The Improvement of Severe Psychomotorand Neurological Dysfunctions Treated

with the Tomatis Audio-Psycho-PhonologyMethod Measured with EEG Brain Map

and Auditory Evoked Potentials

J. VervoortM. J. A. de Voigt

W. Van den Bergh, MD

ABSTRACT. Background. Pioneering research of Tomatis led to the introduction of theAudio-Psycho-Phonology (APP), to treat, improve, or remediate severely neurologicallyimpaired individual.

Method. Here we present for the first time independent data on the APP method with audi-tive evoked potentials and electroencephalographically based brain mapping.

Results. The improvement of these 4 patients by undergoing APP treatment is shown in theirlistening curves as well as in the results of the EEG based brain maps and the auditory evokedpotentials.

Conclusion. 1. APP method seems to be an effective and harmless treatment for patients withsevere psychomotor and/or neurological dysfunctions.

2. Auditory evoked potentials and electroencephalographically based brain mapping seems tobe an appropriate examination to demonstrate neurological changes after APP therapy.

Besides the presentation of the four cases, a short overview of the method is presented.

KEYWORDS. Audio-Psycho-Phonology, auditory evoked potentials, EEG based brainmapping, neurological deficits, Tomatis

The Tomatis Audio-Psycho-Phonology (APP)listening therapy trains the individual’sneurological and physiological systems by

listening to specially processed and filteredmusic, a mother’s voice, or their own voice.This training is based on the fact that the

J. Vervoort is a retired special education teacher and the founder and leader of Atlantis-vzw Institute andMozart-Brain-Lab, Sint-Truiden, Belgium.

M. J. A. de Voigt, retired professor of physics, Tech. Univ. Eindhoven and Tomatis therapist APP ListeningCenter Gorinchem, The Netherlands, is affiliated with the Mozart-Brain-Lab and the Atlantis-vzw Institute, Sint-Truiden, Belgium.

W. Van den Bergh, Neurologist, private practice, Leuven, Belgium, is affiliated with the Mozart-Brain-Laband the Atlantis-vzw Institute, Sint-Truiden, Belgium.

Address correspondence to: M. J. A. de Voigt, Center of Listening Therapy, Kriekenmarkt 25, 4201 ANGorinchem, The Netherlands (E-mail: m.j.a.de.voigt@tue.nl).

Journal of Neurotherapy, Vol. 11(4) 2007Available online at http://jn.haworthpress.com

# 2007 by The Haworth Press. All rights reserved.doi: 10.1080/10874200802169621 37

ear is the most sensitive entrance to the cen-tral neurological system (i.e., a large part ofthe brain, the vestibule-cochlear, the vagusand recurrent nerves). The sounds, afterfiltering, are presented to the two ears bya headphone as well as to the skull by a bonevibrator. In addition to frequency filtering,the various intensities and delays betweenthose components are also adjusted. Theprocessed sounds stem mainly from Mozartconcerts and Gregorian chants. Tomatishas developed specific electronics duringthe past 50 years, which are utilized andfurther elaborated at Mozart Brain Lab(MBL) in Sint-Truiden, Belgium. ProfessorTomatis, a medical specialist in hearing,developed the method and has conductedmost of the research to date. He discoveredthe great psychological and physical influ-ence the ear has on our functioning, com-munication, learning, language, and speech(Madaule, 1994; Tomatis, 1972, 1989,1991). His research over many experimentsyielded a device called the ‘‘ElectronicEar,’’ which has been successfully appliedin therapies all over the world treating morethan 25,000 people during the last 30 years,of which about 5,000 were treated inSint-Truiden. Statistics show long-lastingimprovements in about 80% of those treatedas obtained from investigations in manyinstitutions; the results are summarized athttp://www.tomatis.com.

