Analysis of the audio-phonology results in the mentally deficient

Communication presented by Dr Spirig, of the Centre of Audio-Psycho-Phonology of Nieuwpoort (Belgium), at the first day of the 2nd International Congress of Audio-Psycho-Phonology held in Paris from 11 to 14 May 1972. Dr Spirig there reports on a comparative analysis carried out on children received as “mentally deficient” — audiometric, psychomotor, neuro-motor, scholastic and electro-encephalographic characteristics — and on re-education through maternal voice (M.V.) and Electronic Ear. There follows the discussion, chaired by Prof. Tomatis, which dwells at length on the body image, selectivity, the intelligence quotient, Einsteinian space-time, the mother-child dialogue, sonic birth, and the role of Gregorian chant (interventions by Mr Bonhomme, Mme Joanny, Dr Sarkissoff and listeners).

Analysis of the audio-phonology results in the mentally deficient

by Dr Spirig
Centre of Audio-Psycho-Phonology of Nieuwpoort (Belgium)

2nd International Congress of Audio-Psycho-Phonology, Paris, 11-14 May 1972 — Proceedings, pp. 73-79.

Introduction

The work presented here bears on a group of children received at Nieuwpoort under the label of “mentally deficient”. We sought to bring out, among what is commonly called mental deficiency, what properly comes back to a defect of audio-phonology and what is distinct from it; this, with the perspective of proposing a differentiated re-education.

A. — Characteristics of the population studied

1. Audio-psycho-phonology. — All these children present disorders of audio-phonology in the sense Prof. Tomatis understands them: defect of selectivity, defect of opening, particular audition curve.

2. Auditory test. — The audiometric curves show constant particularities: weak selectivity, deficient opening, often basin-shaped or irregular profile in the middle frequencies.

3. Psychomotor tests (a — Bender, b — laterality tests, c — graphomotor tests). — Three groups are distinguished:

A first group presents a global psychomotor delay, without marked dissociation;
A second group presents a less deficient psychomotor evolution but with clear inequalities according to the tests;
A third group presents normal or near-normal psychomotor results, even though these children were sent as deficient.

4. Neuro-motor behaviour (a, b, c, d). — Detailed examination of tone, syncinesias, general dynamic coordination and oculo-manual coordination.

5. Mobility profile. — Established from the preceding tests, this profile brings out the properly neuro-motor share of the delay.

6. Scholastic knowledge. — Level reached in reading, writing, calculation, compared to chronological age.

7. EEG. — Electroencephalographic tracings collected on the whole set of subjects.

B. — Re-education

The analysis of the partial failures encountered in the course of re-education by Electronic Ear in a first phase led us to isolate two essential elements, without which re-education does not set itself in place in a durable way:

the resumption of the filtered maternal voice, carried out as far as the sonic birth;
attention to the opening and the selectivity of audition, parameters that must be followed step by step throughout the re-education process.

C. — Resumption of the Maternal Voice (M.V.)

We illustrate this resumption by the case of a Flemish dyslexic child sent to the Centre. The systematic resumption of M.V. enabled the gradual appearance of phenomena that the first re-education, conducted without this resumption, had left in the background.

D. — Reactions observed after the resumption of M.V.

1. — Simultaneous appearance of an improvement in auditory opening and selectivity.

2. — Modifications observed on the psychomotor plane:

reorganisation of tone;
diminution of syncinesias;
improvement of dynamic coordination;
improvement of graphomotor tests;
reorganisation of laterality;
improvement of body schema;
global improvement of behaviour and relational availability.

E. — Conclusions

From the three groups described above, we propose the following conclusions:

Group I — global psychomotor delay, authentic deficiency: re-education by M.V. + Electronic Ear has an adjunct effect but does not shift the underlying structure;
Group II — (a) favourable evolution when the resumption of M.V. is conducted to term; (b) disappointing evolution in the absence of this resumption;
Group III — (a) children sent as deficient but without authentic deficiency: audio-phonological re-education reveals a markedly normal intelligence quotient; (b) the label of deficiency falls in favour of a diagnosis of inhibition of audio-phonological origin.

F. — Proposed re-education schema

complete audio-psycho-phonological assessment at entry;
systematic resumption of M.V. with sonic birth before any other step;
Electronic Ear sessions following step by step opening and selectivity;
periodic re-evaluation of the psychomotor and scholastic parameters.

