Baker Victory Services Results of the Tomatis Program within a Fifth Grade Setting Cheektowaga Central School District Union East Elementary June 2009
Cheryl Callahan, MS Ed Tomatis Consultant
Background At the onset of this program, 10 students with varying learning disabilities were chosen to complete a group Tomatis Listening Program. All students were ages ten or eleven years old and were in a fifth grade placement. One parent chose to withdraw her child from the program, before it started. A second student did not complete the program due to his family’s change in school districts. The eight remaining students completed 3 listening loops for a total of 69 hours. Listening took place in a separate classroom with a Special Education Teacher during the months of September/October, November and January. While the students listened they were instructed in Mathematics and Science/Social Studies. They also participated in daily short exercise breaks and the teacher read aloud from chapter books. During the second and third loops, students participated in audio-vocal work, which required them to read aloud from a book into a microphone. These books typically corresponded to units being taught in science/social studies. Protocol This group listening program consisted of 69 hours of electronically modified sound stimulation through specialized headphones that utilizes both air conduction and bone conduction. These hours were dispersed throughout the school year with the most intensive portion of the program occurring early in the year. The 69 hours were divided into three listening intensives/loops. Listening occurred on school days for two hours each morning. The loops were as follows: Loop1 → Loop2 → Loop3 →
September 22, 2008 – October 10, 2008 November 12, 2008 – November 25, 2008 → January 5, 2009 – January 16, 2009 →
15 days of listening 10 days of listening 10 days of listening
Each day of listening, the children listened to one-and-a-half hours of filtered Mozart music followed by onehalf-hour of Gregorian chants. On November 12-13, listening was only one-and-a-half hours instead of two hours and occurred in the afternoon due to state assessments. Testing Procedures Individual Assessments were completed prior to the onset of the program (June 2008) and upon completion of the program (May 2009). All testing was administered by Cheektowaga Central School District staff and scored by Baker Victory Services utilizing computerized scoring programs. It should be noted that the pre-test and post-test assessments were completed by different staff members. Students were assessed with the Teacher Rating Form of the Vineland Adaptive Behavior Scales, Second Edition and the Scan-C test for Auditory Processing Disorders in Children-Revised. The Vineland is completed by the teacher and provides an assessment of the individual in the domains of Communication, Daily Living Skills, Socialization and Motor Skills. The Scan-C is an imitative test, requiring the student to repeat stimulus words or sentences. It is designed to assess one’s primary perception of what is heard and not one’s understanding of what is heard. Results Summary As indicated by the Scan-C Test results, the students have shown improvement in auditory processing abilities. The students are better able to understand speech in the presence of background noise. This in turn assists them in tuning in and attending to language and learning. This is likely a result of intense exercise of the middle ear muscles through the application of Tomatis. In addition, the majority of students have shown improvement in communication, daily living skills and socialization as indicated by the Vineland-II test results. Some students improved one standard deviation, which in some cases resulted in their abilities changing from moderately low to adequate. These improvements are directly related to their improvements in auditory processing. As the muscles of the ear begin to work more efficiently, an individual becomes better able to listen and communicate. As listening and communication improve, we begin to see a child develop better selfconfidence and improved social skills.
Description of Scan-C Test for Auditory Processing Disorders in Children – Revised FILTERED WORDS SUBTEST: The filtered words test is sometimes considered a test of auditory closure where the child is required to identify the whole word although part of the word is acoustically missing. The words are filtered above 1000 Hz to reduce their high frequency content. High frequencies are necessary for consonant recognition. The words sound "muffled" to the listener. Twenty words are presented to each ear. AUDITORY FIGURE GROUND SUBTEST: The inability to understand speech in the presence of background noise is one of the most common auditory complaints of children who have auditory processing, language, and learning problems. The auditory figure ground test examines a child's ability to understand a series of onesyllable words presented at eight decibels above a speech babble background