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.

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Dr Tomatis

How did Dr Tomatis make his discoveries?

Dr Tomatis, a Paris based ear, nose and throat specialist, was one of the first to investigate the auditory environment of the foetus. His theory was that the auditory relationship between baby and mother lays the foundation for all our other relationships and is therefore the crucial point of intervention to bring about change in the person’s psychological response to sound and language.

In the 1940s Tomatis devised a system of taking the listener back through the auditory experience of being in the womb and first learning to identify sound. He called this process ‘sonic birth’. He began this path of discovery when he learned that if baby birds are hatched under silent foster mothers, the hatchlings will be unable to learn to sing.

The Tomatis Effect

As his initial concern was with hearing loss, Tomatis’s 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 are heard at a lower level. (This is called a scotoma.) 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 framed his first law: “The voice contains only those sounds that the ear can hear.”

To learn more about Dr Tomatis read an article by Rafaele Joudry Tomatis the Irrepressible Pioneer (See articles for Web).

To learn more about the research behind Sound Therapy, request one of our Free Reports.

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 Research Papers

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.

Sound therapy research continues today all over the world. There is simply too much material to cover at once, so the following list is just a small collection of useful and insightful articles on the topic.

You can keep up to date on sound therapy research by visiting this site periodically, as we like to post on important findings in the field. Academic journals, search engines and social media forums on the topic are also good places to look.

www.soundtherapyinternational.com_images_figure1

The therapeutic effect of high band pass classical music

By:
George B. Richards,Ph.D.
Paula J. Richards, A.B.A.
Rafaele Joudry, B.S.W.

The purpose of this paper is to present a critical review of the literature as it relates to the alternative approaches to hearing health through an overview and history of the theories of Dr. Alfred Tomatis, MD and present views toward antioxidant supplements. This review will attempt to explain these views as related to the afferent and efferent auditory neurological pathways and to explain how oxidative stress to the auditory system can be alleviated.

PART 1
A Historical Review of the work of Dr Tomatis and Supporting Literature By Rafaele Joudry BSW

Overview of Dr Tomatis’s work
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. His work was applied most extensively to children with learning disorders and in language learning centres. Extensive anecdotal data and survey results indicate improvement for certain hearing disorders. Through his experiments Tomatis also discovered that high frequency sounds, softly played stimulate and replenish brain energy. He believed that a regular dose of high frequency sound is essential for optimum functioning of the cortex. His method also appears to assist cerebellar integration, leading to improvement in numerous neurological disorders.

Tomatis’s research
On completing his ENT studies Tomatis set up his own research rooms and started amassing clinical data on audiometric tests. He focused on aeroplane mechanics, many of whom had worked in highly detrimental sound environments during the war. After testing in several different situations, Tomatis noticed inconsistencies in results for hearing tests depending on the subjects’ anticipation of the effect of hearing loss on their career or possible pensions.

This inspired him to investigate the psychological aspect of hearing. So began the development of Tomatis’ ideas on the wholistic nature of language as it represents our evolving consciousness within our environment. He was inspired by the work of Negus who determined that ducklings could recognise the sound of their mother’s voice at birth, and from this deduced the fact that much of our neurology for language comprehension is laid down while still in utero.

Dr Agatha Sidlauskas, a psychologist and long time proponent of Tomatis’s work has perhaps the best overall grasp of how the intricate physical involvement of he ear in the entire nervous system implicates its profound role at more psychic levels of our being. “The integration of the ear with the rest of the organism means that to be able to speak one must be able to control posture, to direct his gaze, to be sure of inner dynamics and be capable of hearing sound and to analyze its intake.”

Meanwhile Tomatis had begun working with singers. He subjected the singers to audiometric tests, the same that he had been administering to those people with occupational deafness and noticed a surprising similarity in the audiometric curves. Could it be, he asked, that the singers had deafened themselves with their own loud voices? By measuring the intensity of their voices with a sonometer, he established that powerful singers could reach 130 or 140 decibels, certainly enough to cause deafness with continued exposure! Especially since 130 decibels at a metre’s distance represents 150 decibels inside ones skull!

Tomatis now began to investigate and compare the size of larynxes vis à vis the voice structure against the shape of the audiogram in relation to the voice. He had to conclude from the evidence he gathered that the voice was controlled not by the larynx but by the ear. He was able to verify from his test results that a scotoma in the audiogram exactly matches the same loss of frequencies in the voice. Thus in 1947 Tomatis came to the formulation of his first law: “The voice only contains those frequencies that the ear can hear.”

Tomatis’s next major discovery was that self listening and voice production is controlled by the right ear. This is because the passage of nerve impulses connecting the ear to the larynx and to the cranium is more direct on the right side of the body. The recurrent laryngeal nerves [belonging to the tenth pair of cranial nerves, the vagus] have to cover a longer route on the left side for two reasons. One is that they have to go around the heart. The other is that the central laryngeal motor area is situated in the left brain. In other words, our main speech centre is in the left brain, and this is most directly reached via the right ear.

This means that the right ear has the more efficient route on two counts: for language reception and vocal production. Therefore it must direct. Tomatis says categorically that all great singers and musicians are right-ear dominant. He also states, and other learning specialists confirm his findings, that it is a requirement for efficient processing of language for any person that the right ear must lead. We function more efficiently if the right ear directs our listening.

