By: Ursula Stello OTR/L
Do any of these situations sound familiar?
- Your child has difficulty with attention, arousal, self-regulation or motor planning
- He struggles with fine or gross motor skills, handwriting or coordination
- She has trouble maintaining a consistent sleep schedule or toilet training
- He has difficulty with communication and social skills with his peers
If so, your child may benefit from The Therapeutic Listening Program, a sound-based intervention developed by Sheila M. Frick, OTR and Sally R. Young, Ph.D., of Vital Links.
Listening Plays a Crucial Role in Sensory Integration
The auditory system is a powerful sensory system because our ears never “close.” Since the auditory system is neurologically connected to all levels of brain function, it has a large influence on our overall processing of sensory information.
Listening can have a positive effect on basic arousal, sensory modulation, motor planning, attention and availability to learn. Therapeutic Listening is commonly used within an overall sensory integration program, and can bring about improvements in sensory modulation, posture and movement, attention, motor planning, communication and an overall awareness of the world around them.
An Individualized Approach
Therapeutic Listening is individualized for each child, and with the guidance of a trained professional, such as an occupational therapist, it can be easily followed through in a variety of settings by parents and other caregivers.
As with any treatment program, it is important to carefully evaluate each child to document their current level of functioning, and to assess areas of need. An accurate baseline is important to develop the best treatment plan, make the appropriate music selections and monitor progress.
The Therapeutic Listening Program is not a linear treatment progression, and it can’t be mapped out at the start of therapy. Rather, it is more like a fluid dialogue between the therapist and the child. The therapist constantly observes and analyzes how the child responds to the music CDs, and uses her clinical expertise to determine the appropriate selection of CDs.
Within Therapeutic Listening, there are a wide variety of musical styles and four different programs:
- The Modulated Series
- The Fine Tuning Series
- The Spatial Enhancement Series
- The Gearshifters Series
The CDs for each series have detailed specifications for when to use them, and specific clinical guidelines for when they are appropriate. The therapist and the unique needs of the child determine the program used. It is important to note that the treatment protocol may include CDs from more than one series.
A treatment program frequently starts with the Modulated series, because it provides the framework for all aspects of listening, orienting, engaging, interacting and discriminating.
How Therapeutic Listening Works
A child listens to the modulated CDs for 30 minutes per session, twice a day, with a minimum of three hours between listening times. This can be done while going about every day activities, with the exception of watching TV or playing video games. The music is set at 45-55 Hz, which is the level of a normal conversation, and a child should be able to hear conversation and background noise over the modulated music.
The music provides distinctive and specifically controlled sensory information. It is electronically modified (alternating high-pass/low-pass filter) to highlight different parts of the sound spectrum. The high-pass filter enables only the higher frequencies (over 1,000Hz) to pass through. Since these higher sounds are best perceived up close, they emphasize the auditory foreground and support focused attention.
The low-pass filter enables only the lower frequencies (under 1,000 Hz) to be heard. This accentuates the auditory background, or the space in which it is generated. The alternating sounds provide a significant contrast between foreground and background to naturally trigger attention and activate body movement.
The natural organized rhythmical sound patterns in music, along with the electronical modifications, trigger the self-organizing capacities of the nervous system. Consequently, Therapeutic Listening sets up the body and central nervous system to optimally develop emerging skills. Research and clinical experience prove that Therapeutic Listening speeds the rate of improvement and increases the effectiveness of the treatment.
- Headphones (no ear buds) with frequency range of 20Hz-23,000 Hz, impedance of 150 Ohms, open ear system, circumaural
- Modulated CDs from Vital Links
- Portable CD player/carrying case
- Cost: Purchase of headphone $145 or Rental Rate from Amber Hill PT $50/month, Modulated CD rental $10/2 week period
Frick, S. M., & Young, S. R. (2009). Listening With the Whole Body: Clinical Concepts and Treatment Guidelines for Therapeutic Listening. Madison, WI: Vital Links.
About the author: Ursula Stello, OTR/L, SIPT Certified, is an occupational therapist in the Pediatric Program at Amber Hill Physical Therapy in Frederick, MD and is trained in Therapeutic Listening.
For more information call 301.663.8322.