We all have to be concerned with loud sounds these days, whether it's making sure our kids don't suffer from “iPoditis” or taking care not to destroy our own eardrums in the course of trying to do our jobs. But there is a group of people for whom even normal sounds — at least ones that sound normal to most of us — can be extremely harmful.
That's the crux of a theory developed by French physician Dr. Guy Bérard about autism. And people I know and respect in the audio industry are finding it to be correct — and profoundly helpful. Autism, a disorder affecting both children and adults in which the sufferer fails to respond to normal sensory stimuli or responds in highly distorted ways, has been diagnosed for centuries, but in recent years, it has apparently been showing up more frequently, particularly in highly developed areas of the world. A new survey by the Centers for Disease Control and Prevention shows that approximately one in 150 children born today in the U.S. will show symptoms of autism, while the incidence in Great Britain is reported to be even higher.
It's well-established that there is some genetic basis to the syndrome, and there are a number of theories about environmental factors that may contribute to the incidence of autism. Likewise, a variety of methods of treating autistic children have been tried over the years — particularly to help kids who are more severely withdrawn. Some of these experimental treatments have been pointless, expensive and cruel; others give cause for hope. According to Tom McGurk, an award-winning composer and one of the owners of legendary Seattle studio Bad Animals, an unusual therapy involving exposing autistic children to recorded music may be the key to helping many victims of the disorder.
Before I get into the story, though, let me point out two things that might be obvious: One, I'm not a neurologist or child therapist, but there are many excellent people in those fields and others working with autistic children. If you have a child who is showing signs of slow development or unresponsiveness, then please consult a professional right away. If there really is something wrong, the sooner you find out, the better the child's chances for improvement. Two, autism comprises a whole range of symptoms and syndromes, and while this particular therapy has been helpful in this case, different children will respond to it in different ways, or perhaps not at all. Again, professional guidance is crucial.
Tom and his wife, Danielle, are the parents of a 6-year-old autistic child, Connor. I've known Tom and Danielle for a long time — they were both students of mine nearly two decades ago. As a student, Tom was rambunctious, sarcastic, disruptive and very talented. He became a composer, sound designer and mixer for the smash PBS kids' show Bill Nye, The Science Guy. He and his team won seven Emmys and eventually bought the studio where they were working. Danielle — thoughtful, sensible and methodical as a student — is a product support engineer at Silicon Graphics, where she had been part of the now-defunct audio group.
They noticed when Connor was just out of infancy that he was different from other children his age. He was the last in his play group to roll over and sit up. He never pointed or made eye contact with anyone, he avoided other kids and he recoiled at loud noises. At 18 months, when he still wasn't talking, his parents knew something was wrong. He was diagnosed as being autistic, and they were urged to take early action.
So they researched the syndrome intensively. One treatment they pursued and have had success with is called “Applied Behavioral Analysis,” or ABA. “It teaches skills that typically developing children learn on their own,” says Tom. “The principle behind it is to break down complex skills into component skills, like how to imitate and read facial expressions, and both receptive and expressive language, and teach the skills so that they build on one another.
“It involves carefully charting and graphing what the child understands and what he doesn't,” he continues. “If you look at a chart of Connor's skill levels at the time, it would look like a city skyline. There are deep spikes in some areas that would just not be noticed in a classroom. So it's very focused, and there are specific programs in reading, math and printing — teaching through repetition. It is one of the few therapies that provides tangible data showing an individual's progress. It's sort of like having a really intense music tutor.”
But Tom and Danielle were interested in going further, supplementing ABA with at least one unconventional treatment each year. “I found a book, The Sound of Falling Snow, and one of the stories in it sounded just like Connor,” Tom remembers. The book was edited by Annabel Stehli, a writer and parent of an autistic girl. Stehli is an advocate of a theory developed by French otolaryngologist Bérard, who says that one of the causes of autism may be the way its sufferers respond to sound — that the sounds around them are simply overwhelming them.
