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Interview with Sarah A. Schoen, PhD, OTR

Assistant Director of Research, SPD Foundation
Clinical Services Advisor, STAR (Sensory Therapies And Research) Center

By Randall Redfield
from Integrated Listening Systems (iLs)

I am considering integrating an auditory component to my OT practice, what questions should I be asking? Is the additional investment worth it? How do I know which auditory program to choose?

We've asked Sarah Schoen, PhD, OTR for her thoughts on the topic. Dr. Schoen is the Assistant Director of Research at SPD Foundation and teaches the auditory component of the Mentorship training.

Q: Why do you combine an auditory program with OT at STAR Center?

A: I think the rationale behind using an auditory program is that it's a sensory system that hasn't previously been used with children who have Sensory Processing Disorder. In the traditional Ayres-based sensory integration approach to Occupational Therapy (OT) auditory stimulation using listening stimulation was never a part the intervention. However, most children who we see have significant auditory processing issues. We have found clinically that the listening program we use, Integrated Listening Systems has been beneficial in reducing auditory sensitivity and increasing auditory processing abilities.

Q: In what areas do find an auditory program most helpful?

A: I should preface my answer with the caveat that since we use the 2 methods together - OT and auditory training - it's hard to attribute gains to just one or the other. The gains we see are from the combination. Generally speaking we see motor and language gains, improvements in organization and attention and a decrease in auditory sensitivity. I think what's really important about those gains is that we appear to be seeing them in a shorter period of time than we did when we were not using auditory stimulation. Developmental and other changes appear to accelerate from what we might see otherwise. Some parents report changes in academic abilities such as math and reading as well. We also get reports from parents of improved sleep patterns, self-regulation and self-confidence.

Q: Is an auditory program more important for some STAR clients than others?

A: Many clients at STAR use auditory stimulation (Integrated Listening Systems) with OT. Some children do listening programs during the OT sessions, and others do it over the duration of time OT is completed but they do it at home. Another option is completing a listening program at home after OT is completed. We decide using clinical reasoning which alternative is best for the child depending upon their presenting problems and their needs. In particular, we need to be careful with developmentally younger kids - beginning their listening separate from OT and only gradually combining them. This is one of the reasons we use the auditory system we do - Integrated Listening Systems (iLs, for short). With iLs we have a considerable amount of customization capability. So, for those with a high degree of anxiety we can use the Sensory Motor program, which is very gentle and does not go into the higher frequency filtration levels. We have found that listening is useful with a broad range of problems; it seems to help with anxiety and self-regulation issues and seems also useful in addressing auditory and motor deficits. We feel it complements the goals of OT by addressing the primary problems for which parents are seeking intervention for their children.

Q: How many of your therapists use listening?

A: All therapists at STAR are trained in iLs and use the equipment with clients as needed. Each client program is of course customized based on the clinical reasoning of the therapist and the team.

Q: Have you (or staff) used other listening systems?

A: Some staff members have been trained in other programs, and we often have parents who have experienced other programs. What we at STAR like about iLs is the ease of use, the ability to customize programs and the inclusion of bone conduction. As a clinician being able to individualize the sessions using clinical reasoning is crucial as well as being able to engage the vestibular system through the bone conductor in the headphones. Beyond that, the iLs hardware is well made and holds up.

Q: Can it handle the wear kids put on it?

A: I think they are quite durable. We have kids jumping off zip lines into ball pits and it does not damage the units. Having said that, nothing is completely kid-proof!

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