Last Updated on August 17, 2016
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I have a child on a TL program that has a difficult time with attention. His attention has improved since starting the listening; however his mom reported today that he is a lot more “argumentative” since he started the listening program and she was curious as to whether or not you have seen this in other children. Have you seen this in the past?
What we sometimes can see, is what we like to refer to as a “period of disorganization followed by reorganization”, as the nervous system reorganizes itself. This happens in typical development as well, as a child gains a new skill, they may regress in another for a short period of time. Often when children become more integrated and connected to their emotions and communicative abilities we can see that struggle for independence emerge. Emotionality is typical as a child’s modulation becomes more regulated. I often celebrate the emerge of the “terrible twos” at whatever age the child is chronologically because so many of these children never went through that growth in independence. If this child is coming into his own in a bigger way at this time his arguing could be a response to his new found sense of self. I would encourage the parents to set limits where needed but not to over power struggle with him as he gains this new skill. If on the other hand the arguing is coming from a place of disorganization or irritability that is more than the family can handle or is making his life difficult in other environments, then I would look to make a change in his listening program.
One of my clients has been demonstrating increased negative behaviors since he started on the listening program. He is screaming, biting, hitting, etc. I am not sure what the cause of these behaviors is, but I thought you might have suggestions.
Emotionality is typical as a child’s modulation becomes more regulated. Is the child trying to communicate something to you? The child may be trying to communicate wants/needs, but does not currently have the means to do so. If you are seeing positive changes and parents are supportive, I would continue 2x/day for 30 minutes and support with a good sensory diet.
My child started a Therapeutic Listening & now has increased auditory sensitivity—why is this?
The most primitive defensive response is to shut off sensation. Often times, when these children begin a Therapeutic Listening, they cover their ears; begin to complain of noise, etc. These are all higher level of adaptive behavior than shutting off. It is important to look at the context of what you are observing. For example, is the increase in auditory sensitivity also coupled with an increased attention, increased vocalizations, behavioral changes, or improved postural control? Observing progress in other areas is a key that you are on the right tract. Children will typically progress through the increased sensitivity phase to an even more advanced level of processing auditory input. In this phase you will see increased attentiveness & connectedness. Again, increased auditory sensitivity is usually a positive adaptive response. However, if auditory sensitivity persists for more than 1-2 weeks, consider modifying listening times, CDs, or overall sensory diet strategies.
One of my clients has been demonstrating increased stimming behaviors since starting on the listening program—any suggestions?
To decrease self-stimulatory behaviors, it is helpful to increase proprioceptive input in their sensory diet
I have a child with a lot of sensory issues who is on the Therapeutic Listening program. He already had some bowel/bladder issues, however he started wetting his pants & bed a lot more frequently (1-2x/day). Any suggestions?
If the child has poor vagal tone, there sphincter will be less relaxed. As the music works on the vagal system, you can see relaxing of the sphincter whereas before it was controlled in a narrow range. Now the range of control is broadening. As the child begins to integrate the new range of bowel/bladder control, you will see a decrease in the enuresis and soiling.
Have you used TL with traumatic brain injury or stroke?
We have used Therapeutic Listening with clients with traumatic brain injury and stroke. It may be worthwhile trying the listening with this client. It may help improve his perception of some sensory issues that may in turn improve some timing/sequencing seen in movement and an awareness of his own self. It can be helpful for postural activation, spatial awareness, and attention, as it taps into the orienting response.
I have evaluated a 17 year old male with Aspergers and schizoaffective disorder. He demonstrates sensory processing and modulation difficulties. He is anticipated to develop schizophrenia. I’d like guidance re” TL with the schizoaffective/schizophrenic population—or is it entirely contraindicated?
We do not recommend Therapeutic Listening for clients with Schizophrenic disorders due to the lack of pre-pulse inhibition and the fragile chemistry.
What type of research is available on TL?
You can refer to the March/April 2007 edition of AJOT, for the article entitled,” The Effect of Sound-Based Intervention on Children With Sensory Processing Disorders and Visual–Motor Delays” by Leah Hall and Jane Case-Smith. You can also refer to the “Listening with the Whole Body” book, the work of Steven Porges from the University of Illinois, Chicago, and “When Listening Comes Alive” by Paul Madaule.
Can you explain TL?
