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  • 1. Effects of Auditory Stimulation on A.P.D. 2 COPYRIGHT NOTICE: The following article has been accepted for publication in the International Journal of Listening and is copyrighted by Lawrence Erlbaum Associates, Inc (LEA). Readers must contact LEA for permission to reprint or use the material in any form. Abstract: The study’s purpose is to determine the efficacy of the Tomatis Method of auditory stimulation as a therapeutic intervention for Auditory Processing Disorders (APD). 41 subjects (18 females, 23 males; 4.3 to 19.8 years old) were evaluated for A.P.D.. Performance on standardized tests indicated weaknesses with auditory processing skills. Each subject participated in a 90 hour Tomatis Method protocol and, once completed, was re-evaluated to measure improvement. All subjects demonstrated improvement with skills of immediate auditory memory, auditory sequencing, interpretation of directions, auditory discrimination and auditory cohesion. Pre & post treatment comparison indicated statistically significant differences in the aforementioned skills. These findings suggest that the Tomatis Method of auditory stimulation can be effective as an intervention strategy for A.P.D.. Copyright © Lawrence Erlbaum Associates, Inc
  • 2. Effects of Auditory Stimulation on A.P.D. 3 The Effects of Auditory Stimulation on Auditory Processing Disorder: A Summary of Findings Overview The Tomatis Method of auditory stimulation is a therapeutic intervention used to improve characteristics and behaviors in children and adults with disorders of communication, learning and autism and autism spectrum disorders (ASD). This non-invasive intervention and treatment method has been evaluated and studied in several research projects in Europe, Africa and Canada in the 1980s and 1990s. Surprisingly, there has been no single study examining the effects of the Tomatis Method on auditory processing disorders. Children and adults with auditory processing disorder (APD) are a heterogeneous group of people who have difficulty using auditory information to communicate and learn. APD is a set of problems that occurs in different listening tasks. It is a deficit in the processing of auditory input which can be exacerbated in unfavorable acoustic environments and is associated with difficulty listening, speech understanding, language development and learning (Jerger & Musiek, 2000). An auditory processing disorder is the inability or decreased ability to attend to, discriminate among or between, recognize or understand auditory information. Most language is learned by listening (or processing). In order to learn, a child must be able to attend to, listen to, and separate important speech from all of the other noises at school and home. When auditory skills are weak the child may experience auditory overload. This makes learning more challenging and sometimes too difficult without special assistance. Most people with auditory processing problems have normal intelligence and normal hearing sensitivity. Copyright © Lawrence Erlbaum Associates, Inc
  • 3. Effects of Auditory Stimulation on A.P.D. 4 The purpose of this retrospective study is to determine if the Tomatis Method can be used as a clinical intervention in affecting changes in the auditory processing skills in children who have been identified as having auditory processing disorder. This study will demonstrate the effects of the Tomatis Method that produces improvements in skills of auditory perception and discrimination, immediate auditory memory, interpretation and following directions, auditory sequential memory, auditory cohesion and auditory latency. Study Purpose and Methods The subjects ranged in age from 4.3 years to The primary goal of this study is to 19.8 years. All subjects were presented with determine the efficacy of the Tomatis symptoms and characteristics of auditory Method of auditory stimulation in treating processing disorder. All of the subjects the auditory processing skill weaknesses in were not receiving other therapies during the children who have been identified as having time of participation in the Tomatis