During this period, Tomatis was developing the device which he eventually called the Electronic Ear. This machine had the capacity to feed back the subject’s voice with the frequencies altered so that they could hear themselves in the correct way. Thus their ear was reconditioned to accurate hearing, and the voice was also corrected. Later Tomatis found that he could achieve the same result by playing music, mainly Mozart, through the Electronic Ear. He found that provided the subject experienced these altered sounds repeatedly for a certain period of time, the effects would last. In later years Tomatis trained many different practitioners to use his method and so it became available in about two hundred centres around the world, in addition to his centre in Paris.

Distinctions awarded to Tomatis as recognition of his early work were as follows: Chavalier of public health 1951; International Scientific Research Gold Medal at the Brussels World Fair [1959] awarded for the Tomatis Effect Electronic Ear; International Scientific Research Bronze Medal at the Brussels World Fair [1959] for the Tomatis Automatic Audiometer; Grande Medaille de Vermail of the City of Paris [1962]; Clemence Isaure Prize. March 1967; Arts, Science and Literature Gold medal. April 1968.

Clinical Studies
Recent brain research by Ted Carrick, an important pioneer in the field of chiropractic neurology, indicates that rather than simply psychological factors, brain function and in particular cerebellar integration, determine the essential listening and attending component needed to complete the act of hearing, particularly the ability to focus ones hearing in the face of other sensory inputs, distractions and background noise.
In the last few decades there have been numerous controlled studies, clinical experiments and case histories, primarily in Canada, South Africa and Australia, which confirm benefits of the Tomatis method for a variety of conditions. These have been done firstly on the clinical Tomatis treatment and more recently on the portable treatment developed by Patricia and Rafaele Joudry. A brief summary of these studies follows.

Canada
The Canadian studies focussed primarily on language and learning abilities, demonstrating measurable changes on a variety of indicators. Under-achieving children performed better when compared against control groups according to objective tests and observations by parents and teachers.
Sandislands and Lethbridge, [Sandislands 1989 ] compared 32 underachieving children with a control group of 40. The treated group showed greater improvements in listening, oral reading and behaviour.
Likewise, Wilson [Wilson, 1982 ] found that a group of pre-school language disordered children showed statistically significant improvement in their ability to express thoughts and feelings in words after Tomatis therapy.

Gilmor [Gilmor, 1982 ] found improvement in children and adolescents’ self concept, social and family relations and certain language and motor skills.

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

Two doctoral theses on the effect of the Tomatis method on five dyslexic boys showed improved cognitive control and audio-vocal control in four of the subjects. [Roy and Roy,1980 ]
Weiss [Weiss, 1985 ] showed a shift of vocal energy to the higher frequencies and better articulation in theatre students after Sound Therapy.

South Africa
Van Wyk, 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. [Van Wyk, 1974 ] This was also confirmed by Badenhorst, who found that right eared people communicate more easily. [Badenhorst 1975 ]

Jaarsveld [Jaarsveld 1974 ] treated a group of 43 stutterers, in which 82% got significant relief from the treatment, and 54% retained the improvement for a year or more.

Peche, treated a group of 10 students and found that Sound Therapy helped to alleviate anxiety and remove psychic blocks. He concluded that it is beneficial in conjunction with psychotherapy. [Peche 1975 ]
Botes found improved relationships and self concept in an in depth study of three clients with neurotic depression when treated with Tomatis therapy. [Botes, 1979 ]

A long term study by Du Plesis over 14 months with subjects carefully chosen from a survey of 424 people showed improved mental health and self actualization for both 10 anxious and 10 non anxious people who had Tomatis treatment, as compared to a control group. [Du Plesis 1982 ]

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

The following studies were done using Joudry’s portable program of the Tomatis treatment method.
U.K.

The audiometrician, Eric Jordan, trialled the Sound Therapy tapes on an unspecified number of subjects and claimed he found that 90% of tinnitus sufferers got some relief as a result of Joudry Sound Therapy tapes.

Australia
Special education teacher, Elizabeth Rintel, used Joudry tapes for learning disabled children and found they advanced faster in reading, spelling and auditory discrimination compared to a control group. [Rintel, 1995. ]
Sound Therapy Australia [Joudry 1994. ] undertook a three year survey of 388 respondents which showed 45% to 100% symptomatic improvement in subjects. The percentage who reported a positive outcome for each condition was as follows: tinnitus, 84%; hearing loss, 56%; stress, 86%; fatigue, 84%; sleep problems, 75%; communication, 78%; learning difficulties, 85%; speech problems, 64%; depression, 100%; headaches, 100%; jet lag 100%, and for general well being, 80%. 93% of subjects observed some positive results in at least one area.

Bell, undertook a case study using Joudry tapes on a year 2 boy with delayed development. As a result of the program and according to evaluations undertaken by his mother, the experimenter and his teacher, he showed improved social behaviour and began to read. [Bell 1991 ]
Hearing Instrument Specialist, Paula Richards studied the effect of Sound Therapy on hearing environmental sounds while listening and found almost no impairment of the ability to hear surrounding noise while the tapes are playing, meaning that it is quite safe to use Sound Therapy during daily activities. [Richards 2001 ]

The portable program
Sound Therapy was adapted for cassette tape in the 1980s by Patricia Joudry and Rafaele Joudry, authors of Sound Therapy: Music to Recharge Your Brain and Triumph Over Tinnitus. This meant that thousands of people who did not have access or time to attend the lengthy and costly clinic process could now use the therapy during daily activities. Long term use brought to light more benefits in the areas of sleep, improved energy, reduced stress, relief of tinnitus, improved sound differentiation and in some cases better hearing.