The replication of the method has beenaccomplished with groups of children atschools, including placebo groups (Schydlo,2002; Tomatis, 1991). Independent repli-cation is possible since the introduction,about 12 years ago, of electroencephalo-graphic- (EEG-) based brain mapping atthe Atlantis Institute in St.-Truiden, in com-bination with the Tomatis listening therapy.From the wealth of data available at Sint-Truiden we are presenting only four caseshere to illustrate the replication method.

In general, changes because of the therapyare very visible in the measured EEG-brainmaps and in the AEPs. They can be corre-lated with changes in the listening tests andwith the observed improvements in the prob-lems of the individual participants. Out ofthe many thousands of available files, we

have selected four participants, each withsevere problems. The problems of each par-ticipant were reported very difficult orimpossible to remediate by common medicalor therapeutic methods. The data and back-ground of two participants are described indetail, and two other participants aredescribed more briefly, but all achievedremarkable results. This article ends withgeneral conclusions and recommendationsfor the treatment of certain pathologicalcases.

The APP, introduced by Alfred Tomatis,is described extensively elsewhere (Madaule,1994; Tomatis, 1972, 1989, 1991) along withthe history and motivation of its develop-ment beginning in 1947 (Tomatis, 1991).Here we summarize the main ingredients ofthe method, without too much discussionof the underlying arguments. It is a well-known phenomenon that sounds do stimu-late our total neurological and physiologicalsystem, and in particular hearing organs andthe brain with the coordination between thetwo hemispheres. Also the psychologicaleffects of sound and music are well experi-enced. Tomatis studied the physiologicaldevelopment of the ear from the first stageof pregnancy forward (e.g., Tomatis, 1981).The many experiments with pregnant womenrevealed that the fetus reacts to sounds,particularly above 8000Hz. It appeared thatthe high tones are transmitted dominantlyvia the spine and the pelvis of the motherto the body of the fetus, thus via bone con-duction. This evidence, and also the hightonus of the muscles directly after birth,indicates the effectiveness of high tones instimulating the neural system and muscles.The hearing organs of the fetus are fullydeveloped after about the 4th month of preg-nancy, in contrast to the rest of the neuralsystem that takes more than 20 years to befully myelinated. The part of the cochleanear the base, sensitive for the high frequen-cies, is developed first and is also the mostsensitive part. Those observations led Toma-tis to acknowledge the central role of theear in our functioning. Further experimentswith singers revealed to Tomatis the strongcorrelation between hearing and the voice.This enabled him to remediate the voice

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(e.g., false singing of incorrect tones) using alistening therapy. Those findings and manyother experiences led Tomatis to formulatethree important statements (Tomatis, 1991):

. The voice contains only those frequenciesthe ear can perceive.

. If we give the ear the possibility to hearcorrectly, we improve instantaneously andunconsciously the vocal utterance.

. It is possible to change the phonation withan auditive stimulation during a certaintime.

From various experiments Tomatisdiscovered that high tones, particularlyabove 8000Hz, are perceived well by thefetus, and he derived the hypothesis that theycause efficient cortical stimulation (Tomatis,1981, 1991). Therefore Tomatis called the ear‘‘the battery for the brain.’’ He distinguishedthree main frequency regions and relatedfunctions, with the notion that the cochleaanalyzes all frequencies, particularly hightones, and that the vestibule perceives alsolow tones. The low region up to about1000Hz is predominantly related to equilib-rium, motor, and vegetative functions. Thosetones perceived by the vestibule resonate pre-dominantly on the body. The middle region,of about 1000 to 3000Hz, is related tospeech, language, and communication,because this frequency band is stronglyrepresented in the voice. The region of hightones above 3000Hz relates more to associ-ative and thinking processes, because thehighest frequencies resonate predominantlyin the head. He also emphasized bone con-duction with respect to the air conduction.Bone conduction dominates in the case ofhearing our own voice, thus psychologicallyit relates to the communication with our-selves. Air conduction via the ears, however,dominates in the case of hearing externalsounds, thus it relates to communicationwith those in our surroundings. Harmonybetween the two forms of conduction isimportant for a proper balance betweenour inner and the outside world.

