Auditory integration training for autism: does sound therapy help?

In one sentence

This Cochrane review found no evidence that auditory integration training or similar filtered-music sound therapies are effective treatments for autism spectrum disorder.

What the researchers did

Auditory integration training (AIT) was developed for people with unusual sound sensitivity and behavioural difficulties, including autism. Related approaches include the Tomatis Method and Samonas Sound Therapy. Sessions typically involve listening to music that has been filtered or modulated in specific ways.

The reviewers searched databases through September 2010 and updated the review with one additional study. They included randomised controlled trials in children or adults with ASD comparing AIT or similar sound therapy with no treatment, a wait list, usual therapy, or a placebo-like control.

They identified six trials of auditory integration training and one trial of Tomatis therapy, involving 182 people aged 3 to 39. Two studies used a crossover design. Five trials had fewer than 20 participants each. Allocation concealment was inadequate in all included studies, which increases the risk of biased results.

What they found

• Three trials reported no benefit of auditory integration training over control conditions.
• Three other trials reported improvements on behaviour checklists at about three months, but the reviewers questioned whether the outcome measures were used validly; in one of these studies the result was not statistically significant.
• Only two trials, involving 35 participants total and sharing an author, reported statistically significant improvements — and only on specific checklist scores, not on a broad range of outcomes.
• The Tomatis trial described language changes but no clear difference between treatment and control on behavioural measures used in the AIT studies.
• Studies used about 20 different outcome measures, so combining results in a meta-analysis was not possible.
• The authors concluded there is currently no evidence to support using auditory integration training for ASD.

What this means for families and therapists

Some children are very sensitive to everyday sounds — sirens, hand dryers, crowded rooms — and families understandably look for therapies that promise to “retrain” hearing. This review suggests that filtered-music protocols marketed as AIT should not be expected to change core autism features based on current trial evidence.

Sensory accommodations (headphones, quieter environments, gradual exposure with consent) remain practical tools, but they are different from commercial AIT packages.

If you are offered an expensive sound-therapy program, ask what randomised evidence supports it for your child’s specific goals, and discuss costs and safety with your clinical team.

Limitations and what we don't know yet

The included trials were small, old, and methodologically weak. That makes “no evidence of benefit” more confident than “proof that nothing ever helps anyone,” but it still does not support clinical use.

Because outcomes were measured so differently across studies, a future well-designed trial could theoretically show benefit for a narrowly defined group — but that has not yet been demonstrated.

The review does not replace individual audiology assessment when a child has hearing loss, ear pain, or medical ear conditions.

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This is a plain-language summary of Auditory integration training and other sound therapies for autism spectrum disorders (ASD) by Sinha Y, Silove N, Hayen A et al., Cochrane Database of Systematic Reviews (2011). Source license: CC-BY-NC-4.0.

It is not medical advice — talk to a qualified clinician before changing therapy.