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REGULATION 1 CASE STUDY
Regulation 1 contains easy listening music that flows without a heavy emphasis on timing or rhythmicity. The listener tends to easily synchronize with the music, offering a soothing experience that often assists in arousal and emotional recovery. The musical presentation supports “recovery,” a return to an alpha state from brainwave frequencies that are associated with high arousal, and defensive patterns of response, stress, and anxiety.
Joseph was a seven-year-old boy who experienced a host of challenges related to self-regulation. Joseph was raised by his grandmother, and although she loved him very much, she was concerned about Joseph’s defiant and aggressive behaviors towards her. In the morning before school, Joseph would become angry and frustrated while getting dressed and ready for the day. He would often kick and hit his grandmother and screamed, “You’re not my mom! I don’t want to live here!” In addition to behavioral concerns, Joseph had great difficulties sleeping at night and had a hard time making and keeping friends. Joseph’s therapist implemented Regulation into his home program to support his ability to modulate his arousal levels, emotions, and behaviors. After only one day of listening, Joseph awoke the next morning full of smiles and hugs for his grandmother. Even more, Joseph independently got dressed, ate his breakfast, and was ready to start his school day. Following the second day of listening, Joseph did something he had never done before—he told his grandmother that he loved her. Joseph continued to use Regulation 1 to further support his behavioral and emotional control.
Ask your therapist to listen to a sample of Regulation 1.
REGULATION 2 CASE STUDY
Regulation 2 is similar to Regulation 1 in that it is comprised of easy listening music that flows without an emphasis on timing or rhythmicity. However, there is an additional slight dampening of frequency patterns which are associated with auditory defensiveness. This may be an appropriate choice for individuals with sound sensitivities as well as those in need of support for recovery and regulation of arousal, emotional, and behavioral states.
Steve is a charming and bright 11 year old who was seen for evaluation and consultation at Therapeutic Resources to develop a home program to address sensory processing challenges and difficulties with anxiety. He is one of a set of triplets who appears to otherwise be functioning fairly well within the school and community environments.
A combination of standardized assessments and clinical observations were used during his initial evaluation to obtain relevant clinical information and develop goals. Clinical observations revealed insufficient vestibular processing and subtle oculomotor challenges. On the Sensory Processing Measure Steve fell within the ‘Typical Range’ for most areas with the exception of three that fell into ‘Some Problems’: Hearing, Vision, and Planning and Ideas. Steve has difficulties tolerating any repetitive noise such as clicking sounds, chair tapping, and the dog breathing. When there is excessive noise in the environment he often lashes out at the sound source. These problems appear to co-occur with an increase in anxiety, especially in the evenings during homework and family time. Auditory appears to be causing the most stress and correlates the strongest with his difficulties with regulation and anxiety. Additionally, Steve has an extremely difficult time falling asleep at night often taking an hour to fall asleep. During a semi-structured interview, using the Canadian Occupational Performance Measure (COPM), Steven identified sleep as one of his goals. Specifically Steve would benefit from strategies to help him fall asleep faster. A Regulation 2 Quickshift was chosen due to the impact that environmental sounds had on his regulation and anxiety.
Steve was seen two week later for a follow up appointment. He reported that with use of the Regulation 2 Quickshift he was falling asleep immediately after listening (within 15 minutes). His mother stated that at times he would even fall asleep before the music was finished . His therapist next selected a Regulation 3 Quickshift to continue to maintain his gains with sleep and support his other goals, including completing homework without distraction and need to wear noise canceling headphones.
Ask your therapist to listen to a sample of Regulation 2.
SPACE CASE STUDY
Space contains solely nature sounds that have been specifically recorded to enhance the three-dimensionality of the spatial surround. The listener is enticed to orient outwards into the environment but is provided with the support of a sense of organization and an emotionally neutral template. As an emotional regulator, this selection would be appropriate for individuals who are either emotionally labile or who display a flat affect. Individuals who tend to become stuck in logic, detail-orientation, literal thought, and otherwise strongly “left-brained behavior” may also benefit from this selection.
