Case Studies
Tim’s Story
At age 3 Tim was diagnosed as dyspraxic, with
a severe comprehension problem. His speech therapist referred
him to the Tomatis Method. At the age of 2½ Tim wasn’t
saying very much, he wasn’t able to understand the simple
instructions that other children could of the same age. His
parents were speaking Hebrew at home. There were a lot of tantrums
and frustration, and he seemed to be relying on non-verbal communication
such as high pitched screaming. Tim’s expressive and receptive
skills were at least 12 to 18 months behind his age. At 3 years,
he was not putting more than two words together and didn’t
have consonants at the end of many words.
Tim completed the first 15-day Tomatis Listening
Program in January 2001. Within the first 10 days his parents
noticed some changes and by the end of the 3 weeks these changes
were quite dramatic. He began to use much longer and more complex
sentences. His vocabulary increased and he seemed to be aware
if he said a word incorrectly. He would attempt the word a couple
of times until he was able to pronounce it. Tim began to engage
in more imaginative play. He was imitating scenes from children’s
videos and was also reproducing a number of phrases and using
them in the correct context. He was having fewer tantrums and
there was very little high-pitched screaming. He was using his
words more when playing with his sister and other children.
Overall he seemed less frustrated due to the fact that he was
able to express himself more freely. He appeared to be a more
assertive and confident little boy.
After the initial 15-day program, Tim underwent
two 8-day follow up programs, each 4 weeks apart. There were
still changes to be noted; however these were subtler. He tended
to ask many more questions, especially to ask permission using
the phrase “Can I…” His level of comprehension
improved, he began to cooperate more and he was also beginning
to express his feelings. Socially, he began forming close friendships
at Kindergarten and communicating well with his peers and teachers.
He became better at sharing, asking to have turns and letting
his friends know that he was finished and that they now could
have a turn.
Tim’s Story - Françoise Nicoloff’s
comment
In the initial consultation Tim’s mother
told me of a death in her immediate family which occurred during
pregnancy and also of a long birth. I was informed that Tim
also had a few ear infections during his infancy these things
can all have an effect on listening development. I learnt that
Tim’s developmental milestones were on time except for
language, which did not develop, as it should have.
If a child does not develop their language and
communication skills while everything else seems normal, it
is usually a sign of immaturity in the development of listening
skills at the level of auditory processing. During this initial
assessment it was found that Tim did not seem to be processing
sounds with enough clarity and accuracy.
The diagnosis of Dyspraxia was also a sign of
immaturity of the vestibular system, which is part of the inner
ear, and also responsible for motor control, organisation of
motor movement, motor planning, sensori-spatial perceptual skills
and balance.
With the Tomatis Listening Program we had an immediate
response with Tim who, after four hours of the Listening Program,
was able to increase the length of his sentences. By improving
his processing, the Tomatis Effect was immediately operative.
First Term at School 2003.
Report from Tim's mother
Tim had an amazing start to school- for a child
who was very adamant about not going and wasn’t very interested
in reading or writing. He thoroughly enjoyed going.
Tim settled into his new environment with ease.
He tried very hard to be accepted with the boys. He learnt approximately
60 sight words and is able to read 99% of them with no difficulties.
He is also able to retrieve more than 20 from his head and write
them down and even write sentences without copying eg: “I
can see my home”, or “I can jump”. Tim enjoys
doing homework (he actually reminds his mother to do it) and
they endeavour to revise his ‘words’ nearly every
day. He happily reads from the little ‘reader’,
which he is given from school each week. He is also more willing
to do extra work from his speech therapist. He is obviously
more mature and capable of doing more work , he simply wants
to learn and he is proud of his achievements.
Tim’s drawings have improved immensely.
There is definitely more detail, colour and imagination. He
writes and draws at nearly every opportunity he gets –
whether it is at home on paper, or on the white board, or the
computer. The writing is clear and legible. He gets excited
when he discovers that he can read words when he is in the supermarket
or in the newspaper or a book that he has. He is definitely
more confident with his speech and he often talks to himself
(role playing with toys) repeating phrases his teacher uses.
He doesn’t mind being corrected. His excellent visual
memory has obviously helped him with his reading. Although his
comprehension has improved, there is still a prominent delay
with his comprehension and sometimes certain questions need
to be reworded in order for him to understand them.
