Beyond Modulated Music: Continuing the Therapeutic Listening® Progression

Results from quantitative and qualitative research identify that the addition of Therapeutic Listening to occupational therapy services supports improvements in performance skills and client factors (fine-motor, social skills, visual-motor, arousal regulation, attention) that influence occupational participation (Bazyk, Cimino, Hayers, Goodman, & Farrell, 2010; Hall, & Case-Smith, 2007; Wink, McKeown, and Casey, 2017). If you have found that the addition of the Modulated Therapeutic Listening albums has augmented your practice, you may want to consider other albums within the Therapeutic Listening Library to expand your programming.

An essential addition to a Therapeutic Listening® provider’s treatment toolbox.

The Therapeutic Listening Fine Tuning albums make an essential addition to any trained Therapeutic Listening providers’ treatment toolbox. Used later in a progression, these albums are individually selected to build upon and refine the gains that individuals made while using the modulated music. Due to the unique addition of the sliding high-pass filter, the Fine Tuning albums draw the listener’s attention to the higher frequencies that provide more detailed information. Sounds in the upper frequency range carry the details and subtleties that capture attention, contain the nuances of emotional content, and support identification and discrimination of different speech sounds.

The Fine Tuning albums refine the attention and focus necessary for academic success.

In our clinical practice, we have found that the modulated albums support fundamental skills related to sensory modulation, arousal regulation, perception of space and time perception, postural activation, fine- and gross-motor, and attention/academic readiness. The Fine Tuning albums continue to support the aforementioned gains, as well as, refine the attention and focus necessary for academic success. In addition, we have observed the contributions to fine tuning social interaction, non-verbal communication, affect, and rhythmicity of body movement. A customized combination of the modulated albums followed by individually selected Fine Tuning Mountains can create an ideal listening progression for our clients.

Lacey’s Story:

Lacey was a bright, hard-working, 13-year-old young lady. She had good grades and was interested in extra-curricular activities including singing, dancing, and acting. Unfortunately, Lacey’s difficulties with sensory processing impacted her arousal, affect, and postural activation and motor organization; thus, limiting her energy for and achievement of self-selected extra-curricular interests. Furthermore, her sensory processing difficulties contributed to an increase in stress and effort required for academic participation and completion of activities of daily living.

Clinical observations revealed Lacey’s various difficulties with oculomotor control, inadequately developed anti-gravity holding patterns, inefficient respiratory patterns (short, shallow, and breath holding), and poor core activation. As part of her bi-monthly sessions, Lacey participated in a combination of therapeutic activities to support vestibular activation, enhanced proprioception, oculomotor control, and motor coordination, along with a series of five Modulated albums from the Therapeutic Listening Library.

While Lacey made progress with her ability to tolerate movement, fluidity of motor coordination, improved respiratory patterns, and a reduction in stress and headaches, concerns still existed with Lacey’s ability to keep her belongings organized, maintain an optimal arousal level (often fatigued), self-initiation with and motivation for activities of daily living, and ability to follow-through on verbal directions. Her therapist recommended progressing to the Fine Tuning Mountains in combination with vestibular-proprioceptive activities, both in-clinic and in combination with home programming.

Over the course of three Fine Tuning Mountains, Lacey demonstrated significant improvements in broadening her range of arousal level, reported feeling more energetic, demonstrated an improved ability to execute verbal directions, enhanced interest in self-care and overall body awareness, improved rhythmicity and timing of social interactions, and refined orientation in time and space. These changes supported Lacey’s overall quality of life, as she now had more energy to participate in extra-curricular activities in the evening and outside of the school-day as evidenced by joining her school’s choir and community theater group.

Blending Modulated music with Fine Tuning, Spatially Enhanced, and Quickshifts/Gearshifters.

If you are eager to add the Fine Tuning selections to your practice to enhance your client’s clinical outcomes, join Vital Links for an upcoming Sharpening Focus workshop. In this course, Sheila and I will discuss moving beyond the Modulated music into more advanced Therapeutic Listening® progressions, blending the Modulated music with Fine Tuning, Spatially Enhanced, and Quickshifts/Gearshifters.

-Tracy Bjorling, MS, OTR/L



Bazyk, S., Cimino, J., Hayers, K., Goodman, G., & Farrell, P. (2010). The use of Therapeutic Listening with preschoolers with developmental disabilities: a look at the outcomes. Journal of Occupational Therapy, Schools, & Early Intervention, 3(2), 124-138.

Hall, L., & Case-Smith, J. (2007). The effect of sound-based intervention on children with sensory processing disorders and visual-motor delays. American Journal of Occupational Therapy, 61, 209–215.

Wink, S., McKeown, L., and Casey, J. (2017): Parents’ perspectives of using a therapeutic listening program with their children with sensory processing difficulties: A qualitative study. Journal of Occupational Therapy, Schools, & Early Intervention, DOI: 10.1080/19411243.2017.1304839


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