Friday, September 21, 2012

Therapeutic Listening Program

(Taken from community board “unlimited potential”.  Written by a mother of a child with Down Syndrome, who is also an Occupational therapist.  Interesting information. )
In response to recent threads about using music as a tool to help our children reach their full potential, I thought I would share my experience with a sound based technique called Therapeutic Listening. I am an occupational therapist trained in Advanced Therapeutic Listening, and the mother of a 4 year old girl who has Down syndrome.
Before I describe the "magical" powers of Therapeutic Listening, I want you to think about how music has been powerful in your own life. Does it help you focus? Does it help you dance? Does it make you happy? Does it make you sad? Does it scare the pants off you (think Jaws)?
Therapeutic Listening uses modulated music that has been filtered to enhance elements such as time, space, and detail. Basically, the people who engineer the music are an OT (Sheila Frick) and a musician type (her husband Ron). Sheila tells Ron that she needs a selection that facilitates a specific change, and he makes it happen using the inherent properties in existing music, and then emphasizing (or de-emphasizing) certain qualities that make it even more powerful.
Therapeutic Listening provides direct auditory and vestibular input through specialized and very sensitive headphones and uses the auditory system's connections all over the brain (when you look at a functional MRI of a person who is listening to music, the brain is lit up like a Christmas tree) to affect change at all levels of the nervous system.
Therapeutic Listening is not a stand alone technique. It is important to complete exercises and activities for core and breath activation to achieve the best and most lasting results. I have also found that a reflex integration program done along with Therapeutic Listening seems to have an even more powerful effect. For some clients, specific vestibular exercises are needed as well. For those using Doman (or similar) techniques, you will find a lot of extra activities are probably not necessary.
Together your auditory and vestibular systems are responsible for protection, an understanding of space and time, monitoring and triggering movement, activating core and postural muscles, and they help lay the foundation for vision/oculomotor function. When they are not working well, you may see auditory defensiveness, tactile defensiveness, aimless wandering (inability to "land"), balance/coordination issues, low (or high) arousal, fear of movement, and language/processing delays.
Therapeutic Listening can help with all of the following areas (and more):   Attention,  Visual motor integration,  disorganized behavior, communication, Self-regulation, social skills, Postural Control, oral motor/articulation, Bilateral Coordination, fine motor control, Praxis (Motor Planning-includes speech)
The equipment for Therapeutic Listening is a very good quality pair of headphones and a player (either CD or a specific MP3 with slot radio, depending on whether your therapist has CDs or the newer CHIPs). It costs about $200 and can sometimes be paid for with flex spending funds. You may also be able to get funding from local charitable organizations. Children under two will need to listen to music over speakers, as the headphones may be too much for their tiny ears (according to audiologists). Typically therapists have lending libraries for the music for a small (or sometimes no) fee. Your insurance should cover the therapy visits if your child qualifies for OT or speech therapy already. For my clients, Therapeutic Listening just complements the other techniques I use during my sessions.
A program lasts anywhere from a few months to a little over a year and is very individualized. Music is selected based on a detailed questionnaire and a thorough evaluation and is changed every two weeks with each selection being made after a determination of the progress demonstrated over the previous two week period. The music is tested during a session to see if it is a good fit, and then sent home for the client to listen to for 2, 30 minute sessions each day. Sometimes you will see some regression at first as an individual's brain becomes disorganized before it re-organizes itself in a more efficient way.                                                                                                                                                                                                                                   
It is important to keep your therapist informed of any changes that seem particularly      unusual (or make you uncomfortable).
In order to access this program you will need to find a therapist in your area using this link If a practitioner with advanced training is available, that person would be my first choice as he or she will have access to the entire library of music rather than just the modulated series. If there aren't advanced practitioners in your area, the modulated program (with 24 selections and counting) is still well worth the time and expense. You can always convince your therapist to get the advanced training later on!
I use Therapeutic Listening in my practice with children who have sensory processing disorder, anxiety disorder, autism, ADHD, learning disabilities, and Down syndrome. I have had positive results with everyone including a 10 year old who was suddenly potty trained for bowel movements (with core activation), a boy who has been treated for anxiety with medication for years to no avail who is now having "great" days at school for the first time ever (his words), a child with global apraxia who is using many sentences, a boy who after listening during one session said to me with a smile, "I am unsad!" I replied, "Unsad?" He smiled again, "Yup, and I'm unmad too!"
I also used Therapeutic Listening with my daughter, Carrigain, as soon as she turned 2. She had many signs already, and was a good imitator. She enjoyed pretend play, she knew her body parts, she knew animals and animal sounds. She had a few spoken words and approximations. She did not point, she could crawl but was not motivated to do so, she was never hungry or thirsty, and she was content with whatever was put in front of her. She had some auditory sensitivity, and was especially fearful of the vacuum cleaner (a clear sign of issues with understanding space).
Shortly after starting the program, she started pointing, noticing things that weren't right in front of her, requesting (food, drink, and other things), and crawling faster and with much improved coordination. Her world was starting to make sense and she wanted to explore. Her language exploded. I remember going to an appointment shortly after she turned 2, and her doctor asked how many words she could say. My husband and I were at a loss-we had stopped counting. She was putting two and more words together well before her 3rd birthday. Between 3 and 4, she started using multi-word phrases and sentences regularly. She is now four and her language is not the same as all the other 4 year olds in her preschool class, but tonight she said, "Hey guys, what are you playing with?" Then, "Oh, can I play too?" When she wants something, she says, "Mommy, may I have ______ please?" We have conversations. She makes me laugh. She gives me compliments. She tells her little sister what to do, and helps her feel better when she is sad. She tells me when she is sad, scared, embarrassed, frustrated, etc. using those words.
I was also hoping that Therapeutic Listening would help Carrigain's walking, but she didn't walk until she was almost 3. In hindsight, I think I should have stimulated her vestibular system a little more. Still, when she did start walking, she walked well right away. She tried to do the "Hokey Pokey" the first week she was walking (singing for herself).
I don't know what Carrigain's development would have been like had I not used Therapeutic Listening, but I do know that her language was surprising to most people we encountered in the Down syndrome world. We didn't do any special speech therapy (some early oral motor work and traditional speech). We didn't do an early reading program (although I wish we had). We didn't start Nutrivene, ginkgo, or Longvida Curcumin until after we had finished her Therapeutic Listening program.    Here's what NACD has to say about listening therapy and Down syndrome Please note, that they are promoting a different program, but the justification for a listening based intervention is helpful. I am not familiar with their program, but it seems more specific to auditory processing rather than addressing the range of issues that Therapeutic Listening targets.
For a nice video and more information about Therapeutic Listening try this link