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The ear - the key to positive development of language in children with Down Syndrome

Tomatis therapy! - I have never heard of that. What a pity! Because Tomatis therapy should - according to author Ellen Schlag of Halle, Germany - definitely be part of a programme of early intervention for children with Down Syndrome. She has years of experience in this area, first with her daughter Melanie and since becoming a Tomatis therapist, with many children with Down Syndrome, in her own and in other practices.
Who was Alfred Tomatis?
Alfred Tomatis was born in Nice in the South of France in 1920, weighing 1300g after a pregnancy of 6.5 months. The birth was a big surprise to all, since his mother, a young Italian girl just 16 years old, had hid the pregnancy under her corset right up to the birth. He had no real relationship to her and one never developed. He did have contact with his father, who was an opera singer, but he credits his paternal grandmother, who had brought 24 children into the world, for saving his life. She raised him and cared for him during innumerable illnesses. Alfred Tomatis was not an easy child. He cried a lot, had a weak constitution, was not a particularly good student and hardly had any contact to other children.
At the age of 11, he went alone to Paris to study at the Pasteur Lyceum. He moved near his father, but lived by himself. In order to earn money to support himself, he worked and studied day and night. He learned by speaking aloud whilst walking around his room with Mozart and Gregorian chant in the background. After completing secondary school, he studied maths, physics and chemistry at the Sorbonne. When he was 20, he completed his exams and achieved the highest marks. During the war, after having studied medicine for one year, he was deployed in a field hospital. In that time, he taught himself the knowledge required for the second and third year of medical school and successfully completed his medical exam. He was only 24 when he completed his specialisation as an ear, nose and throat doctor. He then made numerous tests, experiments and studies. He tested the hearing of factory workers and pilots in a airplane turbine factory. Through his father, he became experienced in treating opera singers. He conducted all kinds of experiments regarding hearing inside the womb. He summarized all his knowledge together, creating Audio-Psycho-Phonology.
During his whole life, Alfred Tomatis searched for explanations. The unwanted pregnancy and its premature end were catalysts for his constant search and research of intrauterine listening and its consequences in later life.
Founder of Audio-Psycho-Phonology (APP)
For many years, the French ear, nose and throat specialist Dr Alfred Tomatis researched the relationship between listening, the body, the mind and the voice. A new scientific discipline, Audio Psycho Phonology (APP) is based on his findings.
The three laws of Tomatis
  • "One speaks as one listens", or in other words: the voice only contains the frequencies of overtones which the ear perceives.
  • If the ear is given the opportunity to again hear frequencies correctly, which cannot be heard or cannot be heard well, then these are again heard in the voice immediately and unconsciously.
  • Repeated acoustic stimulation over a certain period of time leads to a permanent change in hearing and thus phonation.
In 1957, Raoul Husson repeated this experiment at the Sorbonne University in Paris and confirmed it, calling it the TOMATIS EFFECT.
The importance of the ear
The ear is the first sensory organ of the unborn child to fully mature, being functional in the uterus already after 4 1/2 months into the pregnancy. Therefore, the ear is the key to the physical, mental, social and communication development of the child.
In the ear, the sense of hearing is united with the sense of balance. The sense of hearing is responsible for language, vocal expression and communication. The sense of balance influences posture.
The listening training developed by Prof. A. Tomatis has a positive effect on the body, the psyche and overall communication. It promotes motor skills, language and social competence, mental skills, even temper, promotes active behaviour and harmonises all bodily functions.
Listening inside the uterus
According to Jozef Vervoort - the director of a large therapy centre in Sint-Truiden, Belgium, a child with Down Syndrome is born with only 50% of the connections between the nerve cells of the left and right hemispheres of the brain compared to a child without this genetic defect.
The ability to learn is based on brain development, in which neurons connect with each other more and more, enabling new mental pathways to be created. In unborn babies, the basis of their later consciousness and its abilities is developed at this time. In Tomatis therapy, new connections between the nerve cells are consciously created. The child is subject to a wash of pre-natal sounds, where primarily the high frequencies of the mother's voice are heard.
Our path to Tomatis therapy
At a roundtable for integration, I met a father who travelled around the world to find help for his son. The boy had a motorcycle accident and was disabled due to the resulting brain injury. He spoke of Belgium and said that "there are children such as yours". I asked him to bring me a flyer from his next trip there, and this is how I became acquainted with Tomatis therapy. During my first phone call with a woman from the Atlantis centre, I learned that the therapy is especially successful with children with Down Syndrome. I wanted to try it out!
My experience with Melanie
When Melanie was 5 1/2 years old, we visited the Atlantis centre in Belgium in January for the first time. Already after the first day of therapy, she could walk up the stairs alternating her feet, which she could not do before. She was still a bit shaky on her feet, but an inner switch had gone on! During the breaks between listening sessions, she showed an unusual amount of physical and language activity. After the first block of listening, when we returned home, she could ride a bicycle with training wheels. And how she was beaming - after three years of practice! Since then, her expression brightened and she was more interested in her surroundings. She asked questions about her environment, for example what the parts of the bicycle are called and what they are used for. Her body perception changed for the better, so that she now usually realizes when she needs to go to the toilet.
