Alfred A. Tomatis

Alfred A. Tomatis (1 January 1920 – 25 December 2001)^[1] was an internationally known otolaryngologist, and inventor. He received his Doctorate in Medicine from the Paris School of Medicine.^[2] His alternative medicine theories of hearing and listening are known as the Tomatis method or Audio-Psycho-Phonology (APP).

Tomatis' approach began as an effort to help professional singers in his native Nice based on his idea that errant hearing is the root cause of a variety of ailments. His Listening Test and later his Electronic Ear therapy were designed to alleviate these problems.^[3]

Tomatis' life and work

Alfred Tomatis grew up in a musical family in France. His father was an opera singer, and he spent much of his childhood traveling with him and watching his opera performances from the wings. At an early age, however, he and his parents decided he was not fit for the stage. So he went into medicine and eventually became an Ear, Nose and Throat physician.

Soon after he began his practice, his father began referring him opera colleagues with vocal problems. Tomatis soon discovered traditional treatments inadequate but also that there was very little research on the voice itself. He formulated the theory that many vocal problems were really hearing problems. His theory that "the voice does not produce what the ear does not hear", is the hallmark of his research and his method. He discovered that the voices of opera singers had damaged their own muscles of the middle ears. With damaged hearing, they were forcing their voices to produce sounds in registers they could no longer hear.

In his attempt to retrain his patients, he developed the Electronic Ear, a device which utilizes electronic gating, bone conduction transducers and sound filters to enhance the uppermost missing frequencies. The goal is to tonify the muscles of the middle ear in order to sensitize the listener to the missing frequencies.

Tomatis began treating a number of other problems with the same methods, including reading problems, dyslexia, depression, severe schizophrenia, and even autism. He found evidence that many of these problems result from a failure of communication, which has to do with listening and the ear.

Scientific reports showed that the ear starts forming a few days after conception and that the ear is fully developed by the fourth month of pregnancy. Tomatis theorized that information coming from the fetal ear stimulates and guides the development of the brain. He believed that a number of auditory communication problems begin in pregnancy, with the fetus not properly responding to the voice of the mother. Tomatis theorized that the whole body is involved in the production of speech and language. He stated that reading, even silent reading, is an activity of the ear. He recommended reading out loud, not only for children and by children, but also by adults, for 30 minutes a day. He claimed this not only stimulates the brain but is the best way to learn.

His most controversial method attempts to lead autistic children to recognize and respond to their mother's voice. The electronic ear, he maintained, could simulate the sound of the mother's voice as heard in the uterus, and to lead the child gradually to accept and respond to her real unfiltered voice. He reported that this method often brought startling results, with children crying with joy as they recognized their mother's voice for the first time.

In many of the differing issues he addressed, Tomatis believed that many problems of learning disabilities, dyslexia, schizophrenia, and depression were caused by some trauma resulting from broken relationships and poor communication. He found that treatment of these maladies requires the cooperation of the parents and even grandparents.

In his autobiography, Tomatis recounts the many run-ins he had with the medical establishment in both France and Canada, where he later worked. Eventually he left the orthodox medical community, admitting that his practice was beyond the scope of normative allopathic comprehension. He named his new field audio-psycho-phonology.

The science of Tomatis

Tomatis reported in his autobiography^[3] that he regretted not providing scientific colleagues with more statistical evidence for his work along with his many publications. But he claimed that the benefits of his methods are difficult to measure.

Due to the lack of scientific basis and the wide range of diseases it claimed to treat, French authorities have always considered Tomatis sound therapy as an alternative medicine which should not be promoted. Alfred Tomatis was banned for life from the French Medical Council in 1977 (a sentence that is extremely rare) and subsequently convicted for "illegal practice of medicine" in 1990. Unfortunately his theories have been adapted and are being used by others as a scam to charge a lot of money in exchange of very cheap equipment by many companies and in several countries. ^[4]

The results of a scientific study published in 2008^[5] reflect a lack of improvement in language using the Tomatis Method for children with autism. However, in 2010 Jan Gerittsen ^[6] conducted a detailed case analysis of Corbet's reported findings on children on the Autism Spectrum Disorder. Gerittsen showed that for this particular research an individual case study design would have been the more appropriate research design method. His individual case study analysis captured with higher fidelity the effect of Tomatis Method in each of the participant. Given individual differences of children on the Autism Spectrum a group design study could omit to address the significant improvements which Gerittsen noted occurred in 60 % of the participants in the areas of language, daily living skills, social interaction and motor skills.

Tim Gilmor's meta-analysis, covering four smaller studies of the Tomatis method found that "Positive effects sizes were found for each of the five behavioral domains analyzed".^[7] These study results, although positive, are limited by major methodological issues such as small sample sizes and limited use of random assignment.

Gerittsen^[8] summarized 35 reteach studies documenting effects of the Tomatis Listening Method in a variety of cognitive, developmental / behavioral and aptitude domains. These include studies on children and adults with learning and developmental disabilities including auditory processing issues as well as applications for optimizing well-being and aptitude in musicians.

Most recently, in 2013, Liliana Sacarin^[9] found significant early effects, after only 30 hours of Tomatis sound stimulation, in children 7-13 of age diagnosed with AD/HD when using standardized measures of performance, observed behavior and brain electrophysiology. The results of her doctoral dissertation evidenced statistically significant improvements in cognitive, attentional and behavioral measures for the Tomatis group when compared to the controls (non-Tomatis group). The Sacarin study reported that the qEEG group analysis resulted in significant brain electrophysiology changes for the Tomatis group but not for the controls.

Despite criticisms of Audio Processing Integration in general and the Tomatis Method in particular, some of those treated, notably Gérard Depardieu,^[10][11] Sting and Maria Callas, maintain that they experienced highly beneficial results from working with Tomatis and his method.

In some websites it is reported, that in the years 2005 - 2007 the Ministry of Education in Poland had implemented the Tomatis Method in hundreds of schools ^{[12][13][14][15]} with financial support of a programme initiated by the European Union,^[16] recommended and scientifically accompanied by the 'Instytut Fizjologii i Patologii Słuchu, Warszawa' ^[17] (Institute for the Physiology and Pathology of the Ears, Warsaw). Research done in Poland (72 schools; 1333 children) proved that the training improved key school competences (ability to learn; social competences; language competences; music competences.

The Tomatis effect

Tomatis adapted his techniques to target diverse disorders including auditory processing problems, dyslexia, learning disabilities, attention deficit disorders, autism,^[7] and sensory processing and motor-skill difficulties. It is also claimed to have helped adults fight depression, learn foreign languages faster, develop better communication skills, and improve both creativity and on-the-job performance. About some musicians, singers and actors it is also claimed they have said they had found it helpful for fine-tuning their tonal and harmonic skills.

The Tomatis Method uses recordings by Mozart and Gregorian Chant as well as of the patient's mother's voice. Tomatis' use of Mozart is not to be confused with so-called Mozart Effect popularized by American author and music researcher Don Campbell. Although Tomatis coined the phrase, his method is not directly related to claims that listening to Mozart increases intelligence.

Tomatis wrote fourteen books and over two thousand articles. His Ear and Language, The Conscious Ear and The Ear and the Voice have been translated into English.

Awards and honors

Tomatis' awards and honors include:

• Knights of Public Health (1951)
• Gold Medal for Scientific Research Brussels (1958)
• Grand Medal of Vermeil from the City of Paris (1962)
• Price Isaure Clemence (1967)
• Gold Medal of the Society "Arts, Sciences and Letters" (1968)
• Commander's Cultural and Artistic Merit (1970)
• Medal of Honor Society for Promoting Arts and Letters (1992).

References