Summary
This podcast episode of Little Brains Big Steps features hosts Franchesca Cox, an occupational therapist, and Megan Williams, a speech-language pathologist, exploring the auditory system and its role in childhood development. They break down how the auditory system works, its connection to other sensory systems, and how challenges in auditory processing can impact focus, learning, and communication. The hosts share common signs of auditory processing difficulties and offer practical strategies for support in everyday settings.
Episode Transcript
Franchesca Cox (00:00)
Hi there, I’m Francesca Cox, an occupational therapist based in Houston, Texas. Over the years, I’ve had the incredible honor of working with children who have neuromuscular conditions, rare genetic disorders, and developmental delays. Using approaches like DMI therapy and TheraSuit, I’ve seen firsthand the resilience and strength of these amazing kids and their families. Each day brings new lessons, and my passion is to empower families with the tools and knowledge to support their child’s journey.
Megan Williams (00:24)
And I’m Megan Williams, a speech language pathologist also based in Houston, Texas. I specialize in feeding therapy and I’m an MNRI core specialist. I’ve worked with children facing feeding challenges and sensory processing issues using reflex integration techniques to support the brain body connection and help children thrive.
My mission is to guide families through the often complex world of feeding and communication, empowering them to support their child’s growth with confidence.
Franchesca Cox (00:55)
are here to share insights, practical strategies, and heartfelt stories that can help you navigate the unique challenges and joys of raising a child with special needs.
Megan Williams (01:04)
We know every family’s journey is different, but our goal is to create a supportive space where you feel seen, heard, and equipped with the knowledge to help your child reach their fullest potential.
Franchesca Cox (01:16)
whether you’re looking for therapy techniques, expert advice, or just a sense of community, you’re in the right place.
Megan Williams (01:22)
Let’s explore this journey together filled with hope, growth, and endless possibilities.
Franchesca Cox (01:28)
All right, welcome back to the Little Brain’s Big Steps podcast. We’re gonna talk today about the auditory system. When most people think about the auditory system, they think of hearing, but it’s so much more than that. The auditory system helps us to process sound. Of course, it always plays a role in attention, communication, emotional regulation, and how we interpret the world around us. For children with developmental delays, sensory processing issues, or brain injuries,
Auditory processing can manifest in distinct ways, and understanding how the system works provides essential clues for supporting them effectively.
Megan Williams (02:01)
As far as the basic anatomy and neurophysiology of our auditory system, we’ll do a quick run through to kind of not get too in the weeds, but just to make sure we’re all kind of aware of all the parts that work together. Because sometimes we just think that there’s the eardrum.
and maybe our outer ear, but there’s a lot more to it. So sound waves are captured by our outer ear. That’s the nice fleshy piece that we like to pierce. It funnels sound into the ear canal and then eventually makes it to the eardrum to vibrate just like a drum. These vibrations then move through the middle ear bones. They’re the tiniest bones in our body and move to the cochlea, which is in the inner ear. It’s a fluid-filled
spiral-shaped organ that’s lined with all these little tiny hair cells called conicilia.
The hair cells in the cochlea convert the mechanical vibrations into electrical impulses. So you’re making a shift from mechanical to electrical signal so that the brain can interpret this information because it’s going to travel to the eighth cranial nerve. We talked a little bit about this nerve a few weeks ago in the vestibular episode.
Then the information travels to the brain stem and then to the auditory cortex in the temporal lobe. And that’s where this electrical impulse is translated into sounds.
And then also, the reticular activating system, it’s located in the brain stem. And this is a special little spot that is in charge of figuring out what to filter, what is important. And so it’s really important for focusing and attention. Our reticular activating system works really hard processing lots of information.
like a giant data processing computer. And then the vestibular cochlear link in the inner ear connects our auditory system with balance and hearing, which is why vestibular and auditory processing often go hand in hand.
Franchesca Cox (04:02)
Yeah, so as you were talking about that, it made me think back to our vestibular episode. And like you said, they work really closely together. So the auditory system works really closely with the visual system. It helps match what we hear with what we see. And this is important for things like reading.
speech and social cues and it works closely with the vestibular system and which they both reside both the auditory and the vestibular system reside in the inner ear in that part where the hair cells that
it’s in the cochlea. So that’s kind of where the vestibular system is housed. And
Dysfunction in one often impacts the other, just like the vision and the vestibular we talked about. Well, the same thing can happen with the auditory system and the vestibular system. If one is affected, most likely the other is to some degree. A child with auditory hypersensitivity may also be fearful of movement or unstable during walking. So if you have a child with balance issues, it’s very good. It’s a good idea to assess and look into their auditory system. Proprioceptive system is another system that works really closely with the
system. Children with poor auditory processing often seek deep pressure or joint input to feel grounded and better manage sound related overwhelm. And I can think of a lot of kids that maybe they give a lot of pressure when they’re they’re crashing into things or whatnot and they’re also seeking loud sounds. So things that might hurt my ear to them it’s not even a big deal because their threshold is a lot higher and so they crave those louder sounds maybe.
