delivered to the World Organization Meeting of the
Institutes for the Achievement
of Human Potential. May 1994, by
William P. Mueller Vice Chairman of the Board
Transient Electronic Auditory
Institutes have known for forty years that certain brain-injuries cause hyperactive
auditory sensitivity. In the past twenty years others have also begun to study
this problem. I first beame aware of that condition when I met David, an eight
year old brain-injured child at The Institutes who had this problem. He screamed
at the slightest noise. In fact, he screamed eight hours a day. His parents whispered
all day to keep from setting him off. When they arrived at The Institutes he was
given the auditory stimulation program as part of his overall program. His parents
were instructed to bang pots and pans randomly around the house! David's mother
told me she laughed all the way home after that initial visit. However, they did
The Institute's auditory stimulation program and within two weeks David was no
longer hypersensitive to sound.
Posterior cortical mid brain-injured
children ( those children commonly labeled autistic) are known to have dramatic
auditory hypersensivity. Some report being able to hear water running in the pipes
underground and the beating of peoples' hearts. Others display obvious pain at
the slightest sound and cover their ears if someone touches their hair.
inside your ear canals with your fingers and you might get a small sampling of
the kind of sound that would be experienced when someone gently puts their hand
on the head of such a brain-injured child. If you do it while someone is trying
to speak to you you will find you are functionally deaf and unable to follow what
is being said..
About a year ago the Institutes received a machine called
an AudioKinetron. The AudioKinetron was designed by Guy Berrard to treat brain-injured
children using music as a kind of stimulus.
Parents have been reporting
positive changes occurring in their children after treatment with the AudioKinetron.
Some parents have observed a marked
decrease in their child's sensitive to sounds, decreased screaming , decreased
hyperactivity, less tendency to have temper tantrums, deeper, better quality sleeping,
increased attention, interest in their surroundings and improved language . Some
of the children have shown affection for their family and friends first time in
creators of the device believed that the machine exercised and trained the muscles
in the ear. "Earobics" they called it. Further they described sound
as "nerve food" or a source of energy for the body. They also ascribed
a kind of intelligence to the ear muscles.
changes in the children were undeniable and they were important changes. The children
themselves reported that the auditory stimulation helped them by making their
lives easier and more enjoyable. However, as we studied the device and the results
of treatment we began to formulated a completely different view on how and why
the machine worked.
Since brain-injury is in the brain not the ear we
knew that these children's problems were not in their ears any more than a mid
brain-injured child's problem is in his legs.
The study of psycho-acoustics
is helpful in defining the links between a healthy auditory pathway and the brain-injured
child's auditory pathway. Unlike the eyes which can be shut when looking into
the sun, the brain has limited mechanical ability to control over-modulation.
However, the brain does have the capability to affect and manipulate incoming
The brain has the ability to rest from auditory
stimulation simply by ignoring it. Children are especially capable of "zoning
out" when something they don't want to hear is being said. The brain also
has the ability to "normalize" auditory stimulation. When we first turn
on a transistor radio the sound is awful. No low frequencies, no high frequencies,
very low fidelity. But we quickly become "accustomed" to it and it no
longer sounds "bad" or "wrong".
ability is called the "Cocktail Party effect". Someone can be talking
to a person in a large crowd when suddenly another voice catches his attention.
If the new voice or subject is interesting enough, a person can tune out the person
in front of him who is producing the loudest acoustic wave form and focus on the
much softer auditory stimulation from across the room. This function is a filter,
but one of astonishing complexity. In order for a system (the brain) to be able
to filter out higher volume stimulus of a similar frequency to lower volume stimulus,
the system must be able to predict the behavior of both sets of stimulus simultaneously.
Speech pattern recognition is fundamental to this activity.
to digital encoding schemes used in digital audio systems are designed around
the brain's ability to "fill in the missing information" thereby allowing
the converter to throw away audio data and compress the bit stream. The smaller
bit stream allows more information to be stored in less disk space.
brain has the ability to normalize and remember acoustic environments. When a
person first enters a very loud room he is accosted by the sound, his adrenaline
levels rise and his ears hurt. But after a few minutes his hearing changes to
accommodate or "normalize" the environment. This is not so much his
tensor muscle tightening but his brain making sense of the noise in the room.
In fact the next time that person enters the room it will not be so uncomfortable.
Speech recognition will be easier and the sense of "loudness induced confusion"
will be less. My wife and I have three young boys and they can make a real racket
when they want to. Our last house had a large ambient kitchen. The boys were so
loud in it I wondered whether I could even live in the house. Within a couple
of weeks the room didn't bother me at all. The blind singer Stevie Wonder is reported
to have a legendary ability to snap his fingers when first entering a room and
from the echoes learn and remember it's boundaries.
The brain has the
ability to differentiate between direct and reflected sound. The difference between
the perceived sound in a room and the sound recorded by a omni directional microphone
is dramatic. The microphone always sounds more reverberant and hollow. I could
never record a symphony from the balcony, the orchestra would sound too far away.
