on amount of time they participated in reciprocal interaction with peers. Reciprocal interaction consisted of eye contact, language exchange, and children playing with an object or toy together. These strategies were taught to the parents:
Why I RunTurning Obstacles into Opportunity When Sandy Shaw started her training to run the 2011 Houston Marathon, which took place on January 30, she didn’t have a reason to run beyond wanting to get fit. Now, she not only has a reason (actually, two reasons), she also has a fundraising campaign and a blazing determination not only to run but to share the reasons she is running with as many people as she can. Shaw, who lives in Houston and works as an accountant for BP, had already begun her training when she hit her first roadblock: she did not get a marathon entry through the lottery. That didn’t deter her for long. Shaw discovered that the Houston Marathon has a program called “Run for a Reason” that allows runners to choose a charity, fundraise, and gain entry into the marathon that way. “As soon as I saw the Organization for Autism Research on the list, I knew that was the charity I wanted to raise money for.” A go-getter, she decided to set the fundraising bar a bit higher than the minimum of $1,000 by trying to raise $1,500. As of the last week in January, Shaw had raised $4,545. Just the Right Cause Shaw is eager to get the word out about how easy it is to “run for a reason.” “I don’t think people understand how easy it is to raise money for a marathon charity,” she explains. “OAR requires only $1,000. I kept raising my goal because the contributions kept coming in.” She adds that the fact that she is raising money for research is very important to her. “I don’t think we know enough about autism, and I am thrilled that OAR’s mission is not only to do research that can help people with autism and their families live their lives but also that OAR does a great job of educating people about autism.” Learning about OAR and autism has turned Shaw into an advocate and educator. “I included information and links to information about autism on my fundraising page.” Reasons to Run Shaw has already put their names on the back of her OAR singlet so everyone on race day will know why she is running. “They keep me going during the long training runs.” Obstacle? Or Opportunity? Now, thanks to bad luck with the lottery, Shaw has found a cause she believes in, great reasons to run, and a commitment to keep coming back. “I’m committed to running the marathon again in 2012 and supporting OAR.” ProfileOhio Center Educates Preschoolers while Doing Research to Improve Education and Intervention Since 1980, the Family Child Learning Center, a program of Akron Children’s Hospital, has been providing services to Ohio families who have children with disabilities, including those who have been diagnosed with autism. Abbie Wheeden McCauley, Ph.D., who is the director of the Integrated Research Preschool at the Family Child Learning Center, describes the center as a “teaching, research, and intervention facility for children from birth to the age of five who have been diagnosed with a developmental delay or disorder and their families.” The center also provides regional services for infants and toddlers with hearing loss and their families. For Children with Autism and Their Families The Integrated Research Preschool for Children with Autism Spectrum Disorders, which has been in operation since 2006, provides classroom- and home-based services to children ages 3 to 5. “The children attend four half days a week and we also do home-based visits with parents or other caretakers to provide them intervention strategies they can use in their homes Both are critical components of the program, Dr. McCauley emphasizes. “We can be the best teachers and therapists in the classroom, but unless parents are involved in their child’s intervention process, we won’t see the expected developmental gains in the children. Parents are their child’s most powerful teachers. The majority of children stay at FCLC for two years and then transition into either a third year of preschool or kindergarten at their local schools (depending upon where their birthday falls) and most of them are placed in a regular classroom.” “Integrated” is a key part of the preschool’s name because the two classrooms, one for younger children and one for older, each have five children with an autism diagnosis and five typically developing children. The typically developing children attend two days a week. The program benefits from the center’s training program for graduate students. “Undergraduate and graduate students from area universities work with the children in the preschool, alongside our teachers and therapists. That gives us a ratio of one adult to one child on the days when the children with an autism diagnosis are in the classrooms by themselves and a ratio of one adult to two kids when the typically developing children are in school.” Not only does this ratio provide our preschoolers with individualized programming, but our training students receive top-notch clinical supervision and gain skills crucial for their future work as teachers and interventionists, she notes. The preschool is free to families in Ohio. “It’s funded through a state autism scholarship program, Akron Children’s Hospital and some grants,” Dr. McCauley explains. Research at School This is the first year of the study but McCauley says they have plans to use LENA “through a second year as well, as we are interested in following children longitudinally.” The goal, she explains, is to use the language samples to see how the program improves children’s language, examine differences in the communication of children with autism when typically developing peers are present, and also to get an idea of how communication is used in the homes. In another study, the researchers are using a Q Sensor, which records skin conductance as a function of children’s sympathetic nervous system. “The Q Sensor is worn on the wrist or the ankle. It looks like a wristband,” McCauley explains. “It records electrodermal activity, which is an indicator of sympathetic nervous system activity. It also records temperature and movement.” The Q sensor may help address questions such as children’s response to different methodologies as well as different types of activities and requests used in the classroom. A third study is looking at peer-mediated intervention as an agent of change. “We’re looking at how best to teach the typically developing children the skills and strategies to influence the children diagnosed with autism through increased interactions.” McCauley says that the center hopes to publish the first-year results of the LENA and Q Sensor studies sometime late in 2011. Science, Fads, and Behavior Analysisby Thomas Zane, Ph.D., BCBA-DHow Science and Evidence Won Out against Auditory Integration Therapies
