Dorinne Davis Chat transcript from her on line chat June 18th, 2002 ParenthoodPlace.com TITLE: How Sound Based Therapies Can Help Autistic Individuals

Rebecca says, "Does anyone have a question for dorinne? Just type a "?" in the message line"
Dorinne S. Davis says, "Yes, that would be great. I will know a little bit more as to how I can direct information to them."
Rebecca announces,Join us Welcoming Specialty Guest Host,Dorinne S. Davis, M.A, CCC-A, FAAA.President and Founder of The Davis Center for Hearing, Speech, & Learning, Inc. featured here in our talkAutism room starting now."
Rebecca says, "Its good to see you again Dorinne, Any new developments in the area you specialize in?"
Dorinne S. Davis says, "The ear is the major sensory integrator of the body. Not only your hearing sense but also vestibular, taste, touch, sight have connections with the ear and the body's integration of those senses. When audition is processed, more than just particular sounds and language are being sent to the brain. Also, subtleties of sound impact us overall such as the pitch of someone's voice, the inflection of their voice and more"
Dorinne S. Davis says, "So, a child with autism often has over reactive sensory information or under reactive sensory information being processed. I look at auditory processing as more than just the audition of sound. Sound impacts our entire body."
Dorinne S. Davis says, "What is important to understand is that in order to process information, the neurological system must be sending processed information first to the brain and secondly back to the rest of the body. If the vibrational impact of this information is deficient, then the entire processed information is also off."
"For the autistic population, it is important to determine which sensory information is imbalanced and help improve it. If sound can stimulate the necessary sensory input, sound is an important starting place for each autistic person. The ear is fully developed by 4 and 1/2 months in utero so it is an important starting place when working with children in particular."
Ron Oberleit says, "?"
Hope4Jerod says, "?"
Dorinne S. Davis says, "If your muscles in your arm are weak and it is difficult for you to pick up something with your arm, you don't work on your legs. For the person with developmental issues that include sensory stimulation, if the therapist wants to develop speech and language, it is important to begin at the beginning of auditory developmental skills. Trying to get the child to say words may not always be the most appropriate beginning spot."
Ron Oberleit says, "What development issues seen with autism can be helped?"
Dorinne S. Davis says, "For example, if a child is unaware that sound is important, trying to get them to say a word for something is only a drop in the bucket if we want to develop overall language skills. Getting the child aware of the importance of sound comes first. Depending upon the skill level determined by evaluation, some children simply need to be stimulated that sound is present. Noticing speech sounds comes after that."
belinda says, "?"
Dorinne S. Davis says, "As for the developmental issues that can help the autistic population with sound therapies, there are many. I will list some of them but as we go along we will probably talk about more. First because of the semicircular canals in the ear, vestibular, movement, proprioceptive connectedness to others, social relationships, emotional relatedness to others, understanding of self, oral motor stimulation, understanding what the articulators are, i.e that the tongue is supposed to move to the top of the mouth for some sounds and against the teeth for others, as ex."
"Also, that through the cochlea, specific sounds are important to try to imitate for speech, words, and sentences and that these speech sounds have meaning. That what a person says is not just from the words that are said but also the rhythm, inflection, and pitch of their voice that information is received."
Ron Oberleit says, "do dev. therapists note dramatic changes after your sound therapy? How do you gauge the changes developmentally?"
Dorinne S. Davis says, "For example, if as parents, you say 'no' to your child, that 'no' may mean 'be careful', or 'definitely stop what you are doing'" "The developmental therapists that I work with have definitely noticed change after sound therapy. However, it is very important to understand that there is an order that is necessary for the change to occur. Everything in my office is done through various evaluations."
Ron Oberleit says, "Do you do the development evals?"
Dorinne S. Davis says, "For example, I have developed my "Tree of Sound Enhancement Therapy". This tree takes a look at one's sense of hearing, auditory processing issues, specific auditory processing skills, and how well the body can maintain changes."
