Sound Therapy Research Summary

Sound Therapy International aims to raise world wide awareness so that all associated specialties and professions will include Sound Therapy in their recommendations. A summary of the science of the Tomatis method and ongoing sound therapy research is given here, references included.

Background on Sound Therapy Research

In the 1940s Dr Tomatis, a Paris based ear, nose and throat specialist conducted clinical trials with singers, aeroplane mechanics and others to determine how their hearing was affected and whether it could be improved.

He went on to develop a method of treatment which addresses hearing and listening from both the physical and the psychological aspects. Through his experiments he also discovered that high frequency sounds, softly played stimulate and replenish brain energy, and are in fact essential for optimum functioning of the cortex.

The Tomatis Method

As his initial concern was with hearing loss, Tomatis’ first experiments dealt with altering the auditory curve.

When there is loss of hearing in a particular frequency it is generally not a total loss – it just means that those frequencies where there is a scotoma are heard at a lower level. Tomatis designed an apparatus called the Electronic Ear, which could manipulate the frequencies of sounds, so it could match a sound to the person’s auditory curve, or it could do the opposite. It could boost the deficient frequencies to make the person hear as a normal ear would hear.

Initially Tomatis worked with singers who had lost certain frequencies from their voices. He found that the dead spots in the voice exactly matched the dead spots on the audiogram, and by correcting the hearing with the Electronic Ear he could restore the missing frequencies to the voice.

Thus he formed his first law: “The voice contains only those sounds that the ear can hear.” This discovery was given official recognition in 1957 by the French Academy of Science as the “Tomatis Effect.” In 1958 Tomatis’ invention, the Electronic Ear won a gold medal for scientific research at the Brussels International Exposition.

The Self Help Method

Patricia Joudry, a Canadian author, underwent the Tomatis treatment in the late 1970s and experienced total relief of her chronic insomnia, exhaustion, writers block and the listening disorder for which she was first referred to the treatment. This is known as “The Cocktail Effect”, which is the inability to discriminate between different sounds in a noisy environment.

Patricia and her daughter, Rafaele Joudry, then released the self help Sound Therapy audio program along with their book: Sound Therapy: Music to Recharge your Brain. Rafaele has since published two further books entitled Triumph Over Tinnitus and Why Aren’t I learning?

Research Results

In the last few decades there have been numerous controlled studies, surveys, clinical experiments and case histories, which confirm the benefits of the Tomatis method for a variety of conditions. A summary of these sound therapy research studies follows.

Tinnitus, hearing and associated problems

Jordan (1989) treated between two and three hundred people who had been seen by an ENT specialist and told that nothing could be done for their tinnitus. He undertook a clinical study and reported that for the majority of patients Sound Therapy alleviated their tinnitus to the point where they were able to enjoy life a lot more. Some of the younger patients achieved total remission and as they were not on any medication there were no apparent contributing factors other than the Sound Therapy. A number of Jordan’s patients also reported an improvement in their hearing.

Joudry, (1994) conducted a three year survey of 388 respondents where 45% to 100% of subjects showed symptomatic improvement in tinnitus, hearing loss, stress, fatigue, sleep problems, learning difficulties, speech problems, depression, headaches, jet lag and general well being. 93% of subjects observed some positive results in at least one area.

Reading and behaviour

Sandislands (1989) Compared 32 underachieving children with a control group of 40. The treated group showed greater improvements in listening, oral reading and behaviour.

Rintel and Rintel (1995) conducted a study in Brisbane in 1995 using the Joudry Sound Therapy program on children in a remedial learning program. An experimental and a control group were used, each consisting of seven children. Five normed tests were administrated to the children. The general trend was that the experimental group advanced faster than the control group in Distractibility, Overactive behaviour, Reading improvement, Left/right confusion and Misinterpretation of questions.

Bell, (1991) ran a case study using the Joudry program on a Year 2 boy with delayed development who showed improved social behaviour and began to read.

Voice

Weiss (1985) found that three theatre students after seven months of Sound Therapy showed a shift of vocal energy to the higher frequencies and better articulation.

Language disorders

Wilson (1982) found pre-school language disordered children showed statistically significant improvement in their ability to express thoughts and feelings in words. The study gives a strong indication that the Tomatis approach is useful when used with pre-school learning disabled children.