Autism is known as a “fad magnet” because of the plethora of treatments available to treat the condition (Jacobson, Foxx, & Mulick, 2005). Because of the varying levels of believability and evidence supporting many of these treatments, there is a need to be skeptical about any particular autism intervention until some minimal level of quality evidence exists showing that the particular treatment has demonstrated positive results. Most professionals adhere to the methods of science and scientific inquiry as the standards against which the quality of treatment evidence is judged. Ideally, by universally adhering to common criteria for acceptable empirical evidence, professionals across disciplines would study a phenomenon and all arrive at the same conclusion as to its “truthfulness” or veracity. A conclusion about, say, the efficacy of an autism treatment would be that much more powerful given the adherence to the scientific method by professionals from varying disciplines all examining the same treatment from different perspectives. Auditory Integration Therapy Researchers have reported that persons with autism spectrum disorders (ASD) show higher incidences of sensory processing difficulties than the general population (e.g., Baranek, Foster, & Berkson, 1997; Gillberg, et al., 1990). Some of these sensory problems consist of abnormal responses to auditory stimuli, which could translate into learning and behavioral challenges (e.g., Dahlgren & Gillbert, 1989). As a result, Berard (1993) and others have proposed a therapeutic approach aimed at reducing or eliminating auditory sensory processing challenges. Berard, a French otolaryngolosit, developed the method in 1982 (Berard, 1993). Although there are variations within the field of auditory integration therapies (e.g., Samonas, 2010; Tomatis, 2010), the general method consists of the recipient listening to music that has been digitally modified in some way. The music is often played through headphones, with multiple sessions across several days (e.g., Dawson & Watling, 2000). The music is altered in some fashion, such as by dampening or limiting the peak frequencies, randomly varying the high and low frequencies on a random basis, or varying the volume. How it is modified depends upon the needs and challenges of the recipient. The advocates of AIT claim that there is scientific evidence to support this therapeutic approach. Indeed, all of the websites devoted to AIT have references to research studies that purportedly confirm that AIT is causally related to improvements of behavior and learning. For example, at the AIT Institute (2010) website, there can be found a list of 23 research studies that purportedly support the effectiveness of AIT. One of the first public criticisms of AIT was provided by the American Academy of Pediatrics (AAP; 1998), which published a policy statement regarding AIT and Facilitated Communication. In unambiguous terms, AAP found that AIT had little to no quality research proving it was effective with persons with ASD. AAP concluded that its use was “not warranted.” Two years later, Dawson and Watling (2000) reviewed the literature that existed at that time. They reviewed five studies, published between 1994 and 1997. Three of the five included a control condition. Two of these three studies found improvement in participants in both of the conditions, thus no causal relationship between AIT and improvement in participants could be believed. One study (Rimland & Edelson, 1994) found improvements made by only the participants in the AIT condition, but there was a design problem in which the researchers didn’t do matching of subjects during pre-intervention. Then, in 2003, the American Speech-Language-Hearing Association (2003) weighed in on the controversy. After reviewing the existing literature published on AIT, this organization adopted a policy statement stating that there was no evidence that AIT improves the behavior of persons who use this treatment. Furthermore, the policy suggests that an ASHA member could be found in violation of the Code of Ethics if that member chose to treat an individual with AIT. The evaluation of AIT continued. Mudford and Cullen (2005) conducted a thorough review of both the conceptual underpinnings of AIT, as well as the research existing up to that date. They concluded that both the philosophy and logic of AIT was weak, and that the research base was both thin and poorly designed, with no obvious causal relationship proven between AIT and any improvement in participants. The most recent review of the AIT group of therapies was conducted by Sinha, Silove, Wheeler, and Williams (2006). These authors limited their search of the research to studies that used randomized controlled trials (recognized as the preferred experimental design when testing treatment efficacy; e.g., Chambless & Hollon, 1998) that included persons diagnosed with ASD. They discovered a total of six studies that met their inclusion criteria. Of these six, the authors of three studies reported no benefit of AIT over the control conditions. The three other studies showed improvement as defined by changing scores of the Aberrant Behaviour Checklist. However, this particular checklist has questionable validity, so the strength of this positive finding is in question. Sinha and colleagues concluded that there was, at that time, no evidence sufficiently powerful to support the belief that AIT was empirically proven to be effective. Also in 2006, the AAP once again reviewed the existing literature and reexamined its policy statement concerning AIT. And once again, the organization found the research base lacking and confirmed its initial policy against recommending AIT be used. AAP updated its policy a second time in 2010 and left it unchanged. Even some