"My evaluations are based upon these four areas. If we talk about the'sense of hearing', then audiometric information must be tested. How well does the person hear. Typically audiologists are training to look for hearing loss. I tend to look additionally for better than normal hearing."
"For the auditory processing of information, the skills of the client are important. For ex. if the person has speech and language and is over 5, I may suggest a Central Auditory Processing Evaluation. However, if the person is non verbal or we know that some form of therapy is needed, I may do what is called a Listening Test or another specific auditory processing skill test."
"When I am looking only at that auditory processing skill level, I will test with specific tests to evaluation the specific skills such as auditory discrimination, memory, sequencing , etc. In some cases, some of the clients I see are not ready for the standardized tests so I have put together my own test battery.""When looking at how well the body can maintain any changes that the body needs I work towards two ways of accomplishing this: both through the voice. Many young autistic children do not have good control of their voice and I may not be able to get them that far right away. We work towards that end. I either work on using the voice to stabilize themselves or use the voice to determine issues to set up sounds from the outside by listening."

Moderator says, "Hope4Jerod you have a question"
Hope4Jerod says, "My child age 3 rec'd AIT a year ago, with no obvious improvements. No auditory testing was performed before AIT to check for certain frequency sensitivities, because he could not cooperate for the tests. I am wondering if you feel that AIT can be effective when done "generally" without using specific frequency adjustments according to audiogram results? I'd like to try AIT again, and thank you. By the way he has super sensitive hearing and ABR's have confirmed no hearing loss."
Dorinne S. Davis says, "Also, Whether AIT and Speech is sufficient, depends upon your child's needs. You only need AIT if sound sensitivities are an issue or is you want to stimulate the brain further as an enhancement."
Momm001 says, "oh, so if they have no speech or lateen speech then we need to work on the words to get the whole picture connected?"
Dorinne S. Davis says, "When I hear that a child had no noticeable improvement with AIT, I always look at what your goals were. In my office, we typically look at AIT as working on change with an audiogram. "Generic AIT" as you mentioned, certainly may not have hurt your child but simply prepared him for further development with auditory processing. Another round of AIT may be helpful or you may want to consider Tomatis. I find this method brings more change for speech and language. Only testing will determine what is needed."
Monika says, "?"
Dorinne S. Davis says, "Getting the child to recognize their voice is an important part of their growth. Some have difficulty with this because they process speech too quickly or slowly, or process speech more quickly with bone conduction vibration versus the typical way that we hear sound which is down the ear canal."
Hope4Jerod says, "Could you do a quick comparison of AIT to Tomatis as far as how they differ? Thanks."
Monik says, "We did the Berard form of AIT and saw phenomenal results. It has only been 2 months. We got prepositions and pronouns and quieter, calmer behavior. Now, we want to go further, do you recommend earobics, fast forWord what?"
Dorinne S. Davis says, "Certainly. From my research, I have determined that AIT works on your 'sense of hearing', i.e.. the physical input of sound via the ear and cochlea. The Tomatis Method works on overall auditory processing of information because it has three components that are essential for this: filtered and gated music, bone conduction stimulation, and active voice work."
Dorinne S. Davis says, "I'm pleased that you got good results with AIT. Your child's ear pathway opened. Next, I suggest Tomatis because it gives the foundation for so much sensory information, but mostly auditory. To find someone in your area, go to www.tomatis.com for someone near you."
Dorinne S. Davis says, "I have found that Fast ForWord works on specific auditory processing skills, i.e.. temporal sequencing. This skill is very important for clarity of speech comprehension. For some children this is the next step. However, a foundation is often needed to make the skills be useful."
Dorinne S. Davis says, "Earobics is a great program that works on many auditory processing skills. It's simple and easy to follow and is a great program for home and school carryover."