Method auditory processing disorder. Specific of auditory stimulation. deficits may include: auditory perception, auditory discrimination, auditory Rationale association, auditory vigilance, auditory Auditory processing disorder is a very memory, auditory analysis, auditory complex and controversial issue. The synthesis, auditory conceptualization, diagnosis of APD is typically given by way auditory endurance, auditory latency, and of testing by audiologists and speech- auditory cohesion. language pathologists. Treatment and Forty one subjects were studied for a therapy programs are typically provided by pre-test post- test retrospective case review. Copyright © Lawrence Erlbaum Associates, Inc
  • 4. Effects of Auditory Stimulation on A.P.D. 5 speech-language pathologists and would be sounds of Mozart music and Gregorian characterized by a variety of strategies that Chants which are believed to be physically are not standardized or necessarily proven to relaxing and stimulating, similar to the be effective. Many of the effects of earliest experiences of sound, those of therapeutic interventions rely heavily on prenatal and early life (DeCaspaar, parent and teacher reports as well as Lechanuet, Busnel, Granier-Deferre standardized testing. &Maugeais, 1994). As the Tomatis protocol The Tomatis Method is an auditory for listening progresses, the child is stimulation intervention that has been gradually introduced to the Active Phase effective in reducing symptoms of auditory that is designed to stimulate processing processing disorder. The Tomatis Method is through first listening to recorded discourse a non-invasive therapeutic intervention that and eventually through audio-vocal has been widely used in Europe and Canada exercises. The progression of the Tomatis since the 1940s. It was introduced to the Method parallels processing, language United States in the late 1980s. development, acquisition and mastery with The Tomatis Method is a 90 hour regard to sound perception, discrimination protocol of auditory stimulation involving and attention. both active and passive listening. It’s focus Research projects studying the effects on is developmental in nature, corresponding auditory processing and learning have with what is believed to be the earliest originated from Europe and Canada. experiences of sound to the human ear Gilmore (1999) studied the efficacy of the (during fetal development). Beginning with Tomatis Method for children with learning the Passive Phase, the child listens to filtered and communication disorders. His findings Copyright © Lawrence Erlbaum Associates, Inc
  • 5. Effects of Auditory Stimulation on A.P.D. 6 reported that the Tomatis Method resulted in construction of the auditory system has positive changes in the following domains: important connections with entire body as auditory processing, cognitive, linguistic, well as the cortex and sub-cortical personal and social adjustment and structures, which are stimulated when stable psychomotor. He further reported that his and normal auditory perceptions occurs. It findings were consistent with clinician’s has been hypothesized that the human reports of beneficial effects. Additionally, auditory system has specific functional investigators have also demonstrated that the capabilities that include: transmission of Tomatis Method has proven to be effective energy, (a cortical change to the brain), in the areas of communication, learning and establishment of equilibrium, perception of social pragmatics (Rourke & Russel, 1992, sound, attention and discrimination of Kershner, et al, 1986, Mould, 1984 & sound, localization of sound and integration Gilmore, 1985). of auditory information for the development Given that alternative interventions are of laterality and language development. being pursued and implemented by parents Typically, children with auditory processing and professionals, the use of the Tomatis disorder, depending on the severity of the Method has become increasingly more deficit, will have difficulty perceiving and popular. discriminating sound, attending to sound, localizing sound as well as other auditory skills that comprise the hierarchy of auditory Hypothesis processing skills (Bellis, 1996; EAA, 1996; DeConde & Gillet, 1993). The Tomatis The Tomatis Method is based on the Method serves as an auditory stimulation/re- evidence that the neurophysiological Copyright © Lawrence Erlbaum Associates, Inc