Molly was initially referred to our center in May 2013 at the age of 4. Molly had previously participated in occupational, speech and physiotherapy services. Molly had a diagnosis of a developmental delay. Molly’s pregnancy was uneventful, and she was delivered via C-section. Molly was hospitalized at four months with bronchitis, and had continued respiratory infections throughout her first year. She was diagnosed with floppy baby syndrome at nine months. She was reported as a fussy eater as a baby, whom did not gain weight easily. Her early milestones were delayed; sitting at eleven months, crawling at eighteen months and walking at twenty-one months. Molly had repeated ear infections between the ages of one and three.
At four years, Molly had difficulty with sleeping and was described as fussy eater. She was increasingly resistant to grooming tasks. Molly could seem preoccupied with seeking out intense movement, and was often ‘fidgety’ both in her body and with clothing. She was sensitive to sounds such as the vacuum cleaner, lawn mower, leaf blower and thunder. She was also easily distracted and overwhelmed in noisy environments. She was described to have ‘no fear’ and poor safety awareness. She had a high threshold to pain sensations. Molly would easily lose her balance, tripping/falling often. Molly can also seem weaker or tire more easily than her peers. Molly could be aggressive, and had frequent tantrums. She was described to be easily frustrated, anxious and overwhelmed.
Molly participated in weekly occupational therapy sessions, along with two 5 day treatment intensives. Molly participated in Therapeutic Listening® at home, listening twice per day.
By the end of 2014, Molly was a much more organized and calmer girl. She was a happy and confident girl who had many friends at preschool. Molly had a much wider food repertoire and grooming was not a challenge. Molly still had some challenges with activating her deep core muscles, and had a strong bias to extension patterns of movement. The quality of Molly’s movements would be described as rigid and lacking good rhythm. While Molly was supported with modulated music, and now able to move throughout in space with greater success, she often appeared stuck in extension or out in space.
In the beginning of 2015 Molly participated in a treatment intensive focused on setting her up and organization in preparation for beginning Kindergarten two weeks following. Molly had previously had significant shifts in her arousal and behavior following two treatment intensives. This treatment intensive followed the same structure as previous, involving two sessions per day over a five day period. Molly participated in both Berard AIT as well as clinic gym work.
Following this treatment intensive Molly’s mother contacted me as she was concerned about Molly’s emotions. These were described as being extreme, for example, ‘when she is happy, she is overly happy,’ as well as increased times of disorganization, tantrums and negative behavior. Molly had also returned to poor sleeping patterns. Molly’s mother had found that a usual organizing music selection of Quickshift Oral Motor did not have the designed affect, but she felt like Molly was somewhat calmer while Quickshift Gentle Focus was on. I asked Molly’s mum to bring Molly in for a session so we could support her and Molly.
On arrival Molly’s posture had increased extensor tone throughout her body, including her upper extremities. It seemed that Molly was stuck in reach for extension, and was not balancing it with any flexion. My treatment goals went immediately to flexion, and support a soft center for Molly to organize and calm with. As we begun to work with push patterns on the ground, it still felt like Molly was out in space and could not organize her movements in space well. We continued to work within suspended lycra to promote some compression in flexion as well as push patterns for climbing. Knowing that Quickshift Gentle Focus had some success whilst listened to, but not a lasting impact, I wanted to support Molly more in the space, especially supporting Molly coming back to her own body/center. We chose Quickshift Space during this session. Molly immediately stilled with the music and an observed softness in her face was present. Molly also sought out a fetal curl position with her mother as she continued to listen. Following this listening position, Molly was also able to gain greater flexion in activities over the ball and seemed to ‘melt’ into her environment.
Later that afternoon, Molly’s mother relayed the following, “THANK YOU, THANK YOU, THANK YOU!! Molls is so mellow and so much more together (exactly what I expected after intensives). Thank you again for seeing her today!”
Molly continued to listen to Quickshift Space two times per day for the next week. One week later, Molly successfully attended her first day of Kindergarten. Molly’s mother relayed, “Thank you for being a big part in getting Molly ready for today!! She did so well and I couldn’t be more proud of her!! Thank you!!”
Ask your therapist to listen to a sample of Space.