Volume 6 Number 1, 1998

Hemisphere Specific Auditory Stimulation: Kari Done, M.A., CCC/SLP
Hemisphere Specific Auditory Stimulation (HSAS) is an auditory stimulation program developed in Denmark by Kjeld Johansen, PhD., who has completed over 30 years of research in auditory processing and the effects it has on learning and in particular, dyslexia. Dr. Johansen has published numerous studies that emphasize the need for a right ear preference for speech sounds, as suggested by Samuel T. Orton, and the need to increase the ability to perceive form, transitions and rhythmical changes before the start of phonemic coding, as suggested by Chr. A. Volf.

The studies published by Dr. Johansen also report how ear preference and perception of sounds, in particular speech sounds, can be achieved through music stimulation. This can be done by completing a pure-tone audiogram, ear preference and auditory discrimination evaluation and then specifically tailoring a music program from the evaluation result to meet the optimal hearing curve developed by A.A. Tomatis. This means the speech frequencies will either be enhanced or decreased when recording the music onto a cassette tape.

Dr. Johansen, along with composer Bent Holbech of ROTNA music, have developed four main CD’s. These CD’s are designed to enhance the stimulation to the right ear as well as enhance rhythmical changes. The music on the CD’s appears to be beneficial in a multitude of ways, which include the left hemisphere and sound perception stimulation, but there is also a strong calming effect which appears to carry over into other activities.

The procedures for this program include having the participant listen to a tailored tape for 10 minutes a day through stereo headphones, which can include the headphones from a mid-quality walkman. A pure-tone evaluation is completed after every 6 to 8 hours of listening to reformat the tape to meet the new results from the pure-tone evaluation. The completion time for this program is usually between 25 and 50 hours.

The program has been labeled Hemisphere Specific Auditory Stimulation (HSAS) in the United States and has been reported to be very effective and easy to implement. Additional information regarding the HSAS program is available through A Chance to Grow (612) 521-2266, fax (612) 521-9647 or you may contact Dr. Kjeld Johansen through the internet at: http://www2.dk-online.dk/ users/dyslexia_research/docs/therapy.htm.

Information on trained therapists and training workshops is also available through A Chance to Grow.

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Delacato Among the First to Identify Auditory Hypersensitivity
In recent years there has been increasing interest in the auditory system, how it functions, and sometimes misfunctions, and sound interventions that may be beneficial. More and more people are beginning to understand that the way a person perceives sound can impact on his behavior, however this is not a concept that originated in the 90’s. Carl Delacato was among the first to identify auditory hyper/hyposensitivity and to explore treatments to improve these auditory problems. In 1974, Delacato’s book, The Ultimate Stranger, presented his theories based on his observations and work with children with special needs, including autism (Academic Therapy Publications, Novato, California).

Delacato categorized children into groups based on their sensory system patterns. Children who seemed to hear as well as smell, taste or feel things too well were considered to have a hyper sensory system. Only a little input or stimulation would activate the system to an extreme degree. The typical stimulation that one experiences in the normal world is far too much for these children. They not only have difficulty managing the amount of stimulation, they experience it in a different way. They seem to have “super highways from their sensory organs to their brains” (Delacato, 1974), causing the sensory message to reach the brain faster and with more strength than one would expect.

A second group of children was characterized as hyposensitive. They did not seem to receive enough sensory information. Much more input was necessary in order for the stimulation to reach the brain. They frequently responded well to loud noises and obnoxious odors. Increasing the stimulation around them aroused the children so they became more involved and engaged in their environment.

The third category of children seemed to have internal sensory interference that decreased their ability to manage input from the external world. Delacato referred to this interference as “white noise.” We are all familiar with white noise; the hum that is heard when you turn on the radio without tuning into a station that is broadcasting, or the noise of a fan motor. When we talk, we no longer notice the fan motor since our system is able to block or filter out the background noise. Children with white noise in their sensory system are unable to appropriately experience the environmental stimulation due to the noise within their own internal system. Delacato believes that children with white noise hear their own heart sounds and other body sounds such as digestion, respiration and circulation. This internal white noise interferes with their processing of sounds from the external environment.

Delacato designed treatments to help normalize the malfunctioning sensory channel. Sensory stimulation was provided according to the frequency, duration and intensity that the child could comfortably manage. The sensory system gradually adjusted to the level of input and could slowly tolerate a little more, until finally, it normalized. Delacato believes that children actually try to help themselves through their repetitious sensory activities, such as flapping, rocking, shrieking, blinking, etc. By observing these behaviors, Delacato identified which channels were not functioning properly, and directed his treatment to these areas.

