Occupational Therapy

The Tomatis Method of Auditory Stimulation: AnOverview
Valerie Dejean, OTR, Director, Spectrum Center and Alex Freer

Most of us think of the ears as a gathering place for sound. We know that we use our ears to hear the sounds around us, but we don’t typically think about what happens to the sound that is collected. In addition to collecting sound, the ear makes sense of that sound, using the vibrations we hear to perceive speech and other sounds, filter out unwanted or unnecessary auditory messages, and produce language. The ear also houses the vestibular system, which manages our movement, balance, coordination, and image of our body in space. In fact, the ear coordinates our eye movement during reading and our hand movement during writing. In other words, the ear is at the heart of sensory integration, and thus is the critical link among our senses. If the ear is not functioning to its fullest potential, we cannot function to our fullest potential.

Dr. Alfred Tomatis, a French physician and ear, nose and throat specialist, has spent his lifetime researching the ear. His extensive work with the ear changed our understanding of the role of the ear from a passive receiver of sound to an active control center of the body’s sensory input. Tomatis asserts that improper functioning of the ear is the root problem for individuals experiencing difficulty with language (comprehension and production), auditory processing, sensory integration, learning, coordination, or other related problems. To address this root problem, Tomatis developed a device called the Electronic Ear that, in essence, “reprograms” the ear—via sound stimulation—in order to improve it’s functioning. The Electronic Ear has helped thousands of individuals worldwide, individuals with problems ranging from speech and language difficulties to autism and cerebral palsy.

In order to understand how the Electronic Ear and the Tomatis Method of auditory stimulation work, one must first understand more about how the inner ear functions.

The Ear
According to Tomatis, “the ear builds, organizes, and nourishes the nervous system.” The body has three main systems that organize sensory information: the vestibular (somatic) system, the visual (spatial) system, and the cochlear (linguistic) system. Two of these systems—the vestibular and the cochlear systems—are housed in the inner ear. The vestibule and the cochlea share a common wall, share common fluid, and perform essentially the same job—the analyses of vibrations. While the cochlea analyzes the vibration of air perceived outside the body (sound), the vestibule analyzes physical vibrations perceived within the body. The intimate connection of these two systems makes them, to a greater degree, interdependent; the functioning of the cochlear system (processing of sound) has a direct impact on the functioning of the vestibular system (body movement and control) and vice versa. For example, individuals with total hearing loss also tend to have difficulty with balance and coordination. Similarly, Occupational Therapists and Speech Therapists will attest to the marked improvement in speech production (controlled by the cochlea) following a gross motor activity such as swinging (vestibular stimulation).

Tomatis recognized the vestibular function of the ear as the primary sensory integrator. The vestibular system detects motion and gravity, and controls all motor functions plus muscle tone, balance, coordination (including coordination of eye movements and coordination of movements between the two sides of the body), and body image. Because the vestibular system allows individuals to have a sense of the relationship between the self and space, it lays the groundwork upon which visual images are superimposed. Finally, it is the “programming unit” of the nervous system, which is directly connected to the cerebral cortex—the portion of the brain responsible for high order processes such as language, reading, writing, and logical thought. The vestibular system, together with the cochlear system, creates the vital link between touch, vision, and hearing.

As you can see, the ear plays an intimate role in the overall coordination of all of our senses. But the ear does even more than coordinate information and sends it to the brain—it is also responsible for giving the brain its essential nourishment and energy.

The Energy Function

The brain receives more stimulation from the ear than from any other organ—60% of total stimuli comes from the body (via bones, joints, and muscles) through the vestibular system to the brain, while another 30% of total stimuli comes from sound processed by the cochlea. This energy is “nourishment for the brain” according to Tomatis. Research has proven that the brain must have sensory stimuli in order to think and operate with vitality. If an individual is unable to listen to or process sounds, brain activity is slowed—the individual begins to feel fatigued or depressed. Conversely, a “well-tuned” ear is able to stimulate the brain, providing increased energy, concentration, attention span, and cognitive skills. Additionally, Tomatis points out that it is high frequency sounds—sounds rich in high harmonics—and not all sound that energizes the brain, since the cells of Corti (receptor cells that transmit sound wave messages to the brain) are more densely packed in the area receptive to high frequency sound.

The Listening Function

Hearing is not the same as listening, a critical truth underlying Tomatis’ work. Hearing is the passive process of receiving sound, while listening is the ability and the desire to actively focus on select sounds and interpret their meaning, while also blocking out irrelevant sounds. Many children with learning difficulties are poor listeners, yet hearing tests indicate that they have excellent hearing. Tomatis defines listening chiefly as a process of focusing the ear, both physiologically and psychologically.

