Spectrum Center Method® New:petition to FDA March 2008

Signs of Autism (click here)

Alfred A. Tomatis

M

y child is not autistic, he has autism...

by Valerie Dejean

Autism is a developmental disorder. This means it is not a disease like chicken pox. Nor is a condition like retardation. It is more akin to a learning disorder. This is why it is accurate to say that "my child is not autistic, he has autism." The word "Autistic" implies some sort of condition that you are stuck with, like brain damage or a missing kidney. Having a developmental disorder  implies that something is missing or blocking the child from climbing the next rung of the developmental ladder. This perspective is more hopeful to be sure, but is it true that autism is a developmental disorder?

Let us say, for the time being, that a  developmental model is a very useful way to understand the disorder of autism. Useful in that it points not only to a diagnosis, but a plan, perhaps even a recovery.

B ut you have heard doctors on the television, doctors of the Blood and Bones variety, say that there is no cure for autism. Our developmental model is philosophically very different from a medical Blood and Bones model, not to say that any model, including ours, has a monopoly on the ultimate truth. Real clinical therapists are what in the world of business would be called Applications Engineers. Applications engineers look for a model that works.  They try to fix your lawnmower, or your child right now, leaving it to the philosophers and researchers to quantify, qualify and otherwise argue about the ultimate truth, hypothesis or paradigm. That being said, I assert that the developmental model is consistent with what we observe, can be tested in the clinic or by some kind of longitudinal study (which would study a human's development over a considerable period of time), and, in fact, adds new insights into that ultimate longitudinal study, the theory of evolution. But let us get back to the child with autism.

A typically developing child does not just start speaking in sentences between his second and third birthday.  There have been many steps along the way.   His brain has made hundreds of thousands of connections between his sensory perceptions and his behaviors and actions upon the environment.  Even if blessed with a normal nervous system this child must still begin with step one and cannot skip any steps between step one and step one hundred.

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 e must "coo" and "aw" at the world as he lays on his back.  As he grows and becomes strong enough to sit up and hold his head steady and eat food off of a spoon, he can then smack his lips together to vocalize  "ba ba", "da da" and "ma ma".  He must learn to copy your gesture of raising his arms in the air to indicate up.  He must point with his finger to gain your attention to either get or identify something in the environment.  All these are pieces of the cognitive foundations for learning to talk.  If these foundations of vocalizing, imitation,  joint attention and praxis are weak then the higher- level skills of communication will be compromised.

The Problem:
For example the capacity to imitate is a basic cognitive foundation for speech.  We do not actually teach our children to imitate; it emerges as predictably as sitting and walking in a typically developing child.  It is almost universally deficient in children with autism. The child with autism does not imitate. The same is true for pointing. No one teaches a typically developing child how to point; rather, he has the wherewithal (cognition) to understand that if he can get you to look at what he is interested in you might tell him what it is or, even better, get it for him. The child with autism can not do this

A ssumptions UNDERLYING TREATMENT: The nervous system is self-correcting or has a natural ability to heal itself. We assume that the childs behavior is purposeful as an effort to self correct. In treatment we try and figure out what the child is trying to accomplish and help him appease his system in a more adaptive manner. In treatment we watch what the child is driven by and guided by this we try to meet the childs need. We assume the child holds the answer if we listen correctly. We don't try to extinguish a behavior, rather we respond to the need and then lead the child to a more adaptive behavior. Engagement of the child is essential.

The Solution: Vestibular-Auditory Re-Integration
These innate understandings of the environment do not emerge naturally in the child with Autism. So what do we do about it?  Using a  developmental model we attempt to elicit the capacity to imitate rather than teach imitation. We elicit pointing rather than teach it.  We do this by improving the children's body image and capacity to self-organize their movements toward their chosen outcome.  We do this by improving their balance.  We do this by improving their sense of self and sense of other.  This neurological capacity is called praxis and it is the foundation for all imitative and later original action.  If we can elicit this capacity then a child can go on to naturally learn from their environment through their day-to-day actions.  This is a radically different approach than trying to teach the technique of imitation and pointing by moving a child's hand through the gesture.  We call our method Vestibular-Auditory Re-Integration.

This article is about the 2000 autistic children we have seen at the Spectrum Center in the last 17 years. We identify their problems and show how we assessed them to be autistic using a developmental model based on Sensory Integration. The developmental model is based on the finding that a child progresses through predictably defined phase or steps. So that, for example, he will progress from the 2 yr 0 month stage to the 2 yr 1 month stage with certain predictable traits emerging.

If the child regresses which is almost always the case in autism, then he will go from 2 yr 1 month to 2 yr 0 months in his development. He will backslide, and lose the ability to do things that he has done before.

We have had about 80 percent success in improving if not curing these 2000 autistic children. To understand this method you must shift your thinking, and your paradigm away from the conventional medicine.

