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NOTE: Tomatis programs are recommended for Autism in The Natural Medicine Guide to Autism (The Healthy Mind Guides)
by Stephanie Marohn

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  Researchers have found that the musical portion of the brain is frequently unimpaired in a child with low receptive language and low or even no expressive language. There is a direct correlation between the musical portion of the brain and the language area in the opposite hemisphere in autistic children. Filtered and gaited musical sound patterns can lead to a better understanding of language sound patterns. 
  
  Therefore the use of The Listening Program will ultimately translate into better language, communication and social skills .   MORE Info on this
  

Using The Listening Program® in the Treatment of Autism
By Alexander Doman and Dorothy Lockhart Lawrence


Children on the autistic spectrum can have difficulties processing various forms of sensory information. Auditory processing issues are one of the most common sensory processing problems and often include extreme hypersensitivity to sound, pitch discrimination issues, and sequential processing difficulties that impact receptive and expressive language, cognition, and social skills. Because the difficulties lie in the processing, in some cases a child may tune out and even act as if deaf, yet their hearing tests in a normal range.

The vestibulocochlear system informs us of sound, movement and orientation of space. The cochlear portion of the system turns sound or vibration into electrochemical messages that are relayed throughout the central nervous system and is critical to auditory processing. The vestibular portion serves to provide stabilization, influences attention and arousal, posture, movement, thus being critical to sensorimotor integration. It is the integration of our senses that allows us to understand what we are experiencing in our world. So it makes sense that a program that would stimulate and help to integrate the cochlear and vestibular systems might be very helpful for the autistic child.


What is The Listening Program®?
While in no way a cure for autism, when used in combination with a therapeutic program tailored to individual needs, The Listening Program (TLP) can be an effective intervention for children on the autistic spectrum. TLP is a music-based sound stimulation program that currently consists of 8 one-hour audio CDs that contain specially processed classical music and nature sounds plus a 112 page guidebook. It is easily used in the home under the guidance of a health, therapeutic, or educational professional who has been trained as an Authorized Provider. The Authorized Provider supplies the program to families, conducts client intakes and pre/post assessments, determines and individualizes the listening schedule, and monitors and consults with families using the program.

Listening sessions are typically fifteen minutes in length, done once or twice a day, five days a week, using high quality stereo headphones. The average program length is eight to sixteen weeks with many people finding it advantageous to repeat the program once or several times to help regulate their auditory system. TLP's modular design lends itself to easy modification for specific purposes. Additional CDs called TLP Extensions allow for further individualization of listening programs.

The most commonly reported benefits from using TLP with a child on the autistic spectrum are in the following areas:

Increasing Engagement
The listening experience can help improve self-image, reduce tactile defensiveness, and lead to a better sense of the body in space. As listeners become more comfortable in their body and surroundings, they may initiate more physical contact, respond better to others, begin to pay more attention and start to make more eye contact. Increased engagement often includes a reduction in aggressive behavior and a desire for more affection.

Emerging Skills
Sound stimulation has commonly shown it can accelerate the rate of progress when used in conjunction with therapeutic, neurodevelopmental, academic, and behavioral programs. When these areas are addressed with individualized programs, improved listening helps facilitate better integration and organization in the sensory and motor systems, leading to a more rapid rate of acquiring skills and desired outcomes.

Auditory Processing
We can only process a sound and understand its meaning if we can hear it well. TLP helps to improve the rate and accuracy of sound perception. As the brain learns to process sound better, improvements are also noted in auditory processing and receptive language. We monitor our communication through listening to ourselves and others. As the ability to perceive improves, better communication skills are often the result.

Reducing Sound Sensitivity
Hypersensitivity to sound can be debilitating for anyone, especially those with additional sensory processing problems. TLP provides sound stimulation that aids the nervous system to better modulate sensory input. With this improved ability, there is often a reduction in abnormal sensory perception, especially with sound. Reducing sound sensitivity allows one to be more comfortable in their environment as they no longer have to constantly protect themselves from unwanted and uncomfortable sounds.

