Case study 20 years old client diagnosed with communication disorders, sensory issues and anxiety us

Case Study: 20 years old client diagnosed with communication disorders, sensory issues and anxiety using the Tomatis® Method Date: 15 April 2016.

Case study submitted at the International Tomatis® Convention 2016 in Paris.

PROFESSIONAL’S DATA Name: Ansie Vercueil Country: South Africa Job: Therapist. Tomatis® Practitioner - Level 1

CLIENT ’ S DATA Client designation (no fullname): Mandy (Pseudonym) Age: 22 Gender: M Issue(s) presentation: Communication problems: She struggled to express herself adequately and therefore spoke a minimum. When asked a question, she always took a long time before reacting and answering the question.

Problems with information processing and integration: The parents called it problems with "integration of brain function".

Anxiety: Mandy were easily stressed when exposed to a new environment or circumstances. She was also prone to performance anxiety, especially during exams.

“Low Initiative”: According to the parents, she never took any initiative – everything had to be suggested to her or initiated by someone else. Even starting something basic such as bathing / washing could be problematic.

HISTORY (MEDICAL HISTORY, ETC.) Mandy has two older sisters. Although she was born 2 weeks prematurely, the birth process was normal. She lived with her biological parents who were happily married.

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Pre-school: According to her parents, Mandy was “neurologically immature”. Thus, there were signs of developmental delay as a child. She received occupational therapy and speech therapy.

She also had low muscle-tone for which she received physiotherapy.

School: Although she was an average, and sometimes a little below average, achiever she was obedient and conscientious. Therefore, her teachers did not notice her performance anxiety and that she displayed signs of ADD. By the end of her grade 11 year, one of her older sisters went missing. Although her sister was found again, the family was traumatized by the event.

College (Tertiary education): Mandy’s learning problems came to the fore during her first year at college. Her grades were low and failed some of her subjects. Although she was allowed to take 2nd year subjects the following year, she still had to pass the rest of her 1st year subjects. During this time, she was diagnosed with ADD and "Concerta" was prescribed. She struggled with the workload, her anxiety increased, she was diagnosed with depression, antidepressant was prescribed, and her doctor advised that she terminate her studies for the time being.

Other medical conditions: Except for allergies and sinus problems, there were no other medical conditions.

GLOBAL INTERVENTION Selected Tomatis ® protocol and programs At that time, I was a Tomatis Level 1 practitioner, and did not have the Tomatis Listening Test at my disposal. Therefore, my evaluation consisted of consultation with the client and her parents, questionnaires, and my own observation.

We used the Solisten ELMA programs. Mandy came to my practice and did two intensives of 15 days each – 2 hours per day. The first intensive consisted of the Basic Program and E1a was used for the second intensive.

Tomatis ® session goal(s) Since the ‘Basic’ program consists of the longest combination of precession and delay, and Mandy struggled with the processing of information and took a long time to react during a conversation, I decided to start with ‘Basic’. Furthermore, this program does much of what is needed, even though the music is unfiltered. The goal for the first intensive was to give her energy while helping her to calm down and to process auditory information, without getting anxious.

Mandy reacted positively on the first intensive, her posture improved, she became aware that she finds it easier to process and understand auditory information, she showed progress regarding communication, and she felt less depressed. Although her feelings of anxiety decreased during the first intensive and she slept better, she still inclined to be more than normally anxious in new situations. In addition she indicated that she still tend to feel tired and then find it hard to concentrate. During the time I worked with her, I also got the impression that she tended to doubt herself and lacked self-confidence.

The goal for the second intensive was to build on the progress she made and to address her anxiety and tiredness. Because Mandy still struggled with anxiety and tiredness and her feelings of depression was not completely sorted out, I thought that a program with MD’s, which provide more energy and helps to decrease anxiety, could be beneficial. Furthermore, low BP’s could still be useful to help her ground in her body, and VL’s could complement the work on the vestibular Copyrights : Tomatis Developpement S.A - 2016

system and help her with executive processes. In addition, she showed progress regarding information processing. Thus, I believed shorter precession and delay would be in order.

Therefore, the E1a program, consisting of the above mentioned music, was used for the 2nd intensive. Since she came to my practice for the listening sessions, I could monitor her on a daily basis and it would have been easy to switch to E1b or back to Basic if she should have a strong emotional reaction.

Observations: First Intensive: During the first 5 days’ listening sessions, Mandy paged through magazines, just sat around and sometimes dozed for a while, even though I told her she could bring something to keep her busy and do any sedentary activity. I also provided her with paper, pencils and crayons in case she would like to draw. She almost seemed to be apathetic and it was very difficult to involve her in conversation. When she came to the sessions, she mostly looked downwards as if she wanted to hide and it was difficult for her to look me in the eye.

She was also encouraged to write how she currently experiences herself as thinking, feeling and communicating individual. She could also draw a picture and use metaphors. She wrote that she was feeling confused, that she “thinks slowly” and as if her brain was “scrambled” all the time.

She also felt alone and that she could not voice her feelings. The way in which she wrote was interesting: Her sentences was disorganized, spelling was often incorrect and there was almost no punctuation. In addition, her handwriting was messy and often strikethrough. Thus, it was difficult to unravel the writing.

On the 6th day, she brought her own puzzle and was sometimes humming with the music. From then onwards, she started to ask questions and sometimes looked me up.

After the first 15 day intensive, her mother reported that for the first time ever, Mandy started to initiate conversations. She further stated that she could now have a proper conversation with Mandy without pulling a response from her through a question and very short answer session.

Second Intensive: In addition to be able to have a more meaningful conversation, Mandy did not seem so apathetic anymore. She seemed more involved, did not ‘hide’, appeared more positive and looked me in the eye when we spoke.

Towards the end of the program, she reacted sooner when asked a question, and seemed generally more confident. She reported that she “felt better regarding herself”, thinks quicker, and concentrates better. She also had more energy.

The way in which Mandy wrote also improved. She actually organized her thoughts by numbering them, one beneath the other. Her sentences were more coherent, spelling was less phonetic, her handwriting was less messy and there were almost no strikethroughs.

QUESTIONNAIRES AND TEST SCORES

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Questionnaire / Test Name

Score before the sessions

Score after the sessions

Comments

Spielberger Trait Anxiety

23

2

Drastic decrease of trait anxiety

Spielberger State Anxiety

42

2

Drastic decrease of state anxiety

Beck Depression Inventory

11

2

Drastic decrease in feelings of depression

COMMENTS Relatives: Mandy’s parents were very pleased with the results. They were especially impressed with her improvement with regard to communication. They also indicated that the results of the program as reflected in the questionnaires, corresponds with how they now experience Mandy at home.

They felt there expectations were met and they now have a happy child with which they can have a meaningful conversation and who could have a productive life ahead.

Professionals: According to the parents, the opinion of the doctor was that Mandy could gradually go off the anti-depressant and possibly also the Concerta.

OTHER IMPORTANT OBSERVATIONS The results from the questionnaires were very positive. Her anxiety and feelings of depression decreased a lot.

Although Mandy’s Psychological Wellbeing were quite satisfactory before the program, it also showed improvement after the program.

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APPENDIX Graphs of Questionnaires Before and After Tomatis Program Anxiety & Depression

Psychological Wellbeing

Copyrights : Tomatis Developpement S.A - 2016