Can you imagine the horror of being trapped in a prison the size of your own body and understanding things far beyond the people who surrounded you, while being unable to express this in any way?
There are such children.
These children have been labeled "autistic". Child brain developmentalists hate the labels "cerebral palsy", "mentally retarded", "epileptic", and "autistic", because none of these words are diseases; they are all symptoms. This is a trap in which all brain-injured children are caught because if one confuses a symptom with a disease then one tries to treat the symptom. There is no disease that can be cured by treating the symptom. One must treat the disease in order for the symptoms to go away.
That is what has happened to brain-injured children since time has begun. Those of us who are concerned with making brain-injured children well hate the label "autistic". The word "autism" in English means "involved with oneself." It implies that the problem is not an injury to the brain, but instead that the child has a psychiatric problem. The label implies that the child is insane.
Institutions are full of such children who are many times more intelligent than the jailers that keep them in the institutions. Thousands of highly intelligent children will spend their entire lives in prisons, being treated as if they were mentally retarded and insane because of the word "autism" and the criminal confusion it creates.
Can you imagine what it would be like to be trapped in such a situation? These children live it every day. They live in a hell, and the better they understand what a hell they live in, the greater the hell becomes. Even worse, in the history of the world, very few children have ever escaped from that hell.
Over ten years ago I received a phone call from a doctor in Paris named Guy Bérard. Dr. Bérard said that he had read my book, How To Teach Your Baby To Read, and that he was fascinated by it. He explained that he had learned some very interesting things about hearing in some brain-injured children, and he was sure I would be interested. I went to see Dr. Bérard and had a very interesting lunch with him, and then I attended his classes for audiologists.
Here is what he was teaching them. Fifteen years earlier, he was doing an auditory examination on a twenty-one-year-old boy who had a hearing problem and whose parents believed was deaf. He was one of these boys who screamed for no apparent reason and behaved wildly, etc., and in examining him, Dr. Bérard, who is a doctor of medicine and an expert in ear problems, realized that the young man had two problems. In some frequencies of hearing he was deaf, but in other frequencies he was overly sensitive. Dr. Bérard realized that certain sounds were extremely painful to the boy.
He didn't know anything about brain-injured kids, as his training was in audiology. But he asked himself whether there could be other children like this. After investigating and studying this problem Dr. Bérard developed a system by which he could not only measure this problem but treat it as well. It seemed strange to him that a child could simultaneously be deaf to some sounds and hypersensitive to others.
However, in the world of the brain-injured child this is really quite common. For instance, some brain-injured people have very little feeling in their legs. The result is that if they are walking and step on a stone they can't feel it, their ankle turns over, and they fall down. Other brain-injured people are hypersensitive in their legs. If they step on a stone and feel it very strongly, their leg jumps up and they fall down. The result is the same.
They're both abnormal–too much and too little. They have no fine tuning, nothing to dampen sensitivity or heighten dullness when it is needed.
This also happens visually and auditorily to brain-injured people. We have known for over forty years that many of our children were hypersensitive to some sounds and hyposensitive to other sounds. Dr. Bérard had proposed both a reason as to why some children might be acutely sensitive and a means of treating the problem. He saw both the problem and the treatment in terms of the ear itself, rather than in terms of the brain. This is entirely understandable since his field was not the central nervous system but rather its periphery.
When we really understood what Dr. Bérard was proposing we agreed that the treatment was effective (there was no denying it). However, we knew from our own work that the underlying problem was not in the ear but in the brain itself. If Guy Bérard's treatment was effective it had to be treating the brain, where the problem existed, not the periphery.
Although it is somewhat of an oversimplification, the brain of each of these children is not only acutely affected by certain noises, but the brain comes to develop a method of protecting itself against these noises. When these noises occur the brain takes action to block or occlude them. Over time, this continual occlusion provides the child with some protection from the harmful and painful effects of noises, but he pays the price of being selectively deaf.
