found in a substantial subgroup of individuals withautism, with estimates ranging from 30–100%. Suchabnormal responses have been found in infants withautism based on observations of home videotapes. Sim-ilarly, Dawson and colleagues, in their case study re-port of an infant with autism, found that disturbancesin sensory processing were apparent during the firstyear of life (Dawson, Osterling, Meltzoff, & Kuhl,2000). Thus, these abnormalities may eventually beuseful in early screening (Baranek, 1999). There is ev-idence to suggest, furthermore, that such disturbancesare more common during infancy and childhood thanduring adulthood (Baranek, Foster, & Berkson, 1997a).The literature includes reports of both hypo- and hyper-responsiveness to sensory input, raising the possibilitythat two groups of sensory responders may exist withinthe autism spectrum. Sensory processing abnormali-ties also have been found to be correlated with higherlevels of stereotypic, rigid, and repetitive behaviors(Baranek, Foster, & Berkson, 1997b). Thus, sensoryprocessing abnormalities may be important to addressin therapeutic interventions aimed to reduce rigidityand stereotyped behaviors.

INTRODUCTION

In this report, we review evidence regarding theprevalence of sensory and motor abnormalities inautism and the effectiveness of three types of inter-ventions designed to address such abnormalities: sen-sory integration therapy, traditional occupational ther-apy, and auditory integration training.

SENSORY PROCESSING ABNORMALITIES

The literature suggests that, although sensory pro-cessing abnormalities are not universal or specific toautism, the prevalence of such abnormalities in autismis relatively high. As shown in Table I, the few stud-ies that have included information on prevalence indi-cate that abnormal responses to sensory stimuli are

Interventions to Facilitate Auditory, Visual, and MotorIntegration in Autism: A Review of the Evidence

Geraldine Dawson1,2 and Renee Watling1

Evidence is reviewed on the prevalence of sensory and motor abnormalities in autism and theeffectiveness of three interventions designed to address such abnormalities—sensory integra-tion therapy, traditional occupational therapy, and auditory integration training. Although sen-sory processing and motor abnormalities are neither universal nor specific to autism, the preva-lence of such abnormalities in autism is relatively high. There is, however, little controlledresearch on the effectiveness of interventions designed to address these abnormalities. Fourobjective outcome studies of sensory integration therapy were identified. These were of suchsmall scale that no firm conclusions regarding efficacy could be made. No empirical studiesof traditional occupational therapy in autism were found. Five studies of auditory integrationtraining were found. Results of these studies provided no, or at best equivocal, support for theuse of auditory integration training in autism.

KEY WORDS: Autism; sensory integration therapy; occupational therapy; auditory integration training.

Journal of Autism and Developmental Disorders, Vol. 30, No. 5, 2000

4150162/3257/00/1000-0415$18.00/0 © 2000 Plenum Publishing Corporation

1 Center on Human Development and Disability, University of Wash-ington, Seattle, Washington 98195.

2 Address all correspondence to Geraldine Dawson, Box 357920,Center on Human Development and Disability, University of Wash-ington, Seattle, Washington 98195.

FINE AND GROSS MOTOR IMPAIRMENTS

The prevalence of impairments in fine and grossmotor skills also appears to be relatively high, based onthe few studies that have included such information. Asshown in Table II, clumsiness and gross motor impair-ment are common features of Asperger syndrome andhigh-functioning autism. The fact that motor impairmentsare evident even in high-functioning individuals indicatesthat such impairments are not simply an aspect of men-tal retardation. Autism appears to be associated witha wide range of motor impairments, as illustrated in Table III. Impairments have been found in fine and grossmotor skills; skilled movement and eye–hand coordi-nation, speed, praxis and imitation, gait, posture, andbalance.

INTERVENTIONS

Despite the high prevalence of abnormalities in sen-sory processing and motor functioning, there has beenrelatively little systematic, controlled research on the ef-fectiveness of various interventions designed to address

416 Dawson and Watling

them. A review of the existing empirical studies exam-ining the effectiveness of sensory integration therapy,traditional occupational therapy, and auditory integra-tion training was conducted. Sensory integration therapyis based on a theory developed by Ayres (1972, 1979)that emphasizes the relation between sensory experiencesand motor and behavioral performance. The interventionstrategies involve the use of planned and controlled sen-sory experiences including, but not limited to, vestibu-lar, proprioceptive, and somatosensory activities, suchas swinging, deep pressure touch, and tactile stimula-tion. The activities are child-directed with an emphasison the production of functional and adaptive responsesto sensory stimuli. Traditional occupational therapy in-volves a range of planned activities designed to promotethe development of skills in the context of work, play,and adaptive behavior.