The sounds cause both physiological andneurological stimulation. The first type of

stimulation is because of the movements ofthe ossicles and of the membranes (i.e., theeardrum and the oval and circular mem-branes, thereby training the relevant musclesof the middle ear). The neurological stimu-lation concerns among other things thehearing, equilibrium, vagus nerve, recurrentnerves, and the brain. The recurrent nervefor the left ear has a longer pathway tothe larynx than for the right ear, which,combined with the localization of the Brocamotor center of speech only in the left hemi-sphere, results in a retardation of speech byabout 0.03 sec when the feedback is domi-nated by the left ear (Tomatis, 1991). Thisfact and the dominance of the left hemi-sphere for logic, abstract thinking, language,reading, writing, and calculus stimulatedTomatis to emphasize training of the rightear. The neural stimulation by sound of allorgans and muscles of the body is largelyaccomplished by means of the vagus nerve,which branches from the eardrum and fromthe outer hearing channel via the spinal mar-row to all those peripheries in the body.

The starting point of the therapy is the lis-tening test, which consists of an audiogram,interpreted both physically and psychologi-cally by a trained APP consultant. An idealcurve is given in Figure 1, which accordingto Tomatis reaches a maximum sensitivityin the communication (speech) region of1000 to 3000Hz. This test indicates possible

FIGURE 1. The listening test with ideal curveaccording to Tomatis. Note. The blue curve repre-sents the air conduction and the red one the boneconduction. Intermediate frequencies at 750, 1500,3000, and 6000Hz are omitted for clarity.

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problems in certain frequency regions inbone and=or air conduction for the left orright ear, thus consequently the right or lefthemisphere, respectively. The latter phenom-enon is based on the notion that contralat-eral connections between the ear and thehemispheres are stronger than the ipsi-lateralones. A high bone conduction with respect tothe air conduction signifies that the partici-pant is dominantly listening to himself orherself, thus living in his or her own worldand controlling poorly the communicationwith his or her surrounding. Localizationerrors are registered if the wrong ear per-ceives the sounds. This may signify con-fusion in orientation and between emotionand rationality. The discrimination betweentones, or selectivity, is measured betweenadjacent frequencies in the listening test. Aclosed selectivity signifies screening fromthe outside as a kind of protection. The eardominance, or laterality, is measured as anindication that the participant is more or lessemotionally or rationally oriented.

Based on the results of the listening test,an individualized listening therapy plan isconstructed. This includes, in most cases,certain filtered music, the mother’s voice,and the individual’s own voice but alwaysa processing whereby a continuous, butirregular, alteration between filtered lowand high tones is provided. The basic soundmaterial is that of Mozart’s concerts, whichare known for their great harmony, highrhythm, large density of high frequencies,and universality. Therefore they providegreat cortical stimulation. To provide suf-ficient training of the body coordinationGregorian chants are used because of thelow rhythm and quietness. The therapystarts with a passive phase of unfilteredmusic, followed by highly filtered and againunfiltered music, on both the ears and skull.Particularly for young persons the mother’svoice is also recorded and used in the high-filter situation. The therapy is concluded byan active phase using the client’s own voicewith reading and singing. The therapy isexecuted uniquely in qualified centers withspecially developed electronics. Generally,the sounds for the listening therapy are pro-vided in cycles of 5 to 9 days with 2 to

4.5 hr of listening and with two interrup-tions of 1.5 hr in the latter case. At thebeginning of each cycle, a Listening test isconducted to check the changes and toadapt the program. Between the cyclesintermissions of at least 4 weeks areplanned. The total duration of the therapydepends on the participant’s problems andresponse to treatment but consists in mostcases of at least three cycles.