Van Wyk, (1974) compared 20 stutterers with 20 normal speakers and found that more stutterers have left ear dominance, confirming Tomatis’ hypothesis of the importance of right auditory laterality.

Badenhorst (1975) found that right-eared people communicate more easily, confirming Dr Tomatis’ theory of right ear dominance.

Jaarsveld (1974) found in a group of 43 stutterers, 82% got significant relief from the treatment and 54% retained the improvement for a year or more.

Self Concept

Gilmor (1982) Found improvement in children and adolescents’ self concept, social and family relations and certain language and motor skills.

IQ

Rourke and Russel (1982) compared experimental and control groups and found improvement in IQ of learning disabled children under Tomatis treatment.

Dyslexia

Roy and Roy (1980) examined the effect of the Tomatis method on five dyslexic boys and showed improved cognitive control and audio-vocal control in four of the subjects.

Anxiety and depression

Peche (1975) studied a group of 10 students and found that Sound Therapy helps to alleviate anxiety and remove psychic blocks, indicating its benefits in conjunction with psychotherapy.

Botes (1979) found improved relationships and self-concept in an in depth study of three clients with neurotic depression.

Du Plesis (1982) in a long term study over 14 months with subjects carefully selected from a survey of 424 people, showed improved mental health and self actualization for both 10 anxious and 10 non anxious people as compared to a control group.

Intellectual disability

De Bruto (1983) found a statistically significant increase in the mental age of profoundly retarded children after Tomatis treatment.

REFERENCES

  1. Bell, E. An Ethnographic Report and Evaluation of the Implementation of Audio­Psycho-Phonology (Sound Therapy) in the Support of Timothy. Griffith University Thesis (unpub.) 1991.
  2. Joudry, P. and Joudry, R. Sound Therapy: Music to Recharge your Brain. Sound Therapy Australia, Sydney 1999
  3. Joudry, R. Sound Therapy Manual for Practitioners, Sound Therapy Australia, Sydney 2000
  4. Jordan (1989), personal correspondence, cited in Joudry, R. Sound Therapy Manual for Practitioners, Sound Therapy, Sound Therapy Australia, Sydney 2000.
  5. Rintel, E and D. Sound Therapy for the Learning Disabled Child: The Effect of High Frequency Filtered Music on Listening and Learning Ability. Brisbane, 1995.
  6. Sandislands, M. The Tomatis Listening Training Program: A Quasi-Experimental Field Evaluation, International Journal of Special Education 1989
  7. Stutt, Howard A. The Tomatis Method: A Review of Current Research. McGill University, 1983.
  8. Tomatis, A.A. The Conscious Ear. Station Hill Press. New York, 1991.
  9. Ivan Jaarsveld, P.E. and du Plessis, W.F.
  10. Audio-psycho-phonology at Potchefstroom: A review. Potchefstroom University of Higher Education, 1988.
  11. Wilson, B.C., Iacoviello, J.M., Metlay W., Risucci D., Rosati, R. & Palmaccio, T., Tomatis Project Final Report. The Listening Centre, Ontario,1992.

Auditory Neurology That May Support The Tomatis Theory and other Auditory Intervention Techniques

By: George B. Richards, PhD

Presented to Audioloical Society of Australia Conference Brisbane 2003

Call it sound therapy, auditory training or auditory intervention techniques; these therapy approaches have been the focus for investigation into many types of auditory processing disorders through out the world in prestigious institutions of higher learning by leading investigators.

Dr. Tomatis had a rather radical view of the transmission scheme that is 180 degrees out of phase from the traditional viewpoint. He believed that through a negative feedback loop originating at the level of the endolyph, hydraulic pressure was being applied to the ossicles along with middle ear muscle activity as a constant dampening and tuning of the tympanic membrane. The tympanic membrane collected the sound and transmitted it to the organ of Corti via the bony sulcus.  Tomatis thus concluded it was the role of the middle ear to regulate sound transmission and provide a buffer for the shearing force required for audition. The human ear must maintain an optimal micro-homeostasis by limiting destructive shearing of the hair cells. Tomatis further believed that it was the middle ear muscles, which control high-frequency audition and have a significant role in cortical charging. (Figure 1)


