As Alexander Teachers you may be seeing students with auditory dysfunction. Learning to recognize its signs can help you understand the root causes of some of the misuse patterns you see and to know when to suggest that your student go for auditory testing.
Very often, these students love to come to their Alexander Technique lessons, enjoy table work, especially the lengthening of the muscles, and love to be moved in and out of the chair--but they never learn their directions. They have trouble learning “forward and up” in their own structure no matter how long they study the Technique because the ear needs to be treated first.
When we engage in re-educating the body, we are working with the inner ear, even though we may not realize it. The way in which we process sound through the ear, both external sound from outside sources and the internal sound of our own voice, establishes the essential foundation for our manner of use. The ear operates closely with the reflexes to facilitate balance and posture and movement. If the ear does not process sound correctly, dysfunction in movement coordination will result.
Dr. Alfred Tomatis (1920-2001), a French Ear, Nose and Throat physician who pioneered psychoacoustics, was the first to define the organ of hearing and to hypothesize a direct relationship between how we take in and process sound and how we organize our structure. Dr. Tomatis claimed that if the ear is not functioning correctly then there is no possibility of being structurally aligned. In defining the ear, it was clear that he saw both parts of the labyrinth of the inner ear, the cochlea and vestibule, as related and both designed to process movement.
The labyrinth is embedded in the temporal bone, the hardest bone in the body. It consists of the cochlea and the vestibule, two tiny fluid-filled chambers inside the inner ear and connected to the vestibular nerve that goes directly to the brain. The cochlea spirals like a snail shell and contains tiny hairs that transfer the vibrations of sound into electrical impulses and send them to the brain.
The vestibule is made up of two cavities, called the sacculus and the utriculus, and three tubes, the semicircular canals, oriented in each of the cardinal planes, which allow us to perceive the three dimensions of space and our relationship to gravity. (Inside the canals are little stones called otoliths and little hairs called cilia. The stones fall toward gravity and stimulate the cilia. This stimulation of the cilia by the otoliths tells us where our head is in relationship to the earth. )This information coming from the inner ear helps establish basic postural tone throughout the body and plays an essential role in balance..
The cochlea perceives sounds, which Tomatis called movement that can’t be seen and the vestibular system registers gross movements or movement that can be seen. These entities are often viewed as separate and as having unrelated functions, but Dr Tomatis did not agree with this viewpoint. “For him [Dr. Tomatis] the cochlea and the vestibular system have the same role. They both help us to perceive movements. The vestibular system is in charge of the slower movements – those that we see, feel and call movements. The cochlea specializes in faster oscillatory movements – those that we don’t see and can hardly feel, but those we hear.”
Tomatis used the term “cochlear-vestibular system” for the inner ear and referred to the cochlea as the “auditory ear” and the vestibular system as the “ear of the body.” He made it clear that the cochlea and the vestibular system together analyze movement and are therefore essential for the development of posture, motor coordination, and balance. “The first of all the senses to develop is the sense of balance. It is vital for posture, movement, and a sense of “center” in space, time, motion, depth and self. All other sensation passes through the balance mechanism (vestibular system) at brainstem level before it is passed on to its specialized higher in the brain...” The vestibular system operates closely with the reflexes to facilitate balance and posture.
Directional awareness is a vestibular based skill. The vestibular system acts like an internal compass to give us a sense of “center” from which we can automatically judge up from down, left from right, start from finish. When the ear is not processing information accurately, false sensory awareness occurs, interfering with the postural reflexes at the midbrain level and leading to postural disturbance. The failure of the ear to function the way it was designed can lead to exhaustion, periodic dizziness that increases with age and poor posture.
Dysfunction may begin with birthing trauma or situations where the early primitive reflexes do not function or do not integrate at the right time. When a child is born, the different regions of the brain are functional but not fully linked. It is through movement, first through spontaneous and reflexive movements and later through developing voluntary control over an increasing range of movements and postural control that the different systems are calibrated. Movement feeds information to the brain, helping to develop a sense of our body map, of spatial awareness and body schema in relationship to the self and to environment.
Each infant reflex should integrate at a specific time so that by the age of three, the primitive reflexes have been replaced by the postural reflexes. The postural reflexes are the Righting Reflexes (Quadruped) and Equilibrium Reactions (Bipedal) and both are essential for posture, movement and stability.
According to L.S.Vygotsky and other important child psychologists and educators, the infant reflexes do not entirely disappear but become part of the “higher nervous formations.” Movement development is therefore the foundation for not only cognitive development but also emotional development. The emergence of the postural reflexes shows that the higher functions of the brain, cerebral cortex, have developed and are functioning. “...Each dynamic and postural reflex, movement scheme, and movement co-ordination system appears at its specific time. This time is the space in which the basic motion is investigated, absorbed, worked out and connected to the whole body movement system. The learned schemes form the basis for the evolution of other motion models. The emergence of every new scheme stimulates the other movement models...”
If the primitive reflexes remain in their original form, they may prevent the development of the succeeding postural reflexes. In infants’ birth trauma, cesarean
sections, or if the mother was ill or in trauma during pregnancy, the reflexes can fail to develop normally. In addition, even in healthy children and adults, primitive reflexes that have become integrated can return at anytime during sickness, physical and/or emotional trauma, for example car accidents, physical or sexual abuse, war situations or any kind of long-time stress.
There are several auditory problems often not recognized in the traditional medical model that are now being studied by occupational therapists. The first auditory dysfunction is taking in too much sound, especially if a person is taking in more sound through bone and tissues than through the ear. This is referred to as high bone conduction. High bone conduction causes anxiety, because sound is not filtered through the ear, but rather inundates and over loads the system. A person who is overwhelmed by sound is referred to as stimulus bound.