Therapeutic Listening is appropriate for individuals with lack of biological foundation for social engagement (facial expression, vocalization, eye contact), lack of foundation for interaction (localization, orientation, filtering for salient features), history of chronic middle ear infections or chronic fluid in the middle ear, regulation issues (disturbances in sleep/wake cycles, hunger/thirst patterns, bowel/bladder control, and other homeostatic functions), sensory defensiveness, history of difficulty grading responses to sensation, difficulty grading functional range of arousal states, vestibular-auditory-visual integration dysfunction, disorders of praxis, and bilateral motor coordination difficulties.
Listening is a part of Sensory Integration and is appropriate with multiple Diagnoses including but not limited to: ADHD, autism, CP, attachment disorder, LD, Down Syndrome, CAP, SI Disorder, etc.
Many children with sensory integrative dysfunction have difficulties with listening.
Listening is the ability to:
- Orient to sounds
- Locate sounds in the environment
- Select certain sounds from the environment
- Direct our attention and focus to those sounds
- Interpret and discriminate sounds
- Feel comfortable in the presence of sounds
Therapeutic Listening addresses these issues directly through the therapeutic use of an extensive portable library of electronically altered music on CDs. Therapeutic Listening coupled with SI has been shown to clinically impact:
- Sensitivity to sound
- Poor auditory orientation and localization
- Auditory distractibility
- Attention difficulties
- Speech and language delays
- Difficulty following directions
- Problems with social skills
- Difficulties with postural activation
- Difficulties with reading comprehension
Can you explain sensory diet?
Incorporation of a sensory diet that includes core-based, resistive activities is the “glue” that makes the changes made by the Therapeutic Listening program stick. Some primary areas to focus on are: balanced flexion/extension and rotation/counter-rotation around the central vertical axis. To work the deep core musculature, the child must work to the point of fatigue. When working to the point of fatigue, you recruit core musculature versus surface musculature.
Respiration must also be addressed—ask yourself where the breath located, observe primary location of breath movement before/during/after core activities and how it has changed, observe link between respiration and modulation. Often “short, shallow breathers” are in a heightened state of arousal. We are looking for a deeper breath with the diaphragm moving freely. Keen observation of the breath is essential during core activities—we want to be certain the child is not holding their breath, as this means they are not activating core musculature. Be sure there is a full exhalation, as exhalation determines a full inhalation.
It is important to remember to incorporate these objectives into fun activities. Some general ideas incorporating these principles include:
- Supine on scooter board (hips and knees at 90 degrees)
– Pushing off wall or using bungee cord
- TV sit
– Ball explosion, ball passing with feet, bicycles
- Therapy ball
– Supine walk-outs, supine-to-sit
- Prone on scooter board
– Pushing off wall or using bungee cord
– Passing ball, hitting suspended ball
- Therapy ball
– Prone walk-outs
- Med Ball activities
– Back-to-back turn and pass, side-to-side toss against wall
- Therapy ball
– Incorporate visual activity behind child
Can you explain the role of core & the vestibular systems?
Emphasis is placed on activating core musculature to achieve deeper respiration and to increase core strength and endurance. The goal is to develop the deep muscles (those closest to the bone), especially the muscles providing three dimensional support around the central vertical axis of the head, neck, and trunk. It is important to maintain a continuous flow of breath with focus on the exhale during core activation so as to coordinate movement with breath. When the deep muscles are engaged, postural control and breath support are effortless since minimal conscious effort is required. Thus, surface muscles designed for sill, are released from undesirable “fixing” and are able to function according to their natural design. When the body moves with ease and fluidity, the child is free to creatively and independently execute complex reasoning for communication, problem solving, planning, organizing, and executing life tasks and roles.
The vestibular system helps us to understand the position of our head and body in gravity-bound space. It gives us information about which way is up and where we are going. It helps us with balance, spatial orientation, and maintaining a stable visual image, even when we are in motion. Since movement is an important part of everything we do, the vestibular system is important for all of our interactions with the sensory world. The vestibular system teams up with the auditory and visual systems to perform may important tasks by helping us understand the 3-D space that surrounds us wherever we go, Through the proper functioning of our vestibular-auditory-visual triad the sights and sounds of our world become meaningful and entice us to move, explore, and engage with objects, people, and events. The vestibular system activates the core postural muscles that surround the central vertical axis of the body. When the vestibular system is not working properly to guide postural control, the eyes cannot participate efficiently in tasks such as copying from the blackboard, reading, writing, or catching/kicking a ball.