METHOD

The EEG-Brain Mapping

Many independent neurological investiga-tions indicated that several problems relatedto language and communication, such asdyslexia, speech, and aphasia, are correlatedwith the pathology of the left temporal hemi-sphere (Mason & Mellor, 1984; Pinkerton,Watson, & McClelland, 1989; Tallal, Miller,& Fitch, 1993; Tallal et al., 1996). Relief ofthose problems was favorably accomplishedwith auditory stimulation, particularly ofthe right ear (Merzenich et al., 1996; Tallalet al., 1996). In recent years, auditory-evokedresponse techniques have been utilized toobjectively assess integrity of the centralauditory system in children with learning dis-abilities, autism, and language and attentiondeficit disorders (Van den Bergh, 1998).

Auditory evoked potentials (AEPs) aremeasured at the Atlantis Institute with 20to 30 electrodes on the skull using the Inter-national 10–20 System of Electrode Place-ment. Auditory clicks or tones arepresented mostly into the left ear and themeasurements are registered (Van den Bergh1998). The responses are recorded as func-tions of time in the millisecond regime. Inthe time domain, the first 10msec relate tofunctions of the lower brain stem and arean objective measure of peripheral hearingin very young or uncooperative children.The middle latency (10–50msec), the longlatency (50–100msec), and the cognitiveauditory potentials (100–700msec) relate tofunctions of the higher brain stem, the tem-poral primary cortex, and to the frontalassociation cortex, respectively. Deviation

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of the middle latency potentials from normalpatterns is indicative for problems with con-sciousness and attention mechanisms and forthe sampling time of the central auditory sys-tem. Language development disorders showup as deviations in the long latency auditorypotentials, particularly in the temporal com-plexes T4 (right) and T3 (left).

With the cognitive auditory potentials, themental processing mechanisms of the audi-tory perception (attention mechanisms) areexplored. There are 150 tones presented tothe participant via headphones. There are120 tones that are frequent, ‘‘standard,’’ andlow pitched, and 30 are ‘‘rare,’’ high-pitchedtones. This test is performed under both theattention (to the rare tones) and nonattentioncondition. Most important is to measure thedifferent amplitudes (e.g., the one of N200)under those two conditions for a certain indi-vidual. Therefore relative amplitude scalesare sufficient, particularly when later themeasurements are repeated for the sameindividual with the same adjustments.

An electrical negative response appears100msec after the tones (N100) at whichtime the participant’s attention is directedto the task. The N100 intensity shouldincrease as a function of early selective atten-tion. Two hundred msec after the rare tones,an electrical negative response appears(N200), even when the participant is notattending. This is a measure of automaticdiscrimination. Three hundred msec afterthe rare tones, in the attention condition,an electrical positive response appears(P300) and is a measure for controlled mean-ingful stimulus processing.

Between 500 and 1000msec after the tonesin the attention condition, an electrical nega-tive response appears in the frontal brainareas (late frontal negativity). This is ameasure for additional controlled processingof the attending stimuli.

Those cognitive potentials are in manycases disturbed in children with cognitiveimmaturity, attention deficit disorders, andlearning disabilities.

The QEEG data are taken with the sameequipment (Sirius, ESAOTE BIOMEDICA).They are processed quantitatively, in con-trast to the classical EEG, as to reconstruct

a map of responses over the brain surface,called the brain map. The standard ‘‘onlyeyes closed condition’’ was being used.Neither database nor statistical analysiswas used because of the comparison of eachcase with itself (before and after treatment),which provides a relative indication of theprogress. Standard QEEG algorithms wereused both in the measurements and analysis.In the frequency domain one usually distin-guishes four different regions, that is, Delta(d ¼ 0–4 c=sec), Theta (h ¼ 4–7 c=sec), Alpha(a ¼ 8–12 c=sec), and Beta (b ¼ 12–30 c=sec).The brain maps can be constructed for thosefour frequency regions. For instance, inthe case of a poor alertness one observeslittle a and b activity and=or much d and hactivity. For learning and language theactivities in the left temporal hemisphereare particularly interesting.

