Listening is the active and motivated process of tuning into and filtering out sounds. By emphasizing good listening skills and well organized intentional interactions with the music, sound therapies allow the child/client to process and integrate both sound and movement. This connection between sound and movement is utilized during occupational therapy sessions by including sound therapy with other sensory-motor activities.
I use a holistic approach to sensory integration for my clients. The implementation of central nervous system inputs (therapeutic activities) activate neural responses that, when repeated and reinforced over time produce adaptive structural changes in the brain and central nervous system and lasting remediation. Therefore, Sound Therapy is integral to the therapeutic process for those children identified through a sensory evaluation as having auditory system dysfunction. The modulated music listened to through the headphones has a powerful effect on the autonomic nervous system producing improved regulation that, when combined with intensive therapy and a sensory diet implemented at home and school, has had permanent positive changes to the nervous system in the children I have worked with.
Theory of Sound Therapy
Besides emphasizing various frequency ranges for specific purposes, the music is also modulated with somewhat random pulses of increased and decreased volume at certain frequencies throughout the therapy session. This prevents conscious adaptive filtering to allow the inner ear muscles to strengthen thus improving their ability to filter out noise. To this end the headphones for iLs program, (but not Therapeutic Listening program) also have (optional) separate bone conduction speakers which deliver sound directly to the inner ear through the skull without first being processed by the middle ear. Finally the left and right speakers are separately balanced and modulated to provide specific left-right hemisphere brain connective adaptations (think left-brain for logic and sequence and right-brain for art and creativity) to improve reasoning and communication.
There are three distinct frequency zones defined in the therapeutic listening process.
- The Sensory Motor Zone includes the lowest frequencies (sounds like kettle drums, bass notes, thunder, and animal growls) and are used to stimulate the vestibular system and influence balance, coordination, and postural stability. These low frequency sounds also stimulate the nerves in the whole body producing increased body awareness and sense of security with regard to gravity.
- The Communication Zone includes middle frequencies that are heard regularly in speech and low quality audio music. They are used to improve speech, language, vocal control, attention, concentration, and memory.
- The Integration Zone includes high notes like flute, soprano voice, and bird song. These frequencies stimulate a greater number of neurons because there are more cells in the nervous system that respond specifically to these frequencies than all the rest of the sounds put together. They send more neuronal pulses to the brain because of this and may improve alertness, energy, intuition, motivation, organization of ideas, speaking, communication, and active listening.
KP was three years old. He was diagnosed with dyspraxia, developmental coordination disorder, and speech apraxia. Following his initial evaluation, there were numerous other issues which were to be addressed.
- sensory modulation
- behavior problems
- delayed postural control
- decreased muscle tone
- poor balance, equilibrium, righting reaction
- bilateral motor coordination
- gross and fine motor delays
- praxis difficulties
- decreased ideation
- organizing ideas
- motor imitation
- motor sequencing and execution
- language delays
- difficulties following verbal directions
- poor articulation and intelligibility due to oral praxis problems
He received a total of 31 90-minute sessions of OT and Sound Therapy (using iLS) for sensory integration over a twelve week period. The first several sessions emphasized postural control, body awareness, and gross motor skills using low frequency sounds and strong bone conduction. KP improved in postural control, muscle tone, equilibrium, righting responses, body awareness, gross motor coordination, visual motor skill, and improved sleep.
Later sessions focused on oral motor activities, continued emphasis on praxis and higher level coordination activities by using mid level frequencies while OT was concentrating on communication, attention and memory. KP improved in verbal output and improved ability to coordinate total body movements such as dressing and playing on the playground.
Finally, higher frequencies were used in therapy sessions to emphasize ideation skills and sequencing. His ability to follow multiple instructions improved. Also KP was better able to plan and sequence his own gross and fine motor skills.
Follow-up activities included:
- collaboration with the school therapist to promote KP’s goals and achievements in the school setting
- Additional home activities with Therapeutic Listening to continue work on his gross motor and praxis skills
After three months KP showed continued improvement in sequencing motor and language skills as well as better attending at school. At this point KP began listening to informal music program CDs appropriate for unsupervised parent use.
In Part 3
A brief review of the various Sound Therapy programs and products with recommendations and (maybe) some parent testimonials.