According to Tomatis, the physical act of focusing the ear is performed by two middle ear muscles (the stapedius and the tensor tympani). The two muscles work like a telescope lens, constantly adjusting to fine tune low, middle and high frequency sounds. In some cases, the middle ear muscles can become weakened, which compromises auditory perception and, in turn, impacts auditory processing, language and academic skills.

In addition to the physiological aspects of listening, active listening also requires intention—the psychological desire to focus on sound. Of all our senses, hearing is the first to develop in utero—by four and one half months gestation, the ear is fully formed and functional. The fetus hears a constant background noise of intrauterine sounds, such as the mother’s heartbeat, respirations, and intestinal gurgling, which is interrupted at irregular intervals by the mother’s voice. According to Tomatis, the mother’s voice penetrates into the intrauterine world via bone conduction, and thus the fetus hears only the higher frequency sounds of the mother’s voice. According to Tomatis, the mother’s voice is not only an emotional nutrient to the child, but also prepares the child to acquire language after birth. In other words, listening begins in the womb.

Language Development

The development of language is intrinsically tied to proper functioning of the ear. The foundation is laid in utero by the baby’s anticipation of the mother’s voice. After birth, a baby will babble to hear it’s won voice—the precursor for the development of language, and the means by which the ear attunes itself to the sound of the human voice. According to Tomatis, “the voice can only produce what the ear perceives.” Any difficulties that interrupt proper listening during this important time of language acquisition can have a lasting impact on language development. For example, a child who suffers from frequent ear infections may develop a speech disorder since he has not heard sounds and words properly as he developed language. Tomatis also identifies the right ear as the leading ear for language control. In most individuals the right ear takes the leading role in control of the voice and language presumably because the “ear-to-brain-to-larynx-back-to-ear” loop is more direct the right ear (Madaule, When Listening Comes Alive, page 44). If, however, the right ear does not assume control, either the left ear will, or neither will (That is, dominance will not develop). Language development and voice production may be problematic as a result.

Tomatis Method of Auditory Stimulation

As mentioned, in order to facilitate effective listening, Tomatis developed the Electronic Ear. The Electronic Ear addresses both the physiological and psychological aspects of listening. First the Electronic Ear exercises the muscles of the middle ear to strengthen them, improving their ability to focus on particular sounds and filter out other sounds. Second, the Electronic Ear replicates the sounds heard in utero—music is played (primarily Mozart) or a recording of the mother’s voice is utilized, while the Electronic Ear filters out the lower frequencies so that only the higher, more stimulating frequencies are heard. This stimulates the inner ear physically, giving it an opportunity to reprogram itself, and also replicates the in utero experience of the individual, often leading to a renewed desire to communicate. There is also an active phase of the Tomatis Method called “audio-vocal training”. After “retraining” the ear to hear a wider range of frequencies, the audio-vocal portion of the Tomatis Method helps individuals enhance the higher frequencies in their voice. At the same time, the right ear is stimulated to augment its role as the leading ear.

For more information or to schedule an appointment please contact the Listening Center:

Santa Rosa, California (707) 575-1468

Walnut Creek, California (925) 952-4724

On another frequency Santa Rosa therapist using Tomatis method to to help kids learn to to to help kids learn to ‘listen’

