Balanced Perspective: Integrating Developmental Readiness With Structured Teaching : Dr Kondekar suggests developmental model superior to structured speech listening

1. Listening is not a skill trained directly
2. It emerges when we shift the child from sensory engagement with objects → engagement with people
3. From visual learning → auditory learning
4 From doing → thinking
5. From stimulation → regulation

Sensory Activities for Listening — A Developmental Approach

Prof Dr Santosh Kondekar Autism Doctor Mumbai, Autism doctor India 9869405747
MD DNB DCH FCPS DNB FAIMER, neurodevelopmental pediatrician, fellowship Pediatric neurology & Epilepsy, www.neuropediatrician.com
Diploma Developmenatl Neurology CDC Kerla ,prof Pediatrics T N Medical College Mumbai, Director AAKAAR CLINIC Byculla west Mumbai INDIA, mobile: 91-9869405747

Affiliation: Cognitive Neurosciences for Autism & ADHD, Website: www.autismdoctor.in, email: autismdrmumbai@gmail.com  

Based on the Concept of Preparing the Brain to Listen

Dr Santosh V Kondekar Framework

Listening is not taught by telling a child to listen.

Listening develops when the brain is regulated, connected, and meaning-oriented.

Many children with autism, ADHD, speech delay, and learning difficulties appear “not listening” because their brain is engaged with sensory input, visual stimulation, or motor activity rather than human communication.

The goal is not to train ears —

The goal is to shift the brain toward people, meaning, and thinking.

 Core Principle

 Listening improves when we change the child’s developmental direction:

From objects → to people

From visual → to auditory

From stimulation → to regulation

From doing → to thinking

From engagement → to connection

Sensory activities are tools to make this shift possible.

 Why Children Don’t Listen

Often the issue is not hearing — it is brain readiness.

The child may be:

Sensory seeking

Overstimulated

Visually driven

Object-focused

Dysregulated

Motorically restless

In this state, language cannot enter meaningfully.

 Goal of Sensory Activities

Not to stimulate more —

But to organize the brain so it becomes ready to listen.

 Sensory Strategies to Prepare for Listening

1. Regulation Before Instruction

First calm the body, then expect listening.

Activities:

Deep pressure hugs

Slow swinging

Firm massage

Quiet corner

Breathing games

 A regulated brain listens naturally.

2. Heavy Work to Shift From Sensory Seeking to Attention

Helps reduce hyperactivity and improves focus.

Activities:

Pushing objects

Carrying weight

Climbing

Animal walks

Wall push

 Body effort reduces sensory noise in the brain.

3.  Reduce Visual Dominance

Children who rely heavily on visual input struggle with listening.

Strategies:

Reduce screens

Reduce visual clutter

Encourage listening games without visual cues

Talk without showing objects immediately

 This shifts learning toward auditory pathways.

4. Increase Human Connection

Listening improves when communication becomes socially meaningful.

Activities:

Face-to-face play

Turn-taking games

Singing together

Emotional expression games

Joint attention play

 Connection drives listening.

5. Movement With Pause

Teach brain to shift from action to attention.

Activities:

Jump → stop → listen

Run → freeze → listen

Musical statues

Stop-go games

 Helps transition from motor state to listening state.

6. Auditory Meaning Games

Not just hearing sounds — understanding them.

Activities:

Follow simple commands

Listening stories with actions

Guess sounds

Sound direction games

7. Turning the Goals (Key Concept)

Instead of asking child to: ❌ Sit and listen

We help them move from:

✔ Engagement with objects → engagement with people

✔ Visual learning → auditory learning

✔ Entertainment → communication

✔ Movement → attention

✔ Reacting → thinking

 Listening Hierarchy (Developmental)

1.  Regulation
2.  Connection
3.  Attention
4.  Auditory awareness
5.  Understanding
6.  Response

Sensory work supports the first three levels — the foundation.

