Sound Therapy for Children with Down Syndrome
Children with Down Syndrome often have speech and language problems. Neurodevelopmentalists have a very different approach to these problems than the normal therapeutic route.
Since these problems are developmental, neurodevelopmentalists look at these problems as opportunities for improvement. With appropriate stimulation (given the fact that the brain is very plastic and function can be changed) the root causes of developmental problems can be address. By addressing causes, much progress can be made.
CAUSES OF SPEECH AND LANGUAGE PROBLEMS
Looking at the pieces needed for good speech and language, the neurodevelopmentalist assesses the following: INPUT - hearing and mouth tactility, PROCESSING - the ability to hold pieces of information in short-term memory, LONG TERM MEMORY - the ability to recall things that have been learned, OUTPUT - breath (vital capacity), articulation with good oral motor skills and the ability to speak in sentences. These pieces are put together as the child develops...as ANY child develops. There is no need to treat a child with Down Syndrome any differently than any other child.
We will not go into all of the pieces of speech and language in this article, but know that they must ALL be addressed in order to develop good speech and language. Often because of congestion, ear infections and chronic fluid in the ear, a major piece of good speech (acute hearing, without sensitivity to certain sound frequencies and good tonal processing) is not developed. This is not unique to children with Down Syndrome. It is present in many, many children labeled autistic, PDD, ADD, ADHD, LD and so forth. We treat the child with Down Syndrome the same way we would treat children with the above labels. Given appropriate stimulation to hearing, problems can be eliminated and a major piece of development - high quality, consistent auditory input - will provide the child with the opportunity to develop normal speech and language.
A newborn baby has to LEARN to hear, just like that baby has to LEARN to see and LEARN to creep, crawl and walk. Normal environmental stimulation, normal sounds and language usually "wires" up the auditory system to the brain and the child puts together the pieces to develop normal language. If during this developmental process, the ears are full of fluid, then this "wiring" takes place in a distorted fashion. A child may not be able to hear certain frequencies appropriately or may be hypersensitive to certain frequencies and hyposensitive to other frequencies. If certain sounds are painful to the child, the brain has a very sophisticated feedback mechanism to shut out those sounds so that the child doesn't hear them. Also, we have seen children whose hearing tests very, very good, but who cannot shut out extraneous sounds to concentrate on the sound of interest. This is like trying to listen to three radio stations superimposed on one another. These children hear EVERYTHING, but generally sounds are a roar to them; hence, they essentially shut down to almost all sounds. For some, sounds are so threatening that they do not develop expressive language. This is often a large part of getting a child labeled autistic or PDD or CAPD and so forth. We have often seen children whose hearing tests "normal" on an audiogram, but whose hearing is so distorted, they don't develop good auditory processing and hence good speech. An audiogram does not test the quality of hearing. Also note that our experience has been that good auditory processing is a major component in developing social maturity and good reading skills.
THE SENSE OF HEARING
When a neurodevelopmentalist looks at a distorted sensory input, we see it as an opportunity to apply appropriate stimulation to normalize that sensory channel. For instance, if a child has low muscle tone and low pain sensation, direct stimulation of that sense can normalize that tactility area. The same is true with vision. If a child has a convergence problem, then direct stimulation via eye exercises can help the brain learn to control vision.
Hearing is different. The sense of hearing is the first to develop in the uterus. At 135 days of gestation, a full sized cochlea has already developed in the baby. The first part of that hearing system to develop is the part that senses high frequencies. Thus, we can see that hearing is very primary to brain development, especially the part that hears high frequency sounds - which is often the first to be lost when there are hearing problems.
The dynamic range of hearing is broader than any other sensory input. We can hear over 10 octaves. If we translated vision to the same scale, we can only "see" over 1 octave. So we have a very, very sensitive system to detect sounds and provide spatial information to the brain. Another part of the auditory system is the vestibular system. It is responsible for balance and for knowing the body's position in space.