(Figure 1)

Dr. Stephen Porges, at the University of Maryland (USA) working with children with autism and other related disorders, has focused on the two muscles of the middle ear. Porges states that the same nerves that control vocalization, facial expression, heart rate and breathing, innervate the tensor tympani and stapedius muscles. He points out that when the human organism is in a state of fear or high anxiety, the middle ear muscles loose the ability to diminish low-frequency sounds and attending to the higher frequencies of speech is thus impaired. Porges has developed an intervention protocol similar to the Tomatis method using filtered music to exercise the middle ear muscles along with whole body relaxation techniques to restore integrity to the middle ear muscle function and has reported improvements in communication skills, handwriting, balance and coordination, sensory processing, visual skill and sleep patterns. (Porges, 2003)

The research of Rideout and Laubach at Ursinus College in Collegeville, Pennsylvania required eight students to perform spatial-reasoning tasks before and after listening to a Mozart piano sonata. EEG recordings were made in each condition and an interesting correlation was observed. The music condition dramatically increased brain wave activity along with a significant increase in spatial-reasoning performance. (Rideout and Laubach 1997). Musical perception occurs in the right hemisphere of the brain, which is the same side of the brain that is involved with spatial analysis. (Roederer)

Dr. John Hughes, a neurologist at the University of Illinois Medical Center in Chicago found that music that regularly repeats every 20 to 30 seconds, just as most of Mozart’s compositions do, trigger the strongest brain activity. Dr. Hughes studied the effects of listing to Mozart on 36 subjects with severe epileptic seizures and found an outstanding 29 out of the 36 patients showed significant improvement by having fewer seizures of less intensity. (Hughes, John 1998)

Neurobiologist Gordon Shaw of the University of California at Los Angeles using MRI studies to chart the brain wave activity of individuals listening to different types of music found that only Mozart activated areas of the brain that process fine motor coordination, vision and other higher thought processing regions. (Rauscher, Shaw and Ky, 1995)

Dr. Ingmar Klochoff of Uppsala, Sweden, describes a psychosomatic syndrome, known as the tensor tympani syndrome and is caused by increased psychic tension due to mental stress. There are individuals who do not have a constant impedance of the middle ear. The conclusion for this irregularity was spontaneous tonic tensor tympani muscle activity. The symptoms of this syndrome are often a fullness, tinnitus and dysacusis with a high relation to tension headache and vertigo. This syndrome does not in its self cause hearing loss; however, persons with this syndrome complain of difficulties in understanding what people say. This psychosomatic syndrome is likely to be caused by an inability to attend or concentrate caused by the ever-present rise in psychic tension. (Klochoff 1979) (Figure 2)


(Figure 2)

The Centrifugal Pathways are where things start to get interesting. We all struggled with the afferent or input pathways and learned how things got to the brain, but it was that efferent or feed back system that always seemed to be so elusive and not very well understood. The efferent nerves run close to, but not within, the same tracts, as do the afferent nerves. The Superior Olivary Complex is the region of the brainstem where efferent neurons arise and have their point of origin, but are not within the afferent nuclei. It is this system that is responsible for the auditory reflex activities of the stapedius and the tensor tympanic muscles.  Traditionally we have been taught that the contraction of these muscles causes the ossicles to become less efficient sound transmitters to the labyrinth, thus protecting the delicate hair cell structure. (Figure 3)


(Figure 3)

Unorthodox theories view this reflexive activity to be a tuning system that is continually monitoring the tension being applied to the tympanic membrane and providing protection to the hair cells from superatheshold stimuli.

The auditory efferent system is also feeding information back to the contractile outer hair cells pulling the tectorial membrane into the afferent inner hair causing a mechanical fine tuning effect as in attention and sound localization. (Figure 4)


(Figure 4)

These unorthodox theories have merit; in that a true feedback system would have a continuous flow of information that provides maximum tone to the middle ear muscles.  Just like an arm or a leg that does not become completely limp when not in use, but maintains a proper tone all of the time, unless injured.  This is one of the main theories of the Sound Therapy; that it will restore tone to the middle ear muscle system and in turn tunes up the entire auditory system, which is responsible for 85% of ongoing cortical activity