His speech therapists reports:
Tim’s process was speeded up with the Tomatis
Method. After he started the Tomatis Method there was not the
need to repeat instructions as frequently as before he was also
able to complete activities upon first instruction. The TM helped
to settle the neurological pathways. Before The Tomatis Listening
Program he could only repeat 3 syllables at a time, afterwards
this increased to 6. He had longer utterances, his sentences
were comprised of many more words, and there were also more
organisation in his sentences.
Chris’s story
Chris had a normal and uneventful birth, but afterwards
he required a colostomy which was followed by several major
surgical procedures. He had grommets inserted at age 3, because
several middle ear infections left him with glue ear and a moderate
hearing loss. At age 2 Chris wasn’t forming many words
and didn’t seem to understand simple commands and was
referred to a Speech Pathologist.
He was diagnosed with receptive and expressive
dyspraxia. Chris’s speech pathologist recommended his
parents ‘help’ him to communicate and give him encouragement
to do so by using some simple sign language. In spite of this
Chris was not progressing well with speech and language development
and he also had some physical challenges, such as low muscle
tone and fine motor difficulties. Chris was left handed like
his mother – he could not put his sandals on, and although
he was dressing himself he was not good at orienting his clothes
or shoes, he was also not riding a bicycle or catching a ball
The speech therapist recommended the Tomatis
Method in October 2001, when Chris was almost 4, saying she’d
seen improvement in children with Chris’s difficulties.
His mother being an occupational therapist was a great believer
in early intervention, so Chris started Tomatis immediately.
The Mother reported “After the second day
of Tomatis, this child who had never really said much, and never
formed a meaningful sentence asked me clearly in a Delicatessen,
Mum, are you going to have carrots today? I looked down, in
such shock, and then he proceeded to tell the shopkeeper that
I wouldn’t have carrots on my sandwich today. It’s
hard to explain to a Delicatessen worker why you are crying
over your son asking you if you want carrots!”
After a year of Tomatis, 8 sessions in all, Chris
was transformed into a sociable, confident, talkative boy. He
attended the Transition class at Scots College Prep, and the
teachers commented on the great improvement they saw during
the year.
At almost 5, Chris began to take a great interest
in books and stories, and began trying to sound out some of
words. He was also starting to take note of his surroundings,
and to remember landmarks and things from the past such as roads
he once travelled on.
Chris’s motor skills also showed signs of
improvement, there was more coordination in his running and
climbing, his writing and fine motor activities were also improving.
The Tomatis programs continued and Chris continued
to show improvements in many areas. The gains became less obvious
as he reached age appropriate abilities in some areas, but his
parents still see the benefits of persevering with the program.
There is also a feeling that Chris senses the
benefit as well!
He knows when he needs the program and asks his
parents when he is going back.
Chris’s story – Françoise
Nicoloff’s comment
Chris was nearly 4 when I first saw him for the
initial assessment. He would speak to his mother softly but
not directly to me. Occasionally he would use a deaf talk sort
of voice. He could only put 5-6 words together and could not
say long sentences. Chris had no social communication with his
peers at preschool where he had been badly bullied, kicked and
punched. He tried to express himself but couldn't, his speech
was muffled and not articulated at all.
On the first day of the TLP, it was like we had
found the key to unlocking Chris’s world or as Chris’s
father said “it has been like someone has lifted a veil
from over him.” At the end of the first 30 hours, Chris’s
father reported: “It’s a miracle! Chris has started
to interact and initiate conversation with other children in
the park. He goes to them and says: Hello, my name is Chris
and what is yours?” Chris is more assertive with his father.
“He shouts at me” says the father, “in the
past; he would just start to whinge or to cry.” Consultations
with Chris’s mother were important to help her to focus
on the positive aspects of her son’s progress, which meant
a reflection on her side about the way she viewed Chris.
Chris’s program was designed according to
his parents’ feedback, his tests and his speech therapists
observations.
First Term at school in 2003, Chris’s
mother reports:
Now Chris is able to ride a bicycle, he can swim,
snorkel and catch a ball. He is definitely involved in school
activities and very involved in his projects He wants to learn
and tell all about his work. He is interested in signs and wants
to read and to spell.
