RESEARCH

 

Research

After decades of research, the jury is in: Neuroplasticity allows the brain to respond to sound therapy by healing, strengthening and/or create new neuronal pathways to transmit information.

DYNAMIC LISTENING/INTEGRATED LISTENING

A PILOT STUDY OF INTEGRATED LISTENING SYSTEMS FOR CHILDREN WITH SENSORY PROCESSING PROBLEMS

Sarah A. Schoen, PhD, OTR, Lucy J. Miller, PhD, OTR, and Jillian Sullivan, PhD
Journal of Occupational Therapy: Schools and Early Intervention, 8: 1-21 2015
Summary: This study explores the effects of iLs on individualized parent goals for children with sensory processing impairments.  The 40-session iLs program was implemented at home and in clinic over a 3-month period. Important and clinically meaningful gains were achieved by all participants in both home and educationally-related goals.  Individualized goal achievement was supported by gains in standardized measures of behavior and adaptive functioning. Changes in physiological arousal (measured by EDA – electrodermal activity) suggest the iLs program is impacting underlying regulation mechanisms that may be contributing to the observed behavioral changes.  Behavioral changes included increased relaxation, fewer meltdowns and a generally calmer disposition for participants whose arousal decreased.

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K-2 LITERACY STUDY

J. Anne Calhoon, Ph. D. Educational Psychology, University of New Mexico
Summary: A controlled study involving 64 K-2 at-risk students was conducted by U of New Mexico researcher Anne Calhoon, Ph.D. Students participated in the Alpha Program,* a program combining iLs with art therapy. The average improvement in reading over the 3-month intervention was 2 years.  “Taken as a whole, this analysis indicates that the students in the experimental group have improved in all categories associated with reading. This improved achievement is significantly greater (more meaningful) than the improvements of the control group peers. Overall the picture presented of the students in ALPHA is one that shows immense growth in cognitive, academic, and psychological areas.”

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AN INVESTIGATION TO EVALUATE THE BENEFITS OF THE INTEGRATED LISTENING SYSTEMS (ILS) IN PRIMARY/EARLY ELEMENTARY CLASSROOMS (K-3): THE CASE OF VALLEY VIEW ACADEMY IN NORTHERN CALIFORNIA

Jeannie Dubitsky, Ed. D., University of California, Davis, 2014
Summary: Ten students were measured over an academic year of using iLs while at school. Students showed improvement in all areas evaluated – physical, academic, social and emotional development – after experiencing the iLs program.

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AUDITORY PROCESSING DISORDER DATA FROM THERAPEEDS CENTER, FORT LAUDERDALE, FL

Julia Harper, PhD, OTR/L and Aimee Levine Weiner, Aud; published in Advance OT Magazine
Summary: Therapeeds, a private clinic in Ft. Lauderdale, Florida, gathered data on 29 children diagnosed with APD (auditory processing disorder) who completed the Therapeeds’ H.O.P.E. sensory motor program combined with iLs. Among the pre- and post-program results are the following:

  • Vestibular function: Pre-testing indicated 0 of the 29 children had intact vestibular processing skills measured by the PrN and functional skills. Post-testing showed all 29 in normal range.

  • Auditory Processing Skills: Post-intervention, 22 of the 29 children had auditory processing skills that were completely within normal limits in every area.

  • Medications: Seven of 29 children began this therapy on medication for attention-related concerns. By the end of the program, the medications for all 7 had all been discontinued.

  • ABR Binaural Summation: Pre-intervention ABR tests showed all 29 children had little difference between listening with one ear and listening with both ears (binaural summation). Post-intervention, all 29 tested in the normal range.

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SCHOOL PILOT STUDY

Denver Area Schools
Summary: A variety of normed, standardized tests were used to assess 20 children with learning difficulties before and after iLs programs. The report includes each child’s pre- and post-program test scores as well as teacher and parent comments. Teachers involved in the program reported “significant improvement” in 19 of the 20 children. The criteria for “significant improvement” include at least one of the following: being transitioned from special education to regular education, having an IEP removed or overcoming a substantial behavioral challenge.
Description: Data on the efficacy of iLs in school programs.

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ILS HOME PROGRAM AUTISM STUDY

Theresa May Benson, PhD, OTR/L
Summary: This study on the effect of the iLs home program on 18 children diagnosed with autism was conducted by Dr. Teresa May Benson of The Spiral Foundation, a non-profit research organization. The purpose of the multi‐site intervention study was to examine the effectiveness of the iLs Focus home program with 18 children, ages 4 to 8, diagnosed with Autism Spectrum Disorder (ASD). Results found significant gains across multiple subjective and objective outcome measures in the following areas: social skills, emotional regulation, number and severity of autistic behaviors, and overall functional adaptive behavior skills.