The system is also very global at a cortical level, sending information to the somatic and automatic nervous system. These more global responses are responsible for feelings of sadness, happiness, anxiety, flight and fight and a host of other visceral responses. It is the ears’ involvement with the X cranial nerve or the vagus nerve (some times referred to as the wandering nerve) that innervates the bronchi and heart going through the diaphragm and on to the entire viscera including the esophagus to the anus. Very simply put, “We therefore have a system in which reflexes can be established at many levels, and in which the cortex controls the reflexes through descending influences..”(Pickles 1988) )

Through over stimulation, sickness and disease, drug therapies and other oxidative stress, the integrity of the afferent and efferent nervous systems is compromised, with loss of muscle tone and synchrony in the synaptic firing order. This compromise manifests itself in myriad of symptomatic maladies, such as hearing loss, tinnitus, loss of balance and coordination, loss of attention, inability to hear and understand in the presence of background noise, fatigue, tiredness, headaches, anxiety, depression and on and on. So when damage occurs to this delicate feed back system, the homeostasis of the entire organism is compromised. Thus is appears through highly organized temporal stimuli (classical music), which has undergone high band pass filtration, a restoration of aural muscle tone and synaptic firing order provides better cortical processing. Better cortical processing corrects a myriad of problems ranging from: anxiety relief, better hearing, tinnitus control, better balance and coordination, to: feelings of happiness and well being.

It seems that it is the reestablishing of the ability to listen to the higher frequency that is responsible for repairing and reorganizing cortical pathways. The energy levels coming in from the high frequency areas are more intense than for the lower frequencies. Dr. Tomatis calls the high harmonics the “charging sounds” while he describes the lower frequencies as the “discharging sounds”. The lower frequencies supply inadequate energy to the cortex and may even exhaust the individual. (Weeks)

REFERENCES:  

  • Hughes, John G. (1998) The “The Mozart effect on Epileptiform Activity. Perceptual and motor skill, Vol.86 P 835
  • Klochoff. Impedance Fluctuation and a “Tensor Tympani Syndrome”, Proc 4th International Symposium on  Acoustic Impedance measurements Lisbon Sept.25-28 1979 Universidad Nova de Lisboa Ed Penha and Pizarro pp 69-76
  • Pickles, Brainstem Auditory Nuclei chapter 6 and Centrifugal Pathways chapter 8 (l988) [online] Lecture presented by Dr. Robert H. Mannell Department of Linguistics Macquarie University, Sydney Australia. http://www.zainea.comThe %20Brainstem%20auditory%20Nuclei.htm
  • Porges, Stephen (2003), The sound Connection Vol. 6 No. Society for Auditory Intervention Techniques (P.O. Box 4538, Salem, OR 97302, USA)
  • Rauscher, F., Shaw G., Ky K. (1995) Listening to Mozart Enhances Spatial-temporal Riasoning: Towards a Neuropsychological Basis. Neuroscience Letters, Vol: 185, Issue: 1, Feb. 6, 1995 pp. 44-47
  • Roederer, Juan G. (1994) The Physics and Psychophysics of Music (pg 13 and 53) Springer-Verlag 1995
  • Weeks, B.S., The Therapeutic Effect of High Frequency Audition and Its Role In Sacred Music In T.M. Gilmore, P. Madeule, and B. Thompson (Eds.), About the Tomatis Method, Ontario, Canada: The Listening Centre Press

The Science of Tomatis

Research summary

The Tomatis method is the foundation for numerous offshoots of sound therapy programs based on Tomatis’s discoveries. There is substantial evidence for the efficacy of the Tomatis method, with studies on a wide variety of health conditions producing a differing range of results that have been interpreted as either positive or neutral.

Tomatis reported in his autobiography on his efforts to collaborate with researchers. Though the methods used in some studies did not succeed in highlighting the positive results observed by clinical practitioners, Tomatis argued this was due to the design of the studies and individual variances. (Tomatis Conscious Ear)

In the last few decades there have been numerous controlled studies, surveys, clinical experiments and case histories, many of which confirm the benefits of the Tomatis method for a variety of conditions. A summary of these studies follows.

Reading, behavior and learning

Sandislands (1989) Compared 32 underachieving children with a control group of 40. The treated group showed greater improvements in listening, oral reading and behaviour.

