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Tomatis, Autism and Sensory Integration

.......Tomatis Topics

B irth of Listening: The desire to communicate is born in utero, by listening to the mother's voice. And Tomatis claims that this child-mother relationship is so important that in order to re-attain it, the ear will make a thousand efforts at adaptation after the baby is born.

During the fetal period the ear is immersed in liquid, the amniotic fluid. Transmission of sound is done through layers of fluid and as we have already said through bone conduction. When the baby is born, he makes the transition to listening in a new acoustic environment, and this cannot be done immediately. At birth the ear partly empties itself of liquid, but the middle ear still holds much of that fluid for several days acting as a buffer for the newborn. Tomatis felt that this made the rupture and separation less brutal. Once this fluid finally disappears it takes weeks and months for the baby to adapt its ear to the impedance of air. Tomatis felt that the Mother-Child relationship (before and after the child is born) was essential to opening the desire to communicate and for the future development of language.

According to whether the first relationship has been accepted or rejected, the ear will know whether to open or to close itself to communication. 'Sound reaches an individual, the next thing is to know whether he desires to hear it or not, whether he wants to take it in or rather to reject it, whether he wishes to prepare his body to receive it, to prepare his facial attitude so as to listen to it or in fact to deny communication."

Functions of the Middle Ear

This is where the middle ear muscles play an important role; In Tomatis' theory the middle ear does not passively transport sound, but rather actively attends and regulates sound for processing

  • Attenuates to the high frequencies,
  • Dampens competing lower frequencies,
  • Helps the person to hear the speech frequencies of an outside communicator,
  • Help the listener to tune into the high frequencies of their own voice in order to bring it under their own control and awareness.)


    Cranial Nerves of the Middle Ear

    The innervation of the face is accomplished in the ear at the location of the meatus by two nerve branches; 1) posterior part, which is directed toward the auricle and which is constituted by the Facial (VII), cranial nerves, which innervates all the muscles of the face (except elevation of the eyelids) (all the muscles of facial expression), 2) the anterior part, is controlled by the Trigeminal (V) cranial nerves, which innervates the musculature of the jaw (in the movement of opening and closing the mouth.

    In the auditory passage the same division is found: the posterior part falls under the control of the facial (VII) cranial nerves (innervates the Stapedius), and the anterior part is controlled by the Trigeminal (V) cranial nerve (innervates the Tensor Tympani).

    Another nerve intervenes here, which Tomatis considered very important; The Vagus or Pneumogastric X cranial nerve provides a Sensory branch to the tympanic membrane Motor control of the pharynx and larynx. Everything that affects the tympanum - especially the word - will interfere throughout the whole parasympathetic system. (Sticks and stones will break my bones but words will never hurt me.)

    • V agus X (Pneumogastric) Nerve: The Vagus (pneumogastric) X cranial nerve governs the. Tomatis notes that often a person first starting the program who as he puts it "does not wish to enter into language" will "somatosize" at the throat level by developing a sore throat or Strep throat. Tomatis has come to know this as a normal reaction. The Vagus controls the larynx in both motor and sensory functions. "This is why it can "cut off" or "give us" our speech"

    Think of Audio-Vocal Control. This is the recurrent branch that is longer on the Left side. The right passes under the sub-clavian and intersects the larynx in its lower part, whereas the left, in order to have the same effect, intersects the larynx by passing under the Aorta - taking a rout forty or fifty centimeters longer than the right circuit. This increase causes a delay, because the input in a nerve goes slowly, (not like the speed o current in an electric wire), an average of twenty meters per second, fifty at the most for certain nerves. The Vagus (pneumogastric) cranial nerve also has communicating branches with the glossopharyngeal IX nerve via the auricular branch of the vagus nerves meaning sensory input from the tympanic membrane affects the motor control of the voice The Vagus (pneumogastric) cranial nerve also has communicating branches with the spinal accessory nerves XI (via the recurrent laryngeal nerve branch) and affects the lateral neck muscles and gives the hang dogged look thus affecting vertical posture.

    Vagus X (Pneumogastric) Nerve 2:

    The Vagus (pneumogastric) cranial nerve also innervates the heart at the level of the coronaries arteries and controls their blood flow. (Palpitations, angina, etc.) On the pulmonary level, it innervates the bronchia and will produce asthma.