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University of Sheffield Research Shows Progress Continues
After Program Use
Dilys Treharne of the Department of Human Communication Sciences at the University of Sheffield conducted a pilot study to investigate the efficacy of TLP when used for clients with auditory processing difficulties. After reassessing the children at the end of the eight week program and then eight weeks later, she wrote in the Winter, 2002 issue of Speech & Language Therapy in Practice, "The results were beyond my expectations: all showed an improvement greater than one would expect from maturation."

Of the many improvements noted, Treharne found the greatest change in selective attention, also known as auditory figure-ground. Those with the severest difficulties made the greatest improvement. The most important thing that the study showed was that the improvements made were not only maintained but progress did not stop after the initial eight week program. Even those without other interventions generally continued to make gains for up to 10 months when they usually reached a plateau. At this point many took another course of TLP.

"The Listening Program is now my first step in auditory training," says Treharne, "as it seems to activate listening skills that have been repressed or never developed, thus priming the system for more specifically targeted therapy programs."


Neural Plasticity is the Key
The theoretical basis of any sensory stimulation program must include neural plasticity. Neurons will branch out and establish new synaptic connections when stimulated and research has shown that this occurs throughout our entire lives.

Neuroscientist Lise Elliot says in her book What's Going On In There?, "Anyone who has ever studied nerve cells can tell you how plastic they are. The brain itself is literally molded by experience: every sight, sound and thought leaves an imprint on specific neural circuits modifying the way future sights, sounds, and thoughts will be registered. Brain hardware is not fixed, but living, dynamic tissue that is constantly updating itself to meet the sensory, motor, emotional, and intellectual demands at hand."

Listening to the CDs in The Listening Program literally exercises and tones tiny muscles in the middle ear called the tensor tympani and stapedius muscles. Exercising these two muscles improves their tone, thus making them more responsive to their task of directing the middle ear bones and eardrum. This helps them to amplify soft sounds and protect the inner ear from damaging harsh or loud noise.

TLP was designed to help balance and restore our ability to listen to and process sounds across the full auditory spectrum, from 20 to 20,000 Hz. The brain receives especially rich auditory stimulation, and because of its ability to change with stimulation, its ability to process sound improves.


Creating The Listening Program
TLP was created by Advanced Brain Technologies, LLC (ABT) in 1998. ABT grew out of the National Academy for Child Development, whose extensive and diverse client base, including thousands on the autistic spectrum, served as a testing ground for its development. ABT's objective was to create a program that was easy to use, effective yet mild enough for home use, proven to have lasting results, and inexpensive for families compared to a facility based program.

The Academy and its founder, Robert J. Doman, Jr. had used several other auditory stimulation programs over the course of three decades, and had found them to have varying degrees of effectiveness. Many were beyond reach for families and if home based, often difficult to administer.

So the ABT team decided to develop a complete program of CDs with gradually increasing stimulation as a base for people to process sounds more efficiently. The music was recorded through a special production process that would allow for the development of new techniques to maximize the effectiveness of the program while maintaining an aesthetic that would make the program enjoyable to listen to. Music and instruments were selected that would work best with the required treatments and sometimes new arrangements of the music were written to suit the requirements of the program. Extension CDs were also created to address more specific issues such as language enhancement and sensory integration. They are used along with the base program and allow for further individualization of TLP.

The design and presentation of The Listening Program were of prime importance so that it would be accessible to any parent or individual. A guidebook providing informative background information, detailed listening schedules, and program support information was created along with a journal for the listener or parent to record their experiences.

A unique design was created for TLP listening sessions. It includes warm-up, exercise, and cool down segments of the music. In this way when a child or adult puts on the headphones, they hear quite normal sounds and music at the beginning and the end. This provides an orienting and grounding experience at the start and end of each listening session. Parents often report that children love to listen and will initiate the listening sessions themselves.