RESULTS

We present the data from four individualparticipants, each exhibiting pathologicalfindings. We verified that no other therapiesor treatments were being provided to thesefour participants during the listening therapytreatment period. Only Participants 2 and 4had continued to receive some medicationafter treatment.

Case 1: Lena

Lena had a history of retardation ingeneral psychomotor and speech develop-ment. She had no conscious contact to theenvironment, had no orientation with otherpersons, had autistic tendencies, lived as if ina cocoon, and exhibited extensive retardationof fine and gross motor skills. The pregnancyof the mother was very troubled, with lossof amniotic fluid, bleeding, hospitalization,and medication (e.g., antibiotics). The birth,however, was normal and at the correct gesta-tional time. At an age of 3.5 months Lena wasenclosed in a spread pant, to force her to lieon her back for 4 month, thus retarding herearly development even more. During the lastmonths of pregnancy the sound transfer of

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the mother’s voice had been far from ideal,because of the diminished amniotic fluidand the enforced laying and resting of themother. The antibiotics influenced negativelythe development of the child. The voice ofthe anxious mother also changed to the lowtones, because she was afraid of losing herchild.

At Lena’s age 2, a listening therapy startedat Atlantis, obviously without listening test;thus therapy was based on the experienceof the therapist. The parents showed con-siderable dedication until Lena was 7 yearsold with a total of 31 cycles of 5 days, onthe average six cycles per year. The first cyclewas 12 days with unfiltered Mozart andGregorian music. Thereafter cycles followedat about 6-week intervals, with the mother’svoice filtered at 8000Hz, achieving a psycho-logical return to the prenatal phase. Duringthis phase, the participant hears the toneslike a fetus in the prenatal phase might haveheard, thus roughly above 8000Hz accord-ing to experiments by Tomatis, previouslydiscussed. Slow progress was noticed, firstin the vestibule domain (i.e., small move-

ments, thereafter some eye contact and evensome alterations between aggression andaffection toward the mother). A year latersome development progress had occurred:She showed better contact with the externalenvironment. At age 4, the first brain mapwas obtained (see Figure 2a). This alreadyshowed a reasonable ground rhythm in theh range (4.0–7.5Hz), but almost no activityin the a and b domains, thus little alertness.In the cognitive-auditory cortex activity, a veryweak auditory AEP N200 signal (evoked in anauditory oddball paradigm) indicated poorautomatic stimulus discrimination.

Lena listened to her mother’s voice andhad been provided with a motor tuning ofthe Electronic Ear to stimulate simul-taneously and harmonically the motor andauditory cortex, by exciting particularly thevestibule with low tones and the cochlea withhigh tones At age 5, the clinician succeededfor the first time in obtaining a listening test(see Figure 3).

The high bone conduction (red line) isvery pronounced, characteristic for childrenliving in their own world. The disorder

FIGURE 2. Brain maps of Lena during (a) and after the therapy (b). Note. The four maps represent the d, h, a,and b waves with indicated frequencies. Note that the different scales (vertical color bars), which are slightlylarger in case B than in A, indicate relative brain activity (deduced from the electrode voltages) with red highand blue low brain activity.

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shows up both at low frequencies, represent-ing the neural vegetative processes; at middlefrequencies, thus in communication and thedevelopment of speech; and at high frequen-cies, representing thinking processes. The airconduction results (blue line) follow thesame pattern but at a much lower level, indi-cating poor perception and communicationwith the outside world, thus little alertness.Such was also observed in the brain map,as indicated by almost the complete absencealpha activity all over the scalp. The manyspatial errors indicate disorientation andconfusion. The transfer of sounds by boneconduction in the skull causes the spatialerrors from left to right or vice versa andare consistent with the observed absence ofalpha activity in the brain map. Furthertreatments accelerated development, parti-cularly in motor, speech, and coordination,and in the domain of consciousness to openup and interact with the outside world.