The first step was to provide an environment in which the child could comfortably survive. Children with hyper systems needed an environment with reduced stimulation; no smells, sounds, and visual distractions. Once comfortable in this calming situation, small amounts of sensory stimulation were introduced. Gradually, the stimulation was increased as the child’s tolerance developed. Those children who were hyposensitive received strong stimulation to arouse them. White noise required more innovative techniques such as vestibular stimulation. Delacato discovered that as the children’s sensory systems normalized, they began to pay more attention to the real world. Prior to treatment, their attention was focused on the strange sensory input they constantly had to manage in order to survive. Once the sensory system processed stimulation in a typical way, children could direct their attention to the normal environment.

In The Ultimate Stranger, Delacato explains how to determine whether a child is hyper, hypo or affected by white noise, and which sensory channels are affected. Activities that can reduce the function of a sensory organ usually indicate hypersensitivity. Auditory hypersensitivity is one of the easiest problems to recognize since the child will frequently block or cover his/her ears, and/or avoid situations with troublesome sounds. He may block out all sounds from external sources and only listen to himself and the noises he controls. He may respond to communication that is whispered, but cannot process speech at a normal volume. A child who is hyposensitive may seek strong input and stimulation. He may turn up the volume on the TV or radio, place his ear on the toilet or washing machine and create a lot of noise with his own shouting and banging. Sound stimulation of a stop-start nature, rather than constant, may be beneficial. He may use palpation and sonar-type bouncing of sound off objects to explore the properties of various sounds. Children who seem to be internally preoccupied may be experiencing white noise. They may hyperventilate and vary their rate of breathing to listen to the differences. They often assume unusual postures, such as hanging upside down or over a chair, to listen to the changes caused by gravity. Humming or other constant, quiet sounds are typical for children who experience white noise. Exposure to sound producing toys can help these children differentiate between internal and external sounds. Let them feel the sound vibrations from objects and minimize noises in their environment that are constant, such as an air conditioner or fan running continuously.

One must be cautious, however, in the conclusions drawn, since each child is unique and may present particular behaviors for various reasons. For example, some children with auditory hypersensitivity may hum to block out external input that overloads their system. Others may, at times, seek loud noises that overload themselves in order to shut down and escape an otherwise intolerable situation. Therefore, it is important to observe the child in various settings and with different sensory stimulation, keeping a variety of possibilities in mind.

Some of the treatment approaches initiated by Delacato are in use today by sensory integration therapists and other practitioners. Vestibular stimulation, brushing therapy, auditory integration training, vision therapy and various types of body work are all interventions directed at normalizing sensory input. Sensory “diets” are often prescribed as a part of the child’s treatment plan. As Delacato discovered, and we often see today, the child can turn his attention to the outside world and becomes available for learning once he no longer needs to concentrate attention on survival in an overwhelming world.

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Middle Ear Infections: A Discussion of Some Issues
Recurrent middle ear infections are quite common in children, estimated to be around 12%; and there is increasing evidence that these infections may be even more common in children with developmental disabilities. Several large- scale surveys have shown that ear infections are more frequent in children with developmental delays, autism, and fetal alcohol syndrome. In fact, there is concern that chronic ear infections and/or the treatment of these infections may actually lead to developmental delays. For example, research has shown that those who have had frequent ear infections often suffer a loss of about 13 decibels. Additionally, researchers have found that children with persistent ear infections often have speech and language problems in later years.

The possible causes associated with ear infections include:

      — consuming cow’s milk

 

      — drinking a bottle in bed/crib

 

      — genetic susceptibility

 

      — breathing second-hand smoke

 

      — experiencing injury during delivery

 

      — having respiratory problem

 

There is mounting evidence that many ear infections, possibly the majority, are primarily a reaction to an allergen. These allergens may be airborne (e.g., pollen, mold, second-hand smoke, dust, animal dander) and/or certain food items. The common food items are: dairy products, wheat, eggs, chocolate, nuts, and sugar. In the past, most of the evidence supporting the allergy/ear infection relationship stems from survey reports and manipulation of the person’s diet, such as using the rotation diet. However, a recent study by Robert F. Labadie, M.D. of University School of Medicine in San Antonio, Texas and several researchers at the University of North Carolina have demonstrated a direct relationship between middle ear infections and an allergic reaction. These researchers inserted a strain of bacteria, which is known to induce an allergic reaction, into the middle ear of laboratory rats. This led to a swelling and then closure of the Eustachian tube, resulting in a build-up of fluid in the middle ear.

The most common treatment for ear infections is antibiotic drugs. However, research shows that the antibiotics prescribed for ear infections are neither effective in the short-term nor in the long term. Research by Erdem Cantekin and his colleagues at the Otitis Media Research Center in Pittsburgh has shown that those treated with the antibiotic, amoxicillin, were more likely to have a recurrence of an ear infection within four weeks after treatment compared to those in the placebo group.

There is also evidence that some antibiotics cause hearing loss, ringing or ear noises, and/or other auditory problems. Parents should consult with their physician, pharmacist, or the Physicians Desk Reference to find out if the antibiotic prescribed to their child can cause hearing damage.

