“Wow, that’s quite a headset!” the man exclaimed as he stepped outside the post office, peering down at the wide-eyed 5-year-old on on a mission to mail a letter.
The boy’s mom just smiled, too focused on making the errand go smoothly to stop and explain the purpose of the large black headphones and MP3 player clipped to its side.
Once back in the car, she checked the visual timer: only five minutes left. She breathed a sigh of relief, but wished she had shared two words with the man: Therapeutic Listening.
Therapeutic Listening (TL) is an auditory intervention that uses electronically modified music with organized, rhythmical sound patterns to impact all levels of the nervous system. In short, how we listen affects our overall physiology and behavior.
Developed by Vital Links and its founder, Sheila M. Frick, OTR/L, TL is considered part of a comprehensive sensory integration treatment formally known as Ayres Sensory Integration, a theory pioneered by occupational therapist and special needs advocate Dr. A. Jean Ayres, Ph.D., OTR. This research-based tool can be used independently or to complement other sensorimotor therapies at home or in a clinical setting to treat difficulties with processing sensory information, listening, attention and communication.
This Concept is not New
“Listening programs have been around since the mid-1900s with Dr. Alfred Tomatis, an ear, nose and throat doctor,” says Christine Chambers, OTR/L, M Ed., owner of Abilities First, LLC in Fairview Park.
Individuals with the following issues may benefit from TL: sensitivity to sound or other input, attention difficulties, speech and language delays, difficulty following directions, regulation of emotions and energy level, challenges with transitions or changes in routine, struggles with body functions (sleep, eating, etc.), poor motor planning, problems with social and play skills, and reading comprehension.
While a formal diagnosis is not needed, according to its creators, TL is appropriate for children with developmental delays, ADHD, autism, Down Syndrome, learning disability and sensory processing disorders, among others.
According to research cited by the American Occupational Therapy Association (AOTA), sensory processing difficulties are estimated to occur in 10-12 percent of individuals in the general population who have no identified diagnostic condition, while an estimated 40-80 percent of children and 3-11 percent of adults with developmental disabilities have significant sensory processing difficulties.
How it Works
Not to be confused with noise reducing headphones for hearing protection and sound sensitivity or wireless musical varieties, TL’s specially engineered headphones connected to an MP3 (or CD) player are worn twice a day for 30 minutes per session (at least three hours apart). SD card “chips” or albums are changed every two weeks as directed by a therapist who is trained and certified in the program and has access to the full library of music.
While other listening therapy approaches consist of a single program that must be followed in a certain order, TL is customized and may last 6 or 8 weeks to several months. Albums with names like “Mozart for Modulation,” “Nature Classics” and “Gravitational Grape” are selected and arranged in sequences based on a person’s unique and changing needs and goals.
“Therapeutic Listening speaks to us occupational therapists with sensory background,” Chambers says. “Bringing in the auditory system puts more pieces of the puzzle together. We move through space using all the sensory systems — including proprioception (body awareness/joint position sense), vestibular (balance and movement) and tactile (touch) — so we need to integrate everything to be in sync and stay in a calm, alert state.”
Chambers has been integrating Therapeutic Listening into broader sensory programs for half of her nearly 30-year career. She sought training for personal and professional use.
“As a toddler, my son had auditory sensitivities to the coffee grinder, toilet flushing and more, impacting daily life,” Chambers says. “If you think of the inner ear muscles opening and closing a dampener, he stayed wide open all the time. The therapy helped by pulling out high and low notes and training the ear to listen to far and near space, tuning out extraneous sounds, for example.”
Her practice services clients from birth to age 21 and implements TL with children as young as 2, as well as adults. During listening sessions, screen time — TV, video games, etc. — is discouraged.
“The goal is getting support with movement or deep pressure, like a cuddle swing… getting input while moving through space,” Chambers says. “Some children enjoy listening while engaged in sensory/tactile bins, quiet play or riding in a car. Others even listen during school.
“The headphones themselves are pretty comfortable,” she adds. “In all my years, there has been only one child I could not get to use the headphones with the program.”
While modulated/modified music is the hallmark series of TL, new Quickshift albums offer additional flexibility to facilitate immediate change.
“Vivaldi is my go-to when I write reports,” says Chambers. “I listen to it myself using the app.”
Negative Effects are Possible
“You can see some dysregulating things,” Chambers says when counseling clients. “During a training where I listened to a lot of binaural beats left and right, I felt seasick, so I stopped and told the instructor. After several minutes, I felt better.”
Since every person’s body reacts differently, there may be some trial and error. Vital Links’ FAQs describe this as “periods of disorganization followed by reorganization” of the nervous system. “This happens in typical development as well, as a child gains a new skill, they may regress in another for a short period of time… Emotionality is typical as a child’s modulation becomes more regulated.”
The Sennheiser HD500A headphones and SanDisk MP3 player cost approximately $200, while music chip prices vary. Since the equipment and albums are not considered a medical necessity, TL is not billed to insurance.
Chambers’ practice loans chips like a video store, charging extra fees if lost or broken. If one or two chips work to regulate and organize a child, she suggests parents purchase them as a go-to for re-grounding.
Parents with sensory processing or other concerns about their child can consult their pediatrician to get a referral or order for occupational therapy, then schedule an evaluation with an OT who is trained and certified in TL.
In addition to various private providers across Northeast Ohio, Cleveland Clinic offers TL at each of its six satellite locations: Cleveland, Beachwood, Medina, Stow, Middleburg Heights and Westlake. While occupational therapists commonly seek this training, other licensed providers may include speech pathologists, behavior analysts, intervention specialists and teachers.