This may work much in the same way that the brain-injured child who has a profound bilateral convergent strabismus learns to occlude one eye. This occurs because crossed eyes create such visual chaos that the child can not see. In order to correct this, the cortex begins to suppress the incoming information from the eye that turns in more acutely. The more the cortex suppresses this information, the less the child uses the suppressed eye. This is called a cortical suppression. It allows the child to have one relatively clear picture of the world instead of two chaotic pictures on top of each other.
However, there is a price to be paid–such a child has no depth perception since he is functionally monocular (one-eyed). The longer this suppression persists the less functional the unused eye will be. One day mother will take the child to an eye doctor, who will point out that the child is blind in that eye. In fact, there is absolutely nothing wrong with that eye except that the brain is suppressing it.
The same thing would appear to be the case in the auditory pathway, as the brain attempts and succeeds in suppressing harmful, chaotic, or unwanted auditory stimulation. The challenge for Bérard was to create a program that could fool the protection system long enough to get by the protective gatekeeper. This would allow the child to get reacquainted with noxious sounds on a gentle gradient that he could handle.
Bérard developed music that could be arranged in such a way that the sound patterns would be unpredictable.
It worked. Children began to tolerate sounds that previously had been intolerable. This had a profound effect on the behavior of these children, who could now handle common household sounds and the sounds of city streets and public areas–noises that before treatment would provoke temper tantrums or terror in many of these children.
With this new insight we set about to find better ways of refining and perfecting both the detection and treatment of auditory problems.
One of the most difficult areas to evaluate in the brain-injured child is the auditory pathway. First of all, the children who are the most severely affected and who need this treatment the most are very hypersensitive. They do not want their ears touched, nor will they tolerate ear phones. They have considerable problems just sitting still, never mind listening with a head set on for thirty minutes or more.
The second problem is doing a reliable audiogram or hearing test. If you have ever had an audiogram, you know that it's rather difficult to do. The audiologist goes through various frequencies and asks, "Can you hear that more in the right side of your head or the left side of your head? Can you hear it more in the front than in the back?"
It's very difficult for even a well adult to be accurate in answering these questions, and without an accurate audiogram it is difficult to design a treatment program that is exactly right for the child. In the absence of an accurate audiogram a child must be given a generalized treatment program, which can never be as effective as one designed just for him.
There are antibiotics that are very specific, for a specific illness, and they are the best. They work most effectively. Then there are broad-band antibiotics that work for many types of bacteria but are not as effective as a specific one for the specific bacteria. Because of the difficulties that exist in getting a very accurate audiogram, we end up with most of these children doing a broad-band analysis and then giving them a broad-band program rather than a highly specific one for that specific child.
When I presented this problem to our board of directors, the vice-president of the Board, Bill Mueller, understood it immediately. As an expert in the field of acoustics he recognized some inherent problems that we would encounter and immediately proposed solutions. He promptly set about the task of finding or designing a piece of equipment that we could use to do an accurate audiogram on any child regardless of age or injury. He also proposed that we could then program the data gained from this new piece of equipment into a computer and have the computer create a specific program individualized to suit that child.
As a result, we have developed a better means of evaluating our children but, what is much more important, a much more effective means of treating them.
Bérard says over and over again that this is not a cure, it is a treatment, and he is quite right. Although we now view this work in a very different context than its creators do, we are very grateful to them for having persisted in their search and for generously sharing their insights and discoveries.
The value of this work is not confined to this one group of children. While it is of huge importance to them, it is also of value to the classically midbrain* injured child and the cortically injured child, both of whom have auditory problems of their own.
In terms of auditory treatment, we have not only scratched the surface but are digging deeper daily.
*This refers to the subcortical areas the form the middle region of the brain, or functional midbrain in The Institutes terminology. This region includes structures such as the basal ganglia, the thalamus, the cerebellum, and the area traditionally called "midbrain", which anatomically is the upper part of the brain stem above the pons.