The second problem is damping of certain frequencies. This is not actual hearing loss because frequencies are still perceived and can be restored, but are not as vivid as they once were. One example is the dentist’s drill. If you are a dentist, after awhile the frequency of the sound of the drill is dampened, which may be helpful at work, but damping frequencies interrupts other communications. Another example occurs in families with one family member who is a compulsive talker; often other family members will dampen the frequencies of that voice. Again, this unconscious phenomenon protects but also interrupts a wide range of other communications. (Each frequency is important to the health of different parts of the body through the vestibular system. Receiving all the frequencies is important to our mental and physical health. For example high frequencies energize the brain while low frequencies support the physical body. Dr. Tomatis was able to identify a frequency for each part of the body.)
A third problem is right ear/ left ear dominance. The right ear listens for close communications, while the left ear picks up sounds of the environment and has a longer, wider reception range. People who have switched ear dominance are inundated with background noise and have a hard time in public following and listening to close communications, as in a loud restaurant. Often in educational settings someone who has switched ear dominance can hear everything but the teacher. This condition also causes an auditory processing delay that makes processing verbal information slower than for those who have right ear dominance. It creates a disadvantage in learning and work situations. Many times people are labeled, “not as intelligent as” their counterparts because they don’t process information as fast. This is not a mental problem but rather a physical problem.
A fourth problem is auditory discrimination. Many people can hear sound but can’t discriminate specific sounds like “ch” and “sh,” “th,” and “f,” “p,” and “b.” When the muscles of the inner ear aren’t working in sync with the ear drum it causes problems in sound discrimination. Again, this is not an intelligence problem, but a processing problem. There is a difference between taking in sound and hearing--ask anyone who wears a hearing aid.
In young children, problems with the ear often are not detected until children go to school, when the problems surface as part of learning difficulties, as well as the inability to stay still or lethargy, hypertonic or atonic muscles, odd movement patterns, over-reactions to light or sound, regular ear infections, unfounded fears and separation anxiety. If the ear is not treated during childhood, individuals with vestibular problems develop an elaborate set of coping mechanisms by the time they are adults, a hidden attempt to look as if they are functioning “normally.” If these individuals don’t find a way to cope, they are often destined to low level jobs, regardless of how intelligent they are, and a lifetime of unemployment and health problems that make it difficult to function in the world.
Among adults, there are two extremes of auditory dysfunction: one type of individual will be lethargic and unresponsive. The first clue that a student is suffering from this kind of auditory dysfunction is a complaint of exhaustion. Typically the individual will have seen numerous medical people, nutritional counselors, body workers, therapists, and tried alternative therapies, but nothing has really worked. The individual typically looks drawn and tired and spends much time resting, managing energy in order to live life. Couch potatoes fit this profile.
The opposite extreme is the over-responsive and hyperactive individual. Individuals with this kind of hearing dysfunction move constantly, energize themselves by self-stimulating through compulsive exercising, talking, working etc. When they sit down they usually fall asleep. They are often found in professions where they can be constantly moving and often are chronically over-stimulated. When they are not working, they are exhausted.
Other signs of auditory dysfunction are: intelligent people who have trouble with spelling, writing composition, syntax and punctuation, math concepts (you need rhythm to perform math well), keeping a beat, learning to speak a foreign language, visual problems, immature handwriting, problems with directional awareness, trouble with personal boundaries, poor posture (too held or no support), over reactivity to sound and light.
When children and adults pull their heads back and down just before speaking, I believe this to be a reflex to protect themselves from the sound of their own voice. When a person who is sound sensitive (inundated with sound) is frozen in what looks to me like a startle reflex, jaw tightened and head rotated back and down, I believe that individual to be sound sensitive and that the early developmental reflexes are not properly integrated.
Alexander Technique lessons are not sufficient to deal with movement and postural disturbances caused by auditory problems. These individuals will need specifically designed therapy. There are now several different methods used to correct auditory dysfunction. Many of them are listed and compared in Joshua Leeds’ book The Power of Sound. The best known treatment is the Tomatis Method, developed by Dr. Tomatis, referred to earlier in this paper. Treatment for auditory dysfunction can bring about some surprising changes, for example, more upright posture, improvement in coordination, more consistent energy level, increased eye contact, deeper and more regular breathing, fewer headaches, improved vision, improved mood and social interaction and increased self-confidence.
As movement specialists our role is to re-educate the body; in so doing we are working with the whole hearing organ. When the head is balanced on the atlas and axis properly, we give new input to the cochlear/vestibular system, which operates closely with all the reflexes to facilitate balance and posture. When primitive developmental reflexes do not integrate properly they interfere with the postural reflexes; this causes false sensory awareness and we lose our balance, energy and audio/visual perception. The structure fails. When we are unable to process sound properly we accommodate by misusing the structure to protect ourselves from sound. One of the ways that we accommodate is by pulling the head back and down in an effort to dampen the sound of our own voice and environmental sounds. When we take in sound with our whole body, including the skin and bones, and when we shorten and tighten to protect ourselves from sound, we are not allowing the organ of hearing to function fully. This feeds into faulty sensory awareness, which includes sight, sound and movement. The hands-on movement that we provide as Alexander Teachers works directly with the vestibular system. When the vestibular system is not functioning properly, the muscles of the body respond with inappropriate tone, either too little or too much, causing poor posture and other problems discussed above.
I hope this paper will help you recognize the signs of auditory dysfunction, so that if you see signs of auditory dysfunction in students, you can encourage those students to seek appropriate testing and therapy.
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