I understand that ultimately it is a home program but, are we as OT’s to complement the program within the clinic setting in order to modulate and scaffold the child with vestibular?
The best way for a Therapeutic Listening program to be most effective is for the child to listen daily. In that scenario a therapist would not need to have the child listen in clinic unless they were changing CDs and wanted to start the new CD in the clinic first to monitor the child’s response. If you are using the CD to set up the child’s nervous system to better take advantage of the treatment session then I would have the child listen during the times in the session that would take the most advantage of the input. If you want to support visual motor and attentional skills then using the music during tabletop activities is fine. If you are using the music to enhance movement or core activities then using a fanny pack and moving is appropriate.
I currently treat a 4 year-old girl who has been toilet trained for at least a year. She finished the Preschoolers protocol, (but did not do well with the strawberry CD, she became very aggressive and obstinate while listening to the music and after the music was removed). She did best on the Apricot CD…but once she finished the 12-week program she became incontinent and is not phased if she has accidents in front of her peers. This is very disconcerting for her family and me. This girl does not have a diagnosis but displays characteristics of ADHD. She has had a hard childhood and is currently being seen by a psychologist.
I have a couple of questions for clarification. Was this little girl continent while she was doing the modulated music program? Did the incontinence start once she stopped listening? If she was doing well with toileting while on the modulated music I would be tempted to put her back on Apricot Jamz or the CD that was most regulating for her. You suggested that she has had a difficult childhood and is seeing a psychiatrist. Is it possible that the incontinence is related to some other emotional issue? Any of the toileting issues I have seen while children are on a therapeutic listening program have usually been the result of a CD that was too intense or a listening time that was too long that resulted in the disorganization. This disorganization dissipated once we made a change in the listening program or ceased listening. I would be tempted to say that the issue she is having is related to something other than her listening program. Again, I would put her back on Apricot and see what happens.
Is it alright for the listening sessions to be 2 hours apart instead of 3, due to a short school day?
No, you should move to only 1 Therapeutic Listening session per day, if this is the case.
Is 2-3x a week sufficient amount of time to do the TLP or is a MUST to do it 2x every day?
You can do this; you just won’t get results as quickly. Also, if the child can be supported outside of treatment with a good sensory diet, that will help.
Does it have to be a full 3 hours in between listening times? What happens if it’s not?
In order for the body to completely integrate the program & based on the way the body’s internal rhythms works, yes at least 3 hours is recommended to separate listening times.
I have a child who will not tolerate headphones at home. He will listen with me in the clinic. Which CDs can I recommend for use over speakers?
We do not recommend listening over speakers with these children. There are too many confounding variables. Please refer to the hard headphone section in the “Listening with the Whole Body” book. Gentle, consistent persistence works very well with hard headphone kids. It is tough when children will wear the headphones in session without difficulty but the family is unsuccessful in following through at home. I would continue to educate the family in the benefits you see for their child with the listening you do in session & then help them set up some sort of behavioral plan around wearing the headphones at home, Encourage them to do the listening while the child is engaged in an activity he enjoys. I’m sure you can think of several behavior plan options to help them… maybe even identifying time of day to listen, etc. Until you get them to buy into the benefit of Therapeutic Listening, it will probably be challenging at home. Some of my families are more successful when they realize it is no different than insisting a child to take a medication they need. Often children cry with administration of meds but the family persists. It should be the same with listening especially if you have no difficulty in the clinic.
Is there any reason why if the headphones fit a child younger than 2 years of age that I couldn’t start using them before age 2? I am using the CDs via speaker right now & am seeing great changes. I would like to start him on headphones sooner rather than later, but wanted to see if there is any neurological reason/precaution to wait.
We do not use headphones on children under 2 years of age because the auditory system is not completely mylenated and may be sensitive to high intensity. Under the age of 2, we recommend using the music over speakers, in a small room, in a triangular configuration (with the child at the apex of the triangle). The child should be no more than 3-5 feet from the speakers.
What Therapeutic Listening CDs do you recommend for a child at 9 months?
Peach Jamz, Links to Modulation, Rhythm & Rhyme, or Mozart for Modulation. Under the age of 2, we recommend using the music over speakers, in a small room, in a triangular configuration (with the child at the apex of the triangle).
Have you had any success with clients who stutter?