Interestingly, the only studies to examine the effect on hearing and ear related problems were the ones using the portable method. It was only with the advent of the portable method that the effectiveness of Sound Therapy for hearing disorders became apparent, as it usually requires long term treatment to see effect in these areas. These studies however were not rigorously controlled and further research is needed to explore the anecdotal evidence which points to many incidences of improved hearing, reduction in tinnitus, improved ability to differentiate sound in a noisy environment, recovery from recurrent and intermittent ear blockage problems, infections, excess wax production and ear related balance disorders.

PART 2
Auditory Neurology That May Support The Tomatis Theory and other Auditory Intervention Techniques. By: George B. Richards, PhD

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]

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]

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]

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]

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]

PART 3

ANTIOXIDANT SUPPLEMENTS FOR THE EAR
By: Paula J. Richards, A.B.A., H.I.S., C.S.T.P.

This presentation’s purpose is to suggest some non-invasive treatment recommendations and the studies that support their potential for tinnitus relief.

We will discuss types of treatments and studies conducted on tinnitus patients along with specific supplements and their levels

Literature, journals and the Internet are overflowing with data regarding antioxidant effects on just about every subject imaginable. When we began to research statements lauding the antioxidants and help for tinnitus, there was no shortage of information.

After wading through test studies and analysis, I have attempted to pick out those studies with the most validity and relevance to our topic here today.

Typically the medical profession has prescribed little help for tinnitus sufferers over the years. Most often antidepressants or tranquilizers were used simply to ease anxiety. But on the extensive list of drugs which create or increase tinnitus, these types of drugs rank pretty high. The side effects were helpful, but did not address relief of the total problem. Most often patients were told they would “Just have to live with it”. That is a tough call when it affects their entire life.

Treatments of every type imaginable have been suggested over time.

Recent information supplied to the 18th Annual Meeting of the International Tinnitus Forum in 2000 by Dr. Michael Seidman discussed intravenous treatments under consideration including caroverine. Also discussed was memantine, which is delivered locally to the cochlea, as well as catheter-delivered infusion of magnesium sulfate to the round window. Although these treatments showed some tinnitus improvement, emphasis was made that the treatment of tinnitus through transtympanic injections is not only invasive, but entails potential risk of damaging the hearing mechanisms. [Seidman, 2000] A risk that the majority of hearing health care professionals choose to avoid, like the plague.

The total problem is that tinnitus is very complex in that it creates a vicious cycle for the patient to overcome. The sufferers get stressed from the continuous noise, the inability to sleep and rest, the resulting eating problems, increased anxiety along with depression. All these factors continue to increase the tinnitus and the cycle grows more intense and more vicious.

Treatment factors need to be addressed which involve all of the aspects that accompany the noise of tinnitus.

The antioxidant theory that free radicals in the ear cells and nerves, which were created by noise and stress, can be either completely or partially cured is an extensive subject all in itself.

Kopke et al noted that noise over exposure leads to the development of reactive oxygen species in the cochlea, i.e. [oxidative stress]. The reactive oxygen steals molecules from the healthy outer hair cell [OHC]. These molecules are normally used to support its healthy functioning. Noise over exposure over works the OHC causing the free radicals to release and prevent the cell from replenishing critical nutrients causing the once healthy cell to go into a death cycle. This is why many researchers believe the damaged OHC can be treated with antioxidants before the death cycle reaches a point of no return. [Wolgemuth, 2000]

I will attempt to address the combination of supplements, which we feel are best able to assist with this oxidative stress damage and assist in tinnitus relief; and even in some cases, better hearing.

The first recommendation accompanying all studies is to suggest that patients avoid alcohol, smoking, caffeine and reduce their salt intake. Since this treatment pattern is suggested by doctors for a myriad of ailments and not observed by their patients for any of them, the recommendation of supplements is more widely accepted. After all, we modern, busy people want the perfect pill that will remedy everything that ails us.

The basis of the program dealing with supplements is the inclusion of not just one element, but the combination of Ginkgo Biloba, Garlic, Zinc and Vitamin A.

Ginkgo Biloba: Studies are ongoing and have been in progress for many years relating to use of ginkgo biloba associated with tinnitus as well as hearing problems. Studies have been going on in France, Italy, Germany, Denmark as well as the U.S.A.; and you are all certain to be aware of Jastreboff’s studies with this herbal supplement. [Hazell, 1990] [Jastreboff, 1997]

The German Commission E, who is considered the world’s most knowledgeable body on herbal medicines, recommends EGb 761 [ginkgo biloba] for the treatment of tinnitus. [Bumenthal, Busse, Goldberg, 1998]

There have been 19 clinical trials in Germany investigating the effects of tinnitus treatment with EGb 761. Investigations of prognostic factors revealed that short-standing disorders have a better prognosis; so better results can be expected from early-onset treatment. [Holstein, 2001]

A French multicenter randomized double-blind drug vs. placebo study of the treatment of tinnitus with [EGb 761] extract was very positive. Ten ENT specialists treated 103 tinnitus outpatients during a 13-month treatment period. They summarized that the [EGb 761] extract treatment improved the condition of all the tinnitus patients, irrespective of the prognostic factor. [Meyer, 1986]

A pharmacologic study in Denmark attributes that the therapeutic effect of ginkgo is based on several active constituents that have vasoactive and free radical scavenging properties. The Danish study also found ginkgo biloba to have a very tolerable side effect profile. [Soholm, 1998]

Garlic is lesser known, but not less valuable. Stress is a significant factor in increasing tinnitus noise levels. The modern use of garlic has focused on its ability to reduce stress, reduce cholesterol and regulate blood pressure. A side effect of reducing cholesterol and blood pressure is reducing the volume of noise produced by tinnitus.