Tricia Cambron, Special to The Chronicle

Friday, July 16, 2004

“Music hath charms to soothe the savage breast,” William Congreve wrote centuries ago, but it also may have the power to help heal children with certain auditory disabilities, a Santa Rosa speech pathologist believes.
Deborah Swain, owner of Swain Learning Centers in Santa Rosa and Walnut Creek, practices traditional therapies in conjunction with the Tomatis method, which is one of a number of techniques known as Therapeutic Listening. The method theoretically re-educates the ear and auditory pathways, based upon the effect of sound upon the nervous system. A change takes place in the brain from the direct application of sound frequencies, practitioners believe, and they say that there is evidence that with a change in serotonin levels, behavior changes.
In practice, the therapy consists of the clients listening to classical music through specialized headphones, primarily compositions by Mozart—because his compositions have a wide range of frequencies—and Gregorian chants, which mimic the resting respiratory rate.
But the client is not hearing a simple recording of music: the music is “gated and filtered,” or modified and modulated so that only certain frequencies are heard. This helps establish ear dominance, and, as clients listen better, they are able to perceive and discriminate better, resulting in improved learning, emotions and physical coordination. The average program consists of 90 hours spread out over four phases or “blocks,” beginning with two hours a day for 15 days. While listening, the child can draw, paint, play games, work on puzzles, read, do exercises to increase sensory awareness or to improve his or her balance and coordination.
This method, Swain says, helps children more quickly than traditional methods. When she started practicing the Tomatis method about five years ago, Swain says, “I got excited about being a speech pathologist again because the changes that we were getting were the kind of changes that would take forever with the normal schedule of 30 minutes twice a week with traditional speech and language therapy.”
Swain, a past president of the California Association of Speech Pathologists and Audiologists in Private Practice and former chief of the UC Davis Medical Center’s Speech Pathology Clinic, recently received funding from the UC Davis Medical Center’s MIND Institute to evaluate the effects of Tomatis upon the communication and behavioral skills of autistic children.
The method’s efficacy with autistic children has been hotly debated since 1994, and two years ago, the American Speech-Language-Hearing Association (ASHA) warned its members—about 100,000 audiologists, speech-language pathologists, and speech, language, and hearing scientists—that there was inadequate scientific support that Therapeutic Listening is successful and that members should be careful not to mislead parents of children with disorders for which there are limited treatment options into false hope based on anecdotal reports of success.
Swain hopes her research will provide some clinical evidence to add to the anecdotal reports of improvements.
The method is used with children who have other problems, not just autism. One mother, Mary Gillis Smith of Rohnert Park, whose 10-year-old son “Michael” is being treated by Swain, said that tests showed that although Michael’s hearing was normal, he had a problem with “listening,” with processing auditory signals.
“It’s kind of like dyslexia of hearing,” Smith explains. “If you put a child like that in a large classroom, the child has to do so much translating of what they are hearing in order to get it straight. Plus, they have to separate it out from the background noise.”
Swain has been fascinated with the physiology behind communication since she took an introductory speech class as a sophomore at Sacramento State. She pursued this interest, ultimately getting a doctorate in education and a master’s degree in speech pathology. She became interested in the work of Alfred Tomatis, a French otolaryngologist who developed his theories after World War II, and spent several years researching the method before applying for certification with Tomatis.
“Because I came from such a conservative background clinically—at Davis everything had to be research-based, and there was no original research on this in the U.S.—I really wanted to spend time learning about it. I didn’t want to be one of these people that said, ‘Oh, I don’t know anything about it, but I don’t think it’s going to work.’ But I really felt there was something there that was going to help children.”
Children with certain disorders can have trouble processing sound, which can cause them to fail in school and to have problems with their peers.
“When you are experiencing academic failure because of auditory- processing problems, socially you have a child in pretty tough shape,” she says.
Swain cautions parents of her patients that Tomatis is not a silver bullet. “It’s not intended to be a solitary intervention.” She uses it in conjunction with traditional therapies such as speech-and-language behavior therapy or occupational therapy.
Greenbrae neurology pediatrician Julie Griffiths has referred patients for Tomatis treatment. She says the reasoning behind the treatment makes sense: “The brain is plastic, and with stimulation they can improve their ability to process sound and to distinguish one sound from another. It may be that sensory processing, the stimulation coming in, may increase brain blood flow and increase brain connectivity.”
Griffiths cautions, however, that parents who suspect their children are having problems comprehending sounds and language should make sure their children have complete physical examinations to check for allergies, middle ear infections or fungal infections, all of which can muffle sounds and inhibit auditory discrimination.
In the past two years, Swain has treated three children: “Michael Smith” (he prefers a pseudonym), Joey Parrick and “Marty Rankin” (Marty’s family prefers a pseudonym to protect their privacy). All three have had at least 90 hours of Tomatis therapy, and the parents maintain that all have shown significant improvement.
“Michael Smith,” 10
Michael’s difficulties became apparent when he was in the third grade, his mother says. He became tense and withdrawn. He seemed to get confused a lot.
“He’d want to tell a joke in the class, but he’d forget what he was going to do,” Smith says, “or he’d get it confused, or he had already told it before. He was getting more and more tense and more self-conscious. The teacher knew something was wrong but she didn’t know what it was.”
Although he had begun talking at a “normal” age, around 11 months, she said, “We noticed that certain words and sounds would get confused.” It was also clear he was having a hard time following directions—he could hear “pick up your shoes” but he couldn’t hear “pick up your shoes and make your bed.” There were lots of misunderstandings, lots of arguments.
“I was getting worried—I think any parent has a certain amount of self-blame, self-accusation,” Smith says. “And then because I’m a psychotherapist, and my husband is a psychotherapist, I was getting worried—
it was like ‘it’s one of us.’ And that’s just an awfully painful piece.”
She also felt that her son’s “difficult forceps birth” might have caused his auditory-processing problems, and she felt guilty about that.
When Smith heard about the Tomatis method from her sister, a special- education teacher in Washington, she “got on the Internet wondering how far in the world we would have to travel to find a Tomatis practitioner and was stunned to find one in Santa Rosa.”