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SURVEY OF ILS PROFESSIONALS

Spiral Foundation, Boston, MA
Summary: Survey reviewing therapists’ experience using iLs with over 1300 children on the autism spectrum. The survey asked the question: In what areas is iLs effective? Results are in 24 outcome categories.

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COCHLEAR IMPLANT STUDY

Ann Brownstone, MS, OTR/L, SWC, Jennifer Aguilar, MS, CCC-SLP, Lisa Marcacci, MS, Aud.
Summary: This study was conducted at the Jean Weingarten Peninsula Oral School for the Deaf, Redwood City, CA by Ann Brownstone, MS, OTR/L, SWC, Jennifer Aguilar, MS, CCC-SLP, and Lisa Marcacci, MS, Aud.  It examines the application of iLs with children wearing cochlear implants and also provides a general reference guide for using iLs in conjunction with cochlear implants and other hearing devices.

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SAFE & SOUND PROTOCOL (SSP)

RESPIRATORY SINUS ARRHYTHMIA AND AUDITORY PROCESSING IN AUTISM: MODIFABLE DEFICITS OF AN INTEGRATED SOCIAL ENGAGEMENT SYSTEM?

Stephen W. Porges, Matthew Macallaio, Shannon D. Stanfill, Kimberly McCue, Gregory F. Lewis, Emily R. Harden, Mika Handelman, John Denver, Olga V. Bazhenova, and Keri J. Heilman 
International Journal of Psychophysiology, 2013 Jun; 88(3): 261-270
In this peer-reviewed study, higher functioning individuals with ASD were tested using an early version of the SSP.  The study showed that auditory processing and state regulation improved following the intervention.

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REDUCING HYPERSENSITIVITIES IN AUTISTIC SPECTRUM DISORDER: PRELIMINARY FINDINGS EVALUATING THE LISTENING PROJECT PROTOCOL (A PRECURSOR TO THE SAFE AND SOUND PROTOCOLTM)

Stephen W. Porges, Olga V. Bazhenova, Elgiz Bal, Nancy Carlson, Yevgeniya Sorokin, Keri J. Heilman, Edwin H. Cook, and Gregory F. Lewis
Frontiers in Pediatrics, 2014; 2:80
In a second peer-reviewed study, children with Autism Spectrum Disorder (ASD) who used an early version of the SSP experienced significant improvements in emotional organization, listening, spontaneous speech and hearing sensitivities.

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THE LISTENING PROJECT: TUNING INTO CHANGE

Stephen W. Porges, PhD, University of North Carolina, Chapel Hill

Summary: A research project funded by the Australian Childhood Foundation (ACF) will be conducted in Australian facilities of the ACF to evaluate the effectiveness of the Safe & Sound Protocol (SSP) in children with a trauma history. The SSP is designed as a “neural exercise” to reduce auditory hypersensitivities, to improve auditory processing of speech, and to improve behavioral state regulation. The SSP uses acoustic stimulation to exercise the neural regulation of the middle ear structures to rehabilitate and to normalize the acoustic transfer function of the middle ear structures. The current study is being conducted to evaluate efficacy and feasibility of the SSP and will use objective measures to evaluate changes in acoustic transfer function of the middle ears structures, auditory processing skills, physiological state regulation, and sensory symptoms.

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THE LISTENING PROJECT AT THE ADD CENTRE AND BIOFEEDBACK INSTITUTE OF TORONTO

Stephen W. Porges, University of North Carolina, Chapel Hill

Summary: A research project will be conducted at the ADD (“Attention Deficit Disorder”) Centre and Biofeedback Institute of Toronto to evaluate the feasibility of the Safe & Sound Protocol (SSP) intervention in individuals with difficulties with autonomic and/or behavioral regulation. The SSP is designed as a “neural exercise” to reduce auditory hypersensitivities, to improve auditory processing of speech, and to improve behavioral state regulation. These improvements should translate into increase feelings of safety and calmness, thereby promoting improvement in social behavior.