Case Study: Six Year Old Robert and TLP
An Occupational Therapist who is an Authorized Provider of TLP told us about Robert, a six year old boy who had recently been diagnosed with Autistic Spectrum Disorder. Language delays, behavior problems and abnormal social skills had been noted by his parents from around age two. Robert had auditory hypersensitivities, severe expressive and receptive language delays, coupled with echolalia, topic fixations and numerous other difficulties related to auditory processing and sensory integration dysfunction.

"Robert began his personalized Listening Program with the Sensory Integration CD and then continued through the 8 week Base Schedule, ending with the Speech and Language Extension CD for this first time through the program. Near the end of his third week listening to the Sensory Integration CD his mother tearfully reported to the therapist, 'I feel like I am talking to someone, not to a wall!' More changes began to be evident with his increased physical play and interaction. After week 6, Robert was able to attend school assemblies. Previously the noise and confusion had been too much for him. His reading comprehension was improving and his voice had more inflection.

"With the addition of the Speech and Language CD, both the family and school continued to report improvement in terms of increased spontaneous speech, improved comprehension, and improved social skills. Robert was also starting to develop a sense of humor! After 5 months, Robert's father reported, 'Much improved social interactions. Talks better. Quicker responses to verbal commands. Follows directions better.' Robert's family was thrilled with the progress he had made."

Robert's therapist reported that she was thrilled too. "I have been an OT for 15 years," she wrote, "and have not seen a child progress so rapidly." ....


Listening to music is an activity that can be enjoyed by every age group in nearly every circumstance. This makes The Listening Program® a fun and easy program for families to integrate into their daily schedules. The result, helping to normalize responses to sensory input and improving the ability to listen, is often the jump-start children need to function more effectively in all aspects of daily life. We are grateful that it has made a difference in the lives of so many.


For more information contact your local Authorized Provider at www.IncredibleHorizons.com or 321 258-9997

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About the Authors:
Alexander Doman was raised in a family of neurodevelopment specialists working with pediatric and adult populations. The third generation of his family in this field, Alex is the former Executive Director of the National Academy for Child Development, a non-profit organization founded by his father Robert J. Doman, Jr. in 1979. His father and grandfather, Robert J. Doman, MD were members of the professional team that developed some of the earliest sensory stimulation programs for children on the autistic spectrum beginning in the late 1960's.

An international trainer and presenter, Alexander is the Founder and President of Advanced Brain Technologies LLC (ABT). ABT is the developer of The Listening Program®, Sound Health® Series, Music for Babies™, music based programs, and BrainBuilder® software.

Dorothy Lockhart Lawrence is a staff writer and editor for an online newsletter about The Listening Program. She was the program director for a series of music festivals when she met her violinist husband Richard. After they married, her background in French, education, and psychology turned into an ongoing passion for learning more about music and neurology. She has worked in various aspects of the publishing industry for the past 25 years.

Reprinted with permission from the May-June 2003 issue of the Autism Asperger's Digest, a bimonthly 52-page magazine devoted to autism spectrum disorders. www.autismdigest.com or call 800.489.0727.

More Info about Incredible Horizons Programs

Autism and Amino Acid Supplementation to improve Brain Function- Serotonin Imbalance in Autism

What Causes Autism?

The National Institutes of Health has been funding several research projects to help identify the causes of autism, in hopes of someday developing better treatment for and prevention of the disorder. The following is reprinted from the website of the National Institutes of Health, at http://www.nimh.nih.gov/publicat/autism.cfm.

It is generally accepted that autism is caused by abnormalities in brain structures or functions. Using a variety of new research tools to study human and animal brain growth, scientists are discovering more about normal development and how abnormalities occur.

Scientists now know that a number of problems may interfere with normal brain development. Cells may migrate to the wrong place in the brain. On the other hand, due to problems with the neural pathways or the neurotransmitters, some parts of the communication network may fail to perform. A problem with the communication network may interfere with the overall task of coordinating sensory information, thoughts, feelings, and actions.