  • 6. Effects of Auditory Stimulation on A.P.D. 7 education intervention to stimulate listening hours of auditory stimulation with the and processing as opposed to hearing. It Tomatis Method and were not receiving any reproduces the developmental steps of other therapy at the time (e.g. speech- listening, language acquisition and use, and language therapy, occupational therapy, learning. tutoring, etc.). Finally, the Tomatis Method 1. Assessment: Each child received a hypothesizes that auditory stimulation, complete battery of standardized particularly with high frequency sounds, is measures prior to beginning the Tomatis an important source of stimulation to the Method protocol. Testing consisted of brain’s ability to receive and process sound. administration of the following Scientists have demonstrated that 80% of batteries: the 24,000 hair cells in the cochlea respond a. The Wide Range Achievement to sounds of 3000 Hz and above. The Test (WRAT) Tomatis Method offers stimulation up to b. The Lindamood Auditory 10,000 Hz. Conceptualization Test (LACT) c. The Phonemic Awareness Test Study Method d. The Token Test for Children e. The Test of Auditory Perceptual Subjects: The pre-treatment post-treatment Skills testing results of forty one subjects between 2. Treatment Procedures: Each child the ages of 4.3 and 19.8 years were review underwent a traditional Tomatis Method for purposes of determining the effects of Protocol. The protocol consisted of 90 the Tomatis Method on auditory processing hours of auditory stimulation. The skill weaknesses. All children received 90 Copyright © Lawrence Erlbaum Associates, Inc
  • 7. Effects of Auditory Stimulation on A.P.D. 8 protocol is divided into four blocks of consisted of non-filtered sound (music) time. The auditory stimulation is with gating up to 8000 Hz. administered by passing high quality, Block II: The Active Phase. specifically prepared auditory Ten days of active listening for two stimulation through equipment designed hours a day. The child begins to tone, to modulate the acoustic signal. The sing, read, and/or repeat words and acoustic signal modulation equipment phrases into a microphone. They listen attenuates low frequency sounds and to modulated voices. This phase ends amplifies higher frequencies that fall with reading aloud thus completing the within the language area allowing the model of language acquisition and child to gradually focus listening on the expression. Auditory stimuli is filtered language frequencies. During all blocks up to 9000 Hz is used during this phase. of the listening protocol the child listen Block III: Stabilization Phase. through headphones with an attached Ten days of mixed active and passive bone conduction oscillator permitting the listening for two hours daily. Children sounds to be perceived through bone participate in both passive work as well conduction as well as the usual air as microphone work. conduction. The following describes the Block IV: Maintenance Phase. different blocks of listening: Ten days of mixed active and passive Block I: The Passive Phase. listening for two hours daily. Various Fifteen days of passive listening for two levels of filtering are used from 2000 Hz hours a day. The auditory stimulation to 9000 Hz. Breaks between blocks: Copyright © Lawrence Erlbaum Associates, Inc