G. — Open questions

To what extent can one push the opening of selectivity in authentic deficients?
What is the role of the EEG as indicator of the potential for recovery?
How to weigh the organic share and the conflictual share in the genesis of the picture of deficiency?
What becomes, in the long term, of Group III when the label of deficiency has been lifted?
What place to give to Gregorian chant in the programming of the deficient?
Is sonic birth to be resumed several times in the same subject, and according to what criteria?
How to articulate the audio-phonological contribution with the existing structures of specialised education?

Discussion of Dr Spirig’s paper (Nieuwpoort)

Debate chaired by Professor Tomatis

Proceedings, pp. 81-95.

Intervention by Prof. Tomatis

Prof. Tomatis, taking up the questions raised by Dr Spirig, returns first to pure tones and to the audition curve. He insists that the body image is constructed in terms of the perception of high frequencies, and that the language zone can only be organised if selectivity is open across the whole audible spectrum.

Dr Spirig

Yes, that is precisely what we observe in these persons: as long as selectivity remains closed, the body image remains fragmentary and the language zone is not organised.

Prof. Tomatis

Dr Spirig is on the same path as we are. The Electronic Ear sessions allow, step by step, the re-establishment of the function of cortical recharge, and schooling resumes during the treatment itself. But it must be understood that what we often call “deficiency” is, in reality, in many cases, a false quotient: the child has not had access to the neurological equipment necessary to give proof of his intelligence, for want of a sufficiently open ear.

Filtered music and the maternal voice allow one to come back below this deficient equipment. We have even obtained surprising results with schizophrenic subjects, by going to look for what happens below the vault of the sebum — there where sonic perception has not yet left the somatic dimension.

It must be recalled that sound does not pass only through the ear; it also passes through the skin. It is the whole human being who hears; the eardrum is but one point among others in this generalised listening. The EEG moreover shows us that sound stimulation has repercussions on the whole cortical tracing, and not only on the auditory areas in the strict sense.

There is here a whole problem of space-time that rejoins, in my eyes, Einstein’s intuitions. In left-handers and in pronounced dyslexias, what is at stake is precisely a defect in the organisation of perceived space-time. The ear — and more widely the whole somatic sensor — must be able to hierarchise what arrives before and what arrives after. As long as this hierarchy is not assured, the child remains caught in the undifferentiated cosmos of his perceptions, without a fully constituted ego.

Mr Bonhomme

The future, properly speaking, does not exist.

Prof. Tomatis

Let us say that the future is what listening tends us towards; it is the direction of transcendence. Without listening, there is no possible future — there is only the repetition of an undifferentiated present.

Mr Bonhomme

And memory?

Prof. Tomatis

Memory is the file where what has been heard and integrated is inscribed. As long as the ear does not hierarchise, there is no real memory but a sonic magma in which nothing can be found again.

A listener

(intervention not recorded)

Prof. Tomatis

To take up the question of the maternal voice as Dr Spirig poses it: we always find ourselves, at one moment or another, before the situation of Oedipus the King. The mother must accept to let go of the child; without that, no true opening is possible.

A listener

And the mother?

Prof. Tomatis

We also play Filtered Music to the mother. Often, it is by this means that she makes herself available to the child.

A listener

(question relating to birth)

Prof. Tomatis

The child, at birth, changes world abruptly. Inside the uterus, he heard in a liquid medium: his middle ear was filled with amniotic fluid, and the acoustic impedances were entirely different from what they were to become.

We thus gradually provoke the change from one to the other of these impedances, until the child feels what happened in the first moments of his life. At the start, indeed, he hears as he heard when he was in the uterus, his middle ear still full of amniotic fluid; this accounts for why he is so tonic during the first ten days of his infant life. Then, gradually, all vanishes for several months; the child loses his tone because he no longer has the chance to hear high sounds, because his impedance-transforming apparatus is not yet developed. Little by little, he will learn to use the air as a medium of transmission, and his eardrum will learn to tighten again as when he was in the uterus.

Mme Joanny (Nancy)

And at the level of the tapes, how does it happen?

Prof. Tomatis

We have filter systems that take the maternal voice from 8,000 Hz to 125 Hz in a single or several stages. We shall speak of this again tomorrow, when we evoke the problem of programming.

The child must be made to hear his mother’s voice again as he heard it at the beginning of his foetal life, and then made to relive his birth, his change of universe.

A listener (female)

For the same kind of cases, do you recommend the same programming each time?

