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CERTIFICATION & COACHING: IM PEDIATRIC BEST PRACTICES
MODULE 8: SPECIAL CONSIDERATIONS –
IM TRAINING PLANS WITH INFANTS-TODDLERS OR CLIENTS WITH
DECREASED COGNITIVE CAPABILITIES
By Mary Jones, OTR/L, DipCOTSensational Kids, LLC
Brain Focus International, Inc
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Outcome Goals for Module 8
• Homework assignment and post-test review from Module 7.
• Age considerations for use of IM.• Review of case examples: Emma; Reyna;
Betsy• Considerations from a parents
perspective• The importance of modifying IM
with this client group.• Review of levels of training
needed when working withchildren with low cognitivecapacity.
• Case example: Katie• Review of Session 8• Assignment/Homework
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Review of Post-Test from Module 7
1. True or False: It is not necessary to consider IM testing data when formulating a treatment plan, only use discipline specific testing.
• Answer: False
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Review of Post-Test from Module 7
2. True or False: The key to success with IM training is to always have a plan laid out for a student to participate in and stick to that plan throughout the training session.
• Answer: False
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Review of Post-Test from Module 7
3. True or False: It is not important to increase repetitions, just as long as your IM student is enjoying their sessions with you.
• Answer: False
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Review of Post-Test from Module 7
4. True or False: You do not need to own expensive therapeutic equipment to modify IM interventions.
• Answer: True
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Review of Post-Test from Module 7
5. True or False: It is important to consider preparing short articles and case studies to support your interventions with Interactive Metronome® and to keep up with current research.
• Answer: True
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The Key to IM Success:
• Modify for Engagement!• Be Spontaneous for
Novelty!• Increase repetition for Synaptic growth!
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Techniques for Success
• Positioning alternatives
• Physical Environment
• Sensory Environment
• Motivation Strategies
• Tempo/Timing variance
• Feedback Strategies
• Interpreting Data
• Pacing of activities and themes
• Duration of tasks and sessions
• Building Relationships – allowing control
• Switch choices and Access
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Age Considerations• “At what age
can I effectively introduce Interactive Metronome® activities into my treatment programs?”
Slide # 10
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My inspiration … Emma …
A presentation at the IM Professional Conference 2007
My thanks to Lucy Barlow, MED, SLP-CCCFrom The Language Learning Center,
Kingsland, Georgia.
Movie: 11.Lucy beginning.mp4
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Interview from Emma’s Mom
Movie: 12.after IM.mp4
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IM Modifications with Emma and Lucy Barlow
(SLP)
Movie: 13.IM teq qith Lucy.mp4
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Why IM for Emma?
• This provider’s prior observations of the success of IM with cross-hemisphere difficulties
• Neuro-rehabilitative aspects of IM
• Prospect of stimulating hemispheric communications
• Motivation to achieve best possible outcome for patient
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Clapping to Music
Movie: 15.clapping to music.mp4
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Using Video Feedback
Movie: slide16-usingvideofeedback.mp4
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Wonderful Reyna
Movie: 17.2008_0731MISCSORT0070.mp4
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Slide # 19
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Slide # 20
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Examples of infant modifications:
Using a folded sheet or large towel, swaddle the infant ‘hammock style’ with their face looking towards their mother or caregiver. Starting low and slow, gently swing to the right and then to the left, providing soft ‘end points’ to mark the beat. Movements may also include up and down, with cushions or a mattress beneath the infant. Tempo should be no higher than 54 bpm, and if the infant shows signs of distress, skip to every other beat for consistency. Follow the infant’s tolerance and lead. A soft song or lullaby can be sung in sync to the beat.
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Secure rhythmic engagement to the metronome beat
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Example of a net hammock used on the beat
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Key systems influenced by
regulating to a beat• Breathing• Engagement• Autonomic nervous system
responses• Vagus nerve• Audition
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Which in turn can help with:
• Down regulation• Up regulation• Respiration• Digestion – reflux (GERD)• Feeding – colic• Sleep – sleep apnea• Alert state and regulation of
primary functions.
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Wearing a hat to decrease sensitivity
to headphones
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Contained sitting to increase attention
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Combine with favorite and ‘safe’ places to increase frequency
and duration
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Allow manipulation of headphones – also consider
using speakers…
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Provide positive support and hand over
hand assist
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If a child wants to use celery as a
drumstick….
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Then let them!
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Introduce headphones as part of play and sensory diet
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Include passive metronome beats and rhythms to daily activities
such as:
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And ultimately…
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Case study: Katie
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Areas commonly identified for treatment in children with low
cognitive and neurological capacity
NEUROLOGICAL:• Developmental delays – genetic• Developmental delays –
environmental• Developmental delays –
acquired
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Use of media to record initial performance and timing
tendencies
Movie: slide43-usingmedia.mp4
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Considerations…
• Long repetitions to increase tolerance to hearing the beat in the environment
• High energy prompting and hand over hand assist to generate pockets of engagement.
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Feeling the beat together
• Hand over hand assist• Containment and postural
support
Movie: slide45-feelbeattogether.mp4
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Considerations…
• Hand over hand assist• Containment and postural
support• Headphones vs speakers
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Independent in supported sitting
Movie: slide47-supportedsitting.mp4
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Considerations…
• Adapt environment to support attention; posture; switch access.
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Keeping the beat at the right pace
Movie: slide49-keepingthebeat.mp4
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Considerations…
• Match tempo to child in the moment.
• Continue to apply rhythm to handling; games; movement activities.
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Review of Module 8 Learning Outcomes
• Age considerations for use of IM• Review of case examples: Emma; Reyna;
Betsy• Considerations from a parents perspective• The importance of modifying IM with this
client group• Review of levels of training
needed when working withchildren with low cognitivecapacity.
• Case example: Katie
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Module 8 Homework
1. Complete Post-Test for Module 82. Select one of the following IM
webinars to consolidate learning in this area:
– “Using IM for Moderately Dependent, Low-Level Inpatients”
– “The Use of Interactive Metronome in Infancy”
2.Complete webinar Post-Test