  • 8. Effects of Auditory Stimulation on A.P.D. 9 Each child takes a three- week break skills. It can result in poor auditory memory between each block and auditory fatigue. The following graph demonstrates improvement with auditory Post Treatment Testing discrimination skills as a result of auditory Eight to twelve weeks following treatment stimulation using the Tomatis Method, each child underwent the same testing battery that was administered prior to their Auditory Discrimination 80 participation in the Tomatis Method. 70 60 Percentile 50 40 68.07 30 Summary of Findings: 20 10 14.23 0 Pre-treatment Post-treatment Auditory Discrimination Auditory discrimination is the process used These results indicate that prior to to discriminate among sounds or different treatment overall auditory discrimination frequency, duration or intensity (e.g. skills of the 41 children were placed at the high/low, long/short, loud/soft). It is the 14.33rd percentile. Following treatment ability to automatically notice, think about auditory discrimination skills improved to or manipulate the sounds in language the 68.07th percentile, reflecting an average (Torgesen, 1997). It refers generally to the improvement of 53.74%. awareness of words, syllables or phonemes. A problem with auditory discrimination can affect following directions, listening understanding, reading, spelling and writing Copyright © Lawrence Erlbaum Associates, Inc
  • 9. Effects of Auditory Stimulation on A.P.D. 10 Immediate Auditory Memory for digits forward of the 41 children were placed at the 9.68th percentile. Following Immediate auditory memory refers to the the treatment these skills improved to the recall of the acoustic signal after it has been 46th percentile reflecting an average labeled, stored and recalled. This skill also improvement of 36.32 %. requires that one be able to remember and Immediate Memory - Digits Reversed recall various acoustic stimuli of different 50 length and/or number. Auditory sequential 40 Percentile memory is the ability to recall the order of a 30 20 37.37 series of details. The following graphs 10 19.10 demonstrate improvement with auditory 0 Pre-treatment Post-treatment memory skills for digits forward and reversed, as well as repetition of sentences These results indicate that prior to and words as a result of auditory stimulation treatment overall immediate memory skills using the Tomatis Method. for digits reversed of the 41 children were placed at the 19.10th percentile. Following Immediate Memory - Digits 60 the treatment these skills improved to the 55 50 45 37.37th percentile, reflecting an average 40 Percentile 35 30 improvement of 18.27%. 25 46.00 20 15 10 5 9.68 0 Pre-treatment Post-treatment These results indicated that prior to treatment overall immediate memory skills Copyright © Lawrence Erlbaum Associates, Inc
  • 10. Effects of Auditory Stimulation on A.P.D. 11 placed at the 12.20th percentile. Following Auditory Sequential Memory 60 the treatment these skills improved to the 55 50 Percentile 45 40 48.49th percentile, reflecting an average 35 30 25 53.41 improvement of 36.29%. 20 15 10 5 16.44 0 Interpretation and Following Directions Pre-treatment Post-treatment These skills are inherently dependent upon These results indicate that prior to skills of auditory discrimination, auditory treatment, overall immediate memory skills association and other auditory skills. for auditory sequencing of the 41 children Directions were presented according to the were placed at the 16.44th percentile. progression of the difficulty of the directions Following the treatment these skills by chronological age and grade. These improved to the 53.41st percentile, reflecting skills, while heavily loaded with auditory an average of 36.97%. memory and sequencing skills, focus on Immediate Memory - Words one’s ability to comprehend and understand 60 50 and interpret meaningful auditory Percentile 40 30 information well enough to follow 48.49 20 10 directions. The following graph 12.20 0 demonstrates the improvement of the Pre-treatment Post-treatment children to interpret and follow directions as These results indicate that prior to a result of the Tomatis Method of auditory the treatment overall immediate memory stimulation. skills for words of the 41 children were Copyright © Lawrence Erlbaum Associates, Inc