proponents of AIT recognize the limitations of the research base. After each study listed at the AIT Institute website (2010), a comment from the Institute critiquing the strengths and weaknesses is posted. Of the 23 studies listed, only one study suggested any positive findings of AIT using an acceptable research design. The remaining 22 studies were considered problematic due to a variety of potential methodological problems, such as small number of subjects, no control group, or the use of unreliable survey data (AIT Institute, 2010). Conclusion In the case of AIT, there is no empirical base demonstrating efficacy. This conclusion is made even more compelling by the process that was used. Over a period of 12 years, investigators from around the world and different disciplines read the extant literature and evaluated that research against criteria exemplified by good science -- use of quality experimental design, operational definition of important terms, adequate reliability and validity, and replication of results. These independent researchers arrived at the same conclusion again and again, finding no compelling evidence that the use of AIT results in any significant improvement of the recipient. Furthermore, organizations (ASHA; AAP) that had professional interests in this therapeutic strategy independently studied the research existing on AIT and, finding it weak, issued formal policy statements explaining to its constituents how the evidence supporting AIT was not compelling and should not be considered an effective therapy. There are still some who continue to use AIT. Green, Pituch, Itchon, Choi, O’Reilly, and Sigafoos (2006) conducted an Internet survey of parents of children with ASD, to learn what treatments exist and which ones parents admit using. The authors categorized the treatments by type, such as medications, educational/therapy, and alternative therapies. The results showed that almost half of the respondents indicated they were using a “physiological”–based treatment, which included specific treatments such as sensory integration, conductive education, and auditory integration (AIT). AIT was the third-most cited treatment in this particular category. Despite continuing use, AIT presents an interesting example of how, by adhering to the methods of science and understanding the definition of quality evidence, the professional communities can speak with one voice about a particular treatment in question. There are many other therapies currently being used for which we could apply the same standards of evidence. Hopefully, this will be done so that, in the future, consumers will be able to select from a menu of treatments that all have an empirical basis of support. References AIT Institute (2010). Reviews of 28 clinical studies on AIT – Auditory Integration Training (Berard AIT). Retrieved September 20, 2010 at www.aitinstitute.org/ait_clinical_studies.htm. American Academy of Pediatrics (2010). Auditory integration training and facilitated communication for autism policy statement. Retrieved September 20, 2010 at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;102/2/431. American Speech-Language-Hearing Association (2003). ASHA adopts AIT policy. Retrieved September 20, 2010 at www.asha.org/Publications/leader/2003/030805/030805c.htm. Baranek, G. T., Foster, L. G., & Berkson, G. (1997). Sensory defensiveness in persons with developmental disabilities. Occupational Therapy Journal of Research, 17, 173-185. Berard, G. (1993). Hearing equals behaviour. New Canaan, CT: Keats Publishing. Chambless, D. L., & Hollon, S. D. (1998). Defining empirically supported therapies. Journal of Consulting and Clinical Psychology, 66(1), 7-18. Dahlgren, S. P., & Gillberg, C. (1989). Symptoms in the first two years of life: A preliminary population study of infantile autism. European Archives of Psychiatry and Neurological Sciences, 238, 169-174. Dawson, G., & Watling, R. (2000). Interventions to facilitate auditory, visual, and motor integration in autism: A review of the evidence. Journal of Autism and Developmental Disorders, 30, (5), 415-421. Gillberg, C., Ehlers, S., Schaumann, H., Jakobsson, G., Dahlgren, S. O., Lindblom, R., Bagenholm, A., Tjuus, T., & Blinder, E. (1990). Autism under age 3 years: A clinical study of 28 cases referred for autistic symptoms in infancy. Journal of Child Psychology and Psychiatry, 31, 921-934. Green, V. A., Pituch, K. A., Itchon, J., Choi, A., O’Reilly M., & Sigafoos, J. (2006). Internet survey of treatments used by parents of children with autism. Research in Developmental Disabilities, 27, 70-84. Jacobson, J. W., Foxx, R. M., & Mulick, J. A. (2005). Controversial therapies for developmental disabilities: Fad, fashion, and science in professional practice. Lawrence Erlbaum Associates, Inc.: Mahwah, New Jersey. Mudford, O. C., & Cullen, C. (2005). Auditory integration training: A critical review. In J.W. Jacobson, R. M. Foxx, & J. A. Mulick (Eds.), Controversial therapies for developmental disabilities: Fad, fashion, and science in professional practice. Lawrence Erlbaum Associates, Inc.: Mahwah, New Jersey. Rimland, B., & Edelson, S. E. (1995). Brief report: A pilot study of auditory integration training in autism. Journal of Autism and Developmental Disabilities, 25, 61-70. Samonos (2010). Retrieved September 20, 2010 at www.samonas.com/index.html 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 the Disabled Child, 91, 1018-1022. Tomatis (2010). Retrieved September 22, 2010 at www.tomatis.com/index.php?lang=2. |
|
Do you tweet, twit, or chirp? Do you keep in touch with the world through Facebook? Let OAR join the conversation! OAR is embracing social media with daily tweets and Facebook updates. 
You can help by following us at 
Dr. Thomas Zane is a professor of education and director of the Applied Behavior Analysis Online Program at the Van Loan Graduate School of Endicott College. He is a licensed psychologist in New York and Massachusetts. Dr. Zane has published in various journals and books, presented at regional, national, and international conferences, and been an invited lecturer in Ireland and the Republic of China. His research interests include teacher training, staff development, and evidenced-based practice in autism. As part of his duties at Endicott College, he offers a BCBA certificate program through distance learning. 