The majority of studies show that the positive effects of garlic are those that delivered a sufficient dosage of allicin. Since allicin is the component responsible for the distinctive “ODOR” of garlic we have all come to know and love, manufacturers have developed methods of concentrating another component in garlic, alliin [which is odorless], which is then converted to allicin in the body. [Angerstein, 1995]

Zinc: Studies on zinc and hearing have evolved valuable insight. In 2003, a Turkish placebo-controlled study with tinnitus patients was very successful. Researchers Arda et al, measured blood zinc levels at the beginning of the study. They found that 31% of the subjects suffering tinnitus had lower-than-normal-zinc levels. In the same research group, 82% of the tinnitus sufferers reported a significant decrease in tinnitus severity. [Arda, 2003]

A Japanese study of 121 tinnitus patients suggested a benefit from zinc supplementation. This same investigation suggested it was possible to identify tinnitus patients by measuring serum zinc levels; thus aiding in the overall treatment. [Ochi, 1997]

An important note on Zinc is that large doses can be toxic and should be recommended at less than 40 mg per day.

Finally, Vitamin A: A New York Otorhinolaryngologist, M. J. Lobel, was one of the first to demonstrate in 1949 that vitamin A is useful in treating human hearing loss and tinnitus. Between 1941 and 51, five experimental research studies were conducted into the correlation between the ear and vitamin A. Authors concluded vitamin A was a valuable therapeutic agent in the treatment of deafness and tinnitus. [Lobel, 1951]

Identical trials with 103 patients in 1952 by G. Nager concluded that vitamin A did accomplish an improvement in pure-tone hearing, improvement in speech perception and reduction of accompanying tinnitus. [Nager, 1952]

It is important to note that vitamin A can be toxic in large amounts [over 50,000 I.U. per day] and should be consumed in the form of beta carotine, which the body then converts to vitamin A. [Diesel, 2002]

The trial period in the studies and product literature ranges between 60 to 120 days to determine if any result will be obtained. In many studies, extended trials gave even better results. The majority of recommendations for trial periods of the supplements were 90 days.

Most of these supplements include little or no side effects. As with any patient who is taking medications, they should be informed to check with their physician for any contraindications. However, caution must be exercised to warn patients who might be taking agents for blood-thinning such as coumadin or warfarin to check with their primary physician before taking Ginkgo Biloba.

Additionally, Ginkgo Biloba should be discontinued two weeks prior to any surgical procedure.

Of course if any of your 60 to 80 year old patients are pregnant, they should also check with their doctor.

Futuristic scientific research at Harvard Medical School involved reproducing mouse embryonic stem cells inculture that resemble sensory hair cells in the inner ear. These cells were transplanted into developing ears of chickens and appeared to be very similar to the chicken hair cells surrounding them. This technology may be used to treat disorders primarily due to cell degeneration, including hearing loss. [Cunningham, 2003] But not in the near future.

In summary, areas presented here today are non-intrusive methods that give some level of relief to most tinnitus sufferers.

In our practice, we recommend the combination of Sound Therapy and antioxidant supplements. This synergistic combination allows hearing health care professionals to offer an alternative path for their patients to follow in an effort to alleviate tinnitus suffering.

PRODUCT RECOMMENDATIONS
by Rafaele Joudry

Sound Therapy International recommends a combination of Feroxin and Revenol in combination with the Sound Therapy program. Feroxin provides a wide range of at least 60 minerals in a colloidal [liquid] form, derived from a natural source. These minerals assist with a wide range of body and brain functions, assisting the liver to detox so the body can more effectively utilize other nutrients.

Revenol is a powerful antioxidant formula containing several of the most powerful and effective natural antioxidants. The first generation, vitamins A, C and E will work for three hours in the body. The second generation found in grape seed extract and pine bark extract and Ginkgo biloba will last two to three times longer. Third generation anti oxidants, [circuminoids] have now been discovered and will last for up to three days, cleaning your body of free radicals.

Doctors Use Mozart

Ngare Ring lives on the Sunshine Coast in Queensland and practiced for many years as a speech pathologist, before being struck by a mysterious 21st century disease. She says “from one day to the next, my energy disappeared and I was baffled as to the cause of the problem.” But the disease, despite its debilitating effects, has proven to have changed her life for the better.

Ngare’s father, the late Dr. Frank Ellis (1912-1974) used to play Mozart and other composers to his patients during surgery when they were under local anaesthetic. He found that the music soothed and calmed them, making the experience much more comfortable and even pleasant. He adopted this procedure after spending time in the USA with the famous ear, nose and throat surgeon, Dr. Morris Cottle, who loved music and began the practice of using music during surgery. This was in the 1950s and the music he used was on a large reel-to-reel tape player. Many music connoisseurs still claim this is the best sound reproduction system ever invented.

Dr. Frank Ellis was one of Australia’s leading ENT (ear nose and throat) surgeons between the 1950’s and 1970’s and was president of the Otolarygological Society of Australia for a time. He was a pioneer in Australia in the use of microsurgery to remove austic neuromas (benign tumours of the auditory nerve).

Ngare was led to speech pathology due to her father and a lifetime interest in language which, she remembers, began even as a toddler. She believes that she was very fortunate to have been raised on classical music as it has greatly enriched her experience of speech and language. While working in California, she was able to combine her interest in language and learning with her fascination for foreign languages and became fluent enough in Spanish to work as a bilingual Special Education teacher with immigrant children from Mexico.