They took Michael to the Swain Center for testing in October 2002. The tests, which Smith says were more exact than what was given by the school, revealed that 9-year-old Michael was processing sounds at the level of a 4- to- 5-year-old.
“It was shocking, but it felt true,” she says. The family decided to make the investment in Tomatis in time — 90 hours over six months, and money — $50 an hour.
“I had read a little bit about Tomatis and knew it had been around Europe for a long time. And I’ve had an interest in thinking about the world as being harmonically based, so to me it made just elegant sense. Dealing with Deborah didn’t feel New Agey; it felt more exact than anything so far.”
It took some persuading to get Michael to accept the therapy: “The thing was just to get him here, and we made a bargain that he could get a snake,” Smith says.
After the first three blocks, Smith noticed Michael was starting to relax. By the next session, “Things started getting much easier. The arguments about ‘you didn’t say do that,’ or ‘that’s not what you said,’ just went away. Unless it was a really bad day, it just went away.”
Swain emphasizes that treating a child’s auditory problems will often improve social and emotional problems as well.
“Kids like Michael are always in kind of a defensive posture, because first of all they are misunderstood until they are assessed, so they are always unsuccessful,” she says. “They become argumentative and moody and negative because they don’t know why they can’t do what people ask of them, they just know they can’t. They feel very misunderstood—correctly so—because characteristically they are saying, ‘I’m trying as hard as I can.’ “
Asked if it is possible that Michael has just matured out of his problems, Swain says the older a child is when he or she begins treatment, the less likely it is the changes are due to maturation and more likely to be the result of an intervention.
Smith has no doubt that the Tomatis treatments have helped Michael.
“I felt like it was a miracle. It was hard earned; it was a lot of time and money (about $4,500). But you have to think about what if he had been in therapy to address the anxiety, how long would that have taken? You would pass $4,500 quickly. And you still wouldn’t have gotten the neurological shift. I think it’s a bargain.
“The big thing is that he is just so much happier. He likes to build, he has these blocks—his play was getting more and more defensive, more about war, and about defending your territory and creating more and more elaborate forts that would hold up in the world under endless sieges. He still likes to play with these little guys and make things, but the theme has changed, the world’s opened back up and is more varied. He also has become a reader, he started reading while sitting with the headphones, and now he has set a goal for himself of reading all 50 or so Hardy Boys books.”
And he got his pet snake.
Joey Parrick, 5
Since Joey Parrick was diagnosed as autistic at 18 months, he has been treated by just about every traditional therapy available, his mom, Rocky, says. But until about 10 months ago, his progress was discouraging. He had terrible temper tantrums; he spoke of himself in the third person; he would never ask for what he wanted.
Parrick, a Petaluma resident and nurse at Kaiser, says she and her husband, Bret, a journeyman electrician, are not into alternative therapies, but after they saw a segment about Tomatis on the “Today” show two years ago, they were curious to know more. “You get to that point when you have a child like this you want to try everything that you can hear about.”
Joey started a Tomatis treatment program last August, when he was 4 ½. Unlike some autistic children, Joey has language skills, but Tomatis has helped him become spontaneous with his language, Parrick says.
“Before, if we asked him a question, he would just ask it back. Now he’s able to answer it back. He’s more spontaneous with his playing; he’s definitely using his imagination more. He’s easier to comfort when he’s upset. We can rationalize with him better.”
Joey has undergone 110 hours (five blocks) of treatment. The Parricks’ health insurance doesn’t cover it—most health plans don’t. But for the Parricks, there’s no doubt it is worth it.
“People are so afraid to try different things, and believe me we were, too, but I can’t say enough about this,” Parrick says. “It’s great. It works.”
“Marty Rankin,” 6 ½
Marty suffers from a variety of developmental delays, including autism, as well as a physical disability called hypotonia, which means he has very loose ligaments. At age 5, he tested as having the auditory processing skills a child of 3.
Marty, of Santa Rosa, was verbal at a “normal” age, but the ability to interact with language was missing, says his father, “Ted.” Marty started speech therapy at the North Bay Regional Center when he was 18 months old. One of the counselors there suggested the family contact Swain.
“She just had this gut feeling that it was something we should look into, “ Rankin says.
Rankin, a Santa Rosa optometrist, says he got the science behind Tomatis right away.
“If someone has a lazy eye, you patch the good one; you force them to use the other eye, that’s how the brain develops so they don’t have a lazy eye. This (Tomatis) stimulates his auditory system.”
Marty began therapy with Swain in August 2002. Results were not immediate.
“Quite frankly, after the first two (blocks), I hadn’t seen anything,” Rankin says. “But after the third one, he made this leap—all of the changes have been leaps—all of a sudden, boom, he’s talking more.”
In five months of treatment (90 hours), Marty went from being able to answer a yes-or-no question 1 in 10 times to 1 in 5. However, his answers were still only one- or two-word sentences, and there was still a lag between question and answer. But in May, Marty gave his family a very special Mother’s Day present.
“He woke up (on Mother’s Day), and he was just blathering away, just talking,” Rankin says.
The next day, Rankin was in the kitchen cooking, and Marty was on the other side of the house playing.
“I couldn’t see him, so I went out to the back door and said, ‘Marty, where are you?’ “
“I’m over here. I’m playing with the water,” he answered.
“He not only told me where he was, but told me what he was doing. And that’s the progress we’ve made in less than two years.”
Marty’s sensitivity to sound has also lessened.
“We live kind of near a hospital and kind of near a fire station—and when he heard a siren, he would just panic and start running around.” Rankin says. “When we took him into kindergarten with a room of screaming kids, we thought, ‘He’s never going to survive this,’ but he’s hanging in there. Now even a siren is not a big deal.”
The Rankins’ health insurance consists of a “rock-bottom Blue Shield health care policy that doesn’t cover anything,” Rankin says, so the treatments have all been out of pocket. “But he’s our only one, and we invest in him. We’re starting our eighth block today, and we have the ninth scheduled—we believe in it that much.”
Rankin says Marty’s progress has been transformative for the family.
“It’s allowed him to be in louder environments; it’s allowed him to communicate much, much better. He’s still not 100 percent; he’s 6 ½ now, and his speech isn’t normal—but it’s getting closer and closer.
“Before, we’d ask him what he was thinking; you could see his brain was turning but you wouldn’t get a response. Now he can tell us—we ask what are you thinking, you see a big grin on his face, and he can tell you.”