  • 11. Effects of Auditory Stimulation on A.P.D. 12 Interpretation of Directions understanding ambiguous information and 80 abstract reasoning and problem solving. 70 60 Percentile 50 Auditory Cohesion 40 66.54 30 70 20 31.29 60 10 0 50 Percentile 40 Pre-treatment Post-treatment 30 56.63 20 10 23.15 These results indicate that prior to 0 Pre-treatment Post-treatment the treatment, overall ability of the 41 children to interpret and follow directions These results indicate that prior to was at the 31.29th percentile Following the the treatment, overall auditory cohesion treatment, these skills improved to the th ability of the 41 children was at the 23.15th 66.54 percentile reflecting an average percentile. Following the treatment, these improvement of 35.25%. skills improved to the 56.63rd percentile, reflecting an improvement of 33.48%. Auditory Cohesion Auditory cohesion is the ability to interpret, Overall Auditory Processing organize and synthesize auditory The following graph reflects the information on a higher-order level of improvement of all auditory processing functioning. These skills are necessary for skills that include immediate auditory listening comprehension, organization, memory, auditory discrimination, semantic and linguistic organization, Copyright © Lawrence Erlbaum Associates, Inc
  • 12. Effects of Auditory Stimulation on A.P.D. 13 interpretation following directions, and delays as a result of auditory stimulation auditory cohesion. using the Tomatis Method. Overall Auditory Processing Auditory Latency 110 70 1 00 60 90 80 50 70 63 Percentile 40 60 % Delay 50 30 58.34 38.77 40 20 30 20 10 8.41 10 0 0 Pre-treatment Post-treatment Pre-treatment Post-treatment These results indicate that prior to These results indicate that prior to the treatment overall auditory processing the treatment average delays in processing skill ability of the 41 children was at the were present 63% of the time. Following st 8.41 percentile. Following the treatment treatment delays were reduced by 24.23%. th these skills improved to the 58 percentile Statistical Analysis reflecting an improvement of 49.93% A t-test for comparison of pre- Auditory Latency treatment post-treatment scores was used on the results for the Test of Auditory Auditory latency refers to processing Perceptual Skills (TAPS) and the Token test delays. This can be a lapse, hesitation, or for children (TTC). Significant differences frank delay in response time when were shown when pre- and post-therapy presented with auditory stimuli requiring a results for both TAPS and TTC were response. The following graph reflects a compared. Before Tomatis intervention, reduction in auditory latency or processing TAPS mean subtest scaled scores ranged Copyright © Lawrence Erlbaum Associates, Inc
  • 13. Effects of Auditory Stimulation on A.P.D. 14 from 4.2 to 8.12, and the overall Auditory Auditory Processing 7.22 2.52 10.83 3.3 Overall Quotient 72.2 11.5 101.49 14.88 Quotient mean was 72.2. After Descriptive Statistics – Token Test for Children intervention, the subtest scaled scores of AGE SC GRADE SC PRE SD POST SD PRE SD POST SD student's t-test analysis showed all of these Mean Mean Mean Mean Part I 494.82 11.82 500.46 2.13 496.96 11.07 502.75 2.56 differences to be significant (p < 0.00). Part II 492.43 9.33 501.96 1.5 492.07 10.53 502.32 3.08 Part 486.75 11.02 499.25 5.62 486.93 8.64 499.21 4.93 III They ranged from 8.76 to 11.88, and the Part IV 492.14 4.61 499.82 6.42 491.75 4.77 499.5 6.41 Part V 487.86 7.83 498.75 5.98 487.14 7.92 498.29 6.74 mean Auditory Quotient was 101.49. Total 485.68 7.63 499.57 4.98 485.64 7.18 499.5 4.74 Similarly, TTC scores before Tomatis Paired t-Test Comparisons – TAPS intervention showed marked differences, PRE POST Diff. (Post- Mean Mean Mean Pre) t p with pre-treatment Age Scores ranging from SD Number 11.0 5.68 9.8 4.12 2.38 .00 Memory F 9 485.68 to 494.82 and Grade Scores from Number 7.46 8.76 1.29 2.58 3.21 .00 Memory R Sentence 486.64 to 496.96, while post-treatment Age Memory 6.59 10.37 3.78 2.73 8.85 .00 Word 6.15 9.83 3.689 2.57 9.16 .00 Memory Scores ranged from 499.25 to 501.96 and Following 8.12 11.76 3.63 2.91 7.99 .00 Directions Grade Scores ranged from 499.21 to Word Discr. 