noise (+8 dB S/N ratio). Twenty words are presented to each ear. COMPETING WORDS SUBTEST: The competing words test is a dichotic speech task that reflects development of the auditory system, auditory maturation, and hemispheric specialization for language. During the competing words test semantically unrelated monosyllable word pairs with simultaneous onset times are presented to the two ears. The child repeats both words giving the right ear first for the first 15 word pairs, and then repeating both words with the left ear first for the last 15 word pairs. COMPETING SENTENCES SUBTEST: The competing sentences test is a dichotic speech task that reflects the development of the auditory system, auditory maturation, and hemispheric specialization for language. During the competing sentences test semantically unrelated sentences with simultaneous onset times and duration are presented to the two ears. The child repeats the sentence from one ear only, while ignoring the competing sentence in the opposite ear. The ten sentences heard in the right ear are repeated first, followed by the ten sentences heard in the left ear. EAR ADVANTAGE: Analysis of ear advantage scores provides additional information on specific auditory pathway development. Ear advantage scores are powerful indicators of hemispheric dominance for language, and neurologically based language/learning disorders. The following are some general principles for interpreting ear advantage scores on the Competing Words test. 1. A Right Ear Advantage indicates that language is appropriately established in the left cerebral hemisphere. 2. An atypical Left Ear Advantage score indicates that the child may either have right hemisphere dominance for language or (more likely) an abnormal finding consistent with a neurologically based language or learning disability. The greater the Left Ear Advantage (i.e., the more atypical the child's performance) the greater the possibility of a neurologically based disability. 3. An atypical Right Ear Advantage in the Right-Ear First Task and a switch to an atypical Left Ear Advantage in Left-Ear First Task is an abnormal finding associated with neurologically based language and learning disabilities. Some investigators claim that an atypical switch in ear advantage indicates an abnormality in communication between the right and left cerebral hemispheres that interferes with a child's ability to learn appropriate cognitive strategies 4. The finding of an atypical large Right Ear Advantage in children may indicate the presence of a developmental disorder of the auditory system. 5. The failure to show improvement in overall performance, and failure to show improvement in the left ear score, as shown on repeated testing over several years, indicates a disordered or damaged auditory system that is not improving. This information is taken from the following source: Keith, Robert W. Scan-C Test for Auditory Processsing Disorders in Children-Revised. The Psychological Corporation, 2000.
Student: 1 Student: Scan-C Test for Auditory Processing Disorders in Children – Revised Subtests:
Pre-test Standard Score
Post-test Standard Score
4 8 4 6 70
10 5 13 10 96
Filtered Words Auditory Figure Ground Competing Words Competing Sentences Scan Composite Pre-Test
Pre-test % Rank 2 25 2 9 2
Post-test % Rank 50 5 84 50 39
Post-Test
Vineland-II (Teacher Rating Form) Subdomain / Domain
Pre-test V-Scale Score
Post-test V-Scale Score
Receptive Expressive Written Communication Personal Academic School Community Daily Living Skills Interpersonal Rels. Play & Leisure Time Coping skills Socialization Gross Fine Motor Skills Adapt. Behav. Comp.
9 9 13 Sum = 31 11 14 10 Sum = 35 12 10 9 Sum = 31 10 16 Sum = 26 Sum = 224
13 10 12 Sum = 35 16 14 12 Sum = 42 13 13 13 Sum = 39 16 20 Sum = 36 Sum = 259
Pre-test Standard Score
72
78
74
88 73
Post-test Standard Score
80
91
88
127 85
Pre-test % Rank
3%
7%
4%
21% 4%
Post-test % Rank
Pre-test Age Eq.
Post-test Age Eq.
3:8 4:4 8:2
6:3 5:1 8:6
6:0 10:0 4:7
12:3 10:0 5:8
5:5 3:0 <3:0
5:11 5:10 5:6
3:3 >6:11***
7*** 7***
9%
27%
21%
96% 16%
Student: 2 Scan-C Test for Auditory Processing Disorders in Children â&#x20AC;&#x201C; Revised Subtests:
Pre-test Standard Score
Post-test Standard Score
8 5 3 3 66
10 5 7 5 78
Filtered Words Auditory Figure Ground Competing Words Competing Sentences Scan Composite
Pre-Test
Pre-test % Rank 25 5 1 1 1
Post-test % Rank 50 5 16 5 7
Post-Test
Vineland-II (Teacher Rating Form) Subdomain / Domain
Pre-test V-Scale Score
Post-test V-Scale Score
Receptive Expressive Written Communication Personal Academic School Community Daily Living Skills Interpersonal Rels. Play & Leisure Time Coping skills Socialization Gross Fine Motor Skills Adapt. Behav. Comp.
11 11 14 Sum = 36 10 15 9 Sum = 34 11 9 8 Sum = 28 10 16 Sum = 26 Sum = 227
13 11 12 Sum = 36 16 16 11 Sum = 43 11 10 13 Sum = 34 16 16 Sum = 32 Sum = 254
Pre-test Standard Score
82
76
69
88 74
Post-test Standard Score
82
93
79
108 83
Pre-test % Rank
12%
5%
2%
21% 4%
Post-test %Rank
Pre-test Age Eq.
Posttest Age Eq.