Antibiotics may also lead to a yeast overgrowth, often termed ‘Candida albicans,’ in the intestinal tract. Candida albicans can release toxic substances into the body which may alter brain functioning. There is evidence that the toxins released by this yeast overgrowth can cause autism and other related disorders.

Another form of treatment for ear infections is to surgically implant patchless eustachian (P.E.) tubes to drain the fluid from the middle ear. There is evidence that P.E. tubes may lead to permanent hearing loss.

Due to the growing concern of the dangers and ineffectiveness of antibiotics and P.E. tubes, many families are starting to rely on safer and healthier treatments, such as dietary interventions (e.g., removal of certain foods from the child’s diet) and strengthening their child’s immune system. Some homeopathic therapies have also been successful in treating ear infections, such as Belladonna and Chamomilla. Interestingly, there is evidence that chewing gum sweetened with xylitol may decrease the frequency of ear infections. Xylitol inhibits Streptococcus pneumoniae, which often causes ear infections.

Many parents and physicians are not aware of the various causes of ear infections as well as the negative side-effects of commonly prescribed treatments. Through better public awareness and, because of the increasingly prevalent ineffectiveness of antibiotics due to resistance from over- prescription, we must acknowledge more effective and safer interventions. — Recommended Readings:

Two quarterly newsletters often feature articles on ear infections and various treatments: New Developments, published by the Developmental Delay Registry, (Developmental Delay Registry, 6701 Fairfax Road, Chevy Chase, MD 20815, USA); and the Autism Research Review International,published by the Autism Research Institute (Autism Research Institute, 4182 Adams Ave., San Diego, CA 92116, USA).

Dr. Michael A. Schmidt has also written two excellent books: Childhood Ear Infections and Beyond Antibiotics, written with Drs. Lendon H. Smith and Keith W. Sehnert (both books are published by North Atlantic Books, P.O. Box 12327; Berkeley, CA 94701, USA)

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SAIT Holds 1998 Annual Meeting
The Society for Auditory Intervention Techniques held its annual meeting on July 9, 1998 in Reno, Nevada. The results of the recent election of members to the Board of Directors were announced. Sally Brockett and Margaret Creedon were re-elected to the Board for the professional category, and Patrick Bihn was elected for the parent category. There was discussion on membership and a notice to be placed in Advance magazine in order to inform people about the recent expanded field of SAIT’s focus. As announced previously, SAIT is now reviewing information on new developments in the field of sound therapy (The Sound Connection, Vol. 5, No. 2). Questions arose as to whether there is a need to test the calibration of auditory training devices since many machines have been in use since 1992. We plan to investigate this issue and will report our findings in the next issue of The Sound Connection.

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Verbal Absurdities
While travelling this summer, my kids caught a terrible case of “I-thought-you- saiditis”. If you haven’t heard of this, read the book, Mrs. Piggle Wiggle’s Magic, by Betty MacDonald. It is a great read-aloud for the whole family.

If children really do mis-hear what is being said, this can be a sign of central auditory processing disorder. It can be more difficult to listen in noise and when the speaker is not looking at the listener.

Our troubles began early on in the adventure. I would ask, “Could you get me some water?” One child would cheerfully reply, “What? Did you see that one otter?” The other would chime in, “Otter!” “I thought-you-said, ‘The pigs are in the fodder.'”

This verbal banter drove me nearly crazy but happily so. I could tell the children were able to rhyme and play with words. Sometimes we forget that language is not only useful, it can be fun.

This time while camping, my goal was to foster some independence in the children and encourage them to wait on me a little! I asked one of them to make pancakes. Not knowing where the supplies were, I gave verbal directions from the comfort of my chair. My son asked, “Where’s the butter?” I said, in a very clear and crisp voice I’m sure, “In the closet next to the cocoa.” He questioned me with a very serious look on his face, “The butter went to Acapulco?”

That’s where I’m going next time “I-thought-you-saiditis” strikes our family.

Written by Marna Scarry-Larkin is the mother of two children, 12 and 8, and writes software for children with special needs.

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Secretin and Sound Sensitivity?
The Autism Research Institute (ARI) in San Diego has received reports from two parents who described a decrease in sound sensitivity in their autistic children after receiving secretin. Currently, secretin is a topic of interest following several television and newspaper stories on autistic children who responded markedly well. Secretin is a hormone and is commonly used to treat gastrointestinal problems. ARI is distributing a survey, entitled the Secretin Outcomes Survey (S.O.S.) which can be obtained by writing to ARI (4182 Adams Ave., San Diego, CA 92116) or by visiting the web site at: www.secretin.com Let us know if you are aware of anyone who received secretin treatment and who would like to report their experiences related to sound sensitivity.