4.2 11.88 9.68 3.92 3.66 .00 Auditory 7.22 10.83 3.61 2.61 8.87 .00 502.75. Student's t-Test showed all of those Perception Overall 14.9 72.20 101.49 29.29 12.53 .00 Quotient 6 differences to be significant (p < 0.00 for most, and p = 0.01 and p = 0.02 for others). Paired t-Test Comparisons – Token Test For Children Descriptive statistics and t-Test PRE POST Diff. (POST- Mean Mean Mean PRE)SD t p comparisons are shown in tables below. AGE SC. 494.82 500.46 11.54 5.64 2.59 .02 PART I Descriptive Statistics – TAPS Part II 492.43 501.96 9.54 9.31 5.42 .00 Part III 486.75 499.25 12.5 12.47 5.3 .00 Part IV 492.14 499.82 7.68 7.49 5.43 .00 PRE POST Part V 487.86 498.75 10.89 8.8 6.55 .00 TAPS SUBTEST Mean SD Mean SD TOTAL 485.68 499.57 13.89 6.92 10.62 .00 Number Memory F 5.68 1.52 9.8 2.86 GRADE SC 496.96 502.75 5.79 10.95 2.8 .01 Number Memory R 7.46 2.46 8.76 1.77 PART I Sentence Memory 6.59 1.96 10.37 3.05 PART II 492.07 502.32 10.25 10.43 5.2 .00 Word Memory 6.15 1.49 9.83 2.48 PART III 486.93 499.21 12.29 9.56 6.8 .00 Following Directions 8.12 2.12 11.76 3.14 PART IV 491.75 499.5 7.75 7.14 5.74 .00 Word Discrimination 4.2 4.28 11.88 3.04 PART V 487.14 498.29 11.14 9.92 5.94 .00 Copyright © Lawrence Erlbaum Associates, Inc
  • 14. Effects of Auditory Stimulation on A.P.D. 15 TOTAL 485.64 499.5 13.86 7.14 10.27 .00 following the Tomatis Method. Skills of Discussion: auditory discrimination demonstrated the Overall auditory processing skills improved area of greatest improvement with the following participation in a 90 hour average improvement being 53.74%. Tomatis Method auditory stimulation Problems with auditory discrimination can protocol. Comparison of pre and post affect all other auditory processing skills. treatment evaluations indicates It is logical to suggest that as auditory improvement in the skills of immediate discrimination skills improve other skills auditory memory, auditory sequencing, will improve. Problems with auditory interpretation and following directions, discrimination can affect auditory memory, auditory discrimination and auditory auditory comprehension, auditory cohesion cohesion. Auditory processing skills are a and result in processing delays. Analysis of cluster of skills that are basic to the the information obtained from this study listening, communication and learning indicates that as a result of improved processes. Although sequential in auditory discrimination, all other auditory development, these skills overlap and are processing skills improved. essentially inseparable. Auditory processing skill weaknesses result in Skills of immediate auditory memory as difficulty in the ability to use auditory measured by digits forward and reversed information to listen, communicate and sentences and single words demonstrated learn. improvement following the Tomatis Method. Auditory memory skills are The findings of this study indicate that affected by skills of auditory measurable improvement was attained Copyright © Lawrence Erlbaum Associates, Inc
  • 15. Effects of Auditory Stimulation on A.P.D. 16 discrimination, auditory latency, and The ability to interpret and follow familiarity with the language that is being directions demonstrated improvement processed and auditory endurance. When following the Tomatis Method of auditory referring to the auditory processing skills stimulation. As with other auditory skills, hierarchy (Bellis, 1996), immediate this skill ability requires prior acquisition of memory skill acquisition requires prior auditory discrimination, auditory acquisition of auditory discrimination, association, auditory closure and immediate localization, auditory figure-ground, auditory memory. For the most part, not auditory association and auditory closure. one auditory skill functions independently of the others. However, when examining the pre-post treatment assessment results the findings strongly suggest that the ability to interpret and follow instructions is measurably improved. Auditory cohesion skills demonstrated improvement. This higher order skill ability improvement is reflective of improvement of auditory skills that are further down on the auditory skills hierarchy. Copyright © Lawrence Erlbaum Associates, Inc
