Auditory Processing Training: A Novel Treatment for Sound Hypersensitivities in A

描述（由申请人提供）：自闭症谱系障碍[ASD]包括一组由行为和社交技能异常定义的神经发育状况。据估计，目前仅在美国就有超过150万自闭症患者。近50%的自闭症儿童完全不会说话，不到10%的儿童成年后能够独立生活。虽然感觉处理问题不被认为是自闭症的核心诊断症状，但临床观察和家长问卷调查都证实了42-88%的学龄自闭症儿童存在感觉异常。声音过敏似乎对大约25%的自闭症儿童特别有问题。这是一个重要的治疗目标，因为越来越多的证据表明，自闭症的早期感觉处理异常是更复杂的认知问题的神经生物学前兆，特别是在语言领域。基于音乐的疗法[例如，Tomatis方法、听力程序和Berard听觉整合训练]经常被希望改善其孩子的听觉处理的父母尝试。这些程序可能是适度昂贵的[成本范围从$500-$3000+]，并可能需要多次每天访问一个从业者的办公室。有些令人不安的是，虽然有关于这些干预措施有效性的轶事报告，但缺乏支持性的同行评审文献，拟议的行动模式未经证实。基于我们自己对自闭症声音敏感性的行为和大脑成像研究，我们开发了一种新颖的基于音乐的创新疗法，我们相信这将有助于改善听觉处理能力。这种新的治疗方法，听觉处理训练（APT），使用特别调制的音乐，努力重新组织听觉皮层中的非典型功能相互作用，使其成为正常模式。该方法利用了动物和人类的数据，这些数据表明，对传入的音乐或其他声音的听觉流进行选择性过滤会导致皮层组织和声音感知的改变。令人兴奋的是，这种方法可以在家里以相对较低的成本（<400美元）实施。在拟议的项目中，我们将进行I期临床试验，评估APT的安全性、耐受性和有效性。主观父母问卷调查和客观行为，听力学和功能性脑成像测试[脑磁图和脑电图]将用于探索APT对听觉处理和自闭症特征的影响。 公共卫生相关性：听觉处理问题对于超过150万患有自闭症谱系障碍的美国人来说尤其成问题。该项目将评估听觉处理训练[APT]的安全性，耐受性和有效性，这是一种新的治疗方法，我们根据我们先前对自闭症的行为和脑成像研究开发。该方法可以在家里以相对较低的成本（<400美元）实施。

DESCRIPTION (provided by applicant): The autism spectrum disorders [ASDs] encompass a set of neurodevelopmental conditions defined by abnormalities in behavior and social communicative skills. It is presently estimated that there are more than 1.5 million autistic individuals in the US alone. Almost 50% of children with autism are completely non-verbal, and less than 10% achieve independent living as adults. Whereas sensory processing problems are not considered to be core diagnostic symptoms of autism, both clinical observations and parental questionnaires confirm the presence of sensory anomalies in 42-88% of school age children with autism. Sound hypersensitivities seem to be especially problematic for about 25% of children with autism. This is an important therapeutic target because there is mounting evidence in autism that early-stage sensory processing abnormalities are neurobiological precursors of more complicated cognitive problems, especially in the language domain. Music-based therapies [e.g., the Tomatis method, the Listening Program, and Berard Auditory Integration Training] are often tried by parents hoping to improve auditory processing in their children. These programs can be moderately expensive [costs range from $500-$3000+], and may require multiple daily visits to a practitioners office. Somewhat disturbingly, although there are anecdotal reports on efficacy for these interventions, there is a lack of supportive peer-reviewed literature, with proposed modes of action being unsubstantiated. Based on our own behavioral and brain imaging studies of sound sensitivities in autism, we have developed a novel and innovative music-based therapy that we believe will lead to improved auditory processing abilities. This new therapy, Auditory Processing Training [APT], uses specially modulated music in an effort to re-organize atypical functional interactions in auditory cortex into a normal pattern. The method takes advantage of animal and human data showing that selective filtering of an incoming auditory stream of music or other sounds can lead to alterations in cortical organization and sound perceptions. Excitingly, the method can be implemented at home for a relatively low cost (<$400). In the proposed project, we will conduct a Phase I clinical trial evaluating the safety, tolerability, and efficacy of APT. Both subjective parent questionnaires and objective behavioral, audiological, and functional brain imaging tests [magnetoencephalography and electroencephalography] will be used to explore the impact of APT on auditory processing and autistic features. PUBLIC HEALTH RELEVANCE: Auditory processing problems are especially problematic for the more than 1.5 million U.S. individuals with an Autism Spectrum Disorder. This project will evaluate the safety, tolerability and efficacy of Auditory Processing Training [APT], a new therapy that we have developed based on our prior behavioral and brain imaging studies of autism. The method can be implemented at home for a relatively low cost (<$400).