Because hearing provides so much information such as, language with tone, frequency, emotional content, spatial information (where things are located in space and the nature of the space in which we are listening) and because the vestibular system is also involved, treating hearing problems is critically important. It must be noted also that the auditory nerve is in close conjunction with other parts of the central nervous system and auditory system that functions well affects an individuals overall sense of well-being.
TREATING HEARING PROBLEMS
From the above, one can see that treating hearing problems is of primary importance and takes very special techniques. We cannot go in and directly stimulate the auditory system as we do tactility and vision because the brain will simply block out sounds that it anticipates will be painful. We have to "trick" the brain to listen to sounds. With electronics, we can introduce a sound to the auditory system in a step function, without the brain having a chance to anticipate it. If, when this new sound is introduced, it is gentle and non-threatening, the system won't shut it out and we then have the opportunity then to provide stimulation to the auditory system that was previously blocked.
This is the theory of Sound Therapy. Dr. Alfred Tomatis, a French ENT, was the pioneer in this work back in the 1970's. Building on this work was Berard from whose work AIT and AET was developed. Patricia Joudry developed a series of tapes called "Sound Therapy for the Walkman". Building on the work of these pioneers, coming at this from a perspective of physics, music theory and also understanding the fundamental problems of sound reproduction and the nature of sounds comes Ingo Steinbach with SONAS and SAMONAS Sound Therapy.
SAMONAS SOUND THERAPY
The German scientist and musician Ingo Steinbach developed Samonas Sound Therapy. From his background in the physics of sound and music theory, and building on the work of Tomatis, he developed ways to record music that preserves the special spatial qualities of music and nature sounds that is usually lost in the recording process. Given the breakthroughs in recording and reproduction technology with the advent of CD's, these qualities can now be reproduced and made generally available. SONAS is the trademarked name for music and nature sounds recorded with this special technology developed at Steinbach's Klangstudio Lambdoma in Germany. SAMONAS recordings of music and nature sounds take the technology of SONAS one step further. Given the importance of high frequencies to the brain, there was a need to enhance these high frequencies (the overtones) in a natural way. Though it is technically a complex, essentially what is done with SAMONAS recordings is to boost the high frequencies of the recordings, lowering the base frequencies in a way that maintains the same energy for the whole base tone with its overtones. The result is beautiful music and nature sounds with enhanced high frequencies.
SAMONAS Sound Therapy is administered by a trained Samonas therapist. It must be done gently and appropriately to the individual. Great care has been taken to select or make recordings that meet different needs. The music, filtering and spectral activation must be matched to the needs of the individual and monitored closely. This is the best sound therapy in the world.
Given the wonderful tool of Samonas Sound Therapy, a major component of speech and language is now accessible for treatment with great success. We have seen hypersensitivity to sounds reduced, tonal processing improve, auditory processing improve, even recovery of some hearing loss. With this tool and by addressing all of the other pieces of good speech and language, normal speech and language can become a reality for many, many more individuals.
Little children are "wired" to learn language. It doesn't matter if that child has Down Syndrome or not. Because so many children with Down Syndrome have hearing problems, many therapists want to teach sign language starting at a very young age. Often the children learn sign language very, well and very quickly. Neurodevelopmentalists are opposed to this. The reason is that, if a child can communicate with sign language, then the motivation to talk is greatly reduced. It gets so bad at times that we have to have the parents ignore the sign language to frustrate the child enough to talk. "Demand language" becomes the rule and it can be a very frustrating process to go through for the parent and the child. It is much better to require language from the beginning. Our motto is: if a child can say one word, that child can learn to speak 1000 words.
Another major point for parents of children with Down Syndrome is to aggressively treat fluid in the ears. A child cannot hear normally if fluid is present, and this alone is enough to cause major developmental delays. Regular tympanograms and tubes, if necessary to keep the ears clear, are recommended. A device can be purchased at most drug stores today that allows you to measure if there is fluid in the ear and reduce the cost of the tympanograms.
Kay Ness, Copyright, 1999