Prof. Tomatis

Yes, in general, since human evolution is the same for each individual. But there are however particular cases that require modifying to a certain extent the distribution of information. Suppose you do a sonic birth after a series of M.V.; the child evolves well; you therefore continue and pass to the next stage, but there you observe a resistance, an intolerance. You then have an interest in resuming the M.V. and starting a sonic birth again after a certain time. You then see how the child reacts, and if he is not yet ready you can start again. Do not be afraid to do it as many times as necessary; there is no danger.

Dr Sarkissoff

Can one do two or three sonic births one after the other?

Prof. Tomatis

Yes, and even more, without any drawback — quite the contrary. You then attend to a kind of pleasure, of revival, in the child, very extraordinary to observe.

Dr Sarkissoff

Do you follow this birth with one or several sessions of non-filtered maternal voice?

Prof. Tomatis

Yes, preferably; you often have the surprise of seeing, at that moment, that the child hears his mother; his relation with her becomes better. Above all, the father’s voice must not be played immediately afterwards, for there may be very violent reactions. The father is the other; he is the becoming, he is the right; he is what the child in treatment often refuses.

There is therefore reason to follow a very nuanced programming. After M.V.N.F. (non-filtered maternal voice), filtered music is played; then language is broached with words rich in high frequencies. It is only after 60 to 80 sessions that one may envisage playing the father’s voice. We shall speak of all this again tomorrow on the occasion of the paper Mme Espinat is to give on the subject.

Dr Sarkissoff

I have not much to add; I should like, however, to come back on what Prof. Tomatis has just said concerning sonic births. I think that one of the great advantages of those who do not treat the deficient is, as Prof. Tomatis mentioned, this possibility of provoking a resurgence of conflicts.

When we perform the sonic birth, we see quantities of conflicts appear; it is marvellous, for at that moment we can help to untie these conflicts by verbalising them, by understanding them. As for the conflicts of the deficient, we cannot generally detect them; it is impossible to untie them otherwise than with the Tomatis apparatus. We are thus in a position to bring into play the neurological dimension of sounds, whereas usually we have at our disposal two dimensions in the human contact we can have with the child, which enables us to understand his conflicts.

Prof. Tomatis

I think that, for the deficient, we find again somewhat what Dr Dubard set out to us this morning about the handicapped and otherwise deficient child. There exists in him a rejection; there exists in these people a great underlying fear, a psychotic one, of which we must absolutely take account and for which we can intervene with the help of our techniques.

It is certainly unthinkable to have a child with an IQ of 70 benefit from an analysis; the approach is difficult and reduces to a few games and a few movements, but it must be known usually, with the auditory revalidation, if the IQ rises to 80, the subject will then increase his field of consciousness and the problem changes aspect.

I believe that, in giving current to an individual through the ear and through the purely energising play of the recharge function, with the percussions of awaiting an electrical co-activation plane to the neurological co-activation plane belonging. That is also where the danger lies — as consciousness begins to awaken, the analyst can then play this factor to go further. I know how the analyst plays with the unconscious and I would like to ask him to explain it to us. I must say that this word “unconscious” makes me uneasy; I do not know what Dr Sarkissoff thinks.

Dr Sarkissoff

The unconscious is a hypothesis; it is something invisible that one cannot reach consciously; it is always reached in an indirect manner. But it is by this indirect way of being conscious. That is why the activity of the Tomatis apparatus is to be compared with the activity of a sonic psychoanalysis — both aim to reach something that is beyond the phenomenon and that is the unconscious.

On the other hand, I was very interested by Dr Spirig’s remarks on the epileptoid and the subject the analyst designates in this sense. In a short time, some strike us neurologically on what one must have courage about, but I do not, to broach themes that do not form part of your speciality. The penumbra of this appearance of the epileptoid in the epileptoid and the subject of sending erasures in the cortex in the direction of the temporal area, to what could, as Dr Spirig said, and as Prof. Tomatis has just confirmed, be a maturation of these zones that have never been able to awaken for want of receiving the necessary stimuli.

This maturation accompanying me would have been elementarily elided, by phenomena that may be of epileptoid type. It seems that in the course of the epileptoid, or one is in the presence, at the moment when the defects cross the barriers and permanent a certain, of an increase in seizures or phenomena that evoke the appearance of authentic epileptoid. This recrudescence is, I believe, a very good prognosis of the maturation process. It is, notable, a kind of reactivation that one can

attribute, if one wishes, to the death instinct or to other hypothetical causes that provoke the crises and that comes to insert itself into the birth. Everything happens as if this maturation strove to unveil these data in our psychoanalytic theses. Accompanied by a kind of release of the death drive that provokes the epileptic crisis and a vital function that would correspond to the maturation of these cerebral zones.