In May, we went to a second block of listening in Belgium. She again started looking for new challenges to her sense of balance. She wanted to swing, rock back and forth and climb. Her fine motor skills improved. She finally started painting and doing puzzles with 20 and 49 pieces. She slept more deeply.
In July, we travelled to Belgium for the third listening block. Melanie's behaviour already changed during the therapy block. She became a self-confident little person - stubborn and fresh. She perceived her surroundings better and was constantly looking for new challenges and people to test her strength. She no longer needed a nap in the afternoon and had longer active periods during the day. Since then, she likes to talk a lot. She developed faster than before in all areas. We went on our first bicycle tour together on holiday in Holland. In everything she does, she shows how strong her determination is.
In October, we started our fourth listening block. We saw great progress, especially in communication. Not only did she talk to other children, she also asked about words and their meanings, repeated stories almost verbatim and invented her own. Her right-handedness developed.
Over a period of 2 years, Melanie had a total of 8 therapy blocks at the Atlantis centre in Belgium.
In the first grade of an integrated primary school, Melanie learned all the printed letters of the alphabet along with the other children in her class. In the second grade, she learned all the letters in script. Since then, she constantly improves her reading, writing and her language skills. She is currently in the seventh grade in an integrated comprehensive school and is working on the "Fliegende Klassenzimmer" by Erich Kästner in her German class. Reading and writing have become her biggest hobbies. She reads thick books which interest her in no time and also understands their content. This is how she has a acquired a wonderful vocabulary and very good spelling.
When I think back that Melanie hardly spoke when she was 4 years old, I can now see that Melanie's language skills, the most important means of communication in all human relationships, has developed very well. She is a well-balanced, happy and self-confident girl.
Since I was so pleased with Melanie's development as well as the positive reports of other parents of our organisation "Down-Kind Halle (Saale) e.V.", who also ran around to various therapists, I decided to train as a therapist in Belgium.
Experience from my practice
  • The new networking of the nerve cells bring additional developmental possibilities for children with Down Syndrome.
  • After doing Tomatis therapy, children with Down Syndrome react better to conventional therapies such as physiotherapy, speech therapy and occupational therapy.
  • In order to support language acquisition, I work with visual aids during the active language phase, since this is a special strength of children with Down Syndrome.
  • Tomatis therapy is recommended at any age, but especially before entering school. Between the ages of 3 and 6, great success can be achieved. Starting at an integrated school will be easier for all those involved.
Listening test
Before beginning listening therapy, a listening test with an audiometer, gauged according to the Tomatis hearing level, is given for diagnostic purposes. The thresholds of hearing via air and bone conduction are noted, and the direction of sound and the ability to differentiate tones are also checked. On the basis of this test, a full assessment is presented at a meeting with the parents of the child. Further listening tests are performed at regular intervals to monitor progress, and along the way the listening programme is adjusted.
Tomatis therapy
After this process, Tomatis therapy begins. This is essentially listening training, where the child is offered technically altered music by W.A. Mozart, Gregorian chant or the voice of the mother, either in the "Mozart Brain Activator" or the "Electronic Ear". This is done over a special headset, which enables transferring the sound to the air ducts and bones. In this way, listening is trained. This is the equivalent of "wanting to hear", or listening attentively.
Phases of Tomatis therapy
The phases of auditory development are reviewed in order to enable disruption-free integration of the senses of hearing and balance.
  • Phase 1= Acclimation and acoustic regression to pre-natal hearing
  • Phase 2= Listening as in the uterus. Influence of original communication patterns. Awakening the desire for communication.
  • Phase 3= Birthing on a sonic level. Transferring the auditory perception through the placenta to air conduction.
  • Phase 4= The active language phase. Speaking, singing or reading into a microphone.
Listening training plan
Therapy is given in several blocks. The first block is 15 days, and listening takes place 2 hours each day. The child wears earphones and can play, build, paint or look at books. The accompanying mother listens to the same pieces of music as the child in phase 1. In phase 2, the child hears the high frequencies of the voice of the mother as if in utero. The mother follows an accompanying programme in accordance with her needs.
After a 4-6 week break, the second listening block of 8 days follows, and the programme is continued. Each of the following listening blocks are 8 days long, but the breaks between them are then longer and longer. The duration of the therapy can vary, but you should plan for a year, since changes do not happen overnight.
Atlantis centre
The Atlantis institute in Sint-Truiden (Belgium) is the largest centre worldwide today and is visited by people from many nations. Treatment takes place on 363 days a year - it is only closed Christmas Eve and New Year's Eve.
The name "Atlantis" is also the programme. In the centre, hidden treasures of guests of all ages are brought to light. The youngest listener was a 2 month old baby, the oldest a 95 year old senior.
The story of Atlantis began in 1983 in Jozef Vervoort's house with two children. In the meantime, 16000 children and 8000 adults have gone through the treatment. The centre has 42 full-time employees and 310 beds in several houses (as of January 2009). Atlantis, a not-for-profit organisation, offers its guests every kind of accommodation, from a single room to an apartment for six and diverse meals in its cafeteria. Therapy spots during school holidays are especially sought after, so reserving in advance is recommended.
Listening training in Belgium is very intensive. Nine listening units at 30 minutes a piece are done during the day, divided into three groups. The first therapy block there is twelve days, and all following blocks are usually 5 days long. Additional information can be found at