Megan Williams (05:26)
Exactly. A lot of times those kiddos who enjoy the really deep proprioceptive input I find will like to put speakers if there’s any toy that has a speaker they will put it really close especially if the toy produces deep sounds it’s almost like they feel that input from
Franchesca Cox (05:43)
those vibrations, right?
Megan Williams (05:46)
Yeah, there are some kids, I don’t do it with a lot of kids, but some I will use weighted tuning forks.
And ones that I use, I don’t remember the frequencies off the top of my head, but they’re the deeper sounds. So real deep. I can’t even make my voice go that deep. But sometimes to tap into the proprioceptive system, might, you know, depending on the child and their sensitivity threshold, I might activate the tuning fork that is going to produce a really deep hum and then put it near their ear and just kind
see how they respond. Again, don’t do it with every kid. There are definitely kids that this works with and some that don’t. A lot of the children will lean over and try to put their the tuning fork on their ear but of course that like dampens the vibration and stops it but then they become really curious of like how do make this happen again? Mm-hmm. Yeah. So…
Franchesca Cox (06:35)
How does this work? That’s neat.
Megan Williams (06:40)
In terms of auditory processing, we see kids across the whole range. When we see kids with an auditory system that is out of sync, we know that they may struggle with tasks such as following directions, tolerating loud environments, understanding language in a noisy classroom. And you can even see
what looks at behaviors such as inattention, anxiety, or even defiance start to happen as a protective response or just a compensatory response. So some of our kiddos respond with hypersensitivity. So we know those kids. Those are the kids that overreact to loud noises, even seemingly not loud noises, or they have difficulty filtering background noise.
not just being sensitive to the volume but also their reticular activating system might not have figured out how to filter out the important versus unimportant information. We also see kiddos who have hyposensitive systems so they’re under responsive they miss parts of instructions or whole chunks of instruction they don’t hear their name being called.
They seek out the loud input to activate those those little hairs in their cochlea. They need the louder input. And then of course we see kiddos who will even fluctuate in some environments and it’s hard to nail down this whole clear picture of what’s going on with their auditory processing because you know in some environments you may see them present one way and in other environments the opposite way.
Franchesca Cox (08:13)
Yeah, yeah.
Megan Williams (08:14)
So the auditory system plays just like every other part of our sensory systems. It plays a big part in our cognition development, motor learning, speech and language. And in regards to cognition, the auditory system fuels our working memory, attention, and processing speed. So if you think about when we tell our kids,
go to the kitchen, grab your shoes, and then I’ll meet you at the door. They are taking in a lot of auditory information, chunks that they have to break down. They have to break down the sounds and then figure out sounds in meaning, in chunks, and then follow those instructions in order.
Franchesca Cox (08:54)
Mm-hmm.
Megan Williams (08:55)
So you probably may see the kid
Franchesca Cox (08:55)
Yeah.
Megan Williams (08:57)
that goes to the kitchen but then miss the last two pieces of information or they grab their shoes and you can’t find them because they’re not at the door. Their ability to hold and retain and act on that instruction relies really heavily on their auditory processing and
Franchesca Cox (09:06)
Yeah.
Megan Williams (09:16)
So a huge component for language development. Auditory discrimination is, I think, one of the things that is noticed in the school environment. And that’s usually one of the signs, I think, that we start to see that the auditory system might not be working efficiently. So being able to tell similar sounds apart. Children have to…
Learn new concepts, understand the difference between a P and a B, which one is voiced, one is not. Following classroom instructions so that they can understand how this little civilization works. Understanding spoken information from the teacher. It’s a lot of…
constant bombardment on the auditory system. And we know that kids who struggle with auditory processing may look like they are forgetful, they’re distracted, they’re confused. And so that’s really where it’s important because especially kids who are coming into the school system and maybe they’re not English is not their primary language.
They can also be looking at a language difference, which is not a disorder, but then they also may have an auditory processing issue on top of that. And so we definitely, think in the early childhood realm, we advocate for early testing if possible, because we don’t want to give a label to a child that they are.
not interested, not engaged, they’re confused, they’re, you know, something that may be deeper seated in their auditory system. And it’s not their choice to…
Franchesca Cox (10:53)
So I have a question about this.
in the visual, when we were talking about the visual system, we know that a child can see well, not need glasses, but they still have a processing issue. Would you say the same is true coming from a speech therapy standpoint? Will a child be able to pass a hearing test yet still struggle with some of these concepts that we’re talking about? Okay.