But it can be a very satisfying musical experience from there, especially if you
can see the orchestra.
So far we have seen psycho-acoustic effects in
well systems range from manipulation to mild defense. But now lets look at the
severely distorted system in the brain-injured child. Because of his brain-injured
auditory pathway. Certain sounds scream at him like a runaway locomotive's brakes,
We have seen that the brain can manipulate auditory
stimulation and does so routinely. When a hurt child experiences uncomfortably
high sound pressure levels his brain goes through a series of self protective
steps. The first step is like the "cocktail party" effect, selective
listening. The second is compression, the ability to reduce or try to control
the effect of loud auditory stimulation. The third level of self defense may be
Stimulus induced deafness.
children live in a world of chaos caused by the bombardment of auditory stimulation.
Their brains are in a state of sensory defensiveness, suppressing or distorting
Why does the AudioKinetron work?
All systems whether mechanical or biological have a finite
duration of time between the command to action and the response. In electronic
devices this time is the speed of light. In mechanical systems, response time
is a function of efficiency of motion. In biological systems, response time is
widely variable and dependent on a host of factors. Restedness, nutrition, alertness
and most importantly wellness. Glenn has described the time delay experienced
by stroke victims which makes it almost impossible for them to do something as
fundamental as answer a simple question. Even when they know the answer! Because
of system response time delay, by the time the victim has mustered a response
to the question, the person asking the question has left or moved on to another
question. As a graduate of the How to Multiply Your Baby's Intelligence Course,
I have been taught to be patient and wait for my baby to respond to my attention,
allowing his newly developing brain time to affect a response.
children do not have a well system. Therefore their system response time is delayed.
When one combines auditory hypersensitivity with a delayed response time a picture
emerges. Only a signal sufficiently long enough to exceed the response time of
the system will elicit a defense mechanism.
The AudioKinetron is a two
stage device. The first stage is a simple cuts only graphic equalizer that is
designed to lower certain sound frequencies by forty decibels. This allows contouring
the stimulus music to the particular patient's hearing.
The second stage
functions by taking music and creating from it a series of powerful, short duration,
random, high frequency pulses. As the child listens to the music, he is attacked
by the accompanying pulses. His hypersensitivity causes his brain to react but
by the time his brain overcomes the time delay, the pulse is gone. The brain no
longer has anything to defend against so it relaxes. Eventually the brain learns
it is futile to either try to predict or respond to the short duration stimulus.
Hyperactivity starts to diminish, the child begins to emerge from below.
This therapy, which I call Transient Electronic Auditory Stimulation or TEAS is
electronic pots and pans. The music is there to entice and relax the child, the
stimulus is unpredictable and short duration, consequently the brain can't defend
How can we become more successful using this information
to treat brain-injured children who have these kinds of auditory problems?
Our first goal is to improve therapy procedures using existing or available
What are the biggest problems facing us in this goal?
First and foremost, analysis.
Brain-injured children have severe
problems communicating with the outside world. The standard audiology exam requires
skill in listening, concentration, sophisticated communication and is only designed
to be effective within a normal to low hearing range because it is designed to
reveal hyposensitivity or loss, not hypersensitivity.
need a way to perform an active, non-invasive, safe, highly accurate, high resolution
frequency analysis of the auditory pathways of all brain-injured children.
We began investigating the Evoked Potential method of audiology about a year
ago. Evoked Potentials are electrical signals evoked within the brain by exterior
stimulus. This technology seemed promising at first but a number of things made
it inappropriate for our work. We could not find a system that was more than a
simple Pass/Fail test. This gave us none of the specific frequency sensitivity
that we needed to use the AudioKinetron properly. Second, we were told that uncooperative
patients needed to be sedated for the test. That was the end of that.
A number years ago it was reported that high frequency whistling could be
heard coming from the ears of cats. As a result it was thought that our auditory
system was not, as we believed, a passive system receiving stimulus in the form
of sound waves, but was instead an active system somewhat like an AM or FM radio
station. Sound waves, generated by nerve endings in the middle ear, are transmitted
to the outer ear where they are modulated by external sound sources and are then
re absorbed by the ear drum. The carrier wave is stripped away from that signal
neurologically and the resultant signal is what we perceive as sound.
These whistles are now called Otoacoustic Emissions.
Whether the original
theory is correct or not is somewhat irrelevant to our needs. Otoacoustic Emissions
seemed to promise a new insight to the function of the Neuro-auditory system.
However when we first discussed this with the manufacturer they told us that autoacoustic
emissions were only a resonance of the nerves in the inner ear. But I was sure
that otoacoustic emissions were a result of active control from the hearing center
in the brain. Consultation with Glenn confirmed that there are more nerve pathways
from the brain to the ear than from the ear to the brain. Once again we found
ourselves on the other side of the fence from a manufacturers theory of operation
of his own machine.