Prof. Tomatis

I should like to add a word on this subject. We thought, at the beginning of our research, that we needed extremely sensitive devices, notably in regard to headphones; we wanted headphones that would go up to 16,000 Hz, and that before knowing what we were researching. Now, it turned out gradually that with these very-high-frequency headphones, we risked provoking epileptic seizures. This answers what you are saying: the epileptoid phenomenon, being a setting into resonance of a part of the edifice usually muffled; something happens; it is very right that the epileptic enter into conflict with his body.

We have therefore eliminated frequencies above 100 Hz to avoid these incidents. One feels indeed, when one plays many low sounds, that a fatigue appears. One enters a kind of stirring, of risk of setting into resonance a poorly channelled cerebral rhythm. Whereas, on the contrary, when we play the highs, we harmonise by setting the cortex into functioning in a direction that gives, at the same time, elements of recharge.

Dr Spirig

We have often noticed, in dyslexics, epileptoid signs during a certain period, that will fade subsequently. We have noted similar phenomena in stammerers.

Now I should like to ask you another question on the following principle: given that we observe that selectivity remains blocked as long as maturation does not evolve, we are entitled to think that it is a psychological phenomenon. I have understood, from the psychoanalytic data, that this non-evolution is, for a large part, unconsciously willed. Is that quite correct?

Prof. Tomatis

I think there is here a blockage at the thalamic level and that, in this case, a well-directed pharmacopoeia could help us: it is a question of the biogenic life viscosity, of total viscosity. One can think there further of free life more to do births, to leave the child in the headphones several hours a day, to use harmonic sound baths. We have even thought of putting loudspeakers to maintain a constant sonic ambience for these subjects — sound does not pass only through the ear; it also passes through the skin and one must think of soaking the individual with sounds over his whole body so that he accedes to a certain level of opening to the outside world. As soon as he reaches 500 Hz, the body image appears, notably the awareness of the viscera; and the subject relives, during this period, his purely umbilical life, which has most often prevented him from rising above a visceralised lived experience.

Dr Spirig

Should one continue sonic births until selectivity is completely open?

Prof. Tomatis

Yes, I think so; I myself have deficients in treatment and I confess that I am often, like you, blocked by this phenomenon of non-opening of selectivity. I then have them do Electronic Ear sessions as long as they do not reach 11 octaves.

One element that gives us extraordinary results (we shall speak of it again in programming) is Gregorian chant; you will see that the deficient open in an astonishing way on listening to Gregorian chant. There are at the Paris Centre children who refuse strictly everything, but as soon as Gregorian chant is played to them, they immediately begin to sing and awaken in an exceptional way.

Gregorian chant is a chant that calls on no psychoanalytic projection; that is why it was created. All sacred chants, which pass into the selective zone of recharge, tone the being without touching his viscerality. If you take a great opera singer, I defy you to make him sing three measures of Gregorian chant; he never succeeds, because he is too caught up in his visceral chant, which is that of the everyday man. To pass to the other chant is very difficult for him. By contrast, when a child tastes the Gregorian modulations, he neuronically appreciates the quality which recalls nothing of his lived experience, which calms him and directs him towards the high spheres of transcendence. We do more and more Gregorian chant sessions.

Mr Bonhomme

Are there sonic blanks in these Gregorian chant trainings, allowing one to repeat the musical phrase?

Prof. Tomatis

Yes. Thinking that memory might be deficient, we have even gone so far as to inject in attenuated form the same sonic phrase so that the subject may repeat at the same time. He thus has at his disposal a support that allows him to repeat until he can do it alone.

Some children accept only Gregorian chant during a certain period. These tapes, which have great soothing power, must then be played to them.

Source: “Analyse des résultats d’audio-phonologie chez les débiles mentaux”, communication by Dr Spirig (Nieuwpoort Centre, Belgium) and discussion chaired by Prof. Alfred Tomatis, in Actes du II^e Congrès International d’Audio-Psycho-Phonologie, Paris, 11-14 May 1972, pp. 73-95. Document digitised from the personal archives of Alfred Tomatis. Transcription: the quality of the period document (typewritten stencil) does not allow a perfectly faithful reading of every line; some turns of phrase of the debate have been restored by visual reading of the high-resolution scanned pages. The concepts and the argument are faithful to the original.