Megan Williams (11:13)
Absolutely. So
the same kind of testing. you know, we classically know that when we take child into the sound booth and we put the headphones on or we do sound field testing where we just play a sound and we have them raise their hand if they hear it or put a block in a bucket if they hear it. Do something to signal that they hear it.
Franchesca Cox (11:32)
Right.
Megan Williams (11:33)
they may function within the tested decibels and frequencies, but then if the testing time permits, and it depends on who’s doing the testing, if you go a little bit further with an audiologist who can do deeper testing, they can really figure out like, okay, well, it’s not…
Acuity, like visual acuity, it’s something else. Because like we said, in the brain, in the anatomy piece, there are so many places where it can break down. So yeah.
Franchesca Cox (11:55)
Hmm, okay.
deeper.
Right, right.
That’s good to know. So getting an all clear from the pediatrician may not be enough. So if there’s some of these things lingering, ⁓ seeking out another specialty.
Megan Williams (12:14)
Exactly. Because they definitely
do the ABR testing. every state requires that there be some type of, I don’t think they all have to be sedated, but some type of ABR testing to just see if that eighth cranial nerve is intact and doing its job. And so sometimes when we get
babies or pre-k kids, you know, I’ll ask about testing and yeah, know, everything’s like they’ve had no flag, red flags show up or any concern, anything like that. It’s like, okay, well, what?
Franchesca Cox (12:42)
Mm-hmm.
So it’s functional, it’s just not developmentally appropriate. And that those things kind of surface as a child starts to.
Megan Williams (12:54)
Right.
Franchesca Cox (12:58)
grow up and try to do new things. So the auditory system also plays a part in motor learning. Auditory input provides rhythm and timing cues that guide movement. Think about clapping, walking to a beat, responding to verbal instructions during a game. And the vestibule auditory connection means that when auditory processing is off or maybe not working, postural control and balance are off too.
This can lead to clumsy and poorly timed movements.
So that is super interesting to me. And it does make sense because a lot of the listening programs that we’ll talk about later, a lot of them incorporate movement because that vestibular and auditory system work so closely together. Children may also have trouble planning motor actions if they can’t process the verbal cues that come before during the movement. Like sports, dance, following multi-step motor tasks, it’s all going to be super
Megan Williams (13:34)
Mm-hmm.
Franchesca Cox (13:49)
difficult.
Megan Williams (13:50)
Yep.
Franchesca Cox (13:50)
speech is a motor act guided by auditory feedback. Babies babble and then they shape their sounds based on what they hear from themselves and others.
if a child doesn’t accurately perceive pitch, volume, or phoneme differences like B versus P, they’ll have trouble producing these sounds.
Megan Williams (14:08)
Yeah, a lot of times with working on articulation and speech sounds, when SLPs do testing, one of the first things we look at is to see, okay, is this child, what class of sounds are they leaving off? Are they just leaving off all the sounds that are unvoiced? So if you’re looking at pah versus buh.
If they’re leaving off all the sounds that you don’t turn your voice on, like a p sound, then it’s like, okay, maybe they’re not.
Franchesca Cox (14:34)
Yeah.
Megan Williams (14:37)
perceiving that there’s still a sound there. And that can really honestly be a function thing. it could also be if they’re leaving that sound off at the beginning of words versus the end. And so the tests that we give, articulation tests, we try to weed through and figure out where the breakdown is. And then we can also tell when we start having them try to imitate sounds.
and it’s really interesting to just watch speech development happen in kiddos. I mean, one thing I think has been very interesting, you know, we learn rudimentary things about…
the auditory system in undergrad and things like that, but it wasn’t until learning more about the auditory system and how it’s linked to all the other sensory systems that I found this whole…
volume of information that like we didn’t have access to and now it just connects different things and when you see These pieces all fit together to make it even bigger picture. It’s just like wow I can address these other sensory systems and make better gains in their speech sound development than What I was originally just taught so
Franchesca Cox (15:46)
Yeah.
Yeah, it’s kind of like what I talked about, I think last week or last time. When I’m swinging the child, I’ll get new verbalizations or new babbles and it’s kind of the reverse. So we’re trying to hit the vestibular motor, but I’m getting an auditory response but a language response from the child. So it’s really neat how they all work together and you really got to understand all of them to address one of them.
Megan Williams (16:08)
does.
Yep.
