Let’s Look at Therapeutic Listening® Research
To the untrained eye, it is often difficult to assess listening skills. Since we cannot directly observe internal listening processes, we must infer listening function through behavioral clues. This task is especially difficult due to the extremely wide range of behaviors associated with poor listening skills and the fact that the behaviors are not always linked to listening in an obvious way, such as cupping one’s hand behind the ear.
“The present study produced encouraging findings to support the use of Therapeutic Listening as part of an overall sensory integrative approach to occupational therapy in elementary school-age children. Therapeutic Listening, along with sensory diet strategies, can be effective in reducing many behaviors associated with sensory integration disorder.”
(Hall & Case-Smith, 2007, p. 215)
Evidence Brief on the Effectiveness of Therapeutic Listening®
The existing body of research on Therapeutic Listening presents positive findings regarding the use of Therapeutic Listening as a treatment tool embedded in a sensory integrative treatment approach. The studies identify multiple positive gains including improved attention, handwriting, ability to perceive and move through space, enhanced interaction with peers, greater ability to attend to and follow directions, improved sleep and wake cycles, and enhanced communication. The current research on Therapeutic Listening does support continued clinical use. Future well-controlled studies would expand and enhance the existing research.
Sarah Wink MSc, BSc (OT), PGCert SI, Laura McKeown PHD, PGCHEP, BSc (Hons) OT & Jackie Casey MSc, BSc (Hons) OT, PGCert SI, PgCHEP, FHEA (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
Results of the parent interview were transcribed from which key themes emerged and were subsequently analyzed and discussed within the study. All parents in the study identified that their child’s anxiety and distress had decreased while participating in Therapeutic Listening. Additionally, all ten parents’ reported that their child was calmer due to Therapeutic Listening. Consequently, families observed a direct link to improvements in family life and participation in activities of daily living and social interactions. This study contributes to the current research on Therapeutic Listening, as well as highlights the importance of including pre- and post- Therapeutic Listening intervention assessments and outcome measures that portray changes with self-regulation, occupational performance, and social engagement.
Level III: Quasi-Experimental/Repeated Measure Design/Pretest - Post-test Design
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.
Participants’ scores on the Sensory Profile indicate a remarkable improvement in sensory processing following the 12-week intervention (scores increased an average of 71 points from pre- to post-test). Following the Therapeutic Listening intervention, participants demonstrated mixed results on the improvement of temporal-spatial skills. Participants demonstrated a significant improvement in scores on the VMI visual subtest and writing lowercase letters (ETCH). Handwriting total legibility improved significantly from initial pre-test to post-test. Parent interviews at the end of the second intervention phase also indicated an improvement in participants’ behavior. Parents reported they observed improvements in their child’s attention, enhanced interaction with peers, improved transitions, greater self-awareness, decreased nightmares, enhanced listening, improved communication, greater regularity following directions, and improved sleep patterns. Overall, the results of this study provide promising support for the use of Therapeutic Listening as an intervention tool to support occupational therapy with sensory integrative treatment approach.
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.
The results of this study indicate that participants made statistically significant changes in visual-motor, fine-motor, language, non-verbal, and social skills from pretest to post-test. The mean of each pretest assessment significantly increased at post-test, with the exception of the SSRS problem behavior standard score and the PLS-3 language standard score. Participants did not demonstrate any significant changes on any of the subtests of the Sensory Profile. In addition to improvements in standardized assessments, both teachers and parents noted encouraging changes in their children’s behavior. Parents reported transformations in their children’s execution of activities of daily living. Teachers stated positive improvements in group activity participation, overall attention and processing, increased number of verbalizations, more positive social interactions, and greater ability to attend to and complete directions. The results of this study indicate that for a group of preschool students, Therapeutic Listening in conjunction with traditional occupational therapy services resulted in a statistically significant improvement in a number of critical performance areas (fine-motor, visual-motor, language, non-verbal, and social).
Cipriani, N. (2010). Using evidence-based practice and pilot programming to explore emergent treatment strategies. Unpublished pilot study.
Frick, S.., Young, S., Huecker, G. (2007). Therapeutic Listening: listening with the whole body. S.I. Focus Magazine, Autumn, 6-7, 14-18.
Sara participated in bi-weekly occupational therapy for duration of 60 minutes, for a total of 15 direct treatment sessions over seven months. Sara participated in a Therapeutic Listening program and a sensory diet home program including the TheraPressure Program, How Does your Engine Run?, and postural and muscle coordination activities.
Sara presented with significant behavioral changes within the first few weeks of Therapeutic Listening. She began to tolerate and seek out touch (i.e. hugging her grandmother), and started to notice sounds for the first time (i.e. birds chirping). In the final weeks of Therapeutic Listening, Sara’s teachers reported improvements in overall attention and visual-spatial skills. Parental report indicated that Sara more frequently engaged in a quiet alert state, demonstrated improved eating, and is now able to fall asleep independently. Sara also displayed significant improvements in four sub-scales on the Sensory Profile. This case study supports the use of Therapeutic Listening with individuals with modulation and self-regulation difficulties in conjunction with other sensory integrative techniques.
Frick, S., Young, Sally. (2009). Listening with the Whole Body: clinical concepts and treatment guidelines for Therapeutic Listening. Vital Links; Madison, WI.
Participants in the Therapeutic Listening program demonstrated a range of positive results and improvements in everyday activities. Individuals displayed improvements in overall self-regulation, ability to fall asleep and stay asleep, enhanced ability to engage in social interactions, improvements in ability to perceive and explore space, and increased ability to engage in movement. Younger participants demonstrated improvements in communication, ability to tolerate transitions, enhanced safety awareness, ability to function in noisy environments, and advanced fine- and gross-motor skills. Improvements related to Therapeutic Listening were observed at home as well as in school environments. Participants demonstrated improved academic performance, enhanced attention, and ability to focus on homework. The results of these case studies substantiate the use of Therapeutic Listening, used within a sensory integrative treatment context, with a broad range of individuals, ages, and sensory integration dysfunction.
Over, K. (2011). Effect of Therapeutic Listening on the occupation of play. Unpublished case report.
Andrew’s play skills were evaluated, using the Revised Knox Preschool Play Scale, prior to and following a 10-week long Therapeutic Listening intervention. Andrew’s play was videotaped over a one-week baseline period at a familiar clinic setting and at a novel playground setting. Following the intervention, play was again videotaped at the clinic and at another novel playground. Videotapes were reviewed by Andrew’s occupational therapist and another occupational therapist blind to the study.
Andrew listened to five albums during his 10-week Therapeutic Listening intervention period. All albums were selected based upon anecdotal evidence that supports their use for self-regulation.
Following the 10-week intervention, Andrew demonstrated 32 additional play skills according to the Revised Knox Preschool Play Scale. Andrew displayed progress with visual-motor skills, increased attention, awareness and exploration of his environment, began sleeping through the night, and overall improvements in self-regulation and behavior. The results of this case report substantiate the use of Therapeutic Listening, used in conjunction with sensory integration, for young children with autism.
Vital Links Practitioner Survey
Practice-based Evidence Approach to Studying the Effectiveness of Therapeutic Listening
The Role of Therapeutic Listening in Social Participation for Preschoolers with Special Needs