"Another computer program that is simpler and more basic than Earobics is 'Away We Go' by Scientific Learning. You can go to their website and find out about that program.""Each autistic child is unique and although they may have a similar umbrella classification, I find that each one's issues must be determined through an evaluation. The four areas I mentioned, hearing, general auditory processing, specific auditory processing, and over all support of changes is important in testing."

Moderator says, "Momm001 please go ahead"
Momm001 says, "Explain the Tree of Enhancement therapies"
Dorinne S. Davis says, "The Tree of Sound Enhancement Therapies if based upon the root system, the trunk of the tree, the leaves and branches of the tree, and overall tree support. In other words, the 'hearing aspect' is the root system, the general auditory processing is the trunk, and specific auditory processing skills are the leaves and branches, and overall body support is what can be done to make sure the changes received through other therapies will be maintained. I will go on.""The Root System relates therapy wise to AIT because it is the only therapy that I have found that retrains one's 'sense of hearing' by retraining the acoustic reflex muscle in the middle ear. Once hearing is okay, then the trunk therapy is the Tomatis Method because of all the sensory integration that it stimulates. This information is necessary for overall development. I can discuss more about Tomatis in a minute. The leaves and branches are specific therapies such as Fast ForWord and Earobics. However, upper trunk and lower leaves and branches may be therapies such as Interactive Metronome and LiFT or DLS."
"The overall body support is accomplished through the voice--either from learning to use the voice effectively or by using the science of BioAcoustics to identify issues in imbalance in the body, presenting a complement or supplement sound so that the body can stabilize itself.""Which of these would you like more clarity on?"
Momm001 says, "I guess the tomatis and Earobics (since we are considering Samonas?"
Dorinne S. Davis says, "By the way, this Tree of Sound Enhancement Therapy is the basis for my upcoming book called "Sound Bodies through Sound Therapy" which should be available in Jan 2003"
Ron Oberleit says, "I'd like to know how bioacoustics is used, and how specifically it works"
Dorinne S. Davis says, "First let me mention Samonas. Ingo Steinbach developed Samonas based upon Dr. Tomatis' research. Instead of making it specific for each individual, which he did do originally, he chose to make generic CD's for listening. Most of them have high frequency information and for some autistic children the high frequency information is difficult for them to process initially. I find Samonas helpful once I have stabilized how the person uses bone conduction stimulation. This therapy is very different from Tomatis because Tomatis incorporates specifics instead of generics. Earobics looks at something totally different in that it helps develop specific skills, not stimulate the body overall."
Momm001 says, "Thank you for that clarification."
Dorinne S. Davis says, "BioAcoustics is the counterpart of the Tomatis Method in that if the voice produces what the ear hears, and there is a voice-ear-brain connection that was recognized in 1957 by the Academy of Science, then newer research has also demonstrated that there is a further connection."
Ron Oberleit says, "how does one apply bioacoustics?"
Dorinne S. Davis says, "Not only does the ear hear sound but the ear gives off or emits a sound. It is called an otoacoustic emission. This is something we all have but don't often recognize. If the ear gives off a sound and there is a sound emitted with the voice, we again have a voice ear brain connection. So we capture the voice's frequencies in a voice print, do a voice spectral analysis, and determine issues that are imbalanced in the body. Then provide a sound complement or supplement for the person and they listen to the necessary sound to support their own body system."
Momm001 says, "does all this work with tubes in their ears??Since the membrane has been "opened" with a tube?"
Dorinne S. Davis says, "For example, with our autistic population, we are identify certain similarities of biochemical issues that appear to be either not utilized in one's body chemistry or something that may need to be detoxed. It is a complicated science but an exciting one for the future of autism. We need to get grants to help work on the specifics but the Davis Centers research is looking at many different autistic children and what their issues are."
Dorinne S. Davis says, "Can it work with tubes.Well, tubes are placed in the eardrum because the middle ear needs ventilation to remain healthy. These tubes are placed in a place that cause the least damage to vibration of sound information., The only therapy where tubes may be an issue is with AIT because it is working on the 'sense of hearing'. When I test for AIT I always mention tubes and let the person know that if tubes are present, then AIT may need to be redone at a later time. One of my specialties are with middle ear infections (two books published) so for me tubes are an important consideration when planning a person's therapy plan."

