Interactive Metronome

1. Interactive Metronome A Group Approach

2. Concept • Introduce IM in a group atmosphere and follow it with gross motor and fine motor tasks. • IM for first hour and gross and fine motor tasks second hour. • Group done in a single room to simulate class environment not SI gym environment. • Twenty-four sessions over eight weeks, three times a week.

3. Evaluations • Evaluated as a group • Bruininks • IM LFT • Handwriting sample • Review of previous Occupational Therapy evaluations.

4. Group Introductions • Child 1 • PDD-NOS • Sensory Integration • Seeks proprioception and deep pressure • Seeks movement • Developmental Delays • Poor Group and Peer Relations • LFT 233 ms.

5. Group Introductions • Child 2 • PDD • Perseverative • Impulsive • Developmental Delays • Below Average Balance and Bilateral Coordination • LFT 376 ms.

6. Group Introductions • Child 3 • Bipolar Diagnosis • Aggressiveness • Poor Motor Planning • Short Attention Span • Overfocuses on objects • LFT 247 ms.

7. Setup • Parent information meeting • The room and three computers • Auto Train • IM first hour • Second hour tasks

8. Using Auto Train • Group Long Form Test • Daily Short Form Tests • Phase One Tasks • Individualized as child moved through phases • Guide Sounds explained to group then used if appropriate

9. The Second Hour • Handwriting • Karate • Gross motor tasks • Balance tasks • Hand eye coordination tasks

10. Week One • Day One • Evaluation • IM conducted on three stations • Day Two • Full hour of IM • Completed 1,500 reps • Phase 1 • Day Three • Continued IM on three stations

11. Week Two • Guide Sounds introduced in Phase Two • Resistance • Children • Parents

12. Week Two • Realization • This is a group a different approach is needed • IM is adaptable • It is OK to have FUN

13. Program Change • First 15 minutes IM over speakers • As a warm-up or gathering task • Conducted varied tasks as a group • Jumping and moving • Clapping and pattycake games • Catching or passing balls or beanbags • Taking turns tapping • Talking to the beat • Follow the leader

14. Motivation • Stickers • Rewards for increased freedoms during second hour • Reports to Parents • Behavior • Scores • Gross and Fine Motor tasks • Compare scores with peers if appropriate • Relation to sports training

15. IM Phases • Each child on a different phase of IM • Vacations • Weeks Three and Four • Weeks Five through Seven • Eighth week re-evaluations

16. Re-evaluation • Bruininks • Interactive Metronome • LFT Child 1 • LFT Child 2 • LFT Child 3

17. Progress Report • Child 1 • Increased calmness • Improved self control • Improved reading and spelling • Improved independence. Using Auto Train

18. Progress Report • Child 2 • Less perseveration and oppositional behaviors more flexible in group • Improved balance and bilateral tasks on Bruininks • LFT Hands 63 ms. Feet 119 ms.

19. Progress Report • Child 3 • Improved sequencing • Remained on Phase One • Remained in group setting 90% of time • Improved motor planning

20. Review • IM can work in a group • LFT and SFT • Plan but be prepared to change those plans • Use the features of the IM such as Auto Train • It is OK to be less formal and make it fun! • Pass items to the beat • Jump over items to the beat • Group can do tasks together with or without switches

21. Changes to Make Next Time • Individual Long Form Tests and Bruininks • Start sessions with group tasks with IM over speakers • More adaptable plan for second hour • Possibly break IM into shorter segments