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Auditory integration training and other sound therapies for autism spectrum disorders

  • Review
  • Intervention




Auditory integration therapy (AIT) was developed as a technique for improving abnormal sound sensitivity in individuals with behavioural disorders including autism. Other sound therapies bearing similarities to AIT include the Tomatis Method and Samonas Sound Therapy.


To determine the effectiveness of AIT or other methods of sound therapy in individuals with ASD.

Search strategy

For the initial review, we searched Cochrane Central Register of Controlled Trials (Cochrane Library Issue 2, 2003), MEDLINE (1966 to February 2002), EMBASE (1980 to February 2002), CINAHL (1982 to December 2001), PsycINFO (1887 to February 2002), ERIC (1965 to December 2001) and LILACS (1982 to March 2002) and reference lists of published papers. Searches were updated in June 2007; no new studies were found.

Selection criteria

Randomised controlled trials (RCTs) of adults or children with ASD. Treatment was auditory integration therapy (AIT) or other sound therapies involving listening to music modified by filtering and modulation. Control groups could be no treatment, waiting list, usual therapy or placebo equivalent. Outcomes sought were changes in core and associated features of ASD, auditory processing, quality of life and adverse events.

Data collection and analysis

All outcome data in included papers were continuous. Point estimates and standard errors were calculated from t-test scores and post intervention means. Meta-analysis was attempted but deemed inappropriate.

Main results

No trials assessing sound therapies other than AIT were found. Six RCTs of AIT, including one cross-over trial, were identified with a total of 171 individuals aged 3 to 39 years. Four trials had fewer than 20 participants. Allocation concealment was inadequate for all studies. Seventeen different outcome measures were used. Only two outcomes were used by three or more studies. Meta-analysis was not possible due to very high heterogeneity or presentation of data in unusable forms. Three studies (Bettison 1996; Zollweg 1997; Mudford 2000) did not demonstrate benefit of AIT over control conditions. Three trials (Veale 1993; Rimland 1995; Edelson 1999) reported improvements at three months for the AIT group based on improvements of total mean scores for the ABC, which is of questionable validity. Rimland 1995 also reported improvements at three months in the AIT group for ABC subgroup scores. No significant adverse effects of AIT were reported. Add

Authors' conclusions

More research is needed to inform parent, carer and practitioner decision making about this therapy for individuals with autism spectrum disorders.

Plain language summary

Auditory integration therapy for autism spectrum disorder

People with autistic spectrum disorders have difficulties with communication, behaviour and/or social interaction, and many also experience abnormal responses to sounds. The purpose of this review was to assess the evidence for the effectiveness of auditory integration therapy (AIT) and therapies like it, which have been developed to improve abnormal sound sensitivity in and autistic behaviours in such individuals. Six relatively small studies met the inclusion criteria for AIT. These largely measured different outcomes and reported mixed results. Suggestion of benefit in two outcomes requires corroboration by further research using well-designed trials with long-term follow-up.