AUDITORY INTEGRATION THERAPY

Auditory integration therapy, developed by Berardand Tomatis (Berard, 1993), typically involves 10 hours

Table I. Prevalence of Sensory Processing Abnormalities in Autisma

Study N CA Comparison group Measures Findings

Baranek, Foster, & 246 AUT and DD 88 Child 158 Adult None Staff questionnaire Auditory: 30% (child);Berkson, 1997a w/stereotypies 11% (adult)

Tactile: 8% (child);7% (adult)

Kientz & Dunn, 1997 32 AUT 3–10 years 64 TYP Parent questionnaire 50%

Gillberg et al.,1990 12 AUT <3 years None Retrospective parent 83%questionnaire

Dahlgren & 26 AUT <3 years 17 DD age, sex, Retrospective parentAuditoryGillberg, 1989 IQ matched questionnaire 100% AUT

12% DD22 TYP age and 0% TYP

sex matched

a AUT = autism, DD = developmental delay, TYP = typical development.

Table II. Prevalence of Fine and Gross motor Impairments in Autisma

Study N CA Comparison group Measures Findings

Manjiviona & 12 AS 7–17 years Normative sample Test of Motor Impairment 50% ASPrior, 1995 9 HFA 67% HFA

Klin, Volkmar, Cichetti, 21 AS 17 years (mean) AUT IQ test 90% AS (AS > AUT)& Rourke., 1995 Normative sample

Ghaziuddin, Butler, Tsai, 9 AUT Children None Test of Motor Proficiency 100% of both groups& Ghaziuddin, 1994 11 AS

Gillberg et al.,1990 28 AUT <3 years None Griffiths Developmental Scale 15%

a AUT = autism, HFA = high-functioning autism, AS = Asperger syndrome.

Interventions to Facilitate Auditory, Visual, and Motor Integration in Autism 417

Table III. Types of Motor Impairments Associated with Autisma

Study N CA Comparison group Measures Areas of motor impairments

Teitelbaum et al.,1998 17 AUT 4–6 months None Retrospective videotape Abnormal movementAnalysis

Smith & Bryson, 1998 AUT Children LANG Grooved pegboard Slower speedMinshew, Goldstein, & 33 HFA Adolescents TYP Grooved pegboard Impaired: Skilled movement

Siegel, 1997 and adults Trails AOther motor tests

Miyahara et al.,1997 26 AS 6–15 years 16 LD Observation Impaired:Manual dexterityBall skills

Nass & Gutman; 1997 5 AS & 4–9 years None Clinical observation Impaired:Tourette Coordination

SpeedBalanceGraspTone

Cornish & McManus, 35 AUT 15 3–5 years LD Annett Pegboard Lower speed1996 20 11–13 years TYP

Eisenmajer et al.,1996 48 AUT 3–21 years None Checklist Delayed walking69 AS 11 years (mean)

Hughes, 1996 36 AUT 13 years (mean) 24 LD Clinical observations Abnormal grasp28 TYP

Rapin, 1996 51 HFA 201 LANG Annett pegboard Impaired:125 AUT 110 DD Sequin formboard Visual-motor

SpeedRogers, Bennetto, 17 HFA 11–21 years 15 LD Imitation of hand and Impaired:

McEvoy, & facial movements Imitation and pantomimePennington, 1996 Pantomime tasks

Manjiviona & Prior, 12 AS 7–17 years None Test of Motor Impaired:1995 9 HFA Impairment Manual dexterity

Ball skillsBalance

Ghaziuddin, Butler, 9 AUT Children None Test of Motor Proficiency No group differencesTsai, & Ghaziuddin, 11 AS All performed below age 1994 level

Hallett et al.,1993 5 HFA 25–38 years 5 TYP Computer video analysis Abnormal gaitof gait

McEvoy, Rogers, & 17 AUT Preschool 13 DD Wallin pegboard No differences in speedPennington, 1993 16 TYP Sequin formboard