  • 16. Effects of Auditory Stimulation on A.P.D. 17 The Tomatis Method of auditory rigid clinical research studies are necessary. stimulation is a controversial method of Until that occurs, clinicians and auditory skills training. This study seeks to professionals would benefit from further provide an initial attempt to demonstrate the study of this methodology and its relationship between the Tomatis Method application to auditory processing disorder and improvement of auditory processing and other behavior and/or communication skills. The results of these findings do disorders. suggest that the Tomatis Method can be an effective auditory stimulation intervention in improving auditory processing skills in some children. Certainly, further more Copyright © Lawrence Erlbaum Associates, Inc
  • 17. Effects of Auditory Stimulation on A.P.D. 18 References American Speech-Language Hearing Association (1996). Central Auditory Processing: Current Status of Research and Implications for Clinical Practice. American Journal of Audiology, 5, 41-52. Anderson, K.L. (1996). Thirteen Facts on the Impact of Hearing Loss on Education. The Hearing Review, September, 19. Bellis, T.J. (1996). Central Auditory Processing Disorders. San Diego: Singular Publishing Group, Inc. Bellis, T.J., & Ferre, J.M. (1996). Multidimensional Approach to the Differential Diagnosis of Central Auditory Processing Disorders in Children. Journal of the American Academy of Audiology. 10, 319-26. Bellis, T,J.. (2002) When The Brain Can’t Hear: Unraveling the Mystery of Auditory Copyright © Lawrence Erlbaum Associates, Inc
  • 18. Effects of Auditory Stimulation on A.P.D. 19 Processing Disorder. Pocket Books. Bishop, D.V.M. (1997. Language impairment: Listening out for subtle deficits. Nature, 129-130. Cacace, A. & McFarland, D. (1998). Central Auditory Processing Disorder in School Aged Children: A Critical Review. Journal of Speech Language Hearing Research, 41, 355-73. Chermak, G.D., & Musiek, F.E. (1997). Central Auditory Processing Disorders. San Diego: Singular Publishing Group, Inc. Chermak, G.D. (1998). Managing central auditory processing disorders: Metalinguistic and metacognitive approaches. Seminars in Hearing. 19,379-391. Cook, J., Mausback, T., Gascon, G., Slotnick, H., Patterson, G., Johnson, R,, Hankey, B., & Reynolds, B. (1993). A Preliminary Study of the Relationship Between Central Auditory Processing Disorder and Attention Deficit Disorder. Journal of Psychiatry and Neuroscience. 18:3, 130-7. Friel-Patti, S. (1999). Clinical decision-making in the assessment and intervention Of central auditory processing disorders. Language, Speech and Hearing Services in the Schools, 30, 363-370. Copyright © Lawrence Erlbaum Associates, Inc
  • 19. Effects of Auditory Stimulation on A.P.D. 20 Feakes, D.R. (1996). Chronic Ear Infections: The Silent Deterrent to Academic and Social Success. Paper presented at the Annual Childhood Education conference (18th Menomonie WI) (ERIC) Document Reproduction Service No. ED 404 004. Foli, K.J. (2002). Like Sound Through Water: A Mother’s Journey Through Auditory Processing Disorder. New York. Pocket Books Gillet, P. (1993). Auditory Processes. Novato, CA: Academic Therapy Publications Grievink, E.H., Peters, S.A.F., von Bon, W.H.J., & Schilder, A.G.M. (1993) The Effects of Early Bilateral Otitis Media with Effusion on Language Ability. A Prospective Cohort Study. Journal of Speech and Hearing Research, 36, 1004-1012. Hall, J.W. (1999). CAOD in Y2K: An Introduction to Audiologic Assessment and Management. The Hearing Journal, 52, 35-40. Hamaguchi, Patricia (1995). Its Time To Listen. Communication Skill Builders, San Antonio, Texas. Iskkowitz, M. (1999). Assessing and Managing CAPD. Advance for Speech- Copyright © Lawrence Erlbaum Associates, Inc
  • 20. Effects of Auditory Stimulation on A.P.D. 21 Language Pathologists & Audiologists. July, 6-8. Katz, J., & Wilde, L. (1994). Auditory Processing Disorder. In J. Katz (ed.) Handbook of Clinical Audiology (pp. 490-502). Baltimore: Williams & Wilkins. Keith, R. (1989), SCAN: A Screening Test For Auditory Processing Disorders. Texas: The Psychology Corporation. Keith, R. (1994). SCAN: A Test for Auditory Processing in Adolescents and Adults. Texas: The Psychology Corporation. Keith, R. (1996). Understanding Central Auditory Processing Disorders: Diagnosis and Remediation. The Hearing Journal. November p. 19-28. Leeds, J. (1999). The Sonic Alchemy. Conversations with Leading Sound Practitioners. Sausalito. InnerSong Press. Levin, M. (2002). A Mind At A Time. New York. Simon & Schuster. Lindamood, P.C. (1998) The need for phonological awareness. ASHA, 40(2), 44-45. Lindamood, C., & Lindamood, P. (1975). Revised. Auditory Discrimination in Depth Program. Texas. ProEd Publishers. Copyright © Lawrence Erlbaum Associates, Inc
