Interactive Metronome A Group Approach

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.

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

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.

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

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

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

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

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

Week One Day One Day Two Day Three 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

Week Two Guide Sounds introduced in Phase Two Resistance Children Parents

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

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

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

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

Re-evaluation Bruininks Interactive Metronome LFT Child 1 LFT Child 2

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

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.

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

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

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