THE TOMATIS METHOD
Dr. Alfred A. Tomatis (1920-2001) started studying the impact of occupational noise after World War II. He discovered that when our ears cannot hear certain frequencies, our voice does not contain them either. In an experiment, Tomatis blocked the ears of a famous singer, letting through only certain frequencies. Almost immediately, the singer’s voice deteriorated. Tomatis postulated that if we modify the hearing, the voice changes immediately.
Another observation he made was that some opera singers developed a “deafness” for the frequencies in the range around 2,000 Hz. As a result they were losing their voices.
Tomatis concluded that constant exposure to loud noise makes the muscles in the middle ear become “flabby,” so that loud sound could not enter into the inner ear. If that was the case, one’s hearing (and voice) could be restored by retraining these muscles.
After much experimentation, Tomatis found that these two muscles can be strengthened by having someone listen to music that is switched on and off continuously. The muscles have to follow by stretching and relaxing, and so become stronger. He later found that a subject could make faster progress if the music wasn’t switched on and off but was switched between two canals: one in which the low frequencies are amplified, and another in which the high frequencies are amplified. He called this “gating.”
Tomatis also found that people who are right-ear dominant learn easier because the right ear is connected to the left brain, the place where language is processed. To improve someone’s listening (and therefore, learning), Tomatis tried “gated” music that he “filtered” to let through only certain frequencies.
The Tomatis Listening Therapy reportedly has helped children and adults with auditory-processing problems, dyslexia, learning disabilities, attention- deficit disorders, autism, and those with sensory integration and motor-skill difficulties.
In recognition of his discoveries, he was named Knight of Public Health of France in 1951, and was awarded the gold medal for Scientific Research (Brussels, 1958).
Tomatis treated many famous people, including Maria Callas and Gérard Depardieu. Tomatis also established centers around the world: There are Tomatis centers in 10 states, including four in California.
Source: www.tomatis.com/English/index.htm

Getting in touch
The Swain Center is at 795 Farmers Lane, Suite 23, Santa Rosa; (707) 575- 1468; www.theswaincenter.com. For more about the American Speech-Language-Hearing Association, visit www.asha.org.
E-mail comments to nbayfriday@sfchronicle.com.

On another frequency Santa Rosa therapist using Tomatis method to to help kids learn to to to help kids learn to ‘listen’