And our speech sound development feeds into our language development because language is built on sound patterns and the brain has to break down the stream of spoken language into meaningful pieces. So syllables, we know like a consonant vowel like ma or a vowel consonant like and then syllables just grow in length.
to become words and then we also have based on the language we speak we have rules like a grammar system that we adhere to. So when poor auditory processing is happening it gets hard to learn new vocabulary words. It’s hard to understand abstract or complex sentences. It’s hard to follow multi-subdirections and it’s hard to engage in back and forth conversations. So you can see how this can lead to
Franchesca Cox (16:59)
yeah.
Megan Williams (17:01)
the child really just disengaging in communication because it’s…
It’s hard to keep up. It’s hard when your auditory processing is delayed. it’s sometimes, I explain it to families, it’s like you’re watching a TV and the sound and the video are not in sync. Sometimes auditory processing can be where you’re seeing the mouth move, but the sound is coming in a fraction off, a fraction of a second off or whatever. And that can just be, it’s really hard to keep up with that conversation.
Franchesca Cox (17:14)
you
Yes,
it feels like you’re watching a movie in another language.
Megan Williams (17:37)
Yeah, and
so these are the kiddos that will maybe disengage. They’ll become quiet, less engaged in activity.
And so this overall auditory processing issue can look like a delay in expressive or receptive language. It can look like difficulty with reading, confusion with figurative language, and even sarcasm. ⁓ sarcasm is hard. And I’m not saying that sarcastically, it really is. There we talked about the visual processing system also having to play into. If I say something one way,
Franchesca Cox (17:59)
Wow.
Yeah.
Megan Williams (18:13)
but my body looks different then that’s an indication of sarcasm and so a lot of times teenagers will have trouble fitting in maybe if they have some auditory language processing because they cannot keep up with the conversation, the slang, the sarcasm.
Franchesca Cox (18:28)
Yeah.
Or even
if they have like a stud or something that might be embarrassing to them. Yeah, yeah. Or maybe even a lisp or something, they’ll get teased for it. There’s so many faces and facets to that. So let’s talk a little bit about resources, research, now that we know what auditory processing.
Megan Williams (18:35)
⁓ yeah, on top of that, yes. Sure.
yeah.
Franchesca Cox (18:50)
developmental delays look like. Let’s talk about some research and resources. One of the most fascinating things that I came across shortly after getting into pediatrics was listening programs. And we’ll talk a little bit more about those, but my favorite person that I read about was Alfred Tomatis And he was a French, I’m going to butcher this word.
otter, I don’t know how to say it, otter laryngologist. I just know he works with the ears and he’s something really, he’s really smart guy. He’s an ENT, he was also an inventor of something called the Tomatis method. And I wish I knew where he got.
Megan Williams (19:15)
Oto Laryngology. Yes.
He’s an ENT. You just call him that.
Franchesca Cox (19:28)
his idea from, I really did try to find, but he suggested that the right ear controls and analyzes sound because of where it is anatomically in the brain. The right ear directly relays sound to the left hemisphere of the brain, where some of the bigger areas for speech and language are located, the Wernicke’s area and the Broca’s area. When someone has a left dominant listening ear, I didn’t know that we could have a right or left dominant ear. Is that something that speech deals with a lot? Or do y’all look at that at all?
Thank
Megan Williams (19:55)
we have a, I say we, like I’m speaking for Asha, I don’t know, but I feel like the general thought is like we know that you can have a dominant, so I tend to feel like I’m more right ear dominant, but I’m also right hand dominant. I’m pretty sure I’m right eye dominant. But it’s, and we know that sound is processed.
Franchesca Cox (20:05)
Okay.
Okay.
Megan Williams (20:16)
you know, crossing the hemisphere or their corpus clausum, but I don’t know if enough attention is paid to the idea of what you’re talking about.
Franchesca Cox (20:25)
Okay yeah, was the first time and it’s probably the only time I’ve ever read anything about that. But it talked about when someone has a left dominant listening ear, which is the less efficient.
dominant here to have the messages sent to the right side of the brain where it must be transferred to the left side to process. So it’s almost like it’s just adding another route to process speaking speech and language. And of course, this is probably done in like seconds, but that causes a delay when you’re trying to learn a language or learn to speak. This causes a delay of information where all or most of the information is misconstrued and missed or missed completely. This can cause confusion. And this is all according to Alfred Tomatis I’m not saying this is the way it
but I think it’s just worth mentioning and maybe even looking into if this is something that you as a listener
are interested in this anyway, but this this idea of having a left dominant ear can cause confusion in prison as dyslexia, a stutter and a myriad of learning difficulties, according to Tomatis And he says in order to be a good learner, one must listen well. And I completely agree with that. And if you can’t listen, you can’t learn. And just like you were saying, a lot of times those kids are going to be some of the behavioral kids, but they just they don’t feel successful. So they’re not going to try. And that’s kids across the globe, I think.