Many listening tests and brain maps hadrecorded changes in the development. The

latest listening tests at age 7 demonstratedthe great improvement. The small gap nowobserved between bone and air conductionillustrates the large improvements. This sig-nifies more harmony between the inner andouter world. The balance between lowand high frequencies is more positive also.This enables a better coordination betweenbody and spiritual processes, thus a morestructural functioning. The air conductiontest shows further improved reproductionin the essential speech domain between1000 and 3000Hz, particularly of the leftear. The spatial errors also diminished.Indeed, her speech has developed very well.The latest brain map confirmed the improve-ments (Figure 2b): There was now alphaactivity of 8 to 9Hz, maximal at P4. Alsothe oddball AEP curves showed considerableimprovements. A normal N100 impulseamplitude is measured under the conditionof focused alertness. Normal automaticstimulus discrimination is also observed atN200 as well as normal P300 latency time

FIGURE 3. Listening tests for the right and left ear of Lena during (above) and after the therapy (below). Note.The spatial errors in the air conduction are indicated by blue stars and in the bone conduction by red crosses.

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and amplitude, which signifies normal, con-trolled meaningful stimulus processing.

The parents also contributed by theirextraordinary perseverance and disciplineduring the long-lasting therapy. Lena isnow at the threshold of a total developmentconsistent with that of other children. Apartfrom her physical development she seemsonly 1 year behind as compared to otherchildren of her age in the field of learningabilities and social attitudes as observed bythe clinician, by the family doctor and bynurses in the kindergarden.

Case 2: Johanna

Johanna had a history of expressive devel-opment aphasia and speech developmentretardation. She exhibited psychoneurologicaldysfunction, extensive retarded development,andgeneral disturbance of obsevation; showedno concentration and extensive speech prob-lems; lived in her own world; and showed nointerest in the outside world.

After an early birth (35th week) by caesar-ian section, her weight was 2.424 g, and shehad many severe problems. For instance,a magnetic resonance imaging (MRI) scanshowed agenesis of the corpus callosumand a CT scan of the skull showed atrophyin the right cerebral and left temporal lobeswith large cisterna magna. Other problemsoccurred afterward, such as cyanosis andhypothonia. From age 4 onward, severalEEGs indicated left hemispheric epilepticactivity and hypersynchrony. Different med-ications had been prescribed, such as Opso-lat (Sultiam), Sabril, and Frisum, withfluctuating results. The allover pattern hadbeen interpreted in various medical reportsas suggestive for the Landau-Klefnersyndrome, characterized by aphasia andbioelectric epileptic paroxysms.

Johanna was provided with therapy forabout 2 years, with 37 cycles in total. OnFebruary 28, 1996, when she was 5 yearsold, a first listening test was administered.It showed wild fluctuations and was ratherchaotic. In that test the gap between thehigh bone conduction and the air conduc-tion results as well as the closed selectivity,

signified that she was living in her ownworld, separated from the others. The veryweak, irregular, and low air conductionresults indicated a distorted perception inall senses, amplified by the closed selectivity.This was particularly the case at low fre-quencies, up to 1000Hz, causing a poorvestibule function. As a result her concen-tration was very weak and she exhibitedsevere speech problems.

The first EEG-brain maps conducted onJuly 29, 1996, confirmed the early MRI,CT, and EEG measurements. The large dactivity (1.5–4.0Hz) with high-power lefthemispherical with maximum at P3 and O1was consistent with an epileptically disturbedtrajectory.

The middle latency AEPs (MLAEPs),evoked by pure tones, are plotted inFigure 4. The results shown in Figure 4a,also obtained on July 29, 1996, presents theresponse after left and right stimulation.The left response was larger than that onthe right, consistent with language develop-ment disorder. Given are T4 (right temporal;solid line) and T3 (left temporal; brokenline) MLAEPs to enable extraction of theMason asymmetry index, being T4=T3–T3=T4 ¼ –0.12. Normal would be 0.5þ 0.5,whereas language development disorderwould score –0.25þ 0.5. This indicated thatJohanna’s index was closer to pathologythan normal.

