OtoLing Philosophy to Communication Disorders

“Every theory that you make up has to be analyzed against all  possible consequences to see if it predicts anything else.” (Feynman,1965). Just because a theory is old does not mean that it is no longer relevant. Dr. Albert Einstein’s Special Theory of Relativity is still applicable more than 100 years later. As such, it is important to apply the scientific method to communication disorders.

To the extent that recent research has emerged to “bridge” time-honored theories to modern techniques, a need for holistic thought has been essential to treating complex neural problems. Dr. Hooks has developed and practiced a holistic approach that includes Auditory, Motor and synergistic coordination, Academic enrichment, Self-esteem, and Social emotional language. He has termed this approach as “AMASS.” The acronym is functional and descriptive, insofar that an individual who has experienced a delay or loss of selected language skills may need to gather and store new skills for effective communication. Therefore, evaluations are supported by evidence-based practice—that is, a research-principled standard diagnostic protocol based on peer-reviewed literature and evaluator expertise (Schuele, 2019). 

As such, there are five components to AMASS diagnosis and intervention that may include varying emphases of (1) Auditory perception and associated skills, (2) Motor and synergistic coordination for tactile feedback and coherence (lips, tongue, soft palate, buccal cheeks, jaw, and breathing mechanism), (3) Academic enrichment (reading, mathematics, written language expression, science, and pattern recognition), (4) Self-esteem to address psycho-social components of overall well-being. (5) Social-emotional learning—that is to facilitate the understanding strategies and skills, which promote respectful relationships and management of their own emotions.

Philosophically, Dr. Hooks believes that the complexity of language problems may emerge as one probes for answers from the bottom down—that is, probing backwards for a solution—at the likely source of the problem (Laughlin, 2005). As such, effective diagnosis and treatment become clearer with the recognition of a multidimensional process through an application of theory and practice that integrates several academic disciplines. Accordingly, the whole is greater than the sum of its parts (Laughlin, 1998).

OtoLing has been structured with a hypothesis-driven approach to investigate individual communication problems with evidence-based solutions. The foundational elements for the design have been derived from interactions among auditory, somatosensory (tactile sense), and visual processes. An integrative approach has been essential to certain diagnoses that may not appear directly related to certain problems—for apraxia and interactions among visual, auditory, and motor systems. 

Additionally, evaluations have been guided by empirical brain and neural circuits from empirical research. Accordingly, insight has been gained from a neuroscience perspective. Connectionist modeling and ecological schools of thought have proposed that mental events such as language should be considered in holistic terms rather than discrete brain processes (Morris, 1998 and Smolensky, 1988). 

Taken together, analyses have been written to characterize strengths, needs, rationale, and recommended strategies for immediate and long-term concerns regarding component parts working together. 

Theory, Preparation, and Practice

Several theories have prevailed and remained relevant over many decades—for example, Dr. Albert Einstein’s Special Relativity Theory (1905). Principles within this theory remain relevant today, and provide a foundation across the sciences and in everyday life. In a similar manner, selected diagnostic strategies and clinical impressions have been supported by several established theories including the Filter Theory of Auditory Attention (Broadbent, 1958), the Zone of Proximal Development (Vygotsky, 1978), The Motor Theory of Speech Perception (Liberman & Mattingly, 1985), and the Ecological Model of Child Development (Bronfenbrenner, 1979). Selected theories have been applicable to pediatric and/or adult cases. 

At the same time, the classic language model (Geschwind, 1979; Geschwind & Behand, 1982) has provided an incomplete explanation. Accordingly, Tremblay & Dick (2016) reported that modern and updated neuroscience techniques have shown connectivity among several systems (i.e., visual, auditory, somatosensory, and motor systems). Tract tracing, electrophysiology, and other research techniques have shown that specific neurons (nerve cells) appear to form circuits related to silent reading and auditory images (Bertolotti et al., 2012). This means that some aspects of auditory language processing may also be influenced by linguistic, visual, and oral motor constraints. 

In another vein, timing cues have been exceedingly important for the processing of language (Berry, 1969 and Broadbent, 1958), and more recently, consistent with synchronous neural coding (Sejnowski & Delbruck, 2012). In this context, it has become clear that current trends have been supported by established theoretical constructs that allow us to solve problems related to the processing of spoken language.

References

Berry, M. F. (1969). Language disorders of children: The bases and diagnoses. NY: Appleton Century Crofts.

Bertolotti,M. P., Kujala, J., Vidal, J. R., Carlos M. H., Ossandon, T., Bertrand, O., Minotti, L. Kahane, P., Jerbi, K., and Lachaux, J. (2012). How silent is silent reading? Intracerebral evidence for top-down activation of temporal voice areas during reading. Journal of Neuroscience 32(49) 17554-17562.

Broadbent, D. E. (1958). Perception and communication. London: Pergamon.

Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge, MA: Harvard University Press.

Feynman, R. (1965). The relation of mathematics to physics , Chapter 2. The Characteristics of Physical Law. Cambridge, MA: MIT Press.

Geschwind, N. (1979). Specializations of the brain. Scientific American (pp. 189-199).

Geschwind, N. and Behan, P. (1982). Left-handedness: Associations with immune disease, migraine, and developmental learning disorder. Proceedings of the National of Sciences of the United States of America, 79, 5097-5100.

Laughlin, R. B. (2005). A different universe: Reinventing physics from the bottom down. New York: Basic Books.

Liberman, A. M. and Mattingly, I. G. (1985). The motor theory of speech perception revised. Cognition. 21(1) 1-36. 

Morris, P. A. (1998). The ecology of developmental processes In W. Damon & R.M. Lerner (Eds), Handbook of Child Psychology: Vol 1: Theoretical Models of Human Development (pp. 993- 1028). New 

York: Wiley.

Schuele, C. M. (2019, June). Enhancing children’s phonological awareness and early literacy achievements. Presentation at American Speech-Language-Hearing Association Schools Connect. 

Sejnowski, T. and Delbruck, T. (2012). The language of the brain. Scientific American (4) 307 54-59.

Smolensky, P. (1988). On the proper treatment of connectionism. Behavioral & Brain Sciences, 11(1), 1-74.

Tremblay, P. & Dick, S. T. (2016). Broca and Wernicke are dead, or moving past the classic model of  language neurobiology. Brain and Language 162, 60-71.

Vygotsky, L. S. (1978). Mind in society: The development of higher psychological processes. Cambridge, MA: Harvard University Press.

“The whole is greater than the sum of its parts.” 

Robert B. Laughlin, Ph.D.  1998 Nobel Laureate in Physics

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