Auditory Re-Training - Article

MY SECOND son was diagnosed in 1988 as gifted with learning disabilities. Two educational psychologists told me that he had a very poor short-term auditory memory ("nothing to worry about!") and poor sequencing in both auditory and visual activities. There was also mention of a problem with the corpus callosum. (The band of neurones that form the link between the left and right hemispheres of the brain). All reports commented upon how easily he was distracted by events outside the room.

I was certain that it had something to do with auditory processing. However, I was informed by both psychologists that tests were not available in Australia. About the same time, I looked through the available results of the use of auditory re-training on Sydney children (Samonas Sound therapy). However, these early results gave mixed results which I attributed to inadequate identification of which child would benefit from Sound therapy. Members of the Gifted Learning Disabled Support group who had "tried" sound therapy also reported similar mixed results.

Academically, from about grade 3, Len (not his real name) had proceeded to drop from the top 1/3 of his class to the middle of the class. When Len reached high school the school did not acknowledge that intervention was required. However, because of poor performance, Len was placed in academically lower and lower classes each year. For every year he attended school during this period he lost a year in reading age (relative to his chronological age). His marks in mathematics were "scaled down" and admission to the advanced mathematics classes, in which school-based testing, showed he belonged, was refused. More sad than these issues was that he, Len, was aware that the children around him did not want to learn. In the schoolyard he was bullied because he played with children two or more years above his own age and because he was stood up for the underdog.

Unfortunately, I was unaware of many of these issues until late 2000. At this time I was talking to Margaret Sassé developer of the "Gymbaroo" - a programme of play exercises for young children designed to enhance the natural sequence of neurological development - about CAPD. She suggested that Len undergo audiological and educational assessment by Shanagh Sangster - an experienced infant and support teacher who now specialises in the treatment of learning disabilities in children with Samonas sound therapy.

At about the same time, I learnt that the identification protocol for CAPD had been much improved by the introduction of a battery of auditory processing tests. (Check CAPD and the Gifted Child for more information.) The tests Shanagh had Len complete showed that he had a slow auditory processing speed (just over 60msecs - borderline learning disabled). His results in the SCAN test were so low that they could not be compared to "normed" data. (This was the 1986 test) In particular, the dichotic Listening test showed him to be in bottom 1% of the population for this test. This result meant that Len would and not be able to distinguish between a teacher addressing the class and a child next to him whispering - in fact he would scramble the two inputs. It also "explained" why he became distracted by noises outside the classroom. His results on the TOVA (Test of Variable Attention) gave a result (19 percentile) that was normal for chronological age but not his mental age. Len also showed no dominance in his ear preference (This has also been linked to reading problems). Reading tests revealed that his level had dropped drastically since the 1988 tests.

Len commenced the sound programme (Samonas Sound Therapy - SST) with a combined air and bone conduction at the therapist's office. Bone conduction occurs where the sound is transmitted through bone rather than the ears - the volume of the sound transmitted through the bone is independent of the volume of the air conducted sound. After a week or two he continued at home listening to carefully graded and specifically acoustically recorded music on a technically superior portable CD player. I was strict about compliance. I knew that, from my research into therapies involving neurophysiology, "having a break" from therapy could jeopardise results.

At the end of about 6 months Len was re-tested. His spelling age had improved by 37 months: in fact all results showed significant improvement. In particular Len's dichotic competing sentence test results were now at the 75 percentile, and his TOVA dramatically improved showing him to be well above chronological age (77%).

Len told me that he no longer became "distracted" in class. Other people commented that his attitude had changed - he was now happy, talkative and no longer sullen or withdrawn. At a new school, reports came home stating that he was participating in classroom discussions. Academically he also improved: Len came first in his Maths class and was given a place in the advanced class, In English (intermediate grade) he also came first and merit letters were received in History. Yet only 3 months before his Year 8 Report had said that he was close to failing.

About 3 months into his SST therapy I began to insist that Len read part of a novel or a short story daily. I explained to him that although he could now learn more effectively he had to catch up on what he had missed. The only way to gain this knowledge of words and how they were used was to "experience" words.