Ngare worked as a speech pathologist/special educator all her life until 1995 when she found that several amalgam dental fillings were cracked and she was advised by her dentist to have the fillings replaced. Being ill informed, like many dentists, on the dangers of mercury in the amalgam; the dentist removed her fillings without taking precautions to protect her from the toxic effects of gases and particles that were released during the drilling process. He then replaced her fillings with fresh mercury amalgam, which increased the level of toxicity.

That was when Ngare’s energy disappeared and, from one day to the next she, was faced with an enduring and inexplicable illness: including lethargy, migraine headaches and vision problems. Ngare was told by another dentist, who finally diagnosed her problem, that she had a very severe case of mercury poisoning along with gangrenous areas in her jawbone where wisdom teeth had been extracted. Because of all this she was also showing signs of early Multiple Sclerosis.

She sought help from many practitioners, and while pharmaceutical medicine made her condition worse, she received some relief from chiropractic and naturopathic treatment. But the beginning of the real turnaround came when she discovered Sound Therapy. Prior to this, Ngare undertook some rebirthing sessions in the hope of getting to the cause of her problems. One day the therapist asked her “tell me what you love most in the world.” Ngare was surprised to notice that the first three things she mentioned all had to do with music. During the rebirthing session, Ngare had what she describes as an incredible out-of-body experience where she saw herself sliding into a pool, surrounded by beautiful music. It was this experience that renewed her great interest in music and which eventually led to her discovery of Sound Therapy.

It was soon after the rebirthing experience that she came across the book “The Mozart Effect” by Don Campbell and from there was led to Sound Therapy, a portable self help listening program based on the work of the French ENT Specialist, Dr. Alfred Tomatis. Ngare read with fascination of the work of Dr. Tomatis who, using the reel-to-reel tape machines of the 1950s devised a listening program which not only could improve speech and language function and was a highly effective treatment for learning difficulties, but also helped to stimulate brain pathways and replenish energy systems in the body. Plagued as she was by chronic fatigue and constant severe migraine headaches related to heavy metal poisoning, Ngare was eager for anything that could give her back her vitality. She began using the Sound Therapy tapes and very soon her energy started to improve. The filtered music also gave her a feeling of hope and, from this time on, she was led to all the other things she needed. Beginning Sound Therapy was a real turning point for Ngare.

Along with a new sense of positivity, Ngare found she had an incredible new musical awareness. She says “I always loved music, but now I can’t live without it. It opens my heart.”

Dr. Tomatis, who knew of the healing power of Mozart for learning and emotional healing long before it was scientifically tested and proven, said “Mozart is a good mother.”

Given courage to seek further healing, Ngare found a Holistic dentist who replaced her amalgam fillings with the new composite type, but this time used proper protective measures such as rubber dams, oxygen supply, proper sequencing to reduce the battery-like effect of dissimilar metals in the mouth (mercury fillings and gold caps) and, of course, safe disposal of the amalgam material. She experienced immediate improvement in her health once the mercury fillings were removed. She also continued to benefit from Sound Therapy and began introducing the method to her family and clients. Ngare says that all members of her family have seen remarkable improvements from the therapy. Her husband has experienced a lowering of blood pressure and, with the reduced stress, he is like a different man. He no longer gets upset about minor things and sleeps like a baby for the first time in years. He uses the Sound Therapy while working in front of the computer. “One of the great benefits”, explains Ngare “is that you don’t have to concentrate on the therapy as it works on your ear at an unconscious level, so it is very suitable for busy people.”

Ngare’s mother, aged 86, had severe insomnia for many years, but now it is rare for her to have any sleeping problem. Her hearing has also improved; she had a loss of high frequencies in her left ear, which is no longer apparent. She now looks and acts like a woman 20 years younger than her actual age!

Ngare’s sister has been through some very stressful years. Since using Sound Therapy, she has become much more positive and is sleeping a lot better. She says: “I can cope with just about anything these days thanks to Sound Therapy. I keeps me calm and centred.” Ngare’s twin nieces who are typical of identical twins, being very emotionally, close have also been through trying times; so Ngare suggested they try Sound Therapy. One of them took up the listening and, as a result, her grandmother describes her as “a different girl.” She now has a much more positive attitude, is sleeping better and no longer waking every night at 2 am.

Ngare is particularly excited by the possibility of using Sound Therapy in conjunction with speech pathology. Having had to give up her practice due to her illness, she intends to resume it in a new form, combined with Sound Therapy. Ngare loved her work but found there were some clients she simply could not help. Coming from a medical tradition of using Mozart in the surgery, Ngare is undeterred by convention, for she has experienced first hand the remarkable healing power of music and is determined to gain for Sound Therapy the recognition it deserves in her field.

This article was written in 2001. Ngare is now retired and prefers not to take enquiries.
For more information please contact Sound Therapy International on 1300 55 77 96.

Evidence for Joudry Sound Therapy

Rafaele Joudry MSc. Psych

Rafaele Joudry is the Founder and Director of Sound Therapy International. She has authored three books and designed a practitioner education program on Sound Therapy. She has completed her Masters and is currently leading a team of practitioners in Sound Therapy research. She is looking for Doctors interested in collaboration.