Researchers supported by NIMH and other NIH Institutes are scrutinizing the structures and functions of the brain for clues as to how a brain with autism differs from the normal brain. In one line of study, researchers are investigating potential defects that occur during initial brain development. Other researchers are looking for defects in the brains of people already known to have autism.

Scientists are also looking for abnormalities in the brain structures that make up the limbic system. Inside the limbic system, an area emotional behavior. One study of high-functioning children with autism found that the amygdala was indeed impaired but that another area of the brain, the hippocampus, was not. In another study, scientists followed the development of monkeys whose amygdala was disrupted at birth. Like children with autism, as the monkeys grew, they became increasingly withdrawn and avoided social contact.

Differences in neurotransmitters, the chemical messengers of the nervous system, are also being explored. For example, high levels of the neurotransmitter serotonin have been found in a number of people with autism. Since neurotransmitters are responsible for passing nerve impulses in the brain and nervous system, it is possible that they are involved in the distortion of sensations that accompanies autism.

NIMH grantees are also exploring differences in overall brain function, using a technology called magnetic resonance imaging (MRI) to identify which parts of the brain are boys, NIMH researchers observed that during problem-solving and language tasks, teenagers with autism were not only less successful than peers without autism, but the MRI images of their brains showed less activity. In a study of younger children, researchers observed low levels of activity in the parietal areas and the corpus callosum. Such research may help scientists determine whether autism reflects a problem with specific areas of the brain, or with the transmission of signals from one part of the brain to another.

Each of these differences has been seen in some but not all the people with autism who were tested. What could this mean? Perhaps the term autism actually covers several different disorders, each caused by a different problem in the brain. On the other hand, perhaps the various brain differences are themselves caused by a single underlying disorder that scientists have not yet identified. Discovering the physical basis of autism should someday allow us to better identify, treat, and possibly prevent it.

This article originally appeared in an issue of “Science in Autism Treatment”, the newsletter of the Association for Science in Autism Treatment (ASAT). It may not be republished or reprinted without advance permission from ASAT. For more information about ASAT, please contact them at www.asatonline.org or 207-253-6008.

Serotonin Imbalance in Autism

Neurotransmitters are powerful chemical messengers that carry messages to and from the brain. These messages are everything that you do, think, say, feel, hear, smell, touch, and taste. The main neurotransmitters are serotonin, norepinephrine, and dopamine.

An imbalance in serotonin is believed to cause many of the characteristic symptoms of autism. This serotonin imbalance can lead to sleep disturbances, speech delays, and sensory integration problems, as serotonin regulates

*sleep
*mood
*speech
*sensory integration
*body temperature
*appetite

This imbalance occurs when the neurotransmitter serotonin does not properly carry the message to the proper portion of the brain. Rather, the serotonin is prematurely 'swept away' for reuse in the re-uptake process before the brain has a chance to receive and make sense of the incoming messages.

For example, if I tell you "Go close the door”, neurotransmitters carry the sound of my voice from your ear to the portion of your brain that understands language in order for you to make sense of what I've said. This is auditory processing...the brain processing the sounds that the ear detects.

Many children with autism, however, have great difficulty with auditory processing because the neurotransmitters are not properly carrying the sounds from the ear to the correct portion of the brain. Many autistic children also have difficulty with sensory integration for the same reason: they do not perceive sensations the way 'typical' children do because the messages are not carried properly to the brain. Before the message is received and processed, it is swept away in the reuptake process.

It is often difficult for autistic children to discern what is an important stimulus and what is not, or which sensation they should focus on and which they should tune out. The serotonin imbalance makes it extremely difficult for them to tune out unnecessary stimulation. The result can be self-stimulation, or repetitive actions such as rocking, spinning, and hand flapping that the child performs to help calm themselves from the flurry of stimulation that they are unable to tune out.

