Monday, April 21, 2008

Getting IM Training

A reader of this blog wrote and asked about getting IM Training. Here is some info for those who are thinking about getting started.

There are 2 modes of training: Interactive (alone) and Workshop (in a group). As usual, there are tradeoffs.

If you have access to the IM equipment, then doing the interactive training is a great option. For $225 (or so), you are sent an excellent training manual with 12 lessons, each 30-90 minutes in length, of hands-on training. Most people complete the training in 4-6 weeks. The beauty of doing this is that you will experience the effects of using the product 2-3 times per week for several weeks. The OTs in my clinic found that doing our own course of IM helped us to get our own gears in sync and allowed us to move forward with projects. (For me, it was my blog.)

The workshop is very vaulable for the instructor contact. (I'm sure I missed a lot by not attending the workshop!) and you learn how to facilitate IM in just 48 hours. (And of course, you can then do your own hands-on training later).

Be aware that the IM equipment costs over $3,000. For that price you get hardware (that hooks to your computer), software, headphones, and hand and foot triggers. In addition to the initial equipment cost, the company charges about $6-8/hr for use of the system. You buy blocks of time from IM so that you can treat your clients. In fact, the real cost for a client's session is much less than $6-8, because the IM clock runs only during active clapping.

By the way, the trainees who purchase the Interactive course are given enough minutes to complete the course.

Friday, April 18, 2008

More about Listening & Rhythm

I continue to be pleasantly surprised at the results of Therapeutic Listening (TL) in my practice. The kids get calmer, attention improves, meltdowns decrease and with that, comes real growth. One boy used the headphones for just 4 weeks, and then Interactive Metronome (IM) for another several weeks. Mom reports that he is calm (TL) and has confidence in himself (IM). I've noticed increaed postural control and motor planning, too. Unfortunately, not all children can use TL. Some children do not tolerate headphones or the music through them at all - whether this is due to actual hearing problems such as tinnitus (ringing in the ear) or perhaps a severe tactile issue isn't always clear with some of our non-verbal population.

Therapeutic Listening and Interactive Metronome have overlapping territory in the area of motor planning - although each product works in a unique way. There is rhythmic feedback with IM in which the person actively attempts to increase their rhythmic precision. (See my entry about this, or check out the IM site.) TL is a passive system in which the person receives modulated auditory stimulation through rhythm and music. The therapist can add active components to TL therapy in the form of sensory stimulation, play or exercise.

A third program I have checked into is Samonas. I'll devote a blog to this at some future date. It comes from Germany and is a very high quality listening program that would appeal to adults as well as to children. There are 5 levels of CDs offered. Levels 1-4 require direction from a trained therapist. An introductory set of CDs is available to the general public. The recorded music and nature sounds are gorgeous. I tried a level 1 CD for 15 minutes and felt some powerful broad effects that included auditory refinement, emotional release and energy. I was pleased with it. Samonas offers a series of Listening Programs for the general public specifically aimed at areas including emotional, social, communication, organization, motor planning, etc. The Samonas web site can be very confusing. You can find web-based training programs for professionals at this location. They will be offering live training classes in the fall in New York and Florida. I'll write more when I get the details.

Sunday, April 6, 2008

Parents of kids with Autism

I mentioned in an earlier blog that I am engaged in a small research project. There are 10 parents doing a course of Interactive Metronome. At the start of the study, we gave the parents 2 assessments: The Parental Stress Inventory (PSI) and the Sensory Profile for Adults. I recently scored the PSI and was surprised to see just how high the stress levels are. All of the scores were high and some were literally off the scoring charts. Our clinical director, a psychologist, has analyzed the PSIs and she said that she was gratified to see that in spite of the high stress, there was equally high parent-child attachment levels.

As for the Sensory Profile, most were typical. But 2-3 showed sensory issues.

Calming Rhythms

I have begun to work with a product called "Calming Rhythms" from REI Institute. Calming Rhythms is a CD with three 20-minute pieces of music/alpha-rhythms that are played for a calming affect. Jeff Strong, the head of REI, has tested the product on children with autism and found it to be quite effective, but with a few occasional side-effects - acting out behaviors in some children.

To get a feel for the therapy, I tried it out on myself. I tried it under 3 conditions:

1. At night before bed for 2-3 nights. This is per the instructions from the REI site. I slept deeply, awoke with deep calm and felt like I could handle anything.

2: During the day, during very stressful occasions. I didn't notice anything while it was playing, but within 30 minutes, I was very cranky, and snapped at someone. Later, I became even more irritable. Was it the music or the stressful situation? I am typically very easy-going and handle stress well. The next morning, I was calm and happy.

3. Several times for a few minutes throughout the day under stress-free conditions (on a Friday while treating children in the clinic) . Seemed fine at the time, and all weekend I've had a wonderful sense of calm and perspective as I deal with another stressful situation.

My conclusions: use it when the client is in a good mental state for just a few minutes at a time or at bedtime.

One of my clients,, Tommy, has what appears to be an undiagnosed case of ADHD. I am doing 15-20 minutes of Interactive Metronome (IM) with him once a week as part of his OT session. Since the IM can be very arousing, I thought to counter it with the Calming Rhythms. Jeff Strong told me that other therapists are using this same approach. I gave Tommy's mom the CD and instructions and suggested she try it at night over the weekend. I warned her to watch out for acting-out behaviors. Can't wait to hear how he did.

I think that this will be a good option for my hyperactive kids. By the way, if you want to try it, Jeff Strong offers a free demo download at his site.

4/18/08 Update: 3 parents tried the Calming Rhythms CD for 10 minutes just before bedtime for a few nights. One boy made noticeable decrease in hyperactivity. A second mom reported no change. The third boy, Tommy, liked the rhythms, however, his mom reported that he got up in bed and danced to them ... not exactly what we were hoping for ... but she planned to try it for another night or two and report back.