“Connor always had stuff going on with sound,” says Tom. “There are two floating bridges near us, and when he was little, whenever we'd drive over them, he'd cover his ears. We have a friend who has a very quiet voice, and when he would visit, Connor took to him so much that he even sat in his lap. Before he talked, he used to make this noise, which one day I realized was a siren going by because we lived on a main road. So after that, every time I heard him make a weird noise, I knew he was imitating something. One of his teachers at school asked me if we had a Theremin because she said he was doing a really great imitation of a Theremin. And we did.
“When we did an audiogram on him, it was all over the place,” he continues. “There are anomalies between the two ears and within the ears themselves; it's not flat. One ear showed a spike and the other a drop at the same frequency. Well, if your ears are interpreting what they're hearing completely differently from each other, it's impossible to understand sounds. It affects language development because you can't get meaning or emotions. It's why some autistic kids go into a corner: They can control and localize everything they hear by turning their heads. Or some make a lot of noise: They're trying to balance out the sounds that are around them.
“Going through the audio training I did, I realized that if you don't get the sounds coming at the same time, it's horrible. Once you understand that environmental sound is having an impact on someone, you think, ‘If I were having these problems, it would drive me crazy, too.’ If you're in school and you can't follow directions because you can't understand them, they think it's emotional. And soon it becomes emotional: ‘This environment for me is driving me out of my mind; I have a huge spike right where fluorescent lights buzz — get me out of this room! I can't learn because all I hear is “bzzzz.” But they think I'm dumb.’
“When they rang the bell in church, he would cover his ears and shake his head, and people would think, ‘Hey, he's just a bad kid.’ I asked the therapist about the frequency band where a bell would appear, and she said he's got a huge spike right there. One time he told us he didn't want to go to school, but he loved school. So I started looking for causes, and it turns out there was a kid screaming on the bus, which was driving him nuts.
“Kids can't articulate what's wrong and so they become withdrawn,” he adds. “With some children, it's the stomach. Put them on a gluten-free diet and they get better. Once you try to see through his eyes, you realize he perceives things differently than we do. So you're trying to figure out what that perception is and somehow try to balance it out.”
Dr. Bérard has developed a technique for retraining children with these kinds of hearing issues; he calls it “Audio Integration Training,” or AIT. It comprises a number of 30-minute sessions, twice a day over 10 days, listening to specially recorded music CDs. “The practitioners don't talk much about the technology,” says Tom. “It's music with certain frequency bands and modulations, and you don't want to listen to it yourself. My interpretation of it is that it's retraining your ear to recognize what a level frequency response would be.”
According to Stehli's Website (www.georgianainstitute.org), “By means of audiometric testing using a standard audiometer, it can, in some cases, be determined at what frequencies a person has hyperacute and/or hypoacute hearing. If such an auditory test is possible, then one or two of the frequencies at which hearing is most acute may be filtered.” In other words, the CDs reflect the child's own hearing anomalies and allow him or her to hear music that is not bothersome. The underlying theory, which is still a long way from proven, is that somehow the brain — especially in a young child — compensates by physically reorganizing itself to be less sensitive to the missing frequencies.
“Of course, we were skeptical,” says Tom. “But we said, ‘We're going to do this and not tell any of his therapists, but just get empirical evaluations afterward and see if he's getting better.’ We wanted people who could evaluate the improvement, if there was any, without biases. The first training was when he had limited speech; the therapist got Connor's reactions from his facial expressions.”
AIT is not an easy thing for a child to get started on; initially, children can respond very badly, even violently. “At first, we had to hold the headphones on him,” says Tom, “and he acted like he had hot pokers in his eyes. But at the end of the week, he was falling asleep with the headphones on. They warned us that there would be negative changes in his behavior, too. After the second week, we saw this beast we had never seen.
“But then we started to see positive changes,” he continues. “It wasn't like this big Hollywood, ‘Mom, Dad, I love you!’ but incremental things, like all of a sudden he became interested in the family dog, whereas before he used to hate it when she'd bark. He understands his own behavior now. As he knows more, his other systems take over for them. He's able to tell me that the problem with those floating bridges was that when we drove over the diamond-plate, he was hearing subsonic stuff that we couldn't, and it bothered him.