Kershner et al (1990) undertook a 2 year study of 26 students with a control group using an auditory placebo. As improvements were found in both groups, researchers concluded that there was a lack of support for the educational efficacy of the Tomatis Program for learning disabled children.

Gilmor’s meta analysis (1999) covering four smaller studies of the Tomatis method, including Kershner’s work, found that “Positive effects sizes were found for each of the five behavioral domains analyzed”

Voice

Weiss (1985) found that three theatre students after seven months of Sound Therapy showed a shift of vocal energy to the higher frequencies and better articulation.

Language disorders

Van Wyk, (1974) compared 20 stutterers with 20 normal speakers and found that more stutterers have left ear dominance, confirming Tomatis’ hypothesis of the importance of right auditory laterality.

Jaarsveld (1974) found in a group of 43 stutterers, 82% got significant relief from the treatment and 54% retained the improvement for a year or more.

Badenhorst (1975) found that right-eared people communicate more easily, confirming Dr Tomatis’ theory of right ear dominance.
Wilson (1982) found pre-school language disordered children showed statistically significant improvement in their ability to express thoughts and feelings in words. The study gives a strong indication that the Tomatis approach is useful when used with pre-school learning disabled children.

Swain (2007) studied the effects of the Tomatis Method on 41 subjects from age 4 to age 19 with auditory processing disorders. Standardized tests were used pre and post treatment. All subjects demonstrated statistically significant improvement with skills of immediate auditory memory, auditory sequencing, interpretation of directions, auditory discrimination and auditory cohesion. Researchers concluded that the Tomatis Method can be effective as an intervention strategy for auditory processing disorders. http://www.thelisteningcenter.net/research.php

Self Concept

Gilmor (1982)   Found improvement in children and adolescents’ self concept, social and family relations and certain language and motor skills.

IQ

Rourke and Russel (1982)   compared experimental and control groups and found improvement in IQ of learning disabled children under Tomatis treatment.

Dyslexia

Roy and Roy (1980)   examined the effect of the Tomatis method on five dyslexic boys and showed improved cognitive control and audio-vocal control in four of the subjects.

Intellectual disability

De Bruto (1983)   found a statistically significant increase in the mental age of profoundly disabled children after Tomatis treatment.

Autism

A study was undertaken by the University of California on autistic children using the Tomatis sound therapy, its findings were published in 2007.   The method used was randomized, double-blind, placebo-controlled, crossover design. The study showed that there was improvement in the children, however it did not appear to be related to the treatment. The children that were given the placebo showed a higher percentage of improvement over those given the Tomatis treatment. The study concluded there was no improvement in language using the Tomatis Method.

Anxiety and depression

Peche (1975)   studied a group of 10 students and found that Sound Therapy helps to alleviate anxiety and remove psychic blocks, indicating its benefits in conjunction with psychotherapy.

Botes (1979)   found improved relationships and self-concept in an in depth study of three clients with neurotic depression.

Du Plesis (1982)   in a long term study over 14 months with subjects carefully selected from a survey of 424 people, showed improved mental health and self actualization for both 10 anxious and 10 non anxious people as compared to a control group.