Len's therapist insisted that he concurrently undergo a number of N.O.T. (Neuro-Organisational Therapy) sessions because it greatly enhanced the success of the SST. N.O.T. is a branch of kinesiology. (Gifted,117, 24). Practitioners are convinced that N.O.T can diagnosis and correct problems relating to the fight, flight primitive reflexes and other neurological problems. The presence of these primitive reflexes in children has been shown by researchers to negatively affect reading. If left in place, they can undermine the success of SST. In Len's case, N.O.T. addressed residual problems with his TMJ (jaw joint), and his poor inter-hemispheric transfer of information. (This is shown by low scores on the "Picture assembly" test on the WISC III IQ test - in this test the right hemisphere interprets the pictures and the left hemisphere sequences the story and turns the visual information into language.) N.O.T. is also a powerful emotional stress release that is important to children suffering from the agonies of daily failure. Shanagh would have insisted on treating Len for allergies if they had existed because their effects can noticeably undermine the success of SST.

Dr. Marilyn Dyson, a MD who specialises in the case management of children through the various treatments for learning disabilities insists on children taking specific phospho-lipids (fatty acids), such as Eflalex, before or during auditory re-training. Phospho-lipids are the ingredients for the myelinated sheath that surrounds the auditory neural pathway that is responsible for the "speed" of auditory processing. Underdevelopment of this nerve has been observed in children with learning disabilities and it is proposed that these children either do not process the fatty acids effectively or have an insufficiency in their diet.

Towards the end of Len's' auditory re-training I enrolled him in an extra-curricula English class (Masterclass English College at Pymble run by Ken McDonald). He commenced in the summer holidays and I was unaware that the participants were typically children in the top 10% of advanced classes who wanted to be in the top 2%. It was a very successful if unplanned move for Len. The tutor kept most of the written work for homework which was carefully marked to show my child, not what he had done wrong, but what he had to do to receive good grades. Importantly, Len did not feel as though he had failed - just that he had either missed earlier work or had not understood (heard) what was required. I believe Len's success in the class is the combination of his ideas being valued and the fact that he doesn't have to write them down (at the same time). He has also learnt to switch more readily between visual/ spatial/ emotive tasks and the more evaluative/analytic tasks.

I was excited by Len's success in this class as it upheld a long held belief of mine - that gifted learning disabled children can show that they are gifted if they are allowed to learn/perform using their gifts. The worse case for such children occurs where/when they have to use their area of disability to show what they have learnt. In Len's case his previous undetected use and understanding of metaphor, his understanding of morality/responsibility, his ability to detect and express emotional and visual content was not only uncovered but praised! This has improved self-image and Len has become motivated (less reluctant) to try express his ideas in writing.

Nine months further on and Len is still doing well in most areas, although he often takes a different moral position from his teacher, which can cause friction. He comments that his schoolmates "miss" any allusions or metaphors that he makes.

But why did Len develop CAPD? He had no problems with his ears; he was an active sports player - speed hockey, ice hockey and had an easy birth. Events in 1988 indicate the probable cause of his CAPD - Len's jaw dislocated eight times. It turned out that his jaw did not sit properly in the joint that connects it to the skull (the TMJ). I later found out that, in dentistry, stress in the TMJ is a known factor in auditory problems. The TMJ, it appears, has more proprioceptors (sensory nerve cells that relay information about muscle position or tension etc) than any other joint except the hip. It is proposed that if the joint is stressed, the "noise" from these receptors would be sufficient to interfere with auditory processing / development. I did not find out about Len's TMJ problem until the year before his sound therapy. Now that his jaw is fixed and auditory re-training completed, I believe he would no longer fit the profile of CAPD.

Kay is the co-author of a recently published book (2000) Discovering the Gifts and Talents in Your Child. After completing the book Kay found she still had extensive research material on gifted children, particularly underachieving gifted children that was too technical for general publishing. Her aim, by publishing this article in Gifted is to make relevant research on medical and education issues more accessible to parents and non-academic educators.

Pittelkow, Kay (2001). A New Look at Strategies for Visual Spatial Learners. Gifted, 117, 15-18, 23-25.

Auditory Re-Training - a personal experience