Ghaziuddin, Tsai, & AS N/A N/A Review paper ClumsinessGhaziuddin, 1992

Kohen-Raz, Volkmar, 91 AUT 6–20 years 18 DD Computerized posture Atypical posture& Cohen, 1992 166 TYP analysis

Rumsey & Hamburger, 10 AUT 26 years (mean) 15 LD Neuropsychological tasks Impaired:1990 25 TYP Visual-motor

SpeedSzatmari, Tuff, 26 AS 8–18 years TYP Grooved Pegboard Slower speed

Finlayson, & 17 HFA 7–32 yearsBartolucci, 1990

Szatmari, Bartolucci, 28 AS 14 years (mean) 42 socially impaired Parent report Difficulty learning:& Bremner, 1989 25 HFA 23 years (mean) Adaptive motor skills

WritingPuzzles in all groups

Vilensky, Damasio, 21 AUT Children 15 TYP Video analysis of gait Abnormal gait& Maurer, 1981 (continued)

of listening to electronically modified music deliveredvia headphones during 2 half-hour daily sessions over10 days. The auditory integration training device uses fil-ters to dampen peak frequencies to which the individualis “hypersensitive.” The filtered music is modulated byrandom dampening of high and low frequencies.

As shown in Table IV, four studies on the effec-tiveness of sensory integration therapy in autism that

418 Dawson and Watling

utilized objective measures of behavior to assess outcomewere found. All but one of these studies had samplesof fewer than six participants. No study included a com-parison group. The one study that had a relatively largesample and a better design found no changes in vocalbehavior following brief participation in sensory ac-tivities. It should be noted, however, that the durationof the intervention was very short in this study, and the

Table III. (Continued)

Study N CA Comparison group Measures Areas of motor impairments

Wing, 1981 34 AS 5–35 years None Clinical description Impaired:Coordination and speedFine and gross motor skillsGait and postureClumsinessEye-hand coordination

DeMeyer, 1976 66 AUT 5 years (mean) 29 DD Tests of motor and Impaired ball playperceptual-motor No differences in several skills other domains

Wing & Wing, 1971 27 AUT 2–5 years Aphasic Retrospective parent Impaired skilled movementBlind/deaf questionnaire Abnormal postureDDTypical

a AUT = autism, HFA = high-functioning autism, AS = Asperger syndrome, DD = developmental delay, LD = learning disability, LANG = lan-guage delay, TYP = typical development.

Table IV. Effectiveness of Sensory-Integration Therapy in Autism

Study N CA (years) Design Measures Intervention Findings

Case-Smith & 5 4–5 AB design Videotaped 10 weeks 1:1 sensory 4 children: Significant decrease Bryan, 1999 (baseline observations integration therapy in nonengaged behaviors.

treatment) viewed in and school 3 children: Significant increase random order consultation in goal-directed behavior.

1 child: Significant increase in social interaction.

Linderman & 2 3 AB design Observation 11 weeks of 1 hour Child A: Significant gains in Stewart; 1999 (baseline Parent report 1:1 sensory inte- social interaction, approach to

treatment) gration therapy new activities, and response to holding and hugging.

Child B: Significant gains in social interaction and response to movement.

Reilly, Nelson, 18 6–12 Random Vocal behavior Two 30-minute Greater variety and increased & Bundy; 1984 assignment to sessions each MLU during tabletop activi-

order in ABAB of tabletop vs. ties, which may have been counter-balanced sensory activities related to training children todesign label items during tabletop

activities.Ray, King, & 1 9 Case study Audiotape 15 minutes self- Vocalizations significantly

Grandin, 1988 recordings initiated vestibular greater when swinging aswere coded by activity daily for compared to before and after. multiple raters 17 days Child acquired 13 new words

during the study.

participants had received previous training in the com-parison treatment. No studies on the effectiveness oftraditional occupational therapy in autism were found.Nevertheless, results of a recent national survey of oc-cupational therapists indicate that occupational therapyis a common component of intervention programs forchildren with autism (Watling, Deitz, Kanny, &McLaughlin, 1999). The most frequent domains ad-dressed by occupational therapists include sensory pro-cessing, attention, play, coordination, and fine motorskills. Other areas often addressed include self-care,work-related skills, and independent living skills.