REFERENCES

  • Tomatis, A.A. The Conscious Ear. Station Hill Press. New York, 1991.
  • Sandislands, M. The Tomatis Listening Training Program: A Quasi-Experimental Field Evaluation, International Journal of Special Education 1989
  • Kershner, J., Cummings, R, Clarke, K, Hadfield, A, Kershern, B, Two-year Evaluation of the Tomatis Listening Training Program with Learning Disabled Children, Learning Disability Quarterly, Volumer 13, 1990.
  • Gilmore, Tim, The Efficacy of the Tomatis Method for Children with Learning and Communication Disorders: A Meta-Analysis, International Journal of Listening, Vol 13, 1999.
    Weiss, W. (1985). Long-term average spectra of continuous speech before and after Tomatis audio-vocal training. The Journal of the Acoustical Society of America 78 (S1) p. S56
    Van Wyk, S. (2003). A combined Tomatis and lifestyle enhancement progamme for overweight female students. Unpublished masters thesis, North-West University, Potchefstroom, South Africa
  • Jaarsveld, P.E. and du Plessis, W.F., Audio-psycho-phonology at Potchefstroom: A review. Potchefstroom University of Higher Education, 1988.
  • Badenhorst.F.H. (1975).’n Rorschachstudie van regssydiges en linksluisteraars met gemengde laterale voorkeure. Ongepubliseerde M.-graad-skripsie. Potchefstroom Universiteit vir CHO: Potchefstroom.
    Wilson, B.C., Iacoviello, J.M., Metlay W., Risucci D., Rosati, R. & Palmaccio, T., Tomatis Project Final Report. The Listening Centre, Ontario,1992.
  • Swain, D.R. “The Effects of The Tomatis Method of Auditory Stimulation on Auditory Processing Disorder: A Summary of Findings,” International Journal of Listening, Vol. 21, Number 2, 2007.
  • Gilmor, T.M. (1982). A pre-test & post-test survey of children’s and adolescent’s performance before & after completing the Tomatis Program. Unpublished manuscript. Tomatis Centre (Canada).
    Gilmor, T.M. (1984). Participant characteristics and follow-up evaluations of children and adolescents who have participated in the Listening Training Program (Tomatis Method), 1978-1983. Unpublished manuscript. Tomatis Centre (Canada).
    Cited in Stutt, Howard A. The Tomatis Method: A Review of Current Research. McGill University, 1983.
  • Rourke and Russel cited in Stutt, Howard A. The Tomatis Method: A Review of Current Research. McGill University, 1983.
  •   Roy, J. (1982). Cognitive control functioning and spontaneous speech: Intensive case studies of Audio-Psycho-Phonological remedial training with five dyslexic boys. Doctoral Dissertation. University of Otawa. Unpublished manuscript.
    Roy, R. T. (1982). Perceptual processing abilities and academic skills: Intensive case studies of Audio-Psycho-Phonological
    remedial training with five dyslexic boys. Doctoral Dissertation. University of Otawa. Unpublished manuscript.
  • De Bruto, C.M.E. (1983) Audio-psycho-phonology and mentally retarded children: an empirical investigation. Unpublished master’s dissertation. Potchefstroom University (written in the Afrikaans language).
  • Corbett, Shickman and Ferrer, ” A brief report “The effects of Tomatis sound therapy on language in children with autism” http://www.ncbi.nlm.nih.gov/pubmed/17610057 and http://www.springerlink.com/content/y8834k4h14332625/
    Peché, A. (1975). Anxiety. Unpublished masters thesis, North-West University, Potchefstroom, South Africa (written in the Afrikaans language).
  • Botes, C. E. (1979). Audio-psycho-phonology with neurotic depression. Unpublished masters thesis, North-West University, Potchefstroom, South Africa (written in the Afrikaans language).
  • Du Plessis, W.F. & Van Jaarsveld, P.E. (1988). „Audio-psycho-phonology: A comparative outcome study on anxious primary school pupils”. South Africa Tydskr. Sielk (Journal of Psychology), 18:4, 144-151.

Sound Therapy for the Learning Disabled Child

Summary of research by Elizabeth & Derek Rintel, 1995

SOUND THERAPY FOR THE LEARNING DISABLED CHILD: The Effect of High Fequency Filtered Music on Listening and Learning Ability

A group of Remedial Learning Children were exposed to Joudry Sound Therapy Tapes for 32 hrs over a period of sixteen weeks. The results were as follows:

Goldman-Fristoe-Woodcock Test of Auditory Discrimination

(in percentiles for age group)

Rosner Test of Auditory Analysis Skills

Neale Reading Age Group Means (in months)

Neale Comprehension Age Group Means (in months)

Spelling Age Group Means (in months)

 

Some comments from the discussion paper:

“we can conclude that the change was due to the high frequencies in the Joudry tapes.”

“Experienced teachers consider an increase of five months in reading in four months is good progress for a remedial child.”

“it is unusual for a group to make ten months gain in the period studied.”

“the children who received the high frequency music showed more rapid advances”

“For Special children being integrated into the classroom it is entirely feasible for an individual child to wear a Walkman player with the tapes while attending to lessons in the normal way. It is clear that larger group studies would be worthwhile especially in view of the policy of integrating as many disadvantaged children as possible into the normal school. Sound Therapy may allow them to speed up the learning process.”

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