The family moved to QLD last Xmas and he is settling
beautifully in to his new environment, his new school. His parents
report he is very motivated. He still has poor motor control
at the level of his mouth; he still dribbles at times and can
be unconscious of the way he is eating. (It is still a sign
of vestibular dysfunction. How can this be addressed?)
His mother recently reported that Chris loves
writing; he carries a booklet and pen around the house and is
constantly writing things down. E.g. “this morning he
came to the breakfast table with his pen and pad and asked me
how to spell breakfast and promptly wrote it down!” He
is taking delight in his recent achievements - probably the
single most exciting thing for his parents is when his little
face lights up at his new abilities! Chris loves maps- he likes
to try and work out where he is going on a map. He enjoys the
computer and is quite efficient with kindergarten standard games.
He can count to 100. Chris has taken a real interest in reading,
a lot of it comes from the sight words he has become so familiar
with, but still, that's reading! Chris’s speech is still
a little regressed - mixes words up a bit like remember “bremember”
remote control “mote troll”, uses 'f' sounds instead
of “th” again and some words 'run' together.
Physically he has taken a bit of an interest
in ball games - much more than ever before, he loves to bounce
and catch balls and occasionally kicks the ball around! Chris
is singing all the time!
His parents say that every day “their hearts
'sing' when they see or hear Chris conquer something new that
gives him so much pleasure. They report that they feel the majority
of this is attributed to Tomatis. “I always remember back
to that first day after Tomatis when that little boy who hardly
strung two words together asked me if I wanted carrots on my
salad sandwich...it all took off from that moment!” says
his mother reports his mother.
Very often at the end of the assessment I ask
parents to do an ear candle treatment before starting the program.
What the speech therapist says
Before the TLP, voice production was impossible
for Chris, after completing a number of programs he started
getting into the “nuance” of the voice sounds, for
example: coming (sounding) from the front of the mouth instead
of at the back (as from the front and from the back are quite
different mouth movements) For Chris this was a fantastic effort
on his part, getting into the nuance of the different sounds,
it is quite a difficult task and is not easily achieved. It
represents a dramatic change in his confidence levels.
Conclusion
The Tomatis Method improves the part of dyspraxia
associated with motor planning disorder, for instance the way
that the tongue moves in the mouth. It seems to works at fine-tuning
the coordination of the different components of the mouth for
the production of the appropriate sound. The TM immensely improves
the comprehension and organization of the speech musculature
and as such improves the voluntary production of sound. At the
level of voice/sound production the TM helps children not to
‘grope’ so much, the tongue seems to find the right
spot to form words more quickly and easily. The child's attempts
at word production are more successful. The placement of the
sound in the mouth is more precise.
The Tomatis Listening Program speeds up the pace
of a child in understanding instruction and teaching. The integration
of grammar in a child’s language learning process much
faster. As well as this The TM speeds up and settles the re-patterning
of the neurological parts of the brain associated with language
by rewiring these pathways to the brain. The TM gets into the
neurology and unblocks the whole system. It helps them to re-pattern
when the pattern was not previously formed properly.
At the level of perception, which is often referred
to as a more receptive process, children start to perceive sounds
more accurately within a shorter space of time (3 instead of
6 weeks when working with a speech pathologist).
The “beauty of The Tomatis Method for children
with dyspraxia” says Esther Bruhl, is that children can
improve quickly without the need to struggle to achieve the
right sounds. This also makes the process less repetitive for
the speech therapist, so less frustrating for both. The TM also
affects emotional and behavioural responses to life. Not only
does it affect hearing and listening but by improving these
skills and the organisation of a child’s responses in
communication, it also decreases their frustration, implying
less tantrums and disruptive behaviour.
For Tim by the end of the TLP there was less
physical frustration in his attempts at producing sounds and
words and as such less emotional frustration.
There is much more bodily control to be seen in
a dyspraxic child who has undergone a Tomatis Listening Program.Fine
and gross motor skills are considerably improved. Children learn
to use these skills more appropriately and as such their physical
abilities and their confidence in the use of these is much enhanced.
Benefits of the Tomatis Method