Tricia Cambron, Special to The Chronicle

Friday, July 16, 2004

“Music hath charms to soothe the savage breast,” William Congreve wrote centuries ago, but it also may have the power to help heal children with certain auditory disabilities, a Santa Rosa speech pathologist believes.
Deborah Swain, owner of Swain Learning Centers in Santa Rosa and Walnut Creek, practices traditional therapies in conjunction with the Tomatis method, which is one of a number of techniques known as Therapeutic Listening. The method theoretically re-educates the ear and auditory pathways, based upon the effect of sound upon the nervous system. A change takes place in the brain from the direct application of sound frequencies, practitioners believe, and they say that there is evidence that with a change in serotonin levels, behavior changes.
In practice, the therapy consists of the clients listening to classical music through specialized headphones, primarily compositions by Mozart—because his compositions have a wide range of frequencies—and Gregorian chants, which mimic the resting respiratory rate.
But the client is not hearing a simple recording of music: the music is “gated and filtered,” or modified and modulated so that only certain frequencies are heard. This helps establish ear dominance, and, as clients listen better, they are able to perceive and discriminate better, resulting in improved learning, emotions and physical coordination. The average program consists of 90 hours spread out over four phases or “blocks,” beginning with two hours a day for 15 days. While listening, the child can draw, paint, play games, work on puzzles, read, do exercises to increase sensory awareness or to improve his or her balance and coordination.
This method, Swain says, helps children more quickly than traditional methods. When she started practicing the Tomatis method about five years ago, Swain says, “I got excited about being a speech pathologist again because the changes that we were getting were the kind of changes that would take forever with the normal schedule of 30 minutes twice a week with traditional speech and language therapy.”
Swain, a past president of the California Association of Speech Pathologists and Audiologists in Private Practice and former chief of the UC Davis Medical Center’s Speech Pathology Clinic, recently received funding from the UC Davis Medical Center’s MIND Institute to evaluate the effects of Tomatis upon the communication and behavioral skills of autistic children.
The method’s efficacy with autistic children has been hotly debated since 1994, and two years ago, the American Speech-Language-Hearing Association (ASHA) warned its members—about 100,000 audiologists, speech-language pathologists, and speech, language, and hearing scientists—that there was inadequate scientific support that Therapeutic Listening is successful and that members should be careful not to mislead parents of children with disorders for which there are limited treatment options into false hope based on anecdotal reports of success.
Swain hopes her research will provide some clinical evidence to add to the anecdotal reports of improvements.
The method is used with children who have other problems, not just autism. One mother, Mary Gillis Smith of Rohnert Park, whose 10-year-old son “Michael” is being treated by Swain, said that tests showed that although Michael’s hearing was normal, he had a problem with “listening,” with processing auditory signals.
“It’s kind of like dyslexia of hearing,” Smith explains. “If you put a child like that in a large classroom, the child has to do so much translating of what they are hearing in order to get it straight. Plus, they have to separate it out from the background noise.”
Swain has been fascinated with the physiology behind communication since she took an introductory speech class as a sophomore at Sacramento State. She pursued this interest, ultimately getting a doctorate in education and a master’s degree in speech pathology. She became interested in the work of Alfred Tomatis, a French otolaryngologist who developed his theories after World War II, and spent several years researching the method before applying for certification with Tomatis.
“Because I came from such a conservative background clinically—at Davis everything had to be research-based, and there was no original research on this in the U.S.—I really wanted to spend time learning about it. I didn’t want to be one of these people that said, ‘Oh, I don’t know anything about it, but I don’t think it’s going to work.’ But I really felt there was something there that was going to help children.”
Children with certain disorders can have trouble processing sound, which can cause them to fail in school and to have problems with their peers.
“When you are experiencing academic failure because of auditory- processing problems, socially you have a child in pretty tough shape,” she says.
Swain cautions parents of her patients that Tomatis is not a silver bullet. “It’s not intended to be a solitary intervention.” She uses it in conjunction with traditional therapies such as speech-and-language behavior therapy or occupational therapy.
Greenbrae neurology pediatrician Julie Griffiths has referred patients for Tomatis treatment. She says the reasoning behind the treatment makes sense: “The brain is plastic, and with stimulation they can improve their ability to process sound and to distinguish one sound from another. It may be that sensory processing, the stimulation coming in, may increase brain blood flow and increase brain connectivity.”
Griffiths cautions, however, that parents who suspect their children are having problems comprehending sounds and language should make sure their children have complete physical examinations to check for allergies, middle ear infections or fungal infections, all of which can muffle sounds and inhibit auditory discrimination.
In the past two years, Swain has treated three children: “Michael Smith” (he prefers a pseudonym), Joey Parrick and “Marty Rankin” (Marty’s family prefers a pseudonym to protect their privacy). All three have had at least 90 hours of Tomatis therapy, and the parents maintain that all have shown significant improvement.
“Michael Smith,” 10
Michael’s difficulties became apparent when he was in the third grade, his mother says. He became tense and withdrawn. He seemed to get confused a lot.
“He’d want to tell a joke in the class, but he’d forget what he was going to do,” Smith says, “or he’d get it confused, or he had already told it before. He was getting more and more tense and more self-conscious. The teacher knew something was wrong but she didn’t know what it was.”
Although he had begun talking at a “normal” age, around 11 months, she said, “We noticed that certain words and sounds would get confused.” It was also clear he was having a hard time following directions—he could hear “pick up your shoes” but he couldn’t hear “pick up your shoes and make your bed.” There were lots of misunderstandings, lots of arguments.
“I was getting worried—I think any parent has a certain amount of self-blame, self-accusation,” Smith says. “And then because I’m a psychotherapist, and my husband is a psychotherapist, I was getting worried—
it was like ‘it’s one of us.’ And that’s just an awfully painful piece.”
She also felt that her son’s “difficult forceps birth” might have caused his auditory-processing problems, and she felt guilty about that.
When Smith heard about the Tomatis method from her sister, a special- education teacher in Washington, she “got on the Internet wondering how far in the world we would have to travel to find a Tomatis practitioner and was stunned to find one in Santa Rosa.”