As shown in Table V, five studies (Ns ranging from17–445) examining the effectiveness of auditory inte-gration training (AIT) were found, three of which in-cluded a control condition. Two out of the three studiesthat included a control condition found improvement inbehavior for both the auditory integration training andcontrol conditions. Thus, the positive effects were notspecific to the auditory integration training. One studydid find greater improvement in the auditory integrationtraining condition as compared to the control condition;

Interventions to Facilitate Auditory, Visual, and Motor Integration in Autism 419

however, there were methodological difficulties with thestudy pertaining to a lack of adequate preinterventionmatching of the two groups. Therefore, the existingempirical evidence provides no or, at best, inconclu-sive support for the use of AIT in autism. This posi-tion was underscored in a position paper published bythe American Academy of Pediatrics in 1998.

SUMMARY

In summary, although sensory and motor impair-ments are commonly found in autism, the interventionsthat have been designed to address them have not beenwell validated. In the case of AIT, there is no, or at bestequivocal, support for this intervention approach basedon the available controlled studies. In the case of sen-sory integration therapy and traditional occupationaltherapy, there exist so few studies that conclusions can-not be drawn. Moreover, we know very little aboutwhich ages or subgroups of individuals are most likelyto benefit from therapies addressing sensory and motor

Table V. Effectiveness of Auditory Integration Training (AIT) in Autism

Random Length of Behavioral Study N CA (years) assignment? Intervention treatment measures Findings

Gillberg, 9 3–16 No AIT 30-minute Questionnaires No significant Johansson, sessions for improvementSteffenburg, & 10 daysBerlin, 1997

Bettison, 1996 80 3–17 Yes AIT vs. Two 30-minute Questionnaires Both groups showed unmodified sessions for Cognitive significant positive music 10 days measures changes on both

measures.Rimland & 17 4–21 Yes AIT vs. Two 30-minute Questionnaires Outcomes favored

Edelson, 1995 unmodified sessions for Observations AIT group, but music 10 days there were signifi-

cant pre-treatmentbetween group differences.

Rimland & 445 4–41 Yes AIT with 3 Unclear Responses to No differences Edelson, 1994 different sound between devices.

devices Questionnaires Decrease in reported compared problem behaviors

found.Lowest functioning

individuals madegreatest changes.

Zollweg, Palm, 30 (9 w/ 7–24 Yes AIT vs. Twenty Questionnaires No differences & Vance, 1997 autism) unfiltered 30-minute Observations between groups on

music sessions for questionnaire. Both10 days groups showed

reduction in reportedproblem behaviors.

difficulties. Future research on the following questionsand issues is recommended:

1. Better information is needed regarding the na-ture, course and prevalence of sensory and motor ab-normalities in autism.

2. The question of whether or not specific sensoryand/or motor abnormalities are associated with otherbehaviors and/or diagnostic characteristics needs to beaddressed. Such information may be useful in delin-eating clinical and/or genetic subgroups.

3. Carefully controlled studies to determine thetypes of interventions that are most effective for ad-dressing the sensory and motor abnormalities or im-pairments in autism are needed.

4. Research needs to determine at what ages andfor which individuals these interventions are most effective.

Studies addressing the nature of sensory and motorimpairments in autism are important for understandingbrain function in autism. Evidence suggests that regionsof the brain mediating sensory arousal and motor func-tions, including cerebellum, brainstem, and frontal lobe,are dysfunctional in autism (Dawson, 1996). Such im-pairments clearly impact the lives of persons withautism. Sensory sensitivities and motor difficulties af-fect virtually all aspects of adaptive, cognitive, social,and academic functioning. It is imperative, thereforethat we learn more about how to best address these dif-ficulties by conducting systematic, carefully controlledresearch in this area.

ACKNOWLEDGMENT

This work was supported by a grant from the Na-tional Institute of Child Health and Human Develop-ment and the National Institute on Deafness and Com-munication Disorders (PO1HD34565).

REFERENCES

American Academy of Pediatrics Committee on Children with Dis-abilities. (1998). Auditory integration training and facilitatedcommunication for autism. Pediatrics, 102,431–433.

Ayres, A. J. (1972). Sensory integration and learning disorders.LosAngeles: Western Psychological Services.

Ayres, A. J. (1979). Sensory integration and the child.Los Angeles:Western Psychological Services.

Baranek, G. T. (1999). Autism during infancy: A retrospective videoanalysis of sensory—motor and social behaviors at 9–12 monthsof age. Journal of Autism and Developmental Disorders, 29,213–224.