Yes, we have seen changes in stuttering with the music. What is important to keep in mind is looking at his whole communication profile & not just his stuttering*. I typically start with modulated music and then move into (when appropriate for each child) Fine-tuning depending on what qualities are the most striking i.e. timing, respiration, emotion. I think listening highlights how poorly the 2 hemisphere may be communicating and, thus, the listener stutters. I would add a lot of voice work for this child as you continue to work on his body and with bilateral tasks to integrate both hemispheres. I would do kazooing and humming for him to play with his own voice. Spatial CDs will pull in both ears.
*With stuttering it is important that both ears are working together. If you can get a full spectrum audiogram & compare his right & left ears – they should be at the same sensitivity level.
Have you had any reports of diarrhea with use of Therapeutic Listening?
It is possible, however; we don’t have any specific cases.
My child is on a TLP & has been wetting the bed and having some sleep disturbances, what should I do?
If the child is having bladder control difficulties during bedtime, it can be an arousal issue. Some accommodations you can make to child’s Therapeutic Listening program include having the child listen earlier in the day, decrease the listening time, or decrease to one listening session per day.
Has listening to modulated CDs even been known to cause an increase in psychotic like behavior (images in clothing coming alike and increase in irrational fears)? Would you try Therapeutic Listening again & at what frequency? Any additional precautions?
I have never observed psychotic symptoms as a result of a Therapeutic Listening program. This child appears to have made changes in his spatial perception. We have seen this type of reaction in individuals, as they work to accommodate their increased spatial perception. I would try the listening program again, but would start with 30 min 2x/day and would help the family set up an appropriate schedule so there was consistency in listening times & sessions. I would also have the family keep a detailed log so you can better keep track of changes as they occur. I would also look at what type of sensory diet was in place as this child continues on his listening program. I would increase the core activities or heavy work that is included as part of his sensory diet.
Child is ill after listening (headache, vomiting) should I continue?
If the child has had only 1-2 episodes of headache or vomiting, I would suggest trying to move through the symptoms. If symptoms have been more frequently and the child is not able to move through them, you might discontinue the Therapeutic Listening for the time being and focus treatment on building a vestibular program first.
Is it appropriate to use Therapeutic Listening when a child has the flu, cold-like symptoms, or a temperature?
Since an individual will the flu or temperature will obviously be feeling quite under the weather, I would take a break from the listening until symptoms clear up and they are feeling better. Just consider it a “natural break from the body”. If an individual has a runny nose or a little cough, you can continue with their listening.
It is safe to use the Therapeutic Listening Protocol with a child who has a seizure disorder?
Yes, as long as the child’s seizures are not sound-induced.
One of my children is on medication for seizures. Would any of the CDs cause him to have seizures?
Neurologists have stated that it is not possible for the modulated or Fine Tuning CDs to cause seizures. The only precaution would be not to listen if seizures are sound induced, which are very rare.
What is your opinion about vestibular input (specifically swinging) with children diagnosed with seizure disorders whom are currently taking medication?
Unless you know movement triggers seizures, swinging should be fine. No photo optic, be careful about rotary near a light source.
When using a CD player with digital volume, what is the recommended volume setting to use?
You cannot go by a number because each model is different and the volume varies by the life of the batteries. The decibel number is 45-55 decibels. You can purchase a decibel reader at Radio Shack for $20. Otherwise, a quiet comfortable volume—the listener should not have to raise their voice to talk to you.
Can a child listen to the CDs over the car speakers if they won’t leave the headphones on?
Listening to the music in the car over the speakers isn’t acceptable quality.
Can listening be done over loudspeakers?
There are an increasing number of variables when listening is attempted over loudspeakers. First, the quality of the delivery system will play a role. Use of the Sennheiser 500A headphones makes up for all the variables within the stereo system or CD player. The environment also becomes a sounding variable. The dimensions of the room, qualities of the room (types of flooring or walls, amount of furniture, etc), and the acoustics will all play a role in the delivery of the sound.
Sound travels as waves through space. The greater the space through which the sound waves must travel, the less the sound waves impact the listener. The modulated CDs were configured for headphone use. We only recommend doing Therapeutic Listening over speakers when the child is under 2 years of age. The child should be positioned in the apex of the triangle formed between the speakers & the child, and the room in which the listening occurs should be small.
Will wireless headphones work?
No. Wireless headphones have a low dynamic frequency range or response. The quality, especially of the upper frequencies in which the important discriminative info is carried, is lost. Wireless headphones also pick up unwanted frequencies form any other electronic appliances that are being used within a nearby space.