Role of Parents

Parents are the primary regulators.

They should:

Reduce overstimulation

Provide predictable routines

Engage face to face

Talk more than instruct

Create listening opportunities naturally

Common Mistake

Trying to teach listening through:

❌ Repeating instructions

❌ Forcing attention

❌ Increasing stimulation

❌ Testing repeatedly

Listening improves through regulation, not pressure.

 Clinical Insight

When sensory regulation improves, we see:

✔ Better eye contact

✔ Increased response to name

✔ Reduced hyperactivity

✔ Improved language learning

✔ Better comprehension

Key Message for parents 

Listening is not trained — it emerges.

When we prepare the brain through regulation and connection, listening becomes natural.

Simple Formula

Regulate → Connect → Capture attention → Build listening → Develop language

When a kid is listening, he is reday to receive. what to receive is discussed below.

Balanced Perspective: Integrating Developmental Readiness With Structured Teaching

It is important to clarify that sensory regulation and developmental preparation are not intended to replace structured language intervention but to enhance its effectiveness. Listening difficulties in children with autism and related neurodevelopmental conditions arise from multiple interacting factors, including sensory processing differences, attention regulation challenges, language comprehension delays, and social communication differences (1–3).

Structured teaching approaches, including behavioral and skill-based interventions, have demonstrated benefits in improving communication outcomes when appropriately individualized (4,5). However, emerging developmental frameworks emphasize that optimal learning occurs when the child is regulated, socially engaged, and neurologically ready to process language (6–8).

Sensory activities, therefore, serve as preparatory strategies that help organize arousal levels, reduce sensory overload, and facilitate attention, allowing children to benefit more fully from direct instruction (9). This perspective aligns with neurodevelopmental models suggesting that regulation and engagement form the foundation for higher-level cognitive and language skills (7,10).

Visual supports remain valuable tools for comprehension and predictability, particularly in autism. The intention is not to eliminate visual supports but to gradually balance them with opportunities that encourage auditory processing and social listening as the child’s capacity develops (2,6).

Similarly, listening can be both a developmental process and a trainable skill. While direct auditory training and structured instruction can build specific listening behaviors, meaningful and generalized listening is more likely to emerge when underlying regulation, motivation, and social connection are addressed (3,8).

Thus, an integrated approach that combines developmental readiness strategies with structured teaching may offer the most comprehensive support for children with listening difficulties.

Clinical Integration Model

An effective framework may include:

1.  Sensory regulation to prepare the nervous system
2.  Social engagement to build communication intent
3.  Structured teaching to develop skills
4.  Practice in natural contexts to support generalization

This sequence reflects a complementary rather than competing approach.

Implications for Practice

Clinicians may consider:

Using sensory strategies as preparation rather than replacement

Maintaining visual supports while gradually expanding auditory learning

Combining relationship-based approaches with structured instruction

Individualizing intervention based on sensory and cognitive profiles

Monitoring outcomes to guide intervention balance

Conclusion 

Listening in neurodevelopmental conditions reflects both developmental readiness and learned skills. Interventions that address sensory regulation, engagement, and structured teaching together may provide the most effective pathway toward meaningful communication. Rather than viewing approaches as opposing, integrating developmental and skill-based perspectives can better support diverse learning needs.

References 

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. DSM-5.

2. Tager-Flusberg H, Paul R, Lord C. Language and Communication in Autism. Handbook of Autism and Pervasive Developmental Disorders.

3. Paul R, Norbury CF. Language Disorders From Infancy Through Adolescence. Elsevier.

4. Schreibman L, Dawson G, Stahmer AC, et al. Naturalistic Developmental Behavioral Interventions. J Autism Dev Disord. 2015.

5. National Research Council. Educating Children with Autism. National Academy Press.

6. Prizant BM, Wetherby AM, Rubin E. The SCERTS Model: A Comprehensive Educational Approach.

7. Greenspan SI, Wieder S. Engaging Autism: Using the Floortime Approach.

8. Dawson G, Rogers S, Munson J, et al. Randomized controlled trial of Early Start Denver Model. J Am Acad Child Adolesc Psychiatry.