Our neighbors at the NIH in Bethesda, Maryland, approach autism from a blood and bones perspective and believe as a matter of faith that any cure for autism, or anything (!) will come from a hard medication based treatment. They can not and will not, as a rule, see an alternate point of view because they are looking at the world thru a different pair of glasses. They will ignore whatever other evidence is presented because it can not fit into their schema, their paradigm, their mission, their funding.

In this article I will tip-toe on the edges of philosophy when I tell you about our developmental model. Then I will show you how this model points to  a definite area for  intervention which has, in fact,  produced good results for about two thousand autistic children at the Spectrum Centers in the last sixteen years.

What's HOT in Autism: The history of fashion in Medicine.
Long gone are the days when autism was viewed from solely a psychological perspective: Those were the days when autism was likened to retardation.. 
The pendulum has swung the other way. Now they are looking for the cause of autism in biology. That is where the funding is, so naturally that is where most of the research is being done.  This has resulted in many Blood and Bones type interventions.  Blood and Bones type Medical models are very concrete.  For example, one well funded line of research is called the Leaky Gut Syndrome. They say that a leaky gut results in opiate crossing the brain-blood barrier and that this has severe  neurological consequences.  The intervention is that  they fix the leaky gut or perhaps even look for the cause of the leaky gut such as mercury toxicity from a vaccination. Very Concrete. Very Tangible.

The treatment for leaky gut does not, however, address the developmental  issues that now exist.  The child whose had multiple ear infections secondary to a weak immune system, may no longer have ear infections now that he has had  bio-medical treatment, but he has missed the critical period for language emergence.  Here the developmental skills of occupational therapists, speech therapists, play therapists, and educators as well as the skills of someone schooled in the Tomatis Method are essential. It is essential to fill in the developmental gaps.

There is some competition between these two points of view. Look at it, if you want, as the boys against the girls. The Blood and Guts type interventions versus the "soft" (read as "cuddly. fluffy, airy-fairy) interventions. The developmental model points to the Soft interventions.

Something must be said of the behavioral models.  Although very useful in eliciting basic skills for children who are severely dyspraxic and benefit from learning in small repeated snippets of information, the behavioral models fall short of helping a child to learn innately and naturally, and to generalize their skills to novel situations.  No one teaches a typically developing child to talk or to play or to read and interpret the thousand of social cues they face daily.  These are innate intelligences that emerge at developmentally appropriate times.

So we will argue that although the Blood and Bones model and the Behavioral models have produced results, on their own they do not steer the child through the developmental maze that emerges from this disorder.  Nor do they help the recovery from autism by helping your child to re-integrate his vestibular-auditory system.

A developmental model is a bottom up approach to interventio n.  It works on the foundations such as vocalizing, imitation,  joint attention and praxis;  not the outcome skills such as speech and reading. In sensory-based intervention we assume that those foundations are of neurological organization.  They cannot be taught; rather they are potentials that can be elicited.  This is Vestibular-Auditory Re-Integration.

A developmental model presupposes that many of the behavioral and communicative idiosyncrasies observed in Autism and PDD are not the causes of the disorder, but rather are symptoms based upon an underlying developmental disorder.  The focus of the intervention is on the sensory systems involved in the child's ability to perceive and understand his environment.

All learning is dependent on this.  In improving this ability, we hope to provide an improved foundation upon which normal development can take place.  There are many studies indicating how sensory deprivation can result in delayed or atypical development.  It is believed that the central nervous systems of children with Autism and PDD do not properly perceive, process and organize sensory information from their bodies and their environment.  Therefore, they are not able to respond effectively to their environment and thus develop normally.

A developmental model is critical to understanding changes when  a child with autism is recovering.   Waiting for a child to speak can be agonizing. Unless a parent can be taught to understand the important developmental markers along the way it can be a discouraging process. If a child is talking when can we expect him to tell us how he feels?  When will our child be in a mainstream class?  What ever our hopes and dreams are for our children, knowing the typical stages of development helps.  Knowing  how far "on" or "off " the mark that our child is this week helps us to know what to look for next week as he moves up the developmental ladder.

A developmental model can also help us understand behaviors that may trouble us when he starts to get better.  For example, a child who was always compliant now is sassy and disobedient. This is actually a sure sign that he or she is getting better.   It can be easier to tolerate when looked at from the developmental perspective. This child, for the first time in his life, has the language to try and control his environment.

 A developmental model can help us understand how to react to new behaviors that are challenging and confusing.  Parents of autistic children are often fearful of placing limits on their child in fear that he may regress again.  It can be helpful to understand that the behavior they are now seeing is typical of a new developmental stage that requires limits and structure. This addresses the issue of whether a recovering child with autism ought to be disciplined. It can now give parents a sense of control because they can now use normal parenting standards to raise their child.