Baranek, G. T., Foster, L. G., & Berkson, G. (1997a). Sensory defen-siveness in persons with developmental disabilities. OccupationalTherapy Journal of Research, 17,173–185.

420 Dawson and Watling

Baranek, G. T., Foster, L. G., & Berkson, G. (1997b). Tactile de-fensiveness and stereotyped behaviors. American Journal of Oc-cupational Therapy, 51,91–95.

Bettison, S. (1996). The long-term effects of auditory training onchildren with autism. Journal of Autism and Developmental Dis-abilities, 26,361–374.

Berard, G. (1993). Hearing equals behavior.New Canaan, CT: Keats.Case-Smith, J., & Bryan, T. (1999). The effects of occupational ther-

apy with sensory integration emphasis on preschool-age chil-dren with autism. American Journal of Occupational Therapy,53, 489–497.

Cornish, K. M., & McManus, I. C. (1996). Hand preference and handskill in children with autism. Journal of Autism and Develop-mental Disorders, 26,597–609.

Dahlgren, S. P., & Gillberg, C. (1989). Symptoms in the first twoyears of life: A preliminary population study of infantile autism.European Archives of Psychiatry and Neurological Sciences,238,169–174.

Dawson, G. (1996). Neuropsychology of autism: A report on the stateof the science. Journal of Autism and Developmental Disorders,26, 179–184.

Dawson, G., Osterling, J., Meltzoff, A., & Kuhl, P. (2000). Casestudy of the development of an infant with autism from birth to2 years of age. Journal of Applied Developmental Psychology,21, 299–313.

DeMeyer, M. K. (1976). Motor, perceptual-motor and intellectualdisabilities of autistic children. In L. Wing (Ed.), Early Child-hood Autism(2nd ed., pp. 169–196). Pergamom: Oxford.

Eisenmajer, R., Prior, M., Leekam, S., Wing, L., Gould., J., Welham,M., & Ong, B. (1996). Comparison of clinical symptoms inautism and Asperger’s disorder. Journal of the American Acad-emy of Child and Adolescent Psychiatry, 35,1523–1531.

Ghaziuddin, M., Butler, E., Tsai, L., & Ghaziuddin, N. (1994). Isclumsiness a marker for Asperger syndrome? Journal of Intel-lectual Disability Research, 38,519–527.

Ghaziuddin, M., Tsai, L. Y., & Ghaziuddin, N. (1992). Brief report:A reappraisal of clumsiness as a diagnostic feature of Aspergersyndrome. Journal of Autism and Developmental Disorders, 22,651–656.

Gillberg, C., Ehlers, S., Schaumann, H., Jakobsson, G., Dahlgren,S. O., Lindblom, R., Bagenholm, A., Tjuus, T., & Blinder, E.(1990). Autism under age 3 years: A clinical study of 28 casesreferred for autistic symptoms in infancy. Journal of Child Psy-chology and Psychiatry, 31,921–934.

Gillberg, C., Johansson, M., Steffenburg, S., & Berlin, O. (1997).Auditory integration training in children with autism. Autism,1, 97–100.

Hallett, M., Lebiedowska, M. K., Thomas, S. L., Stanhope, S. J.,Denckla, M. B., & Rumsey, J. (1993). Locomotion of autisticadults. Archives of Neurology, 50,1304–1308.

Hughes, C. (1996). Brief report: Planning problems in autism at thelevel of motor control. Journal of Autism and DevelopmentalDisorders, 26,99–107.

Kientz, M. A., & Dunn, W. (1997). A comparison of the performanceof children with and without autism on the sensory profile.American Journal of Occupational Therapy, 51,530–537.

Klin, A., Volkmar, F. R., Cicchetti, D. V., & Rourke, B. P. (1995).Validity and neuropsychological characterization of Aspergersyndrome: Convergence with Nonverbal Learning Disabilitiessyndrome. Journal of Child Psychology and Psychiatry, 36,1127–1140.

Kohen-Raz, R., Volkmar, F. R., & Cohen, D. J. (1992). Postural con-trol in children with autism. Journal of Autism and Develop-mental Disabilities, 22,419–432.

Linderman, T. M., & Stewart, K. B. (1999). Sensory integrative-based occupational therapy and functional outcomes in youngchildren with pervasive developmental disorders: A single-sub-ject study. American Journal of Occupational Therapy, 53,207–213.