“There are apparently inner-ear issues, as well. Putting him on an amusement park ride was like throwing him into hell. We couldn't figure out why. After therapy, about two-and-a-half weeks later, he's on every ride. And his therapist laughs and says, ‘What the heck did you do to this kid?’ Now he's skiing, and he's into speed and turns, and the instructor says, ‘Your kid's got great balance.’ Well, he didn't two years ago.
“His speech has improved incredibly. His IEP [Individualized Education Program — the format used in special-needs education] no longer involves academics; now he's above a grade in some areas like reading. Everything that remains is behavioral. I'm not saying that AIT alone did all this; I believe in a comprehensive program. But we can definitely point to this specific time as a big turning point and spike in his development. Big. The therapists who didn't know we had done this treatment all noticed the marked change at the time and commented on it.”
The recommendation of practitioners of AIT is that it should be done several times during childhood. “The body is changing, the brain is growing,” says Tom, “and they think we should do it every two years. The second time we did it, Connor was fine with it — he knew what was going to happen. It even works with older people. We've read about 40-year-olds who get treatment who say their lives have changed. But it's so important, as we were told, to get to them early. If you wait until they're 12 years old, there are all those layers of protection they've built up against the outside world. You have to strip away all that stuff and build it up again. With a kid who's 2 or 3, that hasn't happened yet.”
Connor's sensitivity to sound is now evolving into an appreciation for music. “I am amazed at the responses he has to specific pieces of music as they are playing,” says Tom. “They're all about the actual acoustic elements, as opposed to the thematic or musical elements. He responds to vocal parts, piano and instrumental music differently. Some makes him absolutely calm, some really jumpy. When we visited my family over the summer, my nephew was really into the Icelandic group Sigur Rós. They are an ambient/sound collage-type band, and that music really affected Connor in a positive sense — calming. He really does hear differently than the typical person, and it never ceases to amaze me. We've got a lot to learn about sound and how it affects the individual.”
Besides appreciation, there also appears to be a growing talent there. “We have a piano in the living room, and when he was mad at us, he would pound the low keys,” recalls Tom. “But later, at 3 or 4, he was doing scalar stuff, and I'd notice there was a tonal center to everything he played. It freaked me out.
“It's not a savant kind of thing, but he's musical. His teacher just told me, ‘I think your kid has perfect pitch. Everything that we sang in class, that kid was firing back perfectly.’ We went into Guitar Center, and he saw a drummer, so he sat down behind a kit and tried to imitate him. The drummer said, ‘Wow, you should get your kid a drum set.’”
Not surprisingly, Tom and Danielle have become vocal advocates for early intervention when it comes to dealing with autism. “If you put your money into these kids, they'll be in society,” says Tom. “They might be a little different, but if we help them along the way as they develop, they will be able to go to school and have productive lives. But if you don't, they say it could be a million bucks a person on the back side. How we choose to help these kids will have far-reaching effects in the next few decades, both societal and financial. Finding innovative treatments to enable the kids to learn is paramount, and we really don't have time to wait for the government to come rescue them. Many people are currently searching for the gene, the environmental effect, the triggers that cause autism, and that's great. But just as important is the education and therapy of the kids here now, and also educating the population in general as to how to interact with the ones living among us.”
And Tom sees a role for the audio industry in all of this: “Our industry has a profound effect on these kids in many, many facets of their lives. We have so many great people who could be involved and supplying the resources needed to assist and train the therapists, and to create the technologies needed to get therapies to a wider range of individuals for a more affordable price. In the future, there may be handheld devices a kid can use to help him focus and calm down using sound — as opposed to Ritalin. Imagine that!”
I think there are a lot of parents who would be pretty happy about that.
Paul Lehrman is the director of music technology at Tufts University. You can catch up on 11 years of his scribblings in The Insider Audio Bathroom Reader, published by Thomson Course PTR and available at