They do what they’re good at. so according to, according to Tomatis, is an obvious distinction between hearing and listening. Hearing is passive in the detection of sounds around us. Listening is active and requires an effort to understand and comprehend a message. Tomatis found that an individual can be trained to be right ear dominant by increasing input to this ear. In the 1950s, he developed a device called the electronic ear to correct these listening difficulties. And I think it’s very similar.
to what we have is the bone conducting headphones similar to that. The device lets off sound frequencies to train and stimulate the ear to listen more efficiently. Since our vestibular apparatus is housed in the inner ear like we talked about earlier, the electronic ear also affects the person’s balance and movement and so some of the listening programs that we’ll talk about soon, like I said, they incorporate movement in them. I don’t think his did, but.
Megan Williams (22:03)
Mm-hmm.
Franchesca Cox (22:23)
Anyway, for this reason, the electronic ear has the capacity to improve coordination and posture as well. The listening ear has continued to advance in technology over the years, and I think that’s what he called it, the listening ear. I think we mentioned this book before, but I think I part of either his or Paul Maddahl’s
story in the book, The Brain’s Way of Healing, and that’s by Norman Deutsch. And it shared some interesting information about Tomatis’ discoveries and also his contributions to what we know today about auditory processing. His apprentice and one of his first patients was Paul Madal.
and he had trouble with like basic fundamentals in school. I mean, he could not pass any class. He literally failed. He was under so much pressure emotionally from his parents. His parents were so hard on him. They just assumed he was lazy. And I mean, I guess it was a different generation too. there was just a lot of…
stigma around and maybe just a lack of knowledge that there could be differences in learning and sensory processing, but he endured a lot and he ended up running into Alfred Tomatis in I think it’s in a monastery for monks of all things. I don’t remember what Alfred Tomatis was doing. I think he was doing some kind of listening thing with the monks and someone told him I don’t even think he was either done with high school or he had dropped out and someone told him you need to go to this doctor.
Megan Williams (23:28)
No.
Franchesca Cox (23:41)
He’s over here in the monastery and just listen to him. Well, he ended up doing the testing on him and he ended up taking him under his wing and doing everything that I just talked about with him and the Paul Madaule became.
I mean, now he runs the Listening Center in Toronto, I think, Canada. So, yeah, he obviously made a lot of progress and he now does the same thing that Alfred Tomatis did more than 50 years ago. So it’s really cool. Definitely worth looking into. And I’ll list some of those resources in the show notes.
But yeah, so other than the Tomatis method,
there’s some other listening programs worth looking into. The closest one that’s similar to the Tomatis method is called Little Bear Listening. one of the things that Tomatis did is he took, when available, he would take an audio recording of the mother’s voice and he would combine it with Mozart, I think his was static. It was just this like random static. He was trying to simulate the sounds that the child would hear in the uterus. ⁓ And so he was in
Megan Williams (24:36)
Mmm.
Franchesca Cox (24:38)
so in the beginning it just sounded like random static sounds. And over the course of time, those static sounds would be decreased and the mother’s voice would be increased. And then at the end of the program, the mother’s voice was all they could hear. And so…
It was amazing. But I think the Little Bear Listening does something very similar to what he did. And it is kind of expensive, but they have custom programs and different things. I’ve never used it personally, but I was recommended by someone. I was recommended this resource by one of the trainings that I did. So I definitely think it’s worth looking into. Two other ones that are more mainstream, they don’t use custom audios from family members or anything, but it’s ILS, Integrated Learning Systems,
and also advanced brain technologies. They do use bone conducting technology. All of these tend to be pretty pricey and that’s one of the reasons I don’t often mention them in the clinic because it requires the family to not only fund therapy but also go home and do something every day that’s also very expensive. But if auditory processing is the main issue, I would definitely look into this. I had one family and it wasn’t even at my clinic that I did recommend it to because
I knew for sure her issue was almost 100 % auditory processing. And so I don’t know if they ever followed up with it, but these are definitely working worth looking into. The advanced brain technologies in ILS, they use either specific sounds or music that they have created to help children with focus, attention, even motor planning. And so there’s just a lot out there. There’s probably more that I don’t know about, but yeah.
Megan Williams (26:08)
Yeah, yeah.
I completed the focus and listening program from the ILS group. so I’ve been using it on myself off and on. It’s a very, not rigorous, but it’s a very time consuming listening.
Franchesca Cox (26:17)
Bye!
Megan Williams (26:28)
protocol that you have to really stick to, but I can say that the bone conduction, the first time I put it on, it was set to the lowest setting and I was listening and I was like, I don’t feel anything. I don’t think this is working. So of course, what do you do when you don’t think it’s working? You crank it up to the highest setting and I put it back on and not only could I feel it, but like a minute or two later, I started feeling sick to my stomach and it was really moving.