Phone 1300 557796

www.soundtherapy.com.au

 

Abstract

This paper contrasts and compares Sound Therapy based on discoveries by Dr Tomatis to music therapy, meditation, and various tinnitus treatments including masking, habituation retraining and intermittent masking with music. Tomatis based, Joudry Sound Therapy, has been found to have a more profound effect on ear function and the brain and nervous system for several reasons. It uses the power of classical music. It rehabilitates the middle ear via muscular exercise, it stimulates the brain with concentrated high frequency input and it reorganises brain pathways in a beneficial way by training the listener to be right ear dominant. A review of the clinical evidence points to the efficacy of the Joudry method particularly for the treatment of tinnitus.

Premise
Joudry Sound Therapy is an effective treatment for tinnitus because it directly stimulates the ear mechanism in such away as to improve both the mechanical, muscular function of the middle ear and the sensorineural function of the cochlea. It also activates many brain centres simultaneously, thus promoting the creation of new brain connections and better neural integration between auditory centres as well as integration with other sensory pathways.

Definition and Scope of Joudry Sound Therapy
Joudry Sound Therapy is a treatment system based on the discoveries of the ENT Dr Alfred Tomatis. New treatment protocols and improved algorithms have advanced the therapy to render it more potent in the treatment of tinnitus and other ear related problems.

Background research

Music Therapy. Extensive evidence exists for the efficacy of music therapy in altering stress, mood states and assisting with a range of health disorders. In particular the music of Mozart has proven beneficial in assisting mood and also stimulating neurological connections and improving intelligence and short term memory.

Tinnitus – is learning to live with it still the best answer?
Because no suitable drug therapy has been found for tinnitus there is a tendency to accept that the condition is untreatable. However stimulation and retraining methods have been found to deliver relief for the majority and in some cases total recovery.

Masking. Tinnitus masking was discovered in 1977 by Jack Vernon who observed that an external sound is easier to tolerate than an internal sound and went on to develop specialised devices for masking tinnitus. While helpful to some sufferers, this method was found effective in providing temporary relief only.

Habituation theory. In the 1980s Dr Pawell Jastreboff and Dr Jonathan Hazel, developed the theory of habituation which holds that tinnitus only becomes a problem if the limbic system is activated and the patient associates the tinnitus with stress or another negative emotion. Jastreboff developed Tinnitus Retraining Therapy which uses counselling and sound generators to train the patient not to pay attention to the tinnitus.

This method has gained wide acceptance in the audiology profession. It provides a measure of relief but requires a fair time commitment, and cost, as subjects must attend a course of training to learn the method.

Intermittent masking. In the 1990s a program was developed by Dr Paul Davis and marketed under the brand name Neuromonics. This program delivers a more tailored form of masking which has proved more palatable as it is delivered via music, giving an intermittent effect at a level tailored for the patient. However, the cost is prohibitive for many tinnitus sufferers. The efficacy of this method has not been verified by independent research.

Ear rehabilitation. Dr Tomatis’s discoveries provide a unique approach wherein ear function is rehabilitated using classical music processed with particular algorithms to create a stimulating effect for the ear. His work has been largely overlooked in the audiological field due to the fact that the short term treatment possible in the clinic setting was usually insufficient to produce the needed changes to affect tinnitus. However, the portable program developed by Joudry uses a different protocol which allows for more intensive, long term treatment, and is now proving to be highly effective in this area.

The improvements made to the Joudry program include:

  1. Portability, meaning greater access and ease of long term listening
  2. A more active musically responsive algorithm used in mastering
  3. Audio-visual support materials to increase listener motivation and compliance
  4. Convenience of use as listening can be done during daily activities or sleep

The physiological basis of Sound Therapy
Dr Tomatis in the 1950s invented a method of Sound Therapy where the frequencies in classical music are altered to provide a physical stimulus for the ear as well as the brain.

Tomatis advanced some radical ideas about the ear and nervous system for which he was acclaimed during his lifetime by the French academies of medicine and science. Several of his theories were tested and confirmed at the Sorbonne University. His premises, established through clinical observation included the following:

Efferent impulses activate the ear
The middle ear mechanism is an active organ which responds via efferent nerve stimulus to incoming sounds. While generally thought of as passive, the middle ear muscles tend to be ignored in seeking remedial solutions for ear problems. Their only recognised role is generally the impedance of loud sound, which could damage the ear. However, Weeks and Richards through investigating the role of the cranial nerves and efferent impulses arising within the Superior Olivary Complex in the brain stem, confirmed that there is a voluntary and proactive component to our hearing. In fact it appears that we are continually tuning the middle ear in order to focus on sounds that we deem to warrant our attention.

Sound can improve ossicular performance
The middle ear muscles can be activated by alternating high and low tones, leading to permanent improvement of their functioning. Tomatis made this discovery after many hours of clinical experimentation with his filtering device, the Electronic Ear. Though more interested himself in psychological aspects of hearing, and in treating autism and dyslexia, he laid the foundation for others to exploit his breakthrough for “ear physiotherapy.”

High frequencies reactivate the cilia
Moving through to the cochlea, Tomatis found that presenting the ear with increasing high frequency sound enhances the capacity of the ear to respond to high frequencies. He developed a program which progressively increases the high frequency content of the sound, increasing both tolerance and capacity for frequencies of 8,000Hz and above. Standard medical advice holds that if the cilia are damaged by noise or infection, they have most likely been destroyed and no improvement in hearing can eventuate. This has been called into question by a growing body of evidence that listening to the Joudry Sound Therapy, (an extended version of Tomatis) sometimes results in significant hearing improvement for sufferers of sensorineural hearing loss. This can only be explained by the premise that the hair cells in some instances were not destroyed but only damaged, and that the repeated stimulation by gradually increasing high frequencies helped to reactivate them.

