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Tomatis, Autism and Sensory Integration

.......Tomatis Topics

S o these four factors became very important in Tomatis' theories regarding the treatment of listening disorders. By the 1950's he had identified these following principles.

1.The voice can only produce what the ear can hear

2.The leading ear has a role in the establishment of audio-vocal control.

3.The body has an important role in self-listening.

4.Bone conduction plays an important role in self-listening.

He called this "audiophonology" which means "to hear oneself speak" He then went on to call it Audio-Psycho-Phonology to include the influence of will. "To listen and to listen to one-self are voluntary acts, recent achievements of evolution, while to hear is purely automatic. Listening is quickly replaced by hearing if any unfortunate experience occurs to break up the marvelous but unsteady functional structure." And he felt that all of these were ultimately associated with laterality.

T he Integrators - The Vestibular-Visual-Auditory Interplay

Theory of the Three Integrators The theory of the three integrators describes the neurological integration of the functions that Tomatis thought to be under the influence of the Ear. The three integrators are the foundation for the three areas of development considered to be unique to humans:

Verticality

Laterality

Language

Tomatis view the integrators to be a major mechanism of reception and integration of perception. They are cybernetic loops that are

Audio-linguistic

Audio-corporeal

In nature Vestibular (Somatic) Integrator The vestibular integrator governs the automatic "dynamic structure" by means of a protopathic neural structure, which is outside the realm of consciousness. Over the course of its evolution it progressively takes over all motor functions until it controls all movement of the diverse muscle groups. It both ensures motion and makes standing still possible. It is, in reality, the functional, primitive brain that coordinated all bodily functions, giving it the further designation of "somatic integrator."

It becomes more complex as one follows its development to discover the functional addition of the archeo- and then of the paleocerebellum. One can then justifiably envision its blossoming into the crown of the tree of the nervous system, in other words, the brain. The vestibular integrator is all the more important because it acts as the base element of the subsequent structure. It will simultaneously become the mainstay of and servant to the other integrators. (EandL169) The sensory apparatus we know as the ear is simply an external attribute of the cerebral cortex. The cerebral cortex itself is merely a concentration of vestibular nuclei located in the medulla oblongata zone of the nerve axis. Put another way the nervous system grew out of the ear.

A t the embryonic stage of fetal life, the cortex, and the labyrinth attached to it, induces structuralization of the entire nervous system. Vestibular information leaves the inner ear via the vestibular branch of the 8th (VIII) cranial nerve, a collection of primary afferent fibers with cell bodies in the vestibular ganglion. The peripheral processes the 8th (VIII) cranial nerve innervates the hair cells in the utricle, saccule, and semicircular canals. The central processes terminate in the vestibular nuclei of the rostral medulla and caudal pons.

Anatomically, the vestibular nerve presents itself at every level of the medulla and is thereby indirectly connected with all the muscles of the body. There is not a muscle that does not depend on the vestibule for its tone, equilibrium, and relative position with relation to the whole body (Tomatis, 1979) From there the connection goes to the descending homolateral vestibulo-spinal tract (9) and contralateral vestibulo-spinal tract (10). These tracks connect with the receptors in the muscles (14), joints (15), bones (16), and skin (17). These connections mediate postural responses by innervating motor neurons of antigravity muscles at all levels of the spinal cord. Sensory information returns from the receptors to the paleocerebellum through the tracts of Fleschig (18) and Gowers (19).

Other pathways project from the vestibular nuclei to the abducens (VI cranial nerve), trochlear (IV cranial nerve), and oculomotor (III cranial nerve) nuclei. These mediate the eye movements that compensate for head movements - the vestibuloocular reflex. There are abundant interconnections between the four-paired vestibular nuclei and the cerebellum. There are relays between the archeocerebellum and the paleocerebellum. The passage from one relay in the archeocerebellum to the other paleocerebellum through the network woven by Purkinje cells Connections are made in the cerebellum with the emboliform nucleus (22), which projects to the central portion of the red nucleus and returns information by way of the rubrospinal tract (24). Other connections are made in the cerebellum with the globose nuclei (21), which return through the inferior olivary nucleus (20) and the olivospinal 25) tract down to the spinal column.

There are also interconnections between the reticular formation (attentional processes and sustaining arousal) and the vestibular nuclei There is a projection from the vestibular nuclei to the thalamus, and from there to the cerebral cortex. The thalamic relay is in a small nucleus in the inferior part of the thalamus, near the ventral posterolateral (VPL) and the ventral posteromedial (VPM) thalamic nuclei. These assist changes in head position or motion to reach consciousness Vestibular fibers reach the thalamus bilaterally by traveling with the auditory fibers of the lateral lemniscus or via traversing the reticular formation. Both of these thalamic nuclei (VPL) and (VPM) project to the somatosensory cortex (parietal area) via the posterior limb of the internal capsule. So among other things, the Vestibular Integrator provides information for body image, kinesthesia, and the sensation of bodily movement and position in space.

Olfactory Integrator

Dominant in the rhinencephalon is the central detectors for fish, for whom smell is the primary means of connecting with their surroundings. This organ will locate the food the vestibular integrator will direct it on getting there. So there is interdependence between the two integrators.