Moderator says, "go ahead momm"
Momm001 says, "since sound has been associated with behavior and sensory issues can you explain how this all works?"
Dorinne S. Davis says, "When one takes in the environment appropriately, one feels good about themselves. When the world is distorted, then the 'self' can feel distorted. This distortion can be seen as behavioral or with sensory issues. For a child who behaviorally is all over the place, they are typically simply searching for a way to connect with the outside world. For example, in my office yesterday, I saw a young man that was chewing on a long piece of fabric that he carries with him. When not chewing on it, he was flinging it around hitting everything in site. Or he would bang the wall, hit the windows, pull on the window shades, or jump around searching for input for a connection with the world around him. When I played specific sounds, he responded very well. He always knew when he was being talked about and when I confronted him, he stopped, came literally up to my face and smiled. He wanted to be recognized for what her could do. Emotionally we process sound by going through the limbic syst"
"Sensory stimulation is an issue because of weak responses through the semi circular canals of the ear. This part of the ear has hair cells similar to the cochlea which is your 'sound picker-upper' and so will the semi circular canals will pick up sensory information and send it to the brain. If this center is receiving distorted or underactive or over active stimulation, the person will have many sensory issues such as needing or craving sensory stimulation through swinging, jumping, movement, or through sensory stimulation with oral motor stimulation--drooling, chewing, grinding teeth, etc."
"In order to allow proper balance between sensory stimulation overall and auditory information, both parts of the ear must be stimulated. The Tomatis Method does this the best."
Dorinne S. Davis says, "Did this help?"
Momm001 says, "yes, Question 2: My son had ninety percent fluid in both ears from 15m to 38 m before tubes - his language greatly delayed. I ask does he now need to relearn what he hears. Most of his language has begun since tubes but he has to watch my face for the correct way to say the word.   How do I help him?"
Dorinne S. Davis says, "This is a lot of infections. Thanks for the ages because that is important. Yes, your son must relearn how he hears sound. It has been said that a person with an actual hearing loss is better able to learn language than a child with an ear infection because the person with the hearing loss has a continuous sound input for the brain to recognize and learn words. However, the child with fluctuating middle ear infections hears sound one way one day and another way the next day, thereby creating mixed messages in the brain. So typically I do what I call a Diagnostic Evaluation for Therapy Protocol that determines is hearing is still an issue (over responses from the middle ear muscles) or if processing is an issue. By the way, if a child has 5 or more ear infections before age 2, they are prone for learning disabilities or if they have 5 or more before age 5. The learning issues are just different/t"
Dorinne S. Davis says, "I suggest either AIT or Tomatis. You would be best served by having his hearing tested, especially his middle ear muscles."
Dorinne S. Davis says, "Next ?"
Momm001 says, "They said they can;'t test anything because of the tubes what do I ask for in testing?"
Dorinne S. Davis says, "How old is he now?"
Momm001 says, "3 1/2"
Dorinne S. Davis says, "You need to find someone who can do behavioral or pediatric audiometry and just get a good hearing test. If no issues are present, then try to have a Tomatis assessment. Again, you can find someone through www.tomatis.com"
Momm001 says, "thanks!"
Momm001 says, "I have one more if no one else does"
Monika says, "?"
Moderator says, "Dorinne, the other night on TV I saw a special about a young man who had autism and had a wonderful ability to paint .."
Moderator says, " Monika please ask"
Monika says, "What are the costs for the Tomatis method and how long does it take?"