4:10 5:9 9:8
6:3 5:9 8:6
5:7 10:6 3:10
12:3 12:6 5:3
4:9 <3:0 <3:0
5:2 3:2 5:9
3:3 6:11***
7*** 7***
12%
32%
8%
70% 13%
Student: 3 (missed a number of days) (Also, experienced a death in the family) Scan-C Test for Auditory Processing Disorders in Children â&#x20AC;&#x201C; Revised Subtests:
Pre-test Standard Score
Post-test Standard Score
12 6 6 6 83
12 4 7 8 84
Filtered Words Auditory Figure Ground Competing Words Competing Sentences Scan Composite
Pre-Test
Pre-test % Rank 75 9 9 9 13
Post-test % Rank 75 2 16 25 14
Post-Test
Vineland-II (Teacher Rating Form) Subdomain / Domain
Pre-test V-Scale Score
Post-test V-Scale Score
Receptive Expressive Written Communication Personal Academic School Community Daily Living Skills Interpersonal Rels. Play & Leisure Time Coping skills Socialization Gross Fine Motor Skills Adapt. Behav. Comp.
10 12 12 Sum = 34 9 10 8 Sum = 27 10 10 10 Sum = 30 7 9 Sum = 16 Sum = 213
13 14 16 Sum = 43 9 11 10 Sum = 30 13 9 13 Sum = 35 12 13 Sum = 25 Sum = 246
***Caution is required in interpreting this age equivalent.
Pre-test Standard Score
78
63
72
60 68
Post-test Standard Score
95
70
81
84 80
Pre-test % Rank
7%
1%
3%
<1% 2%
Post-test % Rank
Pre-test Age Eq.
Post-test Age Eq.
3:11 6:10 7:8
6:10 9:4 13:0
4:9 7:6 <3:0
5:2 7:11 4:4
3:10 3:0 3:4
6:6 <3:0 5:9
<3:0 4:2
4:5*** 5:9
37%
2%
10%
14% 9%
Student : 4 Scan-C Test for Auditory Processing Disorders in Children â&#x20AC;&#x201C; Revised Subtests: Filtered Words Auditory Figure Ground Competing Words Competing Sentences Scan Composite
Pre-test Standard Score 12 6 4 4 76
Post-test Standard Score 13 9 9 6 94
Pre-Test
Pre-test % Rank 75 9 2 2 5
Post-test % Rank 84 37 37 9 34
Post-Test
Vineland-II (Teacher Rating Form) Subdomain / Domain
Pre-test V-Scale Score
Post-test V-Scale Score
Receptive Expressive Written Communication Personal Academic School Community Daily Living Skills Interpersonal Rels. Play & Leisure Time Coping skills Socialization Gross Fine Motor Skills Adapt. Behav. Comp.
12 13 12 Sum = 37 16 14 11 Sum = 41 11 13 12 Sum = 36 16 20 Sum = 36 Sum = 256
17 9 16 Sum = 42 16 16 13 Sum = 45 8 13 13 Sum = 34 16 20 Sum = 36 Sum = 269
Pre-test Standard Score
84
89
83
127 84
Post-test Standard Score
93
97
79
127 88
Pre-test % Rank
14%
23%
13%
96% 14%
Post-test % Rank
Pre-test Age Eq.
Post-test Age Eq.
5:6 7:3 8:6
.18:9 4:2 12:3
12:3 10:0 5:3
12:3 12:6 7:7
4:9 5:5 4:6
<3:0 5:10 5:6
7*** 7***
7*** 7***
32%
42%
8%
96% 21%
Student: 5 Scan-C Test for Auditory Processing Disorders in Children â&#x20AC;&#x201C; Revised Subtests:
Pre-test Standard Score
Post-test Standard Score
6 8 10 7 84
13 9 11 6 98
Filtered Words Auditory Figure Ground Competing Words Competing Sentences Scan Composite Pre-Test
Pre-test % Rank 9 25 50 16 14
Post-test % Rank 84 37 63 9 45
Post-Test
Vineland-II (Teacher Rating Form) Subdomain / Domain
Pre-test V-Scale Score
Post-test V-Scale Score
Receptive Expressive Written Communication Personal Academic School Community Daily Living Skills Interpersonal Rels. Play & Leisure Time Coping skills Socialization Gross Fine Motor Skills Adapt. Behav. Comp.
10 11 12 Sum = 33 10 10 13 Sum = 33 13 13 15 Sum = 41 6 12 Sum = 18 Sum = 241
13 14 16 Sum = 43 10 11 14 Sum = 35 14 14 18 Sum = 46 10 13 Sum = 23 Sum = 272
Pre-test Standard Score
76
74
91
63 78
Post-test Standard Score
95
78
99
78 90
Pre-test % Rank
5%
4%
27%
1% 7%
Post-test % Rank
Pre-test Age Eq.
Post-test Age Eq.
