Gifted Issues Discussion homepage Forums Twice Exceptional Listening training/Tomatis for APD

Hi all,

I don't post much, but am a regular reader on this forum. DS7 doesn't have an official diagnosis, but struggles with social skills/hyperactivity and had very low processing scores (results will be in my history somewhere). We've recently been to see a speech pathologist hoping for some guidance to build social skills. She ran some tests including dichotic listening tests, which he did very poorly on (3rd percentile or less), indicating an auditory processing problem. She didn't give a lot of detail on the treatment, but told me that he would benefit from 3 (expensive!) intensive 3 week blocks of daily listening training at her practice. I have previously seen her long term for my other son and trusted her clinical judgment implicitly.

We are two weeks in to the first block, and my alarm bells are slightly ringing. Each day we listen to filtered classical music/chanting through a special (Besson brand) filtering device with bone conducting headphones, and I spend time talking to him through a microphone. She said it had to be me specifically talking to him, as he would have heard my voice in the womb. I also have to bring in pregnancy and baby photos for us to look at while we do this. To be honest, I started getting a "quacky" vibe from it. It is this trademarked program: http://www.listenandlearn.com.au/auditory-training-program/, which appears to be at least partially based on the Tomatis method. DS also spends some time doing dichotic listening training, answering into the microphone so he hears his own filtered voice.

Does anyone have any (positive or negative) experience with APD/Tomatis method/listening training programs? Is this really a type of standard therapy? I have found that there is a lack of evidence for use in autism, but nothing APD specific. Obviously I'll be discussing with the therapist, but I'd really appreciate any thoughts - particularly as he's scheduled for two more three-week blocks in the future.

Thanks
Mel

I sometimes think auditory processing is one of the most frustrating diagnoses, as it is hard to directly remediate it. Mostly, you try to find ways to accommodate, while shoring up with some long, painstaking listening-skills building. Not the kind of answer any parent wants to hear.

As with any learning challenge, be cautious whenever anyone offers a quick fix. As far as I can tell, there just aren't any, for *anything* LD-ish. It's also good to be cautious when people are working outside their area of speciality. Even among audiologists, only a very small portion have expertise in auditory processing issues, rather than physical hearing issues.

While SLPs do work with kids with APD, making a diagnosis in the first place is not straightforward. In our case, for instance, the audiologist ran her standard battery of APD testing, which took about three hours. Each test was designed to tease out specific skills in being able to distinguish and isolate sounds under different circumstances. For example, being able to hear a farther voice when a closer one is also talking (e.g. teacher and classmate speaking simultaneously), or a voice that's been bounced off a wall (teacher facing away while writing on a board). Other specific tests were also aimed to isolate auditory processing skills from other issues with overlapping symptoms, especially inattentive AHDH and dyslexia (both of which my daughter has).

With respect to to your specific question, here are some clinical guidelines that may be of help. Discussion of a broad array of interventions starts on page 27; Tomatis comes up on page 33, in a section that concludes: "Ethical, safety and efficacy issues have been raised in the USA with regard to AIT and similar auditory therapy methodologies, leading to position statements which do not endorse these methods for the APD population." Wish I had better news However, there are types of listening therapies that do help, depending on what the specific issue is, and those may also be part of your program, such as listening to separate texts in each ear, and practicing staying focused on one while the other slowly gets louder (Note, you can do at home with a tablet; the ability to send separate audiobooks to each ear is built into iPads and some others).

http://www.thebsa.org.uk/wp-content/uploads/2011/04/Current-APD-Management-2.pdf

Thank you so much for the detailed reply, and especially for that linked resource - I hadn't seen that one before and it is such a helpful summary! It seems my feeling is right about this program. I believe it may have some evidence based components, but the majority of it seems to be of the controversial auditory integration bent.

I feel pretty deflated and disappointed in his SLP. If I had been aware it was a non standard approach I would not have proceeded with this program at all - it is in fact so expensive that we have had to put other therapies on hold. It's at least been a good lesson to always ask questions!

Thanks again, I really appreciate the reply.

I can't believe how many quack-like therapies and treatments are out there. Someone was pushing cranial-sacral therapy on me because my kid has a chiari malformation and probably brainstem and/or cerebellum compression. That would probably actually be dangerous for him! I'm sorry but I can't help laughing at the pregnancy/baby photos. My god, if he was in psychotherapy because there was some sort of child abuse concern, or adoption related concern, or something of the like, maybe baby photos might be part of it, but otherwise, you have to be kidding me. Did you pay up front for all of these treatments or can you get out of it?

I am wondering if my daughter has auditory processing disorder and got a card for an audiologist that does testing with our regular health clinic. They did come right out and say that if that's the diagnosis, not much can be done about it. The main point (from my perspective) is that then we would know her issues are not just related to ADHD and it might affect treatment decisions down the line.

Oh I know, I found the pregnancy photo thing laughable too. Perhaps more of a bitter laugh over here though. I must sound like an idiot for not getting more information before signing on, but, like I said, DS5 saw this SLP for a number of years with a phonological delay and I saw no evidence of quackery whatsoever! It wasn't even on my radar that a program she would offer could be this alternative. I do know it's a new program she is offering, and I do not believe she is deliberately "scamming" but firmly believes in it herself.

I will be out of pocket for the first three week block, but will not be returning for further blocks. Now how to address it politely with her 🤔...

Yeah, that's always awkward. It's not like you can say "sorry your therapy is a quack therapy so if you could just carry on like normal, now, that would be appreciated.Thanks!"

napanganka, what you've described sounds way out there - but fwiw, we've had a positive experience with one specific type of listening therapy in our family. When my dd was very young she was extremely sensitive to sound, and was also a really bouncy can't-sit-still-and-focus kid. She complained that she couldn't hear what her teacher said at school, even if she was right next to him, because the background noise from other kids in the classroom was so loud. She went through a listening program as part of an OT therapy program, and we saw some tremendous changes. At home, she was able to sit down and work through an entire worksheet without being so distracted she had to get up and move around. At school her teacher noticed that she was much more able to focus and engage.

I didn't routinely listen to them, but the tapes she listened to were really odd - it's been so many years now I can't remember exactly how they sounded, so I can't begin to describe them, but I remember that her OT would change out the tapes each week and tell us in general what would be on them, as well as always tell us that if listening got to be "too much" for dd we could relax and ignore it for a few days. DD was supposed to listen to her tapes everyday at home, but I don't remember how long she had to listen. She didn't have any kind of talking she was supposed to do in conjunction with it.

Best wishes,

polarbear

I know! I really need to find a tactful way of putting it. I still think this woman has good intentions at heart, which makes it harder.

Thanks for a different angle. I know there are a lot of anecdotal reports of people benefitting from this type of therapy, you must've been very happy to see such progress. To be honest if it wasn't so expensive or was something we could just do easily at home, I may have considered continuing just from a "meh, probably not harmful, who knows, could help" perspective. We have done some OT therapies that we knew were not hugely evidence based because they were very cheap, he enjoyed them, and it was an opportunity for him to move and exercise.