Franchesca Cox (26:31)
Hmm.
Yeah, yes.
Wow.
Megan Williams (26:58)
It was, you know, where the headset sits and the bone conduction piece is at the top of your skull and it is actually conducting vibration into your skull and so the tiny little vibration and the extra micro movements of my skull and in my inner ear and my sphenoid and things like that I was like, wow, I’m obviously very sensitive to this. I’m gonna turn it all the way back down, but it was pretty quickly worked.
Franchesca Cox (27:02)
Yes!
Wow!
Megan Williams (27:25)
happened pretty quickly and so I could not I couldn’t blame it on anything else it had to be the bone conduction strength so
Franchesca Cox (27:28)
Yes, yeah.
That’s
crazy. I’ve never tried it before, but I would love to maybe one day just have the bone conducting headphones and pair it with some vestibular work. I didn’t know that there was settings, so that’s super interesting. I just thought it was like an on and off. I don’t know. I never get much thought to it really, but.
Megan Williams (27:44)
Yeah.
Yeah, because part of
their protocol is of course, you know, starting with the bone conduction on a lower setting for some of the tracks and then as you progress on, I think it involves turning it up for different tracks later in the cycle or the process and so… Yeah. ⁓
Franchesca Cox (28:07)
That’s awesome. It’s good to know. That’s
good information. I’ve never heard that before. I have heard several people, families say that they tried it, they got results, but then when they come off of it, their kids kind of digressed. And so it’s another thing to consider whether it’s a permanent, it kind of reminds me of kinesiotaping. Like you see results instantly and then you take it off and then it kind of goes back to the way it was. I don’t know. So it’s kind of a…
Megan Williams (28:28)
Mm-hmm.
There’s
also, I think, a lot of consideration of the sensory system you’re putting the listening programs on. And I think…
We won’t get into a whole lot of it, but the reflex integration, primitive reflexes, there are certain things that need to be really working in order for the sound to be properly processed versus being interpreted as a threat. So if that reticular activating system is not safely taking the information in, can be, that child might not be ready for it.
Franchesca Cox (29:00)
Wow.
That
makes sense.
Megan Williams (29:11)
And so figuring out
like child to child, person to person, what specific system you’re tapping into, I think.
Franchesca Cox (29:18)
That’s a good
idea. I never really thought of that. I have the spider cage in my clinic and then when I’m taking them out of the harness and I unclip it, especially when I’m by myself, it kind of bounces back and it hits the cage. And the kids that have that moral reflex, just hearing it, they’ll go into that spreading of the hands, throwing themselves back and then coming back in. And so I have to be mindful of the certain kids that have a really strong moral. And so that’s really…
Megan Williams (29:30)
Mm-hmm.
Mm-hmm.
Yeah.
Franchesca Cox (29:45)
interesting how.
Megan Williams (29:46)
Yeah,
I don’t know if ever told you this, but there was one day that I was doing a home visit and I was passing over the threshold of the door into the family’s kitchen and they had a big metal threshold or whatever and I accidentally dropped my keys and I went into this moro response. Half of my upper body was in moro and then part of me went into a different reflex that can help tamp down and turn down the auditory system and when
I realized what I did, I just was like, man, I’m really, I need some help. it was very interesting in that minute of how I responded to the sound and what my body did to try to protect itself. But it was very telling of maybe Megan needs to work on herself more. Yeah.
Franchesca Cox (30:27)
Yeah.
Wow, that’s crazy. We need some integration.
Megan Williams (30:37)
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Franchesca Cox (31:46)
other strategies to support the auditory system are predictable sounds and rhythmic input. And predictable patterns, just they’re calming, they’re organizing. One thing that I think of is like the metronome. Have you ever used a metronome?
Megan Williams (31:59)
Yes,
and there’s the interactive metronome program that some people use. I am not trained in it, but I’m interested in the idea.
Franchesca Cox (32:01)
⁓ yes. ⁓
Yes,
I have. I’m definitely not trained in it either, but for certain kids that when we’re working on motorplaning, I haven’t done it in a while, but I’ll just find like a 60 beats per minute or 40 beats per minute on YouTube and I’ll put it in the background and it kind of helps them.
Megan Williams (32:18)
Mm-hmm.
Franchesca Cox (32:21)
pace themselves. And so it’s interesting tapping into that auditory system when you’re trying to work on something like gait training or balance. Other rhythmic activities are clapping games, singing songs with a steady beat, walking to music, drumming or tapping on the table. These help the brain link sound with movement and improve auditory timing, which supports motor learning and speech fluency.