Better ear function increases appreciation of sound
Tomatis asserted that the ear can be re-trained to receive a greater range of sound by repeated stimulus to “exercise” the middle ear muscles. Listeners to the Joudry method frequently confirm this finding by observing that their appreciation of sound improves, musical and vocal ability improve and they are able to hear birdsong and appreciate music in a new way. Along with this, following a conversation becomes easier, they can hear better in different environments and many report being able to turn down the TV so they can listen without annoying the rest of the family.

The right leads language integration
Tomatis discovered that singing, speaking and all language skills are enhanced by ensuring right ear emphasis, which creates a shorter, more direct brain route for processing sound in the left hemisphere. While it is generally accepted that the primary processing centre for language is on the left, no one apart from Tomatis has used this knowledge to create a simple, auditory remedial program for laterality confusion and the resulting learning and language problems. Tomatis discovered this phenomenon by accident when working with singers who he found greatly improved their vocal range, control and fluency when monitoring themselves with the right as opposed to the left ear. He found that subjects could be trained to be right ear dominant by consistently supplying louder sound to the right ear.

High frequency bombardment improves brain energy and integration
Perhaps the most groundbreaking of Tomatis’s discoveries was that intensified high frequency sounds, primarily in the range of 8,000 to 16,000 Hz, consistently supplied, serve to stimulate and enhance brain function. This has implications for a wide range of brain disorders from depression to epilepsy, but also explains the benefit of the method to stress, anxiety and general wellbeing. Tomatis said that the brain needs to receive 3 to 4 billion stimuli per second for at least 4 ½ hours per day in order to function at optimum potential. Various forms of brain stimulation have been looked at for their therapeutic impact on dystonia, stroke rehabilitation, depression and chronic pain. By using classical music with augmented high frequencies, Tomatis found a way, via the auditory system, of making brain stimulus more acceptable and universally beneficial to the nervous system.

Supporting evidence for Tomatis’s discoveries
Enhanced Brain states.
Davidson of Madison University has studied the ability of humans to create and maintain positive emotional states and has integrated Western medical investigation with the teachings of Tibetan Buddhism by engaging in extensive enquiries with the Dalai Lama and other leading Tibetan lamas. Davidson’s research shows that certain centres in the left hemisphere of the brain, which are activated by meditation, contribute to more positive emotional states. This corroborates Tomatis’s discovery that stimulating the left hemisphere via the right ear emphasis produces beneficial results.

Classical music. Tomatis and Joudry Sound Therapy are delivered through classical music that has been altered to enrich the high frequencies, provide a right ear emphasis and present the ear with constantly alternating sounds of high and low tones in a particular algorithm, using Tomatis’s purpose made filtering system, the Electronic Ear. Western classical music is most suitable for this system due to the fact that it uniquely combines complex rhythm, melody and harmony to a greater degree than any other form of music, thereby stimulating numerous parts of the brain at one time. This is believed to enhance brain connectivity by causing connections to be formed by many diverse regions of the brain. Through experimentation Tomatis established that classical music was the most suitable type of music to use for Sound Therapy. The clinic based Tomatis method was used extensively to treat dyslexia, autism and a variety of listening or auditory processing disorders.

Tomatis research. A variety of beneficial effects of the Tomatis method have been recorded in research at specialised clinics in South Africa, Canada and Australia. These include benefits for dyslexia, anxiety and depression, language disorders, stuttering, mental retardation, learning difficulties, vocal quality and tinnitus.

Ear disorders showing improvement. The Tomatis method was made portable in 1984 by the Joudrys, so longer-term treatment became feasible as cost and convenience were dramatically improved. This led to evidence that on-going Sound Therapy can assist in certain cases with a number of ear related problems not previously considered treatable. These include various types of hearing loss: sensorineural, acquired hearing loss, industrial deafness, age related hearing loss and conductive hearing loss for which there is often a muscular component. They also include blocked ear, hyperacusis (sound sensitivity) cocktail party syndrome (difficulty hearing in a noisy room) and tinnitus (ringing in the ears.)

Data has been gathered for these effects through extensive written testimonials, surveys and clinical observations by some 200 allied health practitioners who recommend the method.

Evidence of success with tinnitus
There is extensive clinical evidence for the portable Tomatis (Joudry) method in the form of surveys, case histories and in depth interviews with clients.

 

A survey of Sound Therapy listeners found that 90% of tinnitus sufferers benefited from the method in that it reduced stress, anxiety and sleeplessness associated with the tinnitus. 45% experienced a reduction in the noise level and 7% found their symptoms were completely gone. Of hearing loss sufferers, 56% reported improvement. Improvements were observed through changes on audiograms, decreased volume required on Walkman or TV, being able to hear better in noisy environments, on the phone or when the speaker had their back turned. Such changes made a significant difference to the person’s life.

Numerous practitioners from various fields including musicians, psychologists, medical doctors and audiologists have become advocates and as independent practitioners actively promote and recommend the method.

 

Eric Jordan, a UK based audiometrician treated 200 to 300 tinnitus patients over a 2 year period and observed that 90% of patients benefited. Though not a formal study, this nevertheless constitutes objective, clinical observation of patients using the method in their day to day lives by a pracitioner interested and experienced in the tinnitus field.

As most of these results have been gathered from qualitative measures of actual clinical applications, including the personal reports from the clients on the impact on their lives, they are more informative than single quantitative measures from controlled research situations. More extensive research is needed to determine more precise statistics for the potential results in each category of hearing disorder. However, the information gathered so far leaves no doubt that Sound Therapy is beneficial to most people suffering from a hearing related complaint and that in many instances it can be quite life changing. The affordability of this method makes it a very favourable and low risk option for tinnitus sufferers when compared to other treatments available.