They took Michael to the Swain Center for testing in October 2002. The tests, which Smith says were more exact than what was given by the school, revealed that 9-year-old Michael was processing sounds at the level of a 4- to- 5-year-old.
“It was shocking, but it felt true,” she says. The family decided to make the investment in Tomatis in time — 90 hours over six months, and money — $50 an hour.
“I had read a little bit about Tomatis and knew it had been around Europe for a long time. And I’ve had an interest in thinking about the world as being harmonically based, so to me it made just elegant sense. Dealing with Deborah didn’t feel New Agey; it felt more exact than anything so far.”
It took some persuading to get Michael to accept the therapy: “The thing was just to get him here, and we made a bargain that he could get a snake,” Smith says.
After the first three blocks, Smith noticed Michael was starting to relax. By the next session, “Things started getting much easier. The arguments about ‘you didn’t say do that,’ or ‘that’s not what you said,’ just went away. Unless it was a really bad day, it just went away.”
Swain emphasizes that treating a child’s auditory problems will often improve social and emotional problems as well.
“Kids like Michael are always in kind of a defensive posture, because first of all they are misunderstood until they are assessed, so they are always unsuccessful,” she says. “They become argumentative and moody and negative because they don’t know why they can’t do what people ask of them, they just know they can’t. They feel very misunderstood—correctly so—because characteristically they are saying, ‘I’m trying as hard as I can.’ “
Asked if it is possible that Michael has just matured out of his problems, Swain says the older a child is when he or she begins treatment, the less likely it is the changes are due to maturation and more likely to be the result of an intervention.
Smith has no doubt that the Tomatis treatments have helped Michael.
“I felt like it was a miracle. It was hard earned; it was a lot of time and money (about $4,500). But you have to think about what if he had been in therapy to address the anxiety, how long would that have taken? You would pass $4,500 quickly. And you still wouldn’t have gotten the neurological shift. I think it’s a bargain.
“The big thing is that he is just so much happier. He likes to build, he has these blocks—his play was getting more and more defensive, more about war, and about defending your territory and creating more and more elaborate forts that would hold up in the world under endless sieges. He still likes to play with these little guys and make things, but the theme has changed, the world’s opened back up and is more varied. He also has become a reader, he started reading while sitting with the headphones, and now he has set a goal for himself of reading all 50 or so Hardy Boys books.”
And he got his pet snake.
Joey Parrick, 5
Since Joey Parrick was diagnosed as autistic at 18 months, he has been treated by just about every traditional therapy available, his mom, Rocky, says. But until about 10 months ago, his progress was discouraging. He had terrible temper tantrums; he spoke of himself in the third person; he would never ask for what he wanted.
Parrick, a Petaluma resident and nurse at Kaiser, says she and her husband, Bret, a journeyman electrician, are not into alternative therapies, but after they saw a segment about Tomatis on the “Today” show two years ago, they were curious to know more. “You get to that point when you have a child like this you want to try everything that you can hear about.”
Joey started a Tomatis treatment program last August, when he was 4 ½. Unlike some autistic children, Joey has language skills, but Tomatis has helped him become spontaneous with his language, Parrick says.
“Before, if we asked him a question, he would just ask it back. Now he’s able to answer it back. He’s more spontaneous with his playing; he’s definitely using his imagination more. He’s easier to comfort when he’s upset. We can rationalize with him better.”
Joey has undergone 110 hours (five blocks) of treatment. The Parricks’ health insurance doesn’t cover it—most health plans don’t. But for the Parricks, there’s no doubt it is worth it.
“People are so afraid to try different things, and believe me we were, too, but I can’t say enough about this,” Parrick says. “It’s great. It works.”
“Marty Rankin,” 6 ½
Marty suffers from a variety of developmental delays, including autism, as well as a physical disability called hypotonia, which means he has very loose ligaments. At age 5, he tested as having the auditory processing skills a child of 3.
Marty, of Santa Rosa, was verbal at a “normal” age, but the ability to interact with language was missing, says his father, “Ted.” Marty started speech therapy at the North Bay Regional Center when he was 18 months old. One of the counselors there suggested the family contact Swain.
“She just had this gut feeling that it was something we should look into, “ Rankin says.
Rankin, a Santa Rosa optometrist, says he got the science behind Tomatis right away.
“If someone has a lazy eye, you patch the good one; you force them to use the other eye, that’s how the brain develops so they don’t have a lazy eye. This (Tomatis) stimulates his auditory system.”
Marty began therapy with Swain in August 2002. Results were not immediate.
“Quite frankly, after the first two (blocks), I hadn’t seen anything,” Rankin says. “But after the third one, he made this leap—all of the changes have been leaps—all of a sudden, boom, he’s talking more.”
In five months of treatment (90 hours), Marty went from being able to answer a yes-or-no question 1 in 10 times to 1 in 5. However, his answers were still only one- or two-word sentences, and there was still a lag between question and answer. But in May, Marty gave his family a very special Mother’s Day present.
“He woke up (on Mother’s Day), and he was just blathering away, just talking,” Rankin says.
The next day, Rankin was in the kitchen cooking, and Marty was on the other side of the house playing.
“I couldn’t see him, so I went out to the back door and said, ‘Marty, where are you?’ “
“I’m over here. I’m playing with the water,” he answered.
“He not only told me where he was, but told me what he was doing. And that’s the progress we’ve made in less than two years.”
Marty’s sensitivity to sound has also lessened.
“We live kind of near a hospital and kind of near a fire station—and when he heard a siren, he would just panic and start running around.” Rankin says. “When we took him into kindergarten with a room of screaming kids, we thought, ‘He’s never going to survive this,’ but he’s hanging in there. Now even a siren is not a big deal.”
The Rankins’ health insurance consists of a “rock-bottom Blue Shield health care policy that doesn’t cover anything,” Rankin says, so the treatments have all been out of pocket. “But he’s our only one, and we invest in him. We’re starting our eighth block today, and we have the ninth scheduled—we believe in it that much.”
Rankin says Marty’s progress has been transformative for the family.
“It’s allowed him to be in louder environments; it’s allowed him to communicate much, much better. He’s still not 100 percent; he’s 6 ½ now, and his speech isn’t normal—but it’s getting closer and closer.
“Before, we’d ask him what he was thinking; you could see his brain was turning but you wouldn’t get a response. Now he can tell us—we ask what are you thinking, you see a big grin on his face, and he can tell you.”