Further listening therapy followed forabout 2 years with 19 extra cycles. The latestlistening test, at age 8 years 6 months, showsa remarkable improvement with rather reg-ular bone and air conduction curves closetogether, on both left and right sides. TheMLAEP amplitudes derived from the EEGdata on August 5, 1998, showed a normalpattern with a rather symmetrical responsein the right temporal side and the left one(see Figure 4b).

Notwithstanding her slow developmentand in spite of heavy medications, Johannahas experienced remarkable improvementthat has lasted for many years after therapyterminated, as measured by a test at age 12.She is in contact with her surroundings andparticipates in activities. She speaks better,has good eye contact, plans a lot, and wants

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to improve her knowledge. Also her finemotor control has improved.

Case 3: Francis

Francis was born with deficits thatresulted in a shortage of oxygen, was autistic,did not talk (analyzed at the University ofLouvain), was hyperactive and very aggres-sive, Had psycho-motor retardation, andexhibiting retardation in language develop-ment. Francis was provided with an intensivelistening therapy for 1½ years. The firstsomewhat reliable listening test was obtainedon July 12, 1995, and exhibited a large differ-ence between bone and air conduction tests

with strong and chaotic irregularities, con-sistent with the problems of Francis (seeFigure 5). Eighteen months later, on January10, 1997, the test showed large improve-ments, although the bone conduction resultswere still too high.

In Figure 6 the EEG-brain mapping dataare compared before and after the therapy.The brain map before the therapy (Figure 6)shows an asymmetry in the amplitudes ofthe MLAEPs with dominance of the lefthemisphere. With a stimulus to the left earthe MLAEP response left temporally(T-complex, broken line) was larger thanright (solid line), as can be seen typically inlanguage development disorders. Normallythis test shows a symmetric T-complex or a

FIGURE 4. Middle latency auditory evoked potentials of Johanna after the beginning (a) and after the therapy(b). Note. The strong asymmetry left-right at the beginning has disappeared after the therapy. In Figure 4a thesolid line represents the T4 (right temporal) complex and the broken line the T3 (left temporal) complex afterstimulation the left and the right ear. Note that the negative voltage, in microvolt, is plotted upward. In Figure4b the upper curve represents the T4 complex, the middle one the T3 complex and the lower one the centerposition Cz, all with respect to the same reference. The vertical scale is relative, because it concerns threecurves with each positive and negative electrical potentials, but with the same adjustment as in Figure 4a.

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reversed asymmetry (response higher righttemporally than left). This imbalance wasrestored after the therapy, with even a strong-er response on the right than the left. TheMason asymmetry index (see Case 2) beforethe therapy was –0.64, thus compatible witha language development disorder. After thetherapy this index was restored to normal.

Francis has experienced great progress inthe 1½ years of intensive listening therapy.The boy has become quieter, with more con-centration and better speech. He has becomemarkedly alert and interacts with the outsideworld. These changes have been observed bythe clinician and parents and have beendocumented by his progress in speech andcommunication with the environment, parti-cularly at school.

Case 4: Ambroise

Ambroise, a boy, showed extensive retar-dation in general development, was born 1month too early, and after 1½ monthssuffered from epileptic attacks; he had fallenon his head at age 2 and it resulted in brain

damage, particularly cerebral hemorrhage,affecting predominantly the frontal andleft-temporal hemispheres, and he exhibitedbehavior that was chaotic, as he was difficultto manage.

Because of his age of 2, no listening testscould be obtained. The first EEG-brainmapping taken at the start of the therapyshows a very slow base rhythm of 2 to 5 c=secsec in the d domain, with a maximum in theposterior region and with a certain dominanceat the left side, at F3, T3, andT5 (see Figure 7).