Because the messages are not properly delivered, some things they should notice they do not notice at all, such as when a parent calls out her child's name and the child seems not to hear the parent at all. Many parents of autistic children report initially thinking their child had a hearing impairment, only to discover their child's hearing falls into normal ranges upon having a hearing evaluation. Often, the problem is not with the child's hearing; rather, it is with the neurotransmitters not carrying the sounds from the ear to the brain properly. They are not 'tuning in' to their parents because of all the other stimuli that has grabbed their attention.

It is often difficult for them to tune certain things out, such as the sound of a flickering fluorescent light or constant motion of a ceiling fan. This is the result of a neurotransmitter failing to complete its job to deliver messages to and from the brain, leaving the child unable to discern which stimuli s/he should attend to and which stimuli can be tuned out.

Sometimes, everyday sounds are exaggerated for them, actually causing them discomfort and possibly pain, such as the sound of the toilet flushing or the whir of a hair dryer, (which Temple Grandin claimed sounded to her like a jet plane). It is believed that this sound sensitivity is caused by serotonin imbalance.

Another major problem often seen in autism is sleep disturbance. The neurotransmitter serotonin also regulates the release of melatonin, the body's natural sleep aid that helps establish a sleep cycle. My three-year-old autistic son was locked into a pattern of taking naps at 8:00 pm and finally going to sleep at 3:00 a.m. every night. Nothing I did seemed to help him. It didn't matter if I woke him up early or tried to keep him up from his nap. Attempts to get him to bed at a decent hour made everyone miserable, as he would yell and keep everyone awake.

My son's problem was with his body's release of melatonin at inappropriate times. His body was literally keeping him awake until those late hours in the morning. This was a result of a serotonin imbalance.

A serotonin imbalance in autism as described here can lead to

*Sensory Integration Problems
*Auditory Processing Problems
*Speech Delays
*Repetitive Behaviors
*Self-stimulation
*Sleep Disturbances

Many professionals believe that one way to successfully help treat these problems that are typical in autism is to use Selective Serotonin Reuptake Inhibitors. We believe they put one's adrenal system at risk and have other negative side effects. Amino acid supplements will improve serotonin levels in a safer and healthier way. There are many choices for amino acid products through out our website.

Balance Formula 1-Capsules
Endo Trex is a Theanine Spray
Prevamine is an amino acid powder to put in water for a liquid delivery Coming Soon 

Why Autistics have Serotonin Imbalances

As much as 90% of the serotonin, one of the primary neurotransmitters, is produced in the gut and exerts considerable influence on normal intestinal functionality. Therefore when focusing on neurotransmitter optimization, it behooves us to address issues of nutrition, digestion, liver function and general detoxification.

Supportive research-
Digestion And ADHD/Autism

Digestive problems and stool abnormalities may be present in a large portion of children with ADHD / Autism. Many autistic children display chronic indigestion and gas. One study that examined a small group of randomly selected autistic children found that 40% (6 1/5) had bulky, odorous or loose stools or diarrhea. Interestingly, many parents of ADHD / autistic children report a worsening in behavioral symptoms occurring in conjunction with a flare-up of gastrointestinal problems.

"Although gastrointestinal symptoms frequently accompany the manifestations of autism" points out pediatrician Karolyn Horvath, M.D., and his colleagues at the University of Maryland School of Medicine, "little attention has been paid to this aspect…"Dr. Horvath’s team performed gastrointestinal evaluation on 36 children with severe autism and found several striking abnormalities. The children often showed signs of chronic inflammation in the gut, including the esophagus, stomach, and duodenum. Because of the enzyme deficiencies, many of the children had trouble digesting and absorbing carbohydrates a possible cause for their chronic loose stools and gas. These abnormalities may be closely linked with sudden behavior changes in the children such as irritability, aggression, and nighttime awakenings. 
More info on Digestion and Enzymes 

Another reason to be concerned about digestion, is that about 80-90% of our serotonin is synthesized in the chromaffin cells of the gut. Serotonin is essential to brain function. Other indications of low serotonin may be carbohydrate cravings, Migraines, PMS, Depression, Insomnia or problems falling asleep, obsessive-compulsive behavior and panic attacks. 

Reference

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