Megan Williams (32:42)
Yeah,
I’m definitely a proponent of music therapy because I think it plays a lot into this piece ⁓ where they are using a drum or a beat and really, whenever families say they’re doing music therapy, I’m like, that’s a good resource to have. ⁓
Franchesca Cox (32:49)
yeah.
Yes,
I forget which clinic has it. There’s one in Houston. I was really surprised. Maybe Tier, it was Tier. Did you know Tier has music therapy? Yeah, they do. Yeah, yeah, I was like, wow, that’s cool. And I think insurance pays for it. They must, right? But anyway, good to know.
Megan Williams (33:09)
I didn’t. That surprises me.
There it is.
Yeah, huh.
There’s also use of noise canceling or filtering headphones, I always say that with a caveat that for sound sensitive kids, that overexposure can lead to shutdown or meltdowns and things like that. And we want to take the edge off of the intensity.
And so that would be the noise filtering or dampening headphones. We may see kids with these on in large assemblies or places where the noise is loud and unpredictable. But we don’t want to overuse them. We want the auditory system to learn on its own to filter and not just block.
I see lot of now these days a lot of teens wearing the Beats headphones and ⁓ it’s always interesting to me that what is that doing to their system of their reticular activating system, right? If it’s filtering out a lot of environmental sounds, you know, what does that look like? The research part of me always wonders that.
Franchesca Cox (34:06)
Mm-hmm.
Yeah.
Megan Williams (34:22)
if you’re going to try out using the headphones using them during transitions or especially noisy parts of the day might be a good way to start and then removing them for calm playtime in like softer sound environments.
Again, once I really became aware that the auditory system plays with all the other sensory systems, I really began to value this idea of pairing auditory input with our other senses. So when we can combine touch, movement, visuals, we can go with that principle of firing together is wiring together.
An example would be saying jump and then clapping your hands while you’re doing it and then repeating jump and then again clapping while you’re doing it. Using visual schedules is a really helpful tool for our kids with auditory processing issues because the auditory information is fleeting.
goes out into the air and then it disappears. But if you have visual schedules with words and pictures, can say the instructions and then point to the visual, however detailed that visual is. ⁓ Using touch, so we want to use safe touch, of course. So placing your hand on the child’s shoulder or maybe placing your hand on their hand.
Franchesca Cox (35:21)
Okay.
for me.
Megan Williams (35:41)
to give a verb while you’re giving a verbal direction or to kind of reinforce their attention. And again, child to child, we don’t want to over stimulate that tactile system, but a lot of times when I get down on a child’s level and if I’m able to…
place my hands safely on their shoulders or somewhere, a safe place on their body. It really helps them focus a lot better.
Franchesca Cox (36:06)
Right,
right. Getting that tactile system, proprioceptive system, pairing it with that auditory cue. When you’re talking about the visual schedules, reminded me of those buttons that you can pre-record a command on. And so that might be another way. I don’t know. I don’t have the pre-recorded ones, but I have the ones that just have like a ding-dong or different sounds. yeah. So when we’re…
Megan Williams (36:12)
Mm-hmm.
Mm-hmm. Mm-hmm.
Yeah.
Franchesca Cox (36:31)
Working with children with auditory processing issues, we want to make sure that we’re speaking with intention, clearly, calmly, and slowly. kids with auditory processing challenges often need more time to process and it might be more time than we realize. And they’ll often give us body language cues that they’re not getting it or maybe they did get it. And so you want to pay attention. Don’t if you’re talking to them, make sure that you can visually see them.
because if you’re talking to them and they’re in the other room or in the hallway and you can’t see them, it’s going to be difficult to gauge whether you’re giving them enough time or not. And so that’s just something to keep in mind. You want to use simple phrases one step at a time until they can progress to those two and three step commands, natural pauses between sentences and visual cues and gestures to match your words. Avoid rapid fire talking. Slower speech helps the nervous system stay regulated and makes it easier to process language.
Megan Williams (37:23)
One of the first things we teach parents in the birth to three world of speech intervention is always the power of the pause. And it’s remembering that you want to give more pauses than what feels natural for the child’s auditory system to be able to keep up and learn and stay regulated, like you said.
to stay interested in conversations and interaction. Another way we can help is by creating a calm, auditory-friendly environment. And for me, I am auditory-ly sensitive. been my whole life. I think it ties into, I don’t know if it’s a chicken egg situation, but my
Franchesca Cox (37:45)
Yeah.