4:3 5:9 8:2
6:10 9:4 13:0
5:7 7:9 6:6
5:7 8:11 10:2
6:6 5:10 14:0
9:10 7:4 >18:9
<3:0 5:4
3:3 5:11
37%
7%
47%
7% 25%
Student: 6 (English not spoken at home) Student: Scan-C Test for Auditory Processing Disorders in Children â&#x20AC;&#x201C; Revised Subtests:
Pre-test Standard Score
Post-test Standard Score
8 3 4 5 68
12 4 3 6 75
Filtered Words Auditory Figure Ground Competing Words Competing Sentences Scan Composite Pre-Test
Pre-test % Rank 25 1 2 5 2
Post-test % Rank 75 2 1 9 5
Post-Test
Vineland-II (Teacher Rating Form) Subdomain / Domain
Pre-test V-Scale Score
Post-test V-Scale Score
Receptive Expressive Written Communication Personal Academic School Community Daily Living Skills Interpersonal Rels. Play & Leisure Time Coping skills Socialization Gross Fine Motor Skills Adapt. Behav. Comp.
11 10 11 Sum = 32 11 10 12 Sum = 33 12 13 14 Sum = 39 10 17 ď¨&#x20AC; Sum = 236
12 12 13 Sum = 37 16 13 14 Sum = 43 14 14 18 Sum = 46 16 15 Sum = 31 Sum = 276
Pre-test Standard Score
74
74
88
91 77
Post-test Standard Score
84
93
99
104 91
Pre-test % Rank
4%
4%
21%
27% 6%
Post-test % Rank
Pre-test Age Eq.
Post-test Age Eq.
4:10 4:11 7:8
5:10 7:3 9:8
6:0 7:11 5:8
12:3 10:0 10:2
5:8 5:10 6:8
9:10 7:4 >18:9
3:3 >6:11***
7*** 6:10
14%
32%
47%
61% 27%
Student: 7 Scan-C Test for Auditory Processing Disorders in Children â&#x20AC;&#x201C; Revised Subtests:
Pre-test Standard Score
Post-test Standard Score
6 9 13 7 91
11 9 15 9 106
Filtered Words Auditory Figure Ground Competing Words Competing Sentences Scan Composite Pre-Test
Pre-test % Rank 9 37 84 16 27
Post-test % Rank 63 37 95 37 66
Post-Test
Vineland-II (Teacher Rating Form) Subdomain / Domain
Pre-test V-Scale Score
Post-test V-Scale Score
Receptive Expressive Written Communication Personal Academic School Community Daily Living Skills Interpersonal Rels. Play & Leisure Time Coping skills Socialization Gross Fine Motor Skills Adapt. Behav. Comp.
12 10 14 Sum = 36 9 12 13 Sum = 34 9 11 12 Sum = 32 7 10 Sum = 17 Sum = 234
12 13 15 Sum = 40 9 16 11 Sum = 36 10 9 12 Sum = 31 12 14 Sum = 26 Sum = 244
Pre-test Standard Score
82
76
76
61 76
Post-test Standard Score
90
80
74
88 79
Pre-test % Rank
12%
5%
5%
<1% 5%
Post-test % Rank
Pre-test Age Eq.
Post-test Age Eq.
5:10 5:4 9:8
5:10 8:6 11:9
4:9 8:11 6:6
4:5 12:6 5:5
<3:0 4:6 4:8
4:0 <3:0 5:3
<3:0 4:6
4:5*** 6:3
25%
9%
4%
21% 8%
Student: 8 Scan-C Test for Auditory Processing Disorders in Children â&#x20AC;&#x201C; Revised Subtests:
Pre-test Standard Score
Post-test Standard Score
11 9 11 7 96
12 11 10 13 110
Filtered Words Auditory Figure Ground Competing Words Competing Sentences Scan Composite
Pre-Test
Pre-test % Rank 63 37 63 16 39
Post-test % Rank 75 63 50 84 75
Post-Test
Vineland-II (Teacher Rating Form) Subdomain / Domain
Pre-test V-Scale Score
Post-test V-Scale Score
Receptive Expressive Written Communication Personal Academic School Community Daily Living Skills Interpersonal Rels. Play & Leisure Time Coping skills Socialization Gross Fine Motor Skills Adapt. Behav. Comp.
13 13 13 Sum = 39 16 15 12 Sum = 43 13 13 12 Sum = 38 10 20 Sum = 30 Sum = 267
17 15 20 Sum = 52 16 19 14 Sum = 49 11 11 13 Sum = 35 16 20 Sum = 36 Sum = 303
Pre-test Standard Score
88
93
86
100 88
Post-test Standard Score
114
108
81
127 101
Pre-test % Rank
21%
32%
18%
50% 21%
Post-test % Rank
Pre-test Age Eq.
Post-test Age Eq.
6:10 7:9 9:2
>18:9 10:10 17:6
12:3 10:6 6:2
12:3 15:9 9:4
6:2 5:10 4:6
4:9 4:0 5:6
3:3 7***
7*** 7***
82%
70%
10%
96% 53%