What’s the best CD to help with auditory sensitivities?
To address auditory sensitivities, you should select CDs in the “Orienting, Regulation, & Sensory Modulation” category.
Once a child has completed a 12-week program & wants to go back to the old CDs to maintain his level, can he switch the CDs or does he need to use the same one consistently for a week or 2?
Yes, you can mix the CDs up once you know the effect provided for the child. Select CDs that have proven to be successful at regulating the child. It is helpful to recommend that families purchase the CDs as part of their personal listening library that have been particularly successful for the child, so they can work them into the child’s ongoing sensory diet. Another option would be to move to Fine Tuning.
Is it okay to do Therapeutic Listening with children who have do AIT, since they were told the child should never wear headphones again? Is it okay to use headphones with them? Will it erase the effects of the initial auditory training?
The caution with AIT is not to wear headphones with music in general. Music that has been specifically designed for headphones is okay.
What do I do with a child who has been on a different listening program that I want to put on Therapeutic Listening?
Take a break for about 2 weeks before starting Therapeutic Listening.
Can a child use Therapeutic Listening long term after they have been though the Tomatis program?
Yes, children often use Therapeutic Listening intermittently as a part of their ongoing sensory diet.
An audiologist strongly warned a parent against Therapeutic Listening. I called to clarify her concerns and told her she was confusing it with AIT. She stated the purpose of AIT is to selectively damage hair cells. Can you help?
Therapeutic Listening is NOT the same program. AIT is played loudly by SOME practitioners, which is what breaks the hair cells. Therapeutic Listening is well within OSHA standards.
How does Therapeutic Listening compare with AIT?
Both AIT and TL use music that is filtered in the same way. AIT has the possibility of selecting a narrow-band filter that tailors the program to any peak sensitivities in the audiogram. AIT is done two half hours per day for a total of 10 days and is completed within 12 days. Therapeutic Listening is done 2x/day for 30 min, is done in the context of Sensory Integration and the type of music, and the length of the program and music is matched to the child’s needs. AIT is completed in the clinic and TL is completed in the home. AIT uses a variety of approved commercial music with a broad range of frequencies that is processed through the AIT device.
If you would like further information on AIT, their website is www.drguyberard.com.
How does Therapeutic Listening compare with “The Listening Program”?
Therapeutic Listening has a wider array of music, musical styles, and a longer period of modulation, which has the broadest impact on the basics of listening on multiple levels. Other listening programs use a variety of filtering techniques on one CD and move more quickly into advanced CDs. We have found that kids tend to get better results with modulated music for longer periods of time. Therapeutic Listening trains in the context of sensory processing, from a very clinically oriented point of view. We teach clinicians how to match the music to the individual child, which allows you to meet the specific needs of each client. The workshop is taught by clinicians for clinicians and uses videotape and clinical analysis throughout. This is what is unique from our perspective. The Therapeutic Listening training helps you integrate it into the rest of your practice and provides the follow up support that you need.
We are having a problem implementing Therapeutic Listening—once we set the CD players for random shuffle & it gets to the last selection, it turns off. This might be after only a couple of minutes, since the selections are shuffled. Do you have this problem & how do you solve it?
You may want to check the directions on your CD player. Sometimes you have to set it on “random” & loop to get it to play & not stop at the end.
Please advise: Mozart for Modulation CD has such a low volume that when put on the regular volume setting, it cannot be heard. What setting should it be on or should it be totally inaudible?
You cannot go by a number because each model is different and the volume varies by the life of the batteries. This CD was recorded at a lesser volume, so you may need to turn the volume up slightly more for this CD than others. Remember, a quiet comfortable volume—the listener should not have to raise their voice to talk to you.
When starting a brushing program should I stop the music?
Whether or not you combine the two modalities, will depend on your clinical reasoning for treatment with the child.
Is there a time frame for success with the Therapeutic Listening?
You should see some changes within 2 weeks.
What is the difference between the Structured Listening & Therapeutic Support CDs?
The Structured Listening CDs can be used over speakers or with headphones. They are non-modified that are appropriate for either use. They are useful in classrooms to enhance learning & also can be used to “tone down” a TLP if the modified music appears to be too intense. The Therapeutic Support CDs are for speaker use only. These blend nicely with treatment for engagement, grounding, and/or motivation.
What is the difference between Therapeutic Listening & Samonas CDs?