Dorinne S. Davis says, "Of course, the cost depends upon where you are in the US. The north east will be more costly than the Midwest. Each center is an independent center and so will charge what they need to cover their costs. As for how long the method takes. The basic Tomatis Method consists of two sets of 15 days of listening separated by 1 month. It is also possible to do 15 days, 8 days, and 7 days as a set. This is determined by the initial assessment. For the autistic population, I always say that the child will most likely need a third set of 15 days if we need to develop speech and language. In some cases, continuation programs of 8,7, or 5 days are needed spaced out over a period of months, or years. Again the assessments determine the length of the programs."
Dorinne S. Davis says, "Was this helpful? Anything further ."
Momm001 says, "As an expert in the middle ear I have a question   - A lot of autistic children experience dizziness from their vestibular systems for no apparent reason - many without fluid do you know why this might be? is it just an oversensativity or a ear/brain connection or some other thought?"
Dorinne S. Davis says, "The vestibular portion of the ear works with the same fluid that is in the cochlea separated by a membrane. This fluid triggers responses in the brain. The dizziness comes from the cells being over or under stimulated with little chance to calm down. Some children crave swinging and others loathe it. I know I am making change when the parents report that these cravings change."
"This portion of the ear is important to overall development of speech and language, believe it or not, because Dr. Tomatis felt that speech and language will only come when the rudimentary vestibular sensations are stabilized."
Dorinne S. Davis says, "Any other questions?"
Momm001 says, "ok I have one more"
Moderator says, "sure momm"
Momm001 says, "in tomas you prefer this version but could you break down the components again for us so that we understand Tomas better And will the tomatis web site give more info?"
Dorinne S. Davis says, "It's not that I prefer Tomatis, by the way, I only use it when it is necessary as demonstrated with testing. Some people can easily start with some of the 'leaves and branches' therapies. As for the Tomatis--it is comprised of a number of very important things. 1) all specially chosen music is played through the Electronic Ear machine that Dr. Tomatis designed, 2) each person has an individually designed program of listening, 3) the important parts of the program have to do with air conduction vibration of sound, bone conduction vibration of sound, filtered and gated music, a delay of sound between air and bone conduction of sound, emphasis of developing a 'right ear' lead for listening, incorporating active voice work for the full effect of the method."
Dorinne S. Davis says, "The Tomatis website does provide some good information about the method. Do you need more info?"
Hope4Jerod says, "Question: you said "Speech and language will only come when the rudimentary vestibular sensations are stabilized"....And the best way to achieve this achieve this, do you believe is Tomatis? I just looked it up and there is no Tomatis person in my area. Just AIT.   I am the one whose 3 yr old had no major change from AIT. He tries so very, very hard to say things, but his "jargon" is no better, and in fact worse, than before his regression. As a baby his words were much clearer. Any further suggestions ?"
Momm001 says, "That helped thank you."
Dorinne S. Davis says, "Certainly having an OT that works on sensory integration will be helpful with a combination of AIT. You can also look for information about LiFT or Listening Fitness Trainers in your area. Try searching for LiFT on a search engine. Or look for Developmental Listening System (DLS). These are spin offs of Tomatis that are helpful.   Also, if traveling for Tomatis is not too far from your home, it may be worth the trip for you."
Dorinne S. Davis says, "If there are no more questions, perhaps we can wind down. I appreciate everyone's questions and thank you for allowing me to assist."
Hope4Jerod says, "Thank you for your help!"
Moderator says, "Thank you for sharing this time with us we look forward to doing it again soon"
Momm001 says, "Thank you Dorinne.. Moderator tell us again how we can get a copy of this for our files and therapist?"
Moderator says, "it will be on the boards after it is transcribed"
Dorinne S. Davis says, "I am always available for email questions if needed. My assistant gets those at info@thedaviscenter.com"
Dorinne S. Davis says, "Thanks and everyone have a good evening."
Moderator says, "thank you again Dorinne"
Rebecca says, "Links will be in the TA boards"
Rebecca says, "and in the Live Chat area"
Rebecca says, "Thank you for returning Dorinne, it was a pleasure having you back"
Dorinne S. Davis says, "Thanks. Keep in touch. All the best"
Dorinne S. Davis leaves.