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writes on Vestibular Dysfunction
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Auditory Processing
By Valerie Dejean, Director, Spectrum
Tomates Center and Certified Tomatis Consultant
How Does Auditory Processing Relate to My
Child?
Auditory processing provides the foundation for learning language
and for learning language-based academic skills, such as reading,
spelling and writing. When auditory processing abilities are not well
developed, an individual is at risk for language and learning
disabilities. Children with auditory processing disorders may have
difficulty following multi-step verbal directions.
They may mishear and therefore
misunderstand what is said to them. For example, a request such as "Put
the dishes in the sink and then go to the bathroom to get ready for
bed" may end up with dishes in the bathroom sink.
A question such as "How old are you?" may be heard, as "How are you?"
These children may say "what?" or "huh?" frequently. They often need
directions repeated. Their responses in conversation may be delayed and
at times absent. They may not understand jokes and may have trouble
finding the words to express themselves verbally or on paper. In more
severe cases speech and language may be delayed, as these children are
unable to quickly discriminate and attach meaning to the words spoken
to them. Children who don't process sounds properly don't respond to
verbal cues. They therefore don't experience the pleasure and power of
opening and closing circles of communication, and thus don't attempt to
communicate. They can mispronounce words because they have misheard
them. Their social skills can be affected, as they are not processing
auditory information at a sufficient speed to respond promptly in
two-way verbal exchanges.
Over time, this lack of verbalization deprives the ear of the
stimulation it needs for continued fine-tuning: children learn to focus
on the human voice above all other sounds by hearing their own voice
repeatedly. The human voice may become too complex or difficult for
them to process, and so they continue to tune it out. After a while,
they are disconnected from the outer world. Children with auditory
processing difficulties who develop language may still misunderstand
verbal instruction, or mis-communicate their desires.
They often become frustrated that others do not understand them or that
they do not understand what is going on. Language-based academic skills
are often difficult for these children. Learning to read phonetically
is dependent on auditory decoding and synthesizing, and is therefore
difficult for children with auditory processing disorders. Spelling can
be equally challenging, as they don't hear the words accurately and
therefore are unable to reproduce them. Often reading comprehension is
impaired because they are working so hard to decode what they have read
that there is no room left for understanding. Although these children
may learn to read, they may never do so for pleasure. Classes that are
dependent on language and reading skills, such as social studies,
English and foreign language, may be very difficult. Subjects such as
math and science, which in the early grades may have been easier,
become more challenging, as these subjects become increasingly language
based. By the time these children enter forth grade, the majority of
their lessons are presented orally. By middle school they must learn to
"tune in" to verbal directions from many different teachers. They often
start to daydream and "tune out" because their auditory systems are
simply overloaded. Moreover, as class size becomes larger there is more
background noise competing for their attention, making listening
increasingly difficult. What is Auditory Processing?
Central auditory processing disorders are described as the inability to
attend to, discriminate, recognize, and comprehend information
presented through the auditory channel, despite normal hearing and
intelligence. At the Spectrum Tomates Center we often refer to Auditory
Processing as "Listening."
Dr. A. A. Tomatis distinguished between hearing, which he
described as the passive reception of sound, and listening, which he
described as the active ability, intention, and desire to focus on
sounds. It is possible-and even likely-to have normal hearing, yet poor
listening.
Auditory processing relates to how the ear makes sense of what it
hears. The auditory system is required to interpret all the sounds of
spoken language and attach linguistic meaning to them. For example, a
dog is able to hear as well or better than humans, yet the dog's ear
isn't able to separate the speech stream into meaningful words that he
can understand. This requires auditory perception and auditory
processing; together they provide the foundation for understanding and
using oral and written language. Sound waves arrive from outside the
body to the inner ear where the cochlea analyzes them and that
information is sent to the processing centers in the brain.
We determine what each sound is, if it is important, and whether or not
we wish to respond to it. We have to discriminate sounds, which often
involves "filling in the gaps" as we rarely receive a clear auditory
signal. We have to tune in to one signal and distinguish it from
background noise. We have to compare and share the differing auditory
information we receive from each ear. All this information has to be
shared and integrated with the sensory information coming from our eyes
and body.