Samonas CD uses spatially enhanced recordings and the music is spectrally activated to emphasize the time differences in the shape of the sound. There are also high extensions, which are short passages of high pass filtering which eliminate all sounds below a specific frequency (the degree of filtering progresses with higher levels of activation).
The modulated CDs in Therapeutic Listening, uses a broad range of music (electronic, classical, familiar children’s music, and music highlighted with spatial sounds). The music is modified with a high pass-low pass filter, which is at 1000 Hz. Alternately, the 1000 Hz and above are filtered out and 1000 Hz and below are filtered out. This filter comes on randomly during the music, and is designed to capture attention.
The fine tuning CDs in Therapeutic Listening, uses a combination of the high pass-low pass filter, in addition to a sliding high pass filter. For example, the 2000 Hz sliding filter, will start with approximately 1000 Hz and slide to 2000 Hz as it filters the music. The 4000 Hz filter with slide to 4000 Hz, and the 6000 Hz sliding filter will slide to 6000 Hz. There are 3 levels within each Fine Tuning mountain (2000, 4000, 6000) and 4 mountains in all, with the music in each mountain more complex that the last. The sliding filter and high-pass/low pass filter are each used about 1/2 the time during the music, with the sliding filter used at parts of the music with greater complexity to shift attention.
Could you give me brief summaries of what benefits are seen for the therapeutic support CDs specifically?
Chakra Chants – rhythmic patterns, very grounding. This CD works well for individuals with poor awareness of their body & how it is connected to the outside world.
Hooley Dooley – commercially available children’s music: Ready Set Go! by the Hooley Dooleys. Fun songs for little ones; easy to sing-a-long with, songs about numbers and food, and movement.
Kidz Jamz – Apricot – rhythms inspire movement. Strong vestibular input, good for promoting sensory modulation, attention, timing & sequencing, motor planning, bilateral coordination, postural organization, core activation & arousal.
Kidz Jamz – Grape – rhythms provide strong body connection. Strong vestibular input, good for: postural organization, sensory modulation, attention, core activation, and gravitational insecurity.
Kidz Jamz – Razzberry – musical simplicity with jazzy improvisations. Good to help maintain attention & focus.
Kidz Jamz – Strawberry – songs to spark vocalization, communication & connection. Enhances self-regulation, body movement, communication skills, and emotional tone. Three Tongue Twisters invite listeners to play with language & vocalizations.
No Worries – fun kids music created by OTs. Great for working with kids with SI issues, includes a booklet with the lyrics and movements to match; includes “The Brushing Song.”
Sacred Earth Drums – grounding. Simple rhythmic patterns, good for child with speech/ language but not “body” (no sense of where s/he is in space). Slightly more grounding than Sacred Spirit Drums.
Sacred Spirit Drums – grounding. Simple rhythmic patterns, good for child with speech/ language but not “body” (no sense of where s/he is in space).
Say G’day! – fun kids songs. Another fun CD with songs about movement for little ones created & sung by the vocalist (an OT) of Rhythm & Rhyme and No Worries!
Spirit of the Forest – includes nature sounds. Another grounding CD which also provides information about the spatial envelope.
Tibetan – Golden Bowls – sound created through vibration and touch on metal bowls. Complex harmonics and resonances, grounding, relaxing & promotes good respiration.
Structured Listening CDs:
- Bach for Modulation
- Baroque for Modulation
- Mozart for Modulation
- More Mozart for Modulation
- Vivaldi for Modulation
All 5 of the above are the non-modified (non-high pass/ low pass filter) versions of the recordings of the same title. The baroque CDs (Baroque, Vivaldi, Bach) are helpful with suck/swallow/breathe synchrony and feeding as well as attention, focus, listening in the classroom, handwriting groups, and academics. The Mozart CDs, including Mozart Winds help with regulation, oral motor & respiratory function, affect, communication, academics, social turn-taking, and engagement.
Gregorian Chants – can enhance suck/swallow/breathe with eating and other related oral motor, respiratory activities; can promote attention, focus and self-regulation.
How much movement or activity should be done if the TLP is done at home? Should the exercises mostly be working the core or is jumping sufficient?
Ideally, it is great to give the child prop/heavy work input during or immediately after listening to have the child work until somewhat tired. We generally suggest about 30 minutes 2x/day, but we really need to know the child to make the assessment. Some kids need a lot more & some less… it is best if you use your own clinical judgment in regard to each specific child. In regard to activity type, the “Listening with the Whole Body” book, pages 3-45 through 3-49 and 3-69 through 3-72 are very helpful with this. The “Core Concepts in Action” is also very helpful.