  • 21. Effects of Auditory Stimulation on A.P.D. 22 McFarland, D., & Cacade, A. (1995). Modalitiy Specificity as a Criterion for Diagnosing Central Auditory Processing Disorders. American Journal of Audiology. 4, 36-47. Musiek, F. (1999). Habilitation and management of auditory processing disorders: Overview of selected procedures. Journal of The American Academy of Audiology, 10, 329-342. Musiek, R.E., & Schochat, E. (1998). Auditory training and central auditory Processing disorders. Seminars in Hearing, 19, 357-365. Musiek, F., & Chermack, G. (1995). Three Commonly Asked Questions About Central Auditory Processing Disorders: Management. American Journal of Audiology. 4, 15-8. Schow, R.L., & Chermak, G. (1999). Implications from factor analysis for central Auditory processing disorders. American Journal of Audiology, 8, 137-142. Smoski, W., Brunt, M., & Tannahill, J. (1992). Listening Characteristics of Children With Central Auditory Processing Disorders. Language, Speech, & Hearing Services in the School. 23, 145-52. Copyright © Lawrence Erlbaum Associates, Inc
  • 22. Effects of Auditory Stimulation on A.P.D. 23 Stach, B.A., & Loiselle, L.H. (1993). Central auditory processing disorder: Diagnosis and management in a young child. Seminars in Hearing, 14, 288-295. Tallal, P., Miller, S., Bloedi, G., Wang, X., Nagarajan, S., Schreiner, C., Jenkins, W., & Merzenich, M. (1996). Language Comprehension in Language Learning Impaired Children Improved with Acoustically Modified Speech. Science. 271, 81-4. Task Force on Central Auditory Processing Consensus Development. (1996). Central Auditory processing: Current status of research and implications for clinical Practice. American Journal of Audiology: A Journal of Clinical Practice, 5 (2), 41-54. Wallace, I.F., and Hooper, S.R. (1997). Otitis Media and Its Impact on Cognitive, Academic, and Behavioral Outcomes: A Review and Interpretation of the Findings. In Roberts, J.E. Wallace I.F. & Henderson F.W. (Eds.). Otitis Media in Young Children: Medical Developmental, and Educational Considerations. (pp. 163-193). Baltimore, Md. Paul Brooks Publishing. Copyright © Lawrence Erlbaum Associates, Inc
  • 23. Effects of Auditory Stimulation on A.P.D. 24 BIOGRAPHY Deborah Ross-Swain, Ed.D. is the founder, owner and director of the Swain Center, a clinic for speech, language and learning disorders and research, The Listening Center in Walnut Creek and Orange County. She is the former Chief of Speech-Language Pathology at the University of California, Davis Medical Center and held a clinical staff faculty appointment to the School of Medicine. She is the President of California Speech Pathologists and Audiologists in Private Practice (CALSPAPP) and was recently appointed to CSHA’s Task Force for developing evaluation and treatment guidelines for Auditory Processing Disorder (APD) and CSHA’s Encroachment Task Force. She is the author of six standardized test batteries: The Ross Information Processing Assessment-2; The Ross Information Processing-Geriatric; The Ross Information Processing Assessment-Primary; The Auditory Processing Abilities Test; The Bedside Evaluation and Screening Test; The Swallowing Ability and Function Test. She is the author of six manuals and books: Aphasia Rehabilitation: An Auditory and Verbal Treatment Hierarchy; Aphasia Rehabilitation: A Reading and Writing Treatment Hierarchy; The Cognitive Linguistic Improvement Program; The Voice Advantage; The Geriatric Treatment Manual; and The Geriatric Resource Manual. She is married and the mother of four children. Copyright © Lawrence Erlbaum Associates, Inc
  • 24. Effects of Auditory Stimulation on A.P.D. 25 WEBSITES Copyright © Lawrence Erlbaum Associates, Inc