Tomatis, Sensory Integration, Developmental Model basis for Alzheimers,
Aspergers and Autism
Vestibular
Re-Integration
Alzheimer's can be seen as
development in reverse. First the higher functions such as judgment go,
then the lower functions. Vestibular Re-integration stimulation
operates
on the premise that if you dont use it, you will lose it. If you aren't
growing, you are dying. One practical way to prevent the regression of
Alzheimer's is through vestibular stimulation. Valerie Dejean combines
the Tomatis
Method with
Vestibular Re-integration to restore praxis for
persons who are challenged with a declining ability in the higher
functions.
.......Tomatis Topics
T
his article addresses Alzheimer's dementia from a developmental model.
We view both the difficulties that persons experience as well as the
progress we observe through a developmental model. A developmental
model pre-supposes that growth from infancy (and even before) to
adulthood follows certain predictable stages. In Alzheimer's, the
regression follows the same stages, but in reverse.
Alzheimer's is a developmental disorder and it impacts so many of the
abilities that are unique to us a human beings. It can impact our
physical health. Sensory and motor disturbances are often a
hallmark of Alzheimer's. It can impact our communications skills with
both receptive and expressive language skills often regressed or
unusual in their style. It can impact social interactions, with social
isolation and difficulty understanding social cues often the case. The
ability to work creatively and develop self-sufficient leisure
activities is also affected.
A developmental model is a
bottom up
approach to intervention. It works on the foundations; not the out come
skills. In sensory-based intervention we assume that those foundations
are of neurological organizational. They cannot be taught; rather they
are potentials that can be elicited. This neurological capacity is
called
praxis and it is the foundation for all imitative and later original
action. When praxis fails, we call it Apraxia or Dyspraxia. We can
treat apraxia or Dyspraxia with the Tomatis
method and the Spectrum
Center Method of Vestibular Re-Integration.
Praxis is critical to understanding changes or
improvement in a person with Alzheimer's.
T
he theories of Dr. Tomatis and observations of theory in practice
provided me with a better foundation for understanding of the link
between praxis, communication, and language than just Sensory
Integration theory alone.
Ayres in her
research found a relationship
between improved vestibular functioning and language. She found
improvement in auditory processing as well as a link between depressed
nystagmus and expressive language. When one improved so did the other.
She felt that the therapeutic use of sensory integrative procedures
could have their greatest effect on language test scores. She largely
spoke of the vestibular and auditory systems as separate however.
I remember in a
course 1978 that Josephine Moore
gave about the vestibular system that the vestibular and auditory
system, though separated for teaching purposes were really one system
'the vestibular cochlea system' and it was important that we think of
them that way. Dr. Tomatis most certainly considers them as one.
This in my mind is
where Tomatis added a great
deal. Tomatis saw them much more as one system, the vestibular/cochlear
system, and that sound influenced both the vestibule portion as well as
the cochlear.
Testing
T
omatis sees the ear as an integrator. He saw the vestibular (balancing)
and Cochlear (decoding of sound) functions of the ear joined in a
single system. The vestibule analyzes larger movements, those within
the body, and the cochlea evolved as an addition to analyze smaller
acoustical type movements.
Anatomically he
describes three systems of
integration.
Firstly the
vestibular integrator acts to integrate
all the muscles of the body, noting that all muscles depend on the
vestibule for their tone. Secondly was the visual integrator where the
eye references through the ear. Thirdly the cochlear or linguistic
integrator which interprets sounds and allows for language to develop.
We listen with our whole bodies
And lastly it is
impossible to talk of the
Vestibular system separately from the Cerebellum. When Dr. Tomatis talk
of the vestibular system he is universally talking of the projections
to the cerebellum, especially the archeo-cerebellum.
Participation
S
ound as an entry into the Nervous System
Ayres used movement as her portal into the nervous system while Tomatis
used sound. My observations are that I did a lot of sensory integration
before becoming trained in the Tomatis method, but I never saw the
extent of the impact on language that I see with the addition of sound
stimulation. So with the addition of sound I felt that I was better
able to affect the cochlear integrator.
On the
other hand I see changes in
postural functions with the use of sound that I could not get with
movement-based approaches alone. And that was very interesting to me. I
particularly saw changes in the area of muscle tone - the posture
really improved.
Mostly
I saw changes in what I have
been referring to as the symbolic functions, in the area of non-verbal
communication. This is what I call Communicative Praxis.Theoretically I
find the Tomatis method very consistent with what I was already doing,
I just felt that it added a piece or added a dimension. And I
especially feel that the combination of the two is particularly
powerful.
I
really feel that with the Tomatis
Method I am as much influencing the vestibular system as the cochlear
and I expect to see changes in both functions.'The nervous system grew
out of the ear.'
Benefits
W
hile Ayres came to the vestibular system through her study of learning
disabilities and reading related visual spatial disorders.
Tomatis came to the vestibular system from his desire to understand the
processes of communication. He found the vestibular system when looking
for the first phylogenetic organ of communication.
He saw the
vestibular system as the first system of communication phylogentically.
The primitive vestibular system and its relationship to gravity, was
the first relating from inner life to outer life.
Jean Ayres in her
description of the primacy of the vestibular system in the evolution
and development of the human nervous system put it this way:
' The child's
relationship to gravity is more primal than their relationship to
mother'
Loretta Bender said
in 1956 that 'The vestibular system enabled the developing organism to
distinguish between self and non-self'
This is important to the Tomatis concept of communication. We need a
self and a non-self in order to have an interaction. I can see this
distinction start to evolve in the autistic children as the respond to
therapy. Prior to that their relationship is primarily symbiotic. The
body schema improves along with the motor planning, and they start to
have more of a sense of mastery and autonomy. They see themselves as
separate.
Benefits
T
he vestibular system is anatomically joined with cochlear system, and
the systems lie closely together throughout the nervous system. This
allows for many close neuronal associations with auditory processing
and language. Decreased vestibular processing can impact on the area of
speech and language development, particularly auditory processing.
Research has found that therapy to improve the function of the
vestibular system can also result in improved language development.
Auditory
processing disorders are often related to disorders in processing
within the vestibular system. In actuality, auditory perception is
dependent on good interaction between the vestibular - cochlear
apparatus, which then sends sensory information up to the higher
processing center of the brain. When there is inadequate sensory
information from the vestibular cochlear system it is more difficult to
develop appropriate auditory processing. To develop normal receptive
the foundation of normal sensory input from the vestibular - cochlea
system is important.
The
auditory system needs a stable base provided by the vestibular sy
stem in order to process information. In order to de
velop language it is necessary to process complex information through
the auditory sy
stem. The auditory system is required to separate the speech stream
into meaningful single units of auditory objects. Much as the visual
system, which has to reference what it sees through the vestibular
system, the auditory system also must perform a similar reference.
Without the stability from the vestibular system, it is difficult for
the auditory system to accurately interpret the sound stream well.
Valerie
Dejean Home Page