What activities should be discouraged while listening to CDs?
Any activities that make the child seem “unavailable”. This would include: TV, videos, computer use, video games, and “lining up” toys/objects.
Often my client falls asleep while listening to the CDs. Is this okay?
We do occasionally have some children/adults who fall asleep while listening to the music. This could be from so many different things (long day, quiet period of time, etc.). While it is not ideal to have the client listen while sleeping, it is also not a problem. In an ideal world, we would like the listener to be awake & mindful of the music, but if they listen while sleeping (which is easier for some), the music can still be effective.
Can I use TL with the geriatric population? Does it affect an adult the same way as a child? Are the treatment protocols the same? Do they listen to the same CDs of would they start at a “higher” level like Mozart or Vivaldi?
We have worked with adult & geriatric population, as well as some of our other trained therapists. We primarily have seen the pediatric population, so most of our information reflects these results. We have seen nice results with stroke patients, adults with developmental disorders, chronic pain, and general cognitive difficulties that often appear with aging. Protocols would be followed the same as with peds, but often times, depending on what you are working toward, CDs can be changed more frequently and also, the higher level CDs can be tried sooner in the program.
We had an adult come in just a short time ago that thought she had ADHD (no formal diagnosis… just lots of difficulty with concentration). We had her listen to Links to Modulation and Mozart for Modulation and she saw some nice changes and was very pleased. Let us know if you do try some of the music with geriatrics; we would love to hear how it goes.
Can you refer me to therapists who have been successful in implementing TL with an adult population?
- Judy Notaro (Colorado) 970-262-2333
- Peg Garding (Rice Memorial Hospital) 320-231-4116
Are there any articles on specific CDs, which address specific areas & the hypotheses behind them? I would like specific as to how TL can make changes with oral motor skills.
There is a great description in the “Listening with the Whole Body” book, Chapter 3, pages 22-26, pages 13-17.
Have you had any luck getting insurance companies to pay for the equipment?
We do not bill to insurance—therapeutic listening does not stand alone; we use it as a part of a comprehensive SI treatment. Occasionally, social services may find a group to cover partial costs & very rarely schools may cover costs.
Can a child do their TL program while on an airplane?
Listening on the airplane is just fine.
Can TL help a child transition to oral feeding?
Yes, it helps put a child in a better place and may prevent them from having to go on a feeding tube.
Can TL help an older child with bed-wetting?
If you wanted to use Baroque for a 6-month-old baby in the NICU, would you use the non-modified version?
Yes, due to the fragile nervous system. Keep the same protocol. By the time the child is 8 months, you might switch to a modified version.
I had a child who became emotional on Apricot. Is it possible that he was experienced emotion he had not has a child and we should have worked through it?
We tend to be nurturing and don’t like to create disregulation in a child. Often the child needs to learn how to go to a new place and come back and work through this.
Parents’ greatest concern is the humming, which started when began TL. Any suggestions how to eliminate it or the cause?
Humming is a self-generated form of bone conduction. Voice is connected to the circuitry of the muscles of the middle ear. We actually use humming as a therapeutic modality. Humming helps one “tune into” voice, not block out sound. I would suggest adding a Peach Jamz to his listening program, and incorporate work on posture, breath, and kazooing during therapy sessions.
Can one implement TL without prior training?
We often have the situation of people implementing a TL program prior to actual instruction at a Vital Links course. Inservicing from a co-worker simply does not provide therapists with enough of the clinical background information to fully understand and implement this program. It is a very powerful and effective tool when used by therapists who have been trained properly and know the effects, reasoning, and neurology behind the tool. When in serviced on TL, therapists learn this tool in a very fragmented manner. Thus, the therapist has fragmented clinical reasoning when selecting CDs and knowing what to look for (i.e. what effect is this CD having on this child?), which ultimately is not the best therapy provided for the child.
We advocate that all therapists/health professionals who use Therapeutic Listening attend the Listening with the Whole Body course prior to implementing Therapeutic Listening with children on their caseload. When working with such a powerful tool, it really sets up a situation for “best practice” to be fully educated prior to implementation with one’s caseload. In addition, when one attends a course by Vital Links they have access to our continued clinical support to assist them in any situation where they may need additional support with a particularly challenging client on their caseload. Obviously, this is not provided to those who are not trained in TL.