    The Vagus (pneumogastric) cranial nerve then goes on to have impact through out the body. Though there is some debate on this it seems that the Left and Right branches of the Vagus nerve flow into each other at the level of the solar plexus and go on to innervate the spleen, pancreas, two kidneys, the small and large intestines, the rectum and the genital organs. The Vagus (pneumogastric) cranial nerve innervates the whole interior being and plays a prominent role.

    "To worry is to play havoc with one's pneumogastric."

    In other words, to become master of sound at the level of the tympanum tension is to become master of this nerve, known as "the Vague" because of the "vague yearning" which it can so easily arouse. (Anxiety) If the tympanum is not taut, (too much movement), it will cause the whole pneumogastric path to resound (vagal feedback) and therefore causes pressure at the level of the larynx, or palpitations, or digestive troubles and so on.

    Through the Electronic Ear we are able to stimulate the middle ear complex in such a way that we restore muscle tonus to the middle ear muscles and thus restore the appropriate tension in the tympanic membrane. When the tympanic membrane vibrates at the minimum and thus avoids the vagal repercussions. Then also the tympanic membrane then becomes a real device for transmitting sounds.

    Y omatis' Theory of Hearing: We come back to Tomatis' theory of the transmission of sound. The tympanic membrane inserts into a large groove, which is called "the tympanic sulcus" and, which allows the tympanic membrane to cling strongly to the bone-wall with the help of extremely strong fibers. Major route of sound transmission from the ear drum to the inner ear is through the peripheral bone that surrounds the middle and inner ear.

    The tympanic membrane needs to be sufficiently tensed so that the bone peripheral to the sulcus becomes the transmitter of sound to the osseous labyrinths (the ears skeleton) It is not the fluid of the endolymph, which vibrates the basilar membrane and the cells of corti, but rather the endolymph vibration, results from the resonating membrane Middle ear acts to regulate the pressure of the liquid in the inner ear, after the sound had already been perceived. The middle ear muscle play a role of pressure regulator and as adapter of impedance, (changing the tension at the tympanic membrane) Intervenes only at the end of the path to give the final key thrust, which determines the conscious perception of sound. Work like a telescopic lens to accommodate and fine-tune the perception of low, medium and high frequency sounds

    It is then that the stirrup and the whole ossicular chain of the middle ear comes in the picture in order to ensure or to block the functioning of the inner ear via the tension of the tympanic membrane.

    Steve Porges - The Polyvagal Theory

    Dr. Steve Porges proposes a similar concept in his Polyvagal Theory where he explores the relationship between the autonomic nervous system and the social engagement process. In his theory he describes three stages of the evolution of the ANS. The newest vagus system is unique to mammals and serves to dampen sympathetic reactions to stress and promote self-regulation and attention.

    In his article with Georgia DeGangi, he describes the neuroanatomical connections between the muscles of the middle ear, jaw, facial expression and the muscle responsible for vocalization and head turning. (CN's VII, V, IX, XI) Porges contends that these systems evolved together for the purposes of promoting social behaviors and communication. During times of stress we revert to the more primitive system to reserve our resources for fight or flight, and our middle ear muscles take an attitude of listening for danger in the environment rather than being open to communication.

    The Birth of Listening: The Mother-Child Relationship

    The desire to communicate is born in utero, by listening to the mother's voice. And Tomatis claims that this child-mother relationship is so important that in order to re-attain it, the ear will make a thousand efforts at adaptation after the baby is born. During the fetal period the ear is immersed in liquid, the amniotic fluid. Transmission of sound is done through layers of fluid and as we have already said through bone conduction. When the baby is born, he makes the transition to listening in a new acoustic environment, and this cannot be done immediately.

    At birth the ear partly empties itself of liquid, but the middle ear still holds much of that fluid for several days acting as a buffer for the newborn. Tomatis felt that this made the rupture and separation less brutal. Once this fluid finally disappears it takes weeks and months for the baby to adapt its ear to the impedance of air.

    Tomatis felt that the Mother-Child relationship (before and after the child is born) was essential to opening the desire to communicate and for the future development of language. According to whether the first relationship has been accepted or rejected, the ear will know whether to open or to close itself to communication. 'Sound reaches an individual, the next thing is to know whether he desires to hear it or not, whether he wants to take it in or rather to reject it, whether he wishes to prepare his body to receive it, to prepare his facial attitude so as to listen to it or in fact to deny communication."