As a developmental disorder, Autism impacts on so many of the abilities that are unique to us a human beings. By unique I mean skills that are highly advanced in our species, such as language, culture, arts, technology and many others, that do not exist to such an extent in any other living form on this planet. Because it impacts on so many things, it is often referred to as a Pervasive Developmental Disorder.  Autism can impact our physical development.  It creates Sensory and motor disturbances. Fine motor and visual motor skills are often delayed. It can impact negatively on our communications skills with both receptive and expressive language skills often delayed or unusual in their style.  It can impact social interactions, with social isolation and difficulty understanding social cues often the case.  The ability to play creatively, or imaginatively can be severely curtailed and development of independent and self-sufficient activities is also effected. What can we do about it? Our developmental approach aims at addressing and correcting the nervous system's ability to learn innately and naturally.  If this can be achieved then the child can go on to learn, as he was intended to.

I suppose that it is hard for a Blood and Bones, Blood and Guts type person to fathom  that by rolling around on an OT ball, or by swinging back and forth upside down or that by (eee-gads!) putting on a set of headphones and listening to Mozart we can correct the problems of the vestibular system, and ultimately, of autism.  But to my concrete friend, I say: Think of it this way.  There used to be a second baseman whose name was Roberto Alomar.  He could dive for a ground ball, roll over once or twice and fire the baseball to first base, without even looking. We would say that he had a highly integrated vestibular system. Michael Jordan did the same thing with a basketball. This obviously has something to do with Balance. Now, balance is a soft thing. So is timing. You can't weigh it and you can't photograph it, but if you have it, you can make a million dollars  a year throwing a ball around. (Now do I have your attention?) Most of what we value in an exceptional human being is the soft stuff. Most of what we value in ourselves is the soft stuff.

With Vestibular-Auditory Re-Integration, we correct the nervous system's ability to learn. By using the Tomatis Method, we work directly on the ear. The ear, if you remember from eighth grade science, controls actually two things. It does the hearing for us, and it controls the balance. Alfred A. Tomatis spent about fifty years figuring out how by working on the listening  function of the ear, he could also correct the nervous system's balance function. That is how what we do works, and why it works. (Our website has about a hundred pages on this subject.)

Parents are pragmatic. They are more motivated. The downside of being more motivated is that they are more gullible. To both quackery and to authoritarian proclamations from the National Institute of Health. That being said, we assert that our methods have stood the test of time, and that three quarter of those autistic children came to us by way of referral.

A Paradigm shift
What makes us different from conventional medicine is that they treat the body, with drugs, radiation etc, directly (that's hard science as in hardware) where we treat the senses (this is soft science as in software).

Hard science usually gets more funding than soft science. Soft science can be very "airey-fairey" indeed and will not get much credence from government, congressmen, generals or medical experts who are regularly seen on TV as saying, and I quote,

"There is absolutely NO proof that (fill in the blank) is related to (), or is caused by, or can be cured by ().

< font size="-0">This is true, looking at the world from their reductionist perspective. Reduce everything to blood and bone s, and you will never explain the psyche, or human society or any human traits at all, except perhaps locomotion.

I suggest that we treat the body as a system, (not a new idea), and further that we look at a system of senses (this is getting more novel) in order to understand muscle tone, cognition, autism... This is what Jean Ayers did, and Alfred Tomatis.

It takes a village (to borrow a phrase) to treat an autistic child. Right now the village is dysfunctional.  Our Village seems to be competing over precious resources when, at the same time there is an epidemic of Autism. Research is essential yet the therapists in the field are far away from the academic institutions that jealously guard their funding.  Development, being a somewhat abstract concept, is much harder to understand  than Blood and Bones.  It is not cut and dry and it is often unpredictable. The Developmental professions are frequently dominated by women. We talk about neurological soft signs and the study of development is a soft science.  It is much harder to validate for this reason. It does not pay as much.

However,  all of this politics ultimately has no bearing on whether  the soft science of Vestibular Re-Integration does or does not work.  It works! At the Spectrum Center 90% of our clients see changes that they deem significant in their children. 

We stand on the shoulders of giants (a personal note by Valerie Dejean)
Dr. Alfred A. Tomatis and Dr. A. Jean Ayers devoted their lives to the study of human development. In the creation of original interventions for remediation of these developmental disorders, they have laid the foundation, theoretical and clinical, for a cure for autism. I thank providence every day for their genius and for all the children and adults that they have helped with their thinking. The purpose of this article and others is to discuss their theories and research, particularly as it pertains to autism.  I hope parents will see their children on these pages and gain understanding. Mostly I hope these writings will give hope, because in working with autistic children for 30 years I know first hand that there is tremendous reason for hope. 

I know that in every sound-bite on autism that I have ever seen on television, there has been some expert, usually with a stethoscope hanging around his neck, who will say that "there is no cure for autism".  However I have personally seen miracles more often than I would have ever thought possible. Mostly I am struck by the small miracles, the small steps of human development that add up into the big miracles, and by the courage and tenacity of the families who walk down the road of recovery from autism.

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Valerie Dejean with Alfred A. Tomatis at his villa in Spain (1997)

Kara Tavolacci
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