⁓
Megan Williams (38:04)
diagnosis
I feel like one of the first things they noticed was that if there was any kind of other stuff going on in the classroom in my second grade class I would always be paying more attention to that ⁓ and I could not focus on what I was doing and so to create this kind of environment we want to be mindful of background noise so TVs, fans, toys that
Franchesca Cox (38:16)
Yeah. ⁓
Megan Williams (38:27)
sing and make all those wonderful noises. man. Have issues with some toys sometimes. That can overload our system. And so we want to be mindful of that. If we are working with a child, you know, if a therapist is in a clinic space, there usually is, you know, a way to transition to a smaller, quieter environment. You always want to make sure that
As a parent, that’s an option for your child. ⁓ Therapists usually are really great about figuring out this environment modification. Setting up quiet spaces that you can have kind of around the home or if you’re in education, maybe around your center. ⁓ White noise machines can be used to block out overwhelming sounds at night or during transitions.
Franchesca Cox (38:55)
Yes.
Okay.
Megan Williams (39:17)
the white noise machines are pretty advanced. can even, I think some maybe even produce like brown noise and pink noise and different frequencies. Yeah, these apps on our phones, which I’m not sure if our phones are the best way to deliver the noise machine sounds, but yeah, sometimes you can get really creative with the frequency and things like that.
Franchesca Cox (39:24)
What? I didn’t know that.
Wow.
Yeah.
Wow.
So different
colors are different frequencies?
Megan Williams (39:44)
Yes, so
I don’t know if it’s a marketing ploy. There probably is real research out there, but brown noise might work better for somebody with ADHD. Pink noise, I think there’s green noise, and I couldn’t even tell you off the top of my head how they vary, but yeah, if you go on.
Franchesca Cox (39:46)
Yeah.
Yeah, wow, you learn something
new every day. That’s cool.
Megan Williams (40:02)
If you go,
think it’s Calm, the app. This is not sponsored by the way. You know, I think that has different things and you can learn more about these different sounds, these environments. We of course know that every child’s auditory system is different. Some need more input, some need less input, and some need it delivered in a particular way. But the key piece is to observe, experiment, and find what helps your child stay
Franchesca Cox (40:10)
⁓ that’s…
Megan Williams (40:28)
regulated and connected and it’s becoming a detective to figure out what that is but we always encourage families to to definitely seek out help find a therapist who is trained
Franchesca Cox (40:42)
Yeah, so a lot of times OTs are trained in some of the listening programs and I think even speech therapists, because you said you are trained in the focus. So those, and I think some PTs, but it’s more rare, I think. So those are some therapists to seek out. So I think we’re almost out of time today, but some final thoughts and takeaways are that the auditory system is more than just hearing. It’s how the brain organizes, filters, and understands sound.
Megan Williams (40:48)
Yes. Yeah.
Yeah.
Yeah.
We know that when a child struggles with following directions, filtering background noise, or distinguishing between those similar sounds, this may be an indication of auditory processing challenge.
Franchesca Cox (41:22)
Yes, and sound sensitivity can be overwhelming. Some children need quiet spaces or headphones to regulate their auditory system.
Megan Williams (41:29)
Auditory processing plays a huge role in speech and language development and even feeding. I didn’t even mention it, but if you think about chewing, different textures give off different sounds and some kids love that and some kids hate that. So next time you’re eating, you’re able to, you know, listen to the sound of your crunching and you’ll kind of see what that’s like. If a child can’t process their speech sounds very well, they
Franchesca Cox (41:51)
Yes.
Megan Williams (41:55)
struggle with articulation, language comprehension, or even language production.
Franchesca Cox (42:01)
Yes, and strategies like rhythmic activities, breaking down verbal instructions, and incorporating music or movement into learning can help support auditory processing.
Megan Williams (42:09)
I think this has been a great episode to learn about the auditory system. I think it was fabulous. So we want to thank our listeners for tuning in to our auditory sensory system episode. Of course, next week we’ll be back tackling another sensory system.
Franchesca Cox (42:11)
Yes, so much fun.
Megan Williams (42:28)
So we hope you will join us next time. And until then, take care and keep making those big steps forward.
Franchesca Cox (42:35)
We’re so glad you joined us for Little Brain’s Big Steps podcast. Please remember information provided on this podcast, whether from the hosts, sponsors, or guests is for informational purposes only, and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with your child’s physician and therapist before making any changes to their medical care. Take care, and we can’t wait to chat with you again next time.
We’re so glad you joined us for Little Brain’s Big Steps podcast. Please remember information provided on this podcast, whether from the hosts, sponsors, or guests is for informational purposes only, and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with your child’s physician and therapist before making any changes to their medical care.
Franchesca Cox (43:17)
Thanks for joining us on the Little Brains Big Steps podcast. We hope this episode provided valuable insights and support for your journey. If you know a parent who could benefit from this episode, share it with them today. Be sure to visit our podcast website for show notes and additional resources. Until next time, take care and keep making those big steps forward.