Manjiviona, J., & Prior, M. (1995). Comparison of Asperger syn-drome and high-functioning autistic children on a test of motorimpairment. Journal of Autism and Developmental Disorders,25, 23–39.

McEvoy, R. E., Rogers, S. J., & Pennington, B. F. (1993). Executivefunction and social communication deficits in young autistic chil-dren. Journal of Child Psychology and Psychiatry, 34,563–578.

Minshew, N. J., Goldstein, G., & Seigel, D. J. (1997). Neuropsycho-logic functioning in autism: Profile of a complex information pro-cessing disorder. Journal of the International NeuropsychologicalSociety, 3,303–316.

Miyahara, M., Tsujii, M., Hori, M., Nakanishi, K., Kageyama, H., &Sugiyama, T. (1997). Brief report: Motor incoordination in chil-dren with Asperger syndrome and learning disabilities. Journalof Autism and Developmental Disorders, 27,595–603.

Nass, R., & Gutman, R. (1997). Boys with Asperger’s disorder, ex-ceptional verbal intelligence, and clumsiness. DevelopmentalMedicine & Child Neurology, 39,691–695.

Rapin, I. (Ed.). (1996). Preschool children with inadequate commu-nication. Clinics in Developmental Medicine(No. 139). Lon-don: MacKeith.

Ray, T. C., King, L. K., & Grandin, T. (1988). The effectiveness ofself-initiated vestibular stimulation in producing speech soundsin an autistic child. Occupational Therapy Journal of Research,8, 186–190.

Reilly, C., Nelson, D. L., & Bundy, A. C. (1984). Sensorimotor ver-sus fine motor activities in eliciting vocalization in autisticchildren. Occupational Therapy Journal of Research, 3,199–212.

Rimland, B., & Edelson, S. M. (1994). Second opinion: The effectsof auditory training on autism. American Journal of Speech-Language Pathology, 3,16–24.

Rimland, B., & Edelson, S. E. (1995). Brief report: A pilot study ofauditory integration training in autism. Journal of Autism andDevelopmental Disabilities, 25,61–70.

Interventions to Facilitate Auditory, Visual, and Motor Integration in Autism 421

Rogers, S. J., Bennetto, L., McEvoy, R., & Pennington, B. F.(1996). Imitation and pantomime in high-functioning adoles-cents with autism spectrum disorders. Child Development, 67,2060–2073.

Rumsey, J. M., & Hamburger, S. D. (1990). Neuropsychological di-vergence of high-level autism and severe dyslexia. Journal ofAutism and Developmental Disorders, 20,155–168.

Smith, I., & Bryson, S. E. (1998). Gestures imitation in autism: Non-symbolic postures and sequences. Cognitive Neuropsychology,15, 259–273.

Szatmari, P., Bartolucci, G., & Bremner, R. (1989). Asperger’s syn-drome and autism: Comparison of early history and outcome.Developmental Medicine and Child Neurology, 31,709–720.

Szatmari, P., Tuff, L., Finlayson, M. A. J., & Bartolucci, G. (1990).Asperger’s syndrome and autism: Neurocognitive aspects. Jour-nal of the American Academy of Child and Adolescent Psychi-atry, 29,130–136.

Teitelbaum, P., Teitelbaum, O., Nye, J., Fryman, J., & Maurer, R. G.(1998). Movement analysis in infancy may be useful for earlydiagnosis of autism. Proceedings of the National Academy ofScience, 95,13982–13987.

Vilensky, J. A., Damasio, A. R., & Maurer, R. G. (1981). Gait dis-turbances in patients with autistic behavior: A preliminary study.Archives of Neurology, 38,646–649.

Watling, R., Deitz, J., Kanny, E. M., & McLaughlin, J. F. (1999). Cur-rent practice of occupational therapy for children with autism.American Journal of Occupational Therapy, 53,498–505.

Wing, L. (1981). Asperger’s Syndrome: a clinical account. Psycho-logical Medicine, 11,115–129.

Wing, L., & Wing, J. K. (1971). Multiple impairments in early child-hood autism. Journal of Autism and Childhood Schizophrenia,1, 256–266.

Zollweg, W., Palm, D., & Vance, V. (1997). The efficacy of audi-tory integration training: A double blind study. American Jour-nal of Audiology, 6,39–47.