Development of Auditory Processing
Our ability to analyze sound develops in the womb. The inner ear
is the first sensory system to fully develop in utero. The fetus learns
to tune in the salient sounds of his mother's voice and ignore
background noise.
During this stage he learns to recognize
the sounds (phonemes) that make up language. Research shows that an
unborn fetus will respond with a different movement, to each of the
phonemes (building blocks of language) spoken by the mother. This early
listening in the womb plays a vital role in the later development of
language. At birth a baby is already familiar with and responsive to
all spoken sounds; in other words he is essentially "wired" for
language development. Born with an ear already attuned to language
sounds, the baby is ready to make rapid progress in attaching meaning
to the sounds he hears. Language is not taught to infants; it emerges
just as sitting and crawling, if the baby is given a language
environment. The important ingredient for language to unfold naturally
is normal auditory processing. The foundation for this is established
in the womb. Other than developmental reasons, another way that
auditory processing can be interrupted is by repeated ear infections in
early childhood. Ear infections, medically entitled otitis media,
result in fluid accumulating in the middle ear. Fluid can remain in the
ear for up to several months following an infection. This can result in
intermittent hearing loss during a critical time for language
acquisition. The transmission of high frequency sounds is what is most
commonly compromised when there is fluid in the middle ear.
These
high frequencies provide much of the meaning to spoken language. When
our ear misses sounds such as "th, f, s, sh, t, k, and p," it is
difficult to understand the content of what is being said. "Ship" may
be heard as "ip" and "that" as "at, for example. There are critical
periods of development when the baby's ear is best able to discern
certain sounds. If there is fluid in his ear at those times, it may be
difficult for him to discriminate those particular sounds even when his
hearing returns. This distortion of perception may compromise more
abstract expression of sounds. For example, if we can't perceive the
"th" sound, we may not be able to pronounce it, read it, or spell it.
In this way an auditory processing disorder may negatively impact
higher order learning.
The Vestibular Cochlear System
Movement and sound are closely linked as exemplified in the example of
the fetus moving in response to the phonemes spoken by his mother. That
is because both movement and sound are perceived by the inner ear: the
vestibular cochlear system. The vestibule analyzes longer wavelengths
generated within the body by our movements and body position; the
cochlea analyzes shorter wave lengths (sound waves) generated outside
the body. The ear, then, is responsible for making sense of virtually
all the sensory information received by the body, and functions as the
body's link between the outer and inner world.
Many experts,
including Dr. Alfred Tomatis, feel that these two systems are actually
one, with the related function of the analysis of vibration. The
vestibule and the cochlea are anatomically joined, sharing a common
wall and common fluid. In addition, the systems lie closely together
throughout the nervous system, allowing for many close neuronal
associations. Since these two systems are so closely linked, it is
logical that one would have a direct impact on the other and vice
versa.
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How Can the Spectrum
Tomates Center Help?
The main tenet of Spectrum Tomates Center's program is simultaneous
stimulation of the vestibule and the cochlea. Individually designed
Tomatis auditory training programs are enhanced by sensory motor
techniques to stimulate the whole vestibular/cochlear system at once.
The addition of active listening training, which involves audio-vocal
work, further hones the ear's listening ability. Children speak into a
microphone, hearing themselves through the Tomatis electronic ear and
headphones in order to connect with the sound of their own voices. "For
the first time, I felt that my child wanted to communicate with me,"
says one mother after her son's first week at the Spectrum Tomates
Center. Another family reports that their child is learning to read and
follows instructions in the classroom for the first time. The program
is designed to improve the functioning of the ear and to increase an
individual's ability to listen and understand language. The auditory
processing system can be improved through proper stimulation, opening
up a whole new world for many children with auditory processing
disorders.
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Call the Spectrum Tomates
Center at (845) 915-3288, for additional
information or to schedule an initial assessment. You can contact us
at; Spectrum Tomates Center, Route 17, Suite 4, Tuxedo Park, NY 10987
Copyright 2010 William J. Kennick
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