Auditory interventions - a trip down the rabbit hole

I posted two and a half years ago about problems with a lack of evidence for the Wilbarger intervention methods. In that post I included a link to http://www.sensorydefensiveness.com/ which at the time was allegedly sponsored by Pat Wilbarger. Now that website curiously redirects and links to a mirror page for Valerie Dejean and The Spectrum Center, which is now located in New York. Apparently they used to have a center in Maryland, but according to documents from the Maryland Board of Occupational Therapy Practice, it is a matter of public record that a Valerie Dejean surrendered her license to practice for several reasons including:

• use of the Tomatis Electronic Ear which has been banned by the FDA
• use of unlicensed persons to practice occupational therapy
• fraudulent billing practices

I previously wrote about concerns with the Tomatis program and the FDA ban here.

So in summary this Tomatis progam is not generally accepted but some occupational therapists continue to flirt with these programs. I don't understand why.

I called The Spectrum Center today to get more information and they told me that they do not practice occupational therapy in New York state. They are still using the Tomatis device and they told me that they use a combined approach that includes sensory integration techniques and Tomatis. But it is not OT. On their website they call it "vestibular re integration" and claim "80 percent success in improving if not curing these 4000 autistic children."

This is just conjecture - but based on the current prices they reported to me ($400 for an evaluation and $7440 for the 'therapy') that is a windfall of over $30,000,000.00 dollars. That's not a bad days work, especially for someone who had to surrender their license to practice occupational therapy.

The rabbit hole continues - a Dr. Ron Minson owns Integrated Listening Systems. His work is based largely off of Tomatis as stated on his website - but rather than using the banned FDA device his system relies on music recorded on an IPod. They also have a 'device' that they sell (the iLs 1000) but I don't know if this is related to the banned FDA device.

Interestingly, in a fascinating document available online that references the Dejean case, the FDA is asked to evaluate the Tomatis version of the device. Referenced in the petition is that manipulation of the Freedom of Speech principle would allow filtered music to be streamed online or distributed on compact disc. The CDs or online streamed filtered music would presumably be protected as 'Free Speech.'

There are a plethora of 'filtered music' CDs and programs, like Dr. Minson's, that are being marketed and distributed in an apparent loophole around the FDA ban. So with all this filtered music - where are the devices located that MADE the filtered music?

So why mention Dr. Minson specifically? Well he is directly associated with Dr. Lucy Miller and together they co-founded the Sensory Therapies and Research (STAR) facility. The SPD Foundation (formerly the KID Foundation) is a Colorado public charity sponsored in part by STAR Center. According to this page, iLs makes donations and training discounts for the benefit of The SPD Foundation.

The SPD Foundation, from my perspective, has contributed significantly to the knowledge base of sensory processing disorders. But why be entangled with Tomatis and similar programs that are under such heavy criticism. At a time when people are trying to determine if SPD is eligible for inclusion in the DSM, how can alignment with Tomatis help the cause?

A bottom line issue remains - and I am still waiting for someone to stand up and explain this - but I believe that this auditory intervention is only tenuously related to occupational therapy practice. Occupational therapists don't typically intervene with direct auditory stimulation in any other interventions - so how did some practitioners come to think that this is within the OT scope of practice?

When most people think of auditory evaluations or auditory interventions they obviously think that is within the scope of practice of an audiologist or perhaps a speech pathologist. If you search the American Academy of Audiology website for 'Tomatis' there are no results returned. Anyone out there beside me wonder why? Here is the most recent document on the subject from the American Speech Language and Hearing Association. Do OTs know something that the speech therapy professionals don't?

I think that OT as a profession needs to come to grips with this issue. Here is my attempt to start a conversation.

edit 4/21/11 - fixed a few broken links that were moved/redirected.

edit 3/27/12 - again! fixed broken links that were moved/redirected. Does someone not like this post? Also, the sensorydefensiveness.com website now lists a page in (apparent) Japanese (according to Google Translation) about sushi. TOO FUNNY.