A Case Study: Sean

Sean was enrolled in my Pre-School Disabilities class at age three. He presented with fine motor delays and unintelligible word production. Various interventions over the next year yielded positive gains in isolated skills, but the integration of breath, rhythm, and movement he needed didn’t come together until we tried Therapeutic Listening ®.

At age three, Sean’s body did not support the development of fine motor skills. His shoulders were always hiked to give his head and neck stability. He exhibited low tone, flexion posturing with shallow breath, and a lack of physical endurance. If Sean was asked a direct question or given a physical challenge, his chest, neck, face, and ears would flare bright red. Recovery time was lengthy.

His fine motor weaknesses limited his activity options within the school environment. He found stacking blocks a frustrating experience. He could not color or cut. Manipulatives had to be held close to his body. Sean’s word production was near unintelligible. He reduced all words to one syllable, vowel sounds were distorted, and he only used three consonants for final sounds. Although he sought to interact with peers, these
communication difficulties negatively affected his social relationships.

Various interventions by myself, and the Occupational Therapist I collaborate with did yield some positive gains. Sean’s posture, strength, endurance, and coordination improved allowing him to participate more fully in classroom activities. His conversational speech was still unintelligible, but he was able to produce isolated sounds correctly. It was soon apparent that Sean lacked a sense of rhythm and timing, both motorically and vocally. He was unable to maintain a beat, his movements for finger play never matched the group and when singing, he
was either way ahead of the tempo or lagging behind like an echo.

Sean’s initial Therapeutic Listening protocol was modulated music for 30 minutes each day in school. Ideally he would have had an additional session at home but we didn’t yet have equipment for home use. Sean progressed through Ease 1, Ease 3, and Mozart for Modulation. After one month Sean gave the four distinct syllables of his full name for the first time.

We continued Therapeutic Listening, recently having him listen to Grape Jamz. With the others he would go about his business with headphones on, but with this particular CD he stopped and listened. As he continued with Grape Jamz, he began to spend more time in the art center of our classroom, and his fine motor skills began to improve. Recently we played Pease Porridge Hot, which involves clapping your hands and your partner’s hands in a pattern. It was the first rhythmic task he has ever completed successfully!

For Sean, the Grape Jamz CD was appropriately placed later in his treatment. It gave him the opportunity to connect on a cognitive level. He now produces 7-8 word sentences, and although his speech is not entirely intelligible, his meaning is usually apparent. The red flushing has significantly diminished. Social interactions are flourishing now that Sean is able to verbally navigate the changes in theme during cooperative play, and he is now ready for regular Kindergarten.

- Karen Kistler, Special Education Teacher