PowerPoint - Interactive Metronome

Interactive Metronome®
Pediatric Specialist Coaching
Module 1: Overview and
Foundations
By Mary Jones, OTR/L, DipCOT
Sensational Kids, LLC
Brain Focus International, Inc.
Program Outline
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Module 1: Pediatric Overview and Foundations
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Module 2: Modifying IM to Pediatric Populations
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Module 3: Motivational Strategies
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Module 4: Teaching Auditory Association Skills
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Module 5: Building relationships – Allowing control, switch choices and access.
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Module 6: Interpreting Data
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Module 7: Setting up Individualized Pediatric Treatment Plans with IM: Case
Examples.
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Module 8: Special Considerations – IM training plans with infant-toddlers or clients
with decreased cognitive capabilities.
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Module 9: Use of IM Systems in Group and Social Settings
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Module 10: Moving Forward – Incorporating IM-Home into your pediatric best
practices.
Outcome Goals for Module 1
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Developing the art of ‘thinking outside the box’ with IM
Overview of IM use within the diversity of pediatrics
Getting started – Setting up of equipment/ environments
The Key to IM success – Learning to Modify!
Positioning that can be used with IM – Review of Examples
Review of Module 1 Learning Outcomes.
Thinking ‘outside of the box’
• Use of professional judgment and creativity to modify IM
programming – we are a diverse group!
• Developing the flexibility skills to effectively utilize IM as
a treatment/training tool
• Becoming comfortable thinking ‘outside of the box’
• Taking the principles of the Interactive Metronome®
System and consider them for all
aspects of pediatric services and
performance programs.
Why IM in Peds?
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Timing is critical for the discrimination of sensory stimuli (Shannon
et al., 1995; Buonomano and Karmarkar, 2002; Ivry and Spencer,
2004; Buhusi and Meck, 2005)
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Timing is critical for the generation of coordinated motor
responses (Mauk and Ruiz, 1992; Ivry, 1996; Meegan et al., 2000;
Medina et al., 2005).
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The nervous system processes temporal information over a wide
range, from microseconds to circadian rhythms (Carr, 1993; Mauk
and Buonomano, 2004; Buhusi and Meck, 2005).
Applying IM to the diversity of
Pediatrics
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Educational
Therapeutic
Peak Performance
Recreational
Extra-curricular
Lifestyle
Wellness
Educational
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Low Self Esteem
Struggling with academics
Anxiety
Reactive
Poor motor planning
Difficulty finding their own
‘Rhythm’ or ‘Still point’
Eager to please
Difficulty ‘tuning in’
Difficulty keeping track of time
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Survival reactions
Chronic adrenal stress
Disorganized
Clumsy
Difficulty ‘connecting the dots’
Poor listening skills
‘Quick to quit’
Therapeutic
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Attention Deficit Disorder (314.0; 314.01)
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Unspecified Disorders of the Central
Nervous System (349.9)
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Asperger’s Syndrome (299.0)
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Ataxia (438.84; 334.3; 331.89)
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Hemiplegia (342; 343.1)
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Autism (299.0)
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Pervasive Developmental Delay (299.9)
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Developmental Delays (315.9)
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Dyspraxia (315.4)
Developmental Coordination Disorder
(315.4)
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Dyslexia (315.02)
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Abnormal Posture (781.92)
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Lack of Coordination (781.3)
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Loss of Limb (755.4)
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Speech and Language delays (315.3)
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Abnormality of Gait (781.2)
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Auditory Processing Disorders (388.45;
315.32)
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Difficulty in Walking (719.7)
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Orthotic Training (V57.41)
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Feeding Difficulties (783.3; 307.59; 779.3;
783.41)
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Dysphagia (787.42)
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Articulation (315.39; 524.27)
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Muscle Weakness (728.87; 780.79)
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Tourette’s Disorder (307.23; 333.3)
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Anxiety (300.0)
Peak Performance
• Speed - focuses on developing starting speed and
maximizing top end speed. Utilization of plyometrics and
speed training techniques to maximize performance.
• Agility – focuses on developing coordination, foot speed,
reactive ability, and quickness. Utilization of sport specific
movement pattern drills, plyometrics, and various mobility
training equipment.
• Conditioning – focuses on developing sport specific
fitness by combining creative training methods with
traditional conditioning equipment.
• Strength – focuses on teaching proper resistance training
techniques for a variety of sport specific exercises with
emphasis on core.
Recreational
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Effective use of free time
Personal development of ‘self’
Socially acceptable activities
PLAY!
Keeping up with peers
Ability to engage, socialize, plan,
follow-through
Lifestyle
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Choices
Opportunities
Exposure
Tolerance
Extra-Curricular
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Sports
Drama
Music
Voice
Dance
Clubs
Societies
Cultural
Wellness
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Mental Endurance
Mental Attitude
Stress Management
Focused Attention
Sleep
The Key to IM Success:
• Modify for Engagement!
