Speech therapy and the Tomatis method

Speech therapy

A speech therapist (logopédiste in Switzerland, orthophoniste for our friends in France) works with communication, language, speech and voice disorders.

These disorders may be caused by a brain injury, learning or developmental difficulties, or illness.

Speech therapists use a range of techniques, including phono-vocal ones, to help people overcome their difficulties.

The Tomatis method

An audio-psycho-phonologist trained in Dr A. Tomatis's method also works with communication, language, speech and voice disorders.

However, while the theoretical foundations and the goals are shared, the methods used are different.

Speech therapy and the Tomatis method: what is the difference?

Speech therapy is a set of articulatory, phonological and vocal techniques that aim to treat the symptoms observed, whereas the Tomatis method is listening training, using gated and filtered music, that aims to treat the causes of the symptoms observed.

In other words, where speech therapy will, for example, try to correct the incorrect pronunciation of certain sounds through repetition and listening, the Tomatis method goes further by trying to correct the way the brain areas involved decode and analyse sounds, which is what lies behind the mispronunciation.

In short, if you mispronounce certain sounds, you can correct this by repeating them until you manage it (the speech therapy approach), or act on the brain areas concerned by retraining the muscles of the eardrum and the stirrup bone (the Tomatis method).

Targeted action on the brain's hemispheres

Speech therapy provides articulatory, phonological and vocal training. This training acts specifically on the right ear – left brain pathway, which is involved in spoken language.

The Tomatis method provides audiological, psychological and phonological training. This training acts on both pathways: right ear – left brain, and left ear – right brain. The left ear – right brain pathway is involved in emotional language.

Complementary approaches

Speech therapy and the Tomatis method are two approaches that aim to improve things for people with language and communication disorders such as dysphasia, dyslexia, stammering or aphasia.

Although they complement each other, they do not address the brain hemispheres involved in language in the same way. That is why, depending on the difficulty, one approach or the other will be more appropriate.

For example, if emotions are making the language disorder worse, the Tomatis method will be better suited, because it also addresses the right hemisphere.

If the main problem is articulation, speech therapy will be more appropriate because of the specific exercises it offers.

In other words, speech therapy addresses expressive disorders, while the Tomatis method addresses receptive disorders.

Complementarity backed by science

Source: https://pubmed.ncbi.nlm.nih.gov/12918003/

In short, this meta-analysis shows that speech and language therapies have a positive effect on expressive disorders (phonology and vocabulary), while the results are mixed for syntactic and receptive disorders (listening and understanding).

A few words on how language is split between the hemispheres

Language is generally associated with the left hemisphere of the brain. The left hemisphere is responsible for producing and understanding language, while the right hemisphere plays a part in its emotional and prosodic aspects.

Left hemisphere

• Language production: Broca's area, in the left frontal lobe, is responsible for planning and producing the muscle movements needed for speech.

• Language comprehension: Wernicke's area, in the left temporal lobe, is involved in understanding spoken and written language.

Right hemisphere

• Emotional component: the right hemisphere, through the right angular gyrus, is often associated with the emotional component of language, including picking up emotions in the voice. Facial expressions are processed by the right superior temporal cortex.

• Prosodic features: the prosodic aspects of language, such as intonation and rhythm, are also processed partly by the right hemisphere, in the frontal lobe.

The two hemispheres of the brain work together to allow full understanding and rich expression of language. The left hemisphere is responsible for the formal production and understanding of language, while the right hemisphere contributes the more emotional and prosodic aspects of communication.

An example

When you say to your child “Tidy your room!”, you colour your sentence with emotion through your intonation and rhythm. And you get your instructions across with words that match what you are asking.

On the other side, in your child.

With the right hemisphere, your child tries to understand the emotion colouring your request, anger for example. With the left hemisphere, they identify the words in your sentence, understand what each one means, and then the sentence as a whole.

The importance of auditory laterality according to A. Tomatis

One concept Dr A. Tomatis developed as long as 50 years ago is auditory laterality, which is based on the specific role of each brain hemisphere in processing language.

According to him, children with a language disorder that calls for a speech therapist have a dominant left ear. This means they analyse the emotional and affective components of the message first. This has a big impact: to go back to the example above, the child will understand that you are angry, but will not always understand that they need to tidy their room. Unless you repeat the request several times.

That is why, in our view, treating language disorders starts with the Tomatis method, which regulates the left ear – right brain pathway, and then continues with speech therapy.

Speech therapy will then be much more effective, both in its results and in the length of treatment.

Making your choice

You now understand how speech therapy and the Tomatis method work, but would like help deciding which approach would be best for your child or for yourself?

We suggest you make an appointment with our audio-psycho-phonology specialist for a free information session.

If you have made up your mind, or if you think a listening assessment (audio-psycho-phonological assessment) is the next step, you can book an assessment at our centre.

Funding and waiting times

One major difference is how long you have to wait to start. In Switzerland, speech therapy is paid for by the canton as part of the support measures for children with difficulties at school. Speech therapists are in high demand, and their follow-up often lasts a (very) long time, so places are scarce. Sometimes you have to wait several months, or even years, before your child can start. The problem is the same for adults.

The Tomatis method delivered by Julien Frère is covered by supplementary health insurance in Switzerland, which pays between 75% and 100% of the costs. At the Tomatis centre in Geneva, we can take on 60 people a month, so we can respond very quickly and start treatment within 3 to 4 weeks. Treatment lasts 4 to 6 months, depending on the difficulty.

Depending on the case, the Tomatis method may be covered by disability insurance (AI), the Hospice Général or basic health insurance.