9. Schaaf RC, Mailloux Z. Clinician’s Guide for Implementing Ayres Sensory Integration.

10. Kuhl PK. Early language acquisition: cracking the speech code. Nat Rev Neurosci.

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“Clinical observations further illustrate how listening improves when developmental readiness is addressed alongside structured teaching.”

Clinical Case Illustrations

Case 1: From “Not Listening” to Regulated Engagement

Profile:

A 3.5-year-old boy with autism presented with poor response to name, constant movement, and difficulty following simple instructions. Parents reported he appeared “lost in his own world.” Hearing assessment was normal.

Observation:

The child showed high sensory seeking behavior, particularly movement and proprioceptive input. He demonstrated strong visual attention to spinning objects but minimal engagement with people.

Intervention Approach:

Intervention began with sensory regulation strategies including heavy work activities, deep pressure input, and movement breaks prior to communication tasks. Visual clutter and screen exposure were reduced, and therapy emphasized face-to-face interaction and joint attention activities before introducing structured listening tasks.

Outcome:

Within three months, the child showed improved response to name, increased eye contact, and ability to follow simple one-step instructions. Parents reported improved engagement during daily routines.

Clinical Insight:

This case illustrates how regulation and connection can precede meaningful listening, supporting developmental readiness principles (4,7).

Case 2: Balancing Visual Supports With Auditory Learning

Profile:

A 5-year-old girl with autism used visual schedules extensively but struggled to follow verbal instructions without visual prompts. Language comprehension appeared context-dependent.

Observation:

The child relied heavily on visual cues and showed reduced spontaneous listening. However, she demonstrated good social motivation and imitation.

Intervention Approach:

Visual supports were maintained but gradually paired with verbal instructions before presentation of visual cues. Listening games, storytelling with actions, and turn-taking activities were introduced to strengthen auditory attention while preserving predictability.

Outcome:

Over six months, the child demonstrated improved ability to follow verbal directions and reduced reliance on visual prompts. Teachers reported improved classroom participation.

Clinical Insight:

This case highlights the importance of balancing visual supports while expanding auditory processing capacity (2,6).

Case 3: Integrating Sensory Preparation With Structured Teaching

Profile:

A 4-year-old child with speech delay and sensory dysregulation showed inconsistent attention during therapy sessions and difficulty participating in structured tasks.

Observation:

The child became overwhelmed in structured settings but responded well to movement and social play.

Intervention Approach:

Sessions were modified to include short sensory regulation routines before structured language activities. Therapists used a sequence of regulation → engagement → structured teaching.

Outcome:

The child demonstrated improved participation, longer attention span, and increased verbal attempts. Structured teaching became more effective once regulation was addressed.

Clinical Insight:

This case demonstrates how sensory preparation can enhance responsiveness to structured interventions rather than replace them (9).

Case 4: Parent-Mediated Regulation Improving Listening

Profile:

A 2.8-year-old toddler with early signs of autism showed limited response to verbal communication but strong attachment to routines.

Observation:

Parents frequently repeated instructions but the child appeared disengaged.

Intervention Approach:

Parents were coached to reduce verbal pressure, increase face-to-face play, use calming sensory strategies, and model simple language during shared activities rather than testing responses.

Outcome:

After four months, the child showed increased joint attention, improved response to name, and emerging receptive language skills.

Clinical Insight:

Parent-mediated regulation and interaction can significantly influence listening readiness in early development (4,8).

Key Themes Across Cases

Across these cases, improvements were associated with:

Improved regulation

Increased social engagement

Reduced sensory overload

Integration of structured teaching

Gradual expansion of auditory learning

These observations support an integrated developmental and skill-based approach.

- Dr Kondekar