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THE LISTENING PROJECT AT REISS-DAVIS/VISTA DEL MAR CHILD AND FAMILY SERVICES

Stephen W. Porges, University of North Carolina, Chapel Hill

Summary: A research project funded by the Reiss-Davis Child Study Center of Vista Del Mar (RDCSC/VDM) will be conducted on the Vista Del Mar campus of the RDCSC/VDM to evaluate the effectiveness of the Safe & Sound Protocol (SSP) in children who have difficulties with autonomic and behavior regulation in the classroom. The current study is being conducted to evaluate efficacy and feasibility of the SSP with emotionally disturbed and learning challenged young people and will use objective measures to evaluate changes in acoustic transfer function of the middle ears structures, auditory processing skills, physiological state regulation, sensory symptoms, and academic pre and post testing.

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OPTIMIZING THE SOCIAL ENGAGEMENT SYSTEM IN PRADER-WILLI SYNDROME: INSIGHTS FROM THE POLYVAGAL THEORY

Stephen W. Porges, Indiana University and University of North Carolina, Chapel Hill

Summary: To demonstrate that children with Prader-Willi Syndrome (PWS) have atypical regulation of the Social Engagement System (SES). We hypothesize these effects will be manifested by dampened vagal regulation of the heart (low parasympathetic tone); poor middle ear muscle regulation resulting in auditory hypersensitivities and poor auditory processing; lack of voice intonation (prosody), and difficulties in accurately detecting the emotions of others.

To demonstrate the effectiveness of the Safe & Sound Protocol (SSP) in decreasing the atypical features of the SES in adolescents with PWS. We hypothesize that individuals who complete the SSP will have improved vagal regulation of the heart, improved middle ear muscle regulation, increased voice intonation and improved ability to accurately detect the emotions of others.

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EXAMINING THE EFFECTS OF PROCESSED MUSIC ON CHRONIC PAIN

Stephen W. Porges, Indiana University and University of North Carolina, Chapel Hill

Summary: To examine whether the Safe & Sound Protocol (SSP), a non-invasive audio intervention, can be effective for reducing chronic pain in a sample of older adults and whether increased regulation via the autonomic nervous system accounts for the decrease in pain if the intervention is successful.

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INTERACTIE METRONOME

 Incorporation of Feedback during Beat Synchronization is an Index of Neural Maturation and Reading Skills | Kali Woodruff Carr, Ahren B. Fitzroy, Adam Tierney, Travis White-Schwoch, Nina Kraus

Published in Brain & Language

Speech communication involves integration and coordination of sensory perception and motor production, requiring precise temporal coupling. Beat synchronization, the coordination of movement with a pacing sound, can be used as an index of this sensorimotor timing. We assessed adolescents’ synchronization and capacity to correct asynchronies when given online visual feedback. Variability of synchronization while receiving feedback predicted phonological memory and reading sub-skills, as well as maturation of cortical auditory processing; less variable synchronization during the presence of feedback tracked with maturation of cortical processing of sound onsets and resting gamma activity. We suggest the ability to incorporate feedback during synchronization is an index of intentional, multimodal timing based integration in the maturing adolescent brain. Precision of temporal coding across modalities is important for speech processing and literacy skills that rely on dynamic interactions with sound. Synchronization employing feedback may prove useful as a remedial strategy for individuals who struggle with timing-based language learning impairments.

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 Effect of Interactive Metronome Training on Timing, Attention and Motor Function of Children With ADHD: Case Report | Namgung, Young, M.S., O.T., Son, Da-In, B.S., O.T., Kim, Kyeong-Mi, Ph.D., O.T.

White Paper

To report the effects of a specific intervention, the Interactive Metronome  (IM), on timing, attention and motor function of a children with ADHD. The  study  is  case  reports  about  two  boys  with  ADHD.  One boy who is born 2008 is attending general elementary school as a first year student  (case 1), and another boy who is born 2001 is attending general elementary school as a second year student  (case 2).  For each case subject, IM training was provided during 3 weeks, from January 2015 to February 2015.  Evaluations were performed pre- and post-intervention in order to exam timing, attention and motor skills.  The measurements uses in this study are Long Form Assessment  (LFA) for the timing, RehaCom screening module for the attention, and Bruininks-Oseretsky Test of Morot Proficiency, second version  (BOT-2) for the motor function. The timing function was improved in both cases since both showed reduced response time for all motor tasks of LFA.  In terms of attention, case 1 showed improvement of visual attention division, neglect and response Inhibition, and case 2 showed improvement of sustained attention. Lastly, in the BOT-2, case 1 showed improved the percentile rank of short  (from 42%ile to 96%ile), and case 2 also showed similar improvement  (from 21%ile to 66%ile). This study provides positive evidence that the Interactive Metronome training has positive power to facilitate several body functions such as timing, attention and motor control of children with ADHD, through two case studies.

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