The oddball paradigm AEP lacks theessential N100, N200, and P300 structures,indicating serious auditory perception trou-bles. After the first cycle of 14 days, several6-day cycles about 6 weeks apart continuedfor the rest of 2003. He reacted very welland showed important improvements, parti-cularly in the movements of his legs, arms,and hands. He even started babbling. Theimprovement is also seen in the EEG takenat the end of 2003 (see Figure 7b). Thereappeared to be more harmony in the ddomain. There are no epileptic tendenciesanymore, and the drug Epitomax was being

FIGURE 5. The Listening tests of Francis at the beginning (above) and after the therapy (below).

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FIGURE 7. Brain maps of Ambroise before (a) and after the therapy (b). Note. There are different scales inthe maps a and b, being a factor of 2.8 larger in case b, indicate relative brain activity (deduced from the elec-trode voltages) with red high and blue low brain activity.

FIGURE 6. Middle latency auditory evoked potentials and brain maps of Francis before (a) and after the ther-apy (b). Note. The solid line represents the T4 complex and the broken line the T3 complex. The T complexesare measured as a sum of the P100, N100, P200, and N200 intensities, shortly indicated by P1-N1-P2-N2.Note that in the brain map the blue color represents electrical negative voltage, thus high brain activity andthe red color electrical positive voltage, thus low brain activity, as opposed to the color indications in Figures2 and 7.

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diminished. The oddball paradigm AEPsnow weakly showed the responses of N200(automatic discrimination of stimuli) andP300 (conscious perceptual discrimination).

Ambroise has experienced great progressin only 6 months of listening therapy. Itwas recommended that intensive therapycontinued for about 6 to 9 weeks.

DISCUSSION

These four participants are only a smallselection out of many thousands of clientstreated successfully. Earlier treatments aredocumented less well, because the EEG-brain mapping has been operational at theAtlantis and MBL institutes only duringthe last decennium. Numerous brain mapsand letters by parents, schools, and medicaldoctors support the remarkable improve-ments obtained over a wide spectrum ofdevelopment disorders. These data suggestthat the results reported here are not isolatedincidents but rather common in numerouscases.

It can be concluded that the listening testswere consistent with the EEG-brain-mapdata, thus independently correlating theresults of those tests. In most cases attentionand concentration problems were observedduring the listening test by the high andoften descending bone conduction results atlow frequencies with respect to the air con-duction test results. This correlated stronglywith large d activity frontal and prefrontaland with the absence or weak a activity,mostly occipital, in the corresponding brainmaps and with weak N200 and P300 ampli-tudes in the oddball paradigm AEPs, bothindicating little alertness. After the listeningtherapy those aspects were improved in thelistening tests, as well as in the brain mapsand AEPs. Generally a correlation was alsoobserved in the case of language disordersbetween the diminished sensitivity in themiddle frequency region of about 1000 to3000Hz in the listening tests and the dimin-ished activity at the temporal lobes in thebrain maps. Therefore, listening tests canbe used as reliable evidence to support theresults of the listening therapy.

The four cases reported here concern verysevere disorders and required relatively longand intensive treatments. Less severe butrather uncomfortable disabilities in com-munication, concentration, dyslexia, speech,and language have been treated successfullywith a year of listening therapy. It is essentialthat the therapy be administered by well-trained consultants in a location with theappropriate equipment because of the spe-cific adjustments that need to be made inthe special electronic apparatus and becausecontinuous observation of the reactions ofthe clients is needed.

REFERENCES

Madaule, P. (1994). When listening comes alive.Ontario, Canada: Moulin.

Mason, S. M., & Mellor, D. H. (1984). Middle latencyand late cortical evoked potentials in children withspeech and language disorders. Electroencephalo-graphy and Clinical Neurophysiology, 59, 297–309.

Merzenich, M. M., Jenkins, W. M., Johnston, P.,Schreiner, C., Miller, S. L., & Tallal, P. (1996).Temporal processing deficits of language-learningimpaired children ameliorated by training. Science,271, 77–81.

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