THE TOMATIS METHOD
Dr. Alfred A. Tomatis (1920-2001) started studying the impact of occupational noise after World War II. He discovered that when our ears cannot hear certain frequencies, our voice does not contain them either. In an experiment, Tomatis blocked the ears of a famous singer, letting through only certain frequencies. Almost immediately, the singer’s voice deteriorated. Tomatis postulated that if we modify the hearing, the voice changes immediately.
Another observation he made was that some opera singers developed a “deafness” for the frequencies in the range around 2,000 Hz. As a result they were losing their voices.
Tomatis concluded that constant exposure to loud noise makes the muscles in the middle ear become “flabby,” so that loud sound could not enter into the inner ear. If that was the case, one’s hearing (and voice) could be restored by retraining these muscles.
After much experimentation, Tomatis found that these two muscles can be strengthened by having someone listen to music that is switched on and off continuously. The muscles have to follow by stretching and relaxing, and so become stronger. He later found that a subject could make faster progress if the music wasn’t switched on and off but was switched between two canals: one in which the low frequencies are amplified, and another in which the high frequencies are amplified. He called this “gating.”
Tomatis also found that people who are right-ear dominant learn easier because the right ear is connected to the left brain, the place where language is processed. To improve someone’s listening (and therefore, learning), Tomatis tried “gated” music that he “filtered” to let through only certain frequencies.
The Tomatis Listening Therapy reportedly has helped children and adults with auditory-processing problems, dyslexia, learning disabilities, attention- deficit disorders, autism, and those with sensory integration and motor-skill difficulties.
In recognition of his discoveries, he was named Knight of Public Health of France in 1951, and was awarded the gold medal for Scientific Research (Brussels, 1958).
Tomatis treated many famous people, including Maria Callas and Gérard Depardieu. Tomatis also established centers around the world: There are Tomatis centers in 10 states, including four in California.
Source: www.tomatis.com/English/index.htm

Getting in touch
The Swain Center is at 795 Farmers Lane, Suite 23, Santa Rosa; (707) 575- 1468; www.theswaincenter.com. For more about the American Speech-Language-Hearing Association, visit www.asha.org.
E-mail comments to nbayfriday@sfchronicle.com.