Treating Infants with Interactive Metronome
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TREATING INFANTS WITH INTERACTIVE METRONOME ® Lucy Barlow, M.Ed. CCC-SLP & Patricia Sullivan, M.Ed. CCC-SLP
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NOTE: This webinar is a free version of copyrighted material from Interactive Metronome®. This webinar is not intended as CEU credits and cannot be used for licensing purposes. Please visit www.interactivemetronome.com to learn more about free CEU courses, specialized training, research, case studies and our extensive online course catalog of 100 webinars. The Interactive Metronome (IM) in has been used as a speech therapy modality in The Language Learning Center, Inc. for approximately 8 years. Initially used primarily with clients exhibiting learning disabilities, difficulties in recognizing language components and processing delays, the treatment has now been expanded to provide IM to clients with more profound medical diagnoses, such as Asperger’s, Autism, seizure disorders, etc., who did not fit into the typical age expectant, physical ability profile that her prior clients fell within. Results of IM treatment on this population were amazing, particularly in the areas of auditory concentration, focus, verbal understanding and ability to interact appropriately in family/social settings. Working with these specialized populations showed the principles of IM therapy are effective even when maximum tactile assistance, positional modifications and individualized client reinforcements were required. This willingness to take IM “outof-the-box” and the consistently amazing results lead to the development of a modified protocol to treat a 22 month old diagnosed with Agenesis of the Corpus Collosum. Ongoing treatment and study of this child has resulted in phenomenal gains in gross motor, fine motor and speech, astounding her parents as well as her PT and OT therapists.
Transcript of Treating Infants with Interactive Metronome
TREATING INFANTS WITH
INTERACTIVE METRONOME®
Lucy Barlow, M.Ed. CCC-SLP & Patricia Sullivan, M.Ed. CCC-SLP
Positioning Adaptations in Pediatric IM
Hold Child in Lap
Positioning Adaptations in Pediatric IM
Position Child in Parent’s Lap
Positioning Adaptations in Pediatric IM
Also, Position Child in
Stander (if available)
Sit Child in Chair (or Kinder Chair, if available)
Trigger Adaptations in Pediatric IM
Use Smaller Hand Band
Use Therapy Glove
Therapist can wear
trigger and couple
child’s hand
Trigger Adaptations in Pediatric IM
Use hand triggers for foot
exercises
Place foot trigger on
wedge/slant board
Distractions During IM
Songs/Nursery Rhymes
Word Labeling-Vocabulary Building
Videos/DVDs
One-handed Toys
Visual Toys
Counting
Emma
18 months old at beginning of
training. Suffered from:
Failure to Thrive
Seizure Disorder
Cerebral Palsy
Agenesis of the Corpus
Callosum
Global Developmental Delays
The Corpus Callosum
is a band of over 200 million nerve fibers connecting the two sides (hemispheres) of the brain
provides the main route for the transfer and integration of information between the two hemispheres of the brain
Agenesis of the corpus callosum (ACC) is a birth defect in which the structure that connects the two hemispheres of the brain (the corpus callosum) is partially or completely absent
Emma’s Physical Deficits: Initial Evaluation
No core/trunk tone, unable to sit unsupported
No prone positioning
No step reflex
No protective balance reflex
Unable to weight bear on upper extremities
Limited reach/grasp behaviors/no pincher grasp
No crossing of midline
Presents in the 5th percentile on growth chart
Emma’s Sensory Deficits: Initial Evaluation
Hypersensitive/defensive to touch on face, hands
and/or feet
Severe gag reflex, with non-tolerance to a sippy
cup or textured food
Frequent rocking and head banging
Limited visual tracking/no eye contact
Visual fixation on geometric shapes
Severe startle reflex; easily upset/over
stimulated in crowds
Emma’s Cognitive & Language Deficits: Initial Evaluation
Excessive sleeping (18-20 hours per day)
with limited arousal time
Limited use of pragmatics
Limited oral movements for sound production
Limited localizations to her name
Limited cause-effect behaviors
Limited & infrequent sound productions with
low volume (whispers)
Emma’s Results
Sitting unsupported
Moderate righting/balance reflex
Weight bearing of Upper extremities
Getting on knees & crawling
Grasping objects, banging objects together
Using pincher grasp
Crossing midline, reaching across midline
Frequently makes & maintains eye contact
Less visually defensive when objects approach face/ startle reflex greatly reduced
Consistently eats textured foods without gagging. Using pincher grasp to feed herself
Allows/enjoys use of Z-Vibe for oral stimulation
Non-defensive when touching feet, hands or face
Physical Sensory
Emma’s Results
Cognitive & Language
Consistent localization to name
Rapid increase in babbling & jargoning sound variety
Identifying familiar people by localizing head
Direct imitation of speech sounds
Mouthing “Momma” and “bye-bye”
After 3 sessions Mother reported marked increase in babbling and volume
More affective behavior noted-laughing, smiling, obviously understanding tone of speaker’s emotion
Logan
Approximately18 months old
during training. Suffered from:
Schizencephaly
Septo-optic Dysplasia
Swallowing Problems
Spasticity
Global Developmental Delays
Schizencephaly
A rare cortical malformation of the brain
Affects the central nervous system
Characterized by abnormal clefts in the
cerebral hemispheres
Prognosis depends on the size of the clefts
and the extent of neurological dysfunction.
Logan’s Physical Deficits: Initial Evaluation
Limited Sitting Balance
No Crawling or Prone Positioning
No Midline Movement
No Left Hand Usage
Could Not Lift Arm to Hold Bottle
Logan’s Sensory Deficits: Initial Evaluation
Severe Startle Reflex with Tantrums
Proprioceptive Deficits
Visual Defensiveness
Oral Food Texture Adversions
Hyper Sensitivity to Head, Face and
Left Arm
Logan’s Cognitive & Language Deficits: Initial Evaluation
No Visual Tracking
No Cause-Effect
No Speech Development Other Than
Babbling
No Localization to name
Limited Understanding of Pragmatics
Logan’s Results
Started holding his bottle 3 weeks after
beginning IM
Crawled 3 weeks after beginning IM
Pulls to stand
Cruises furniture
Walking with assistance (holding one
hand)
Climbing
Midline movements
Attempts to use affected hand 30-40%
of the time
Marked decrease of startle
reflex; no “meltdowns”
No visual defensiveness
Limited tactile aversions
Improved tolerance to foods
Increased functional auditory
integration skills
Physical Sensory
Logan’s Results
Cognitive & Language
Visually tracks
Associated language
Started using words almost
immediately
Currently has 100+ words and
multiple phrases
Localizes to sounds/name
Great cause-effect skills
Processes pragmatic concepts
Summary & Further Recommendations
Begin IM training as early as possible to maximize
on brain-neuro networking
Tailor each individual adaptation to fit the child’s
needs and interests
Focus on these exercises: Both Hands, Right Hand,
Left Hand, Both Toes, Right Hand/Left Toe & Left
Hand/Right Toe
Think creatively!
In Conclusion
(912)729-2294
Logan’s Mom:
“I am scared to think about where we
would be today if we had not done IM.”
The End
For more information:
visit www.interactivemetronome.com
or call (877) 994-6776 (*US Only)
Know your party’s extension?
call (954) 385-4660