Supporting our view is a just released study by the
Mayo clinic which confirms the efferent action on autoacoustic emissions through
the neural pathway from the brain. We were relieved to learn of this report. Without
this confirmation, Otoacoustic Emissions Analysis could have been another expensive
dead end. Now we may have a powerful tool to accurately analyze the hearing of
a brain-injured child.
Two months ago Gabriel Medick volunteered to be
tested by the Virtual 330 otoacoustic emissions system. Gabe is extremely hyper
sensitive to many sounds and is receiving Transient Electronic Auditory Stimulation
at the Institutes. On his first test on the machine Gabe exhibited a narrow band
hypersensitive spike of forty to fifty decibels at 4KHZ. When the spike literally
jumped off the computer monitor's display I turned to Glenn and said "There
it is! That's what we've been looking for!". The audiologist who was demonstrating
the machine, turned to me wide eyed and said "I have never seen anything
like that in my life!". This was the first time he had tested a brain injured
child with the machine. We continued to test Gabe but it was soon obvious that
he was in abject pain every time the machine's test frequency approached 4KHZ.
He would start to create noises and writhe but continued with the test because
he knew he was helping us with something important. We took a break and Gabe typed
a message to his mother that he had to block the sound because it was painful!
So we stopped the test.
Later we set up the machine again in order to
do a demonstration for the staff and the board of directors. While one member
was being tested, I noticed the computer was running much more quickly and with
higher resolution. I asked the audiologist what was going on and he told me he
was now using a much shorter duration test pulse and taking far fewer samples
per frequency. That day even our failures had supported the theory. The test signal
that we used for Gabe was of a much longer duration than that for the board member.
Just long enough to elicit a defense response from Gabe's brain, except for the
first time when it was a surprise. Because the tones used by the machine are sine
waves progressing evenly from low to high frequency he was able to predict the
tones after the first test. He even told us so.
The optimum instrument
parameters for testing brain-injured children should be:
2. Smallest number of samples needed to get a result.
3. Lowest amplitude signal, so as not to present a painful stimulus to the patient.
We learned something else that day. Even a test that is benign to most children,
even preemies, can be disturbing to brain-injured children unless the test parameters
are contoured specifically for them. Since that time there has been a published
study citing the discovery of a 4KHZ hyperactive anomaly in some brain-injured
children using otoacoustic emissions analysis techniques.
During a board
meeting after this test the entire clinical staff discussed this issue and decided
that if the children were to wear ear plugs that the level of unwanted auditory
stimulation would drop and their condition should improve. This alone would not
be an acceptable therapy, only a crutch that would not be self eliminating. However,
if we had the kids wear the ear plugs before TEAS, their chemical wall of defense
should be at low levels and therefore TEAS should be more effective. The staff
started with the ear plugs and the response from the children and their families
was immediately positive. By improving the effectiveness of TEAS the plugs are
The next step is to improve the TEAS machine itself.
Right now the machines are like shot guns shooting at a bullseye on the wall because
the stimulation signal is fairly broad band. Without extremely accurate audiology
exams this is the only way to be effective. In fact the staff have so little faith
in the conventional audiology exams that they are not even using the multi-band
filter stage of the machine. However with more accurate otoacoustic emissions
analysis we can first start to use the machines more effectively and second begin
the design of a second generation of machines that focus directly on the hypersensitive
frequencies of the child making the therapy more comfortable and effective.
We envision a machine that can, at the push of a button, perform a complete
audiology exam, adjust the necessary filters automatically and then administer
appropriate TEAS directly to the child. In addition, we intend to design a better
TEAS system using pulsed noise as the stimulation signal and music composed specifically
for the children in this project. We are also designing a digital recording/storage
system that will allow TEAS to be administered to children at home by parents
as well as on campus. This could increase the frequency of treatment as well as
make it more cost effective to the parents.
Even though we are only at
the beginning of Transient Electronic Auditory Stimulation, the Institutes for
the Achievement of Human Potential have been successfully administering mechanical
Auditory Stimulation for many decades. I hope our forays into the technological
side of this subject can lead to more understanding of the problem and so further
the successful treatment of brain-injured children.
Note: Since this lecture was given a major study (Rimland and Edelson) concluded that
there was not a significant difference in the results whether a filtered or unfiltered
signal was used in regard to Autistic children. The significance of this finding
for us was:
1. The importance of the audiogram was lessened. If the mother
said her son was hypersensitive to sound then we could assume he was, instead
of trying to get an audiogram from an individual who could not give us an accurate
one in the first place due to his condition.
2. If the filters did not have
to be used, then encoded music could be transferred to an appropriate medium and
distributed directly to parents, thus bypassing the high cost of travel, hotels,
3. This was good news for parents.
The content on the site is provided for informational purposes only. The content is not intended in any way to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition, medication, wellness program, symptoms, medical diagnosis or treatment. Neither the content nor any other good or service offered by or through the site is intended to be relied on for medical diagnosis or treatment. Never disregard medical advice or delay in seeking it because of something you accessed on this site.