• Be Spontaneous for Novelty!
• Increase Repetition for
Synaptic Growth!
Techniques for success
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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
Set Up - Equipment
Positioning: Upright Stance
UPRIGHT STANCE: Extensor tone; balance; visual orientation; praxis.
• Modify with variance of surface/texture/height/size of
base/footwear.
Half Kneeling
HALF KNEELING
• Core strengthening
• Pelvic segmentation
• Upper body/lower body integration
• Proprioceptive body-in-space
awareness
• Reflex integration
• Bilateral integration (praxis)
MODIFY:
• Surfaces/textures/heights/
stability/alternate knees
Modify Base of Support
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Alter points of stability and mobility
Upper extremities: Clap High-Clap Low
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Adapt lower extremity movement sequence
Side step and clap on the beat
Match tempo of music piece or sing to the
beat
Round Sitting
ROUND SITTING:
• Pelvic and shoulder girdle
alignment
• Posture and positional
awareness (grounded)
• Upper body
strengthening
• Pelvic shift and core
balance
• Diaphragmatic
breathing
Dynamic Postures
DYNAMIC POSTURES:
• Proprioceptive awareness
• Core stability and shift
• Visual orientation
• Strengthening
• Praxis
EXAMPLES:
• Ball sit
• Stool sit
• Bench sit
• Bolster sit (astride)
• Cube sit
• Rocking chair
Supine/Lying Down
SUPINE TIME:
• Facilitates proprioceptive awareness
(firm surface)
• Decreases demands on motor planning
• Work up against gravity
• Reflex integration: Supine flexion
Prone/Tummy Time
PRONE/TUMMY TIME:
• Strengthening shoulder girdle
• Hip flexor stretch
• Facilitate co-contraction to
flexor/extensor core stability
• Visual-motor integration
• Reflex integration
Modifications:
• Floor (good for
sensory feedback
• Floor mat/different
textures
• Inverted/under/over
Review of Module 1 Learning
Objectives
• IM is used as a training tool across multiple domains and
disciplines within pediatrics.
• Professional judgment and creativity are required to
provide optimum outcomes in pediatric IM programs.
• Modification is key to provide
a customized approach to
each individual.
• Pediatrics is diverse – so too is
the application of IM to
this population!
Module 1 Homework
1. Complete Module 1 Post-Test
2. Complete Module 1 Worksheet
3. Review ready reference/resource
sheet for Module 1
References
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Boyle CA, Boulet S, Schieve L, Cohen RA, Blumberg SJ, Yeargin-Allsopp
M, Visser S, Kogan MD. Trends in the Prevalence of Developmental
Disabilities in US Children, 1997–2008. Pediatrics. 2011
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Buhusi, C.V., and Meck, W.H. (2005). What makes us tick? Functional
and neural mechanisms of interval timing. Nat. Rev. Neurosci. 6, 755–
765.
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Buonomano, D.V., and Karmarkar, U.R. (2002). How do we tell time?
Neuroscientist 8, 42–51
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Carr, C.E. (1993). Processing of temporal information in the
brain.Annu. Rev. Neurosci. 16, 223–243.
References 2
• Ivry, R. (1996). The representation of temporal information in
perception and motor control. Curr. Opin. Neurobiol. 6, 851–
857
• Ivry, R.B., and Spencer, R.M.C. (2004). The neural
representation of time. Curr. Opin. Neurobiol. 14, 225–232
• Mauk, M.D., and Buonomano, D.V. (2004). The neural basis of
temporal processing. Annu. Rev. Neurosci. 27, 304–340
• Mauk, M.D., and Ruiz, B.P. (1992). Learning-dependent timing
of Pavlovian eyelid responses: differential conditioning using
multiple interstimulus intervals. Behav. Neurosci. 106, 666–681
References 3
• Medina, J.F., Carey, M.R., and Lisberger, S.G. (2005). The
representation of time for motor learning. Neuron 45,
157–167.
• Meegan, D.V., Aslin, R.N., and Jacobs, R.A. (2000). Motor
timinglearned without motor training. Nat. Neurosci. 3,
860–862.
• Shannon, R.V., Zeng, F.G., Kamath, V., Wygonski, J., and
Ekelid, M. (1995). Speech recognition with primarily
temporal cues. Science 270, 303–304.
Useful Resources
Sensory Processing Disorder:
• www.spdfoundation.net
• www.sensory-processingdisorder.com
• www.sensorysmarts.com
• www.spdsupport.org
Dyspraxia:
• www.dyspraxiausa.org
• www.dyspraxia.info
• www.alifewithdyspraxia.
webs.com
Autism:
• www.autismspeaks.org
• www.aspergersyndrome.
org
• www.autismspot.org
Recommended Webinars
• Introduction to IM
Pediatric Best Practices Self-Study