The role of the middle ear is central to a "revolutionary" US therapy for children with learning and behavioural problems that is being trialled in Melbourne, bringing hopes of a breakthrough for the way abused children are treated, taught and supported.
Stephen Porges, a professor of psychiatry at the University of Illinois, devised the so-called Listening Project, and has successfully treated children with autism spectrum disorder and attention deficit hyperactivity disorder (ADHD). In a partnership with the Australian Childhood Foundation, about 60 children aged up to 14 who have experienced trauma will trial the therapy in Melbourne, with hopes that it could help them develop self-control, interact normally and learn.
Australian Childhood Foundation chief executive Joe Tucci said abused or neglected children could seem locked up; unable to read social cues and make friends or learn because they were overly focused on identifying threats in relationships. "Not only has Stephen Porges showed us where to find the lock, he's given us the key."
The "lock", Dr Porges asserts, is the middle ear, which is central to communicating danger to the brain and body, and the "key" is using certain frequencies of sound to retune it. He says some children who have experienced trauma, such as some with autism spectrum or ADHD, become hypersensitive to sound as their middle ear becomes permanently set to pick up threats. As a result their bodies are constantly in protective mode: they withdraw, attack or freeze up altogether.
The Listening Project exposes them to high-frequency sounds – in this case, Disney theme songs with female singers, for five, daily one-hour sessions. By retuning the middle ear to pick up softer, comfort-inducing sounds, Dr Porges says the body responds by re-engaging and allowing social interaction, self-expression and calm.
Dan Siegel, a professor of psychiatry at UCLA School of Medicine and a world-renowned expert on the nervous system and social behaviour, described Dr Porges' work on the middle ear as "new and important" and "profoundly and revolutionarily helpful". He said the five senses, particularly hearing, had been overlooked in childhood development studies and that many children were misdiagnosed with behavioural problems or mental disorders because of auditory hypersensitivity.
But not everyone is convinced. Professor Stephen O'Leary, an ear, nose and throat specialist at the University of Melbourne and the Royal Victorian Eye and Ear Hospital, said while Dr Porges might have had success in previous treatments, his theoretical explanation, that the middle ear could be retuned, was "exceptionally tenuous".
"I'd be very interested to hear what the outcome is, particularly if these children become less sensitive to sound. But I wouldn't be convinced that the middle ear muscles have been tuned. I think that's in the land of conjecture and requires a much better evidence base," he said.