Bibliography

· Alonso-Alonso, M., Fregni, F. and Pascual-Leone, A. “Brain Stimulation in Poststroke Rehabilitation.” Cerebrovascualr Diseases. 24 (Sup.1):157-166, November 2007.

· Argstatter, H., Plinkert, P., Bolay, HV., “Music Therapy for Tinnitus Patients: an interdisciplinary pilot study of the Heidelberg Model.” HNO. 2007 May;55(5):375-83.

· Campbell, D. The Mozart Effect, Tapping the Power of Music to Heal the Body, Strengthen the Mind, and Unlock the Creative Spirit. Avon Books, 1997.

· Collins, S. http://www.soundtherapyperth.com/index.php and Delafaurie, B. http://www.therapie-par-le-son.com/

· Davidson, Richard J. “Anterior electrophysiological asymmetries, emotion, and depression: Conceptual andmethodological conundrums,” Laboratory for Affective Neuroscience, University of Wisconsin–Madison, USA.

· Davidson, Richard J., Nitschke, Jack B., Pizzagalli, Diego, Putnam, Katherine, “Depression: Perspectives from Affective Neuroscience” Annual Review of Psychology. 2002.

· Davis, Paul. “Tinnitus rehabilitation device and method.” US Patent Issued January 27th 2004

· George, M.S. et al. “Brain Stimulation for the Treatment of Psychiatric Disorders.” Current Opinion in Psychiatry. 20 (3):250-254, May 2007.

· Gilmor, T.M., Maudale, P. & Thompson, B.M. (eds) About the Tomatis Method. The Listening Centre Press Toronto, 1989.

· Hung, S.W. et al. “Long Term Outcome of Bilateral Pallidal Deep Brain Stimulation for Primary Cervical Dystonia.” Neurology. 68(6):457-459, February 6, 2007.

· Jaarsveld, I. P.E. and du Plessis, W.F. Audio-psycho-phonology at Potchefstroom: A review. Potchefstroom University of Higher Education, 1988

· Jastreboff, P. J. and Hazell, J. W. P. Tinnitus Retraining Therapy: Implementing the Neurophysiological Model. Cambridge University Press, 2004.

· Joudry, P. and Joudry, R. Sound Therapy: Music to Recharge Your Brain. Sound Therapy International. Sydney, 2000.

· Joudry, R, Sound Therapy Manual for Practitioners, Sound Therapy International, Sydney 2000.

· Joudry, R. Triumph Over Tinnitus, Sound Therapy International, Gerringong, 2007.

· Kringlebach, M. L., et al. “Deep Brain Stimulation for Chronic Pain Investigated with Magnetoencephalography.” Neuroreport. 18(3):223-228, February 12, 2007.

· MyskiaA. “Can Music Therapy for patients with neurological disorders?” Tidsskr Nor Laegeforen. 2004 Dec 16;124(24):3229-30.

· Richards, G.B., and Richards, P. J. and Joudry, R. “The Therapeutic Effect Of High Band Pass Classical Music And Antioxidant Supplements.” Presented to Australian Audiological Society Conference Brisbane 2004. Cited on http://www.soundtherapyinternational.com/research_and_media_articles.htm#17

· Sinopoli, T., Davis, P. B. and Hanley, P. “Tinnitus: Addressing Neurological, Audiological, and Psychological Aspects with Customized Therapy.” Hearing Review August 2007.

· Skogseid, I. M., “Pallidal Deep Brain Stimulation is Effective, and Improves Quality of Life in Primary Segmental and Generalised Dystonia.” Acta Neurologica Scandinavica. 117 (Sup 188):51-55, May 2008.

· Thaut, MH. “The Future of Music Therapy in Medicine.” Ann NY Acad Sci. 2005 dec;1060:303-8.

· Tomatis, A.A. The Conscious Ear, Station Hill Press, NY 1977.

· Vernon, J. A.,Tinnitus Treatment and Relief. Allyn and Bacon, Boston, 1998.

· Weeks, B. S. ‘The Therapeutic Effect of High Frequency Auditon and its Role in Sacred Music,’ in About the Tomatis Method, edited by Gilmour, T. M., Madaule, P. and Thompson, B. Toronto: The Listening Centre Press, 1989.

Sound Therapy for Children

When your children have a learning or developmental difficulty, nothing is more important than getting the help your child needs. Each day or week in school is an opportunity to learn and get ahead. If your child has trouble processing information, meaning he/she doesn’t hear, see and sense things the same way we do, learning becomes very difficult.

It is vitally important to get help for your child as soon as you can so that he or she doesn’t slip behind in school. Sometimes there may be a diagnosis such as ADHD, dyslexia, autism or learning difficulties. Behaviour problems and difficulty with concentration are often the result. What all of these situations have in common is that the child’s brain is not working as easily as it could.

Sound Therapy is an ideal treatment for all children and can be easily used at home or in the classroom. Simply by listening through ear phones to specially filtered music and stories, the child’s auditory processing system enhanced. The program is valuable for a child’s development, just as physical movement, spinning, swinging and co-ordination skills are important. Sound Therapy is like exercise for the ear and the auditory processing and sensory integration centres in the brain.

Whether your child is developing and performing normally, is exceptionally gifted, or is experiencing some kind of learning or developmental difficulties, Sound Therapy can be a valuable support.

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