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By Mary Jones, OTR/L, DipCOT Sensational Kids, LLC Brain Focus International, Inc

CERTIFICATION & COACHING: IM PEDIATRIC BEST PRACTICES MODULE 8: Special Considerations – IM Training Plans with Infants-Toddlers or clients with decreased cognitive capabilities. By Mary Jones, OTR/L, DipCOT Sensational Kids, LLC Brain Focus International, Inc.

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By Mary Jones, OTR/L, DipCOT Sensational Kids, LLC Brain Focus International, Inc

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  1. CERTIFICATION & COACHING: IM PEDIATRIC BEST PRACTICES MODULE 8: Special Considerations – IM Training Plans with Infants-Toddlers or clients with decreased cognitive capabilities By Mary Jones, OTR/L, DipCOT Sensational Kids, LLC Brain Focus International, Inc

  2. Outcome Goals for Module 8 • Homework assignment and post-test review from Module 7. • Age considerations for use of IM. • Review of case examples: Emma; Reyna; Betsy • Considerations from a parents perspective • The importance of modifying IM • with this client group. • Review of levels of training • needed when working with • children with low cognitive • capacity. • Case example: Katie • Review of Session 8 • Assignment/Homework

  3. Review of Post-Test from Module 7 1. True or False: It is not necessary to consider IM testing data when formulating a treatment plan, only use discipline specific testing. • Answer: False

  4. Review of Post-Test from Module 7 2. True or False: The key to success with IM training is to always have a plan laid out for a student to participate in and stick to that plan throughout the training session. • Answer: False

  5. Review of Post-Test from Module 7 3. True or False: It is not important to increase repetitions, just as long as your IM student is enjoying their sessions with you. • Answer: False

  6. Review of Post-Test from Module 7 4. True or False: You do not need to own expensive therapeutic equipment to modify IM interventions. • Answer: True

  7. Review of Post-Test from Module 7 5. True or False: It is important to consider preparing short articles and case studies to support your interventions with Interactive Metronome® and to keep up with current research. Answer: True

  8. The Key to IM Success: • Modify for Engagement! • Be Spontaneous for Novelty! • Increase repetition for Synaptic growth!

  9. Techniques for Success 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

  10. Age Considerations • “At what age can I effectively introduce Interactive Metronome® activities into my treatment programs?”

  11. My inspiration … Emma … Movie: 11.Lucy beginning.mp4 A presentation at the IM Professional Conference 2007 My thanks to Lucy Barlow, MED, SLP-CCC From The Language Learning Center, Kingsland, Georgia.

  12. Interview from Emma’s Mom Movie: 12.after IM.mp4

  13. IM Modifications with Emma and Lucy Barlow (SLP) Movie: 13.IM teqqith Lucy.mp4

  14. Why IM for Emma? This provider’s prior observations of the success of IM with cross-hemisphere difficulties Neuro-rehabilitative aspects of IM Prospect of stimulating hemispheric communications Motivation to achieve best possible outcome for patient

  15. Clapping to Music Movie: 15.clapping to music.mp4

  16. Using Video Feedback Movie: slide16-usingvideofeedback.mp4

  17. Wonderful Reyna Movie: 17.2008_0731MISCSORT0070.mp4

  18. Examples of infant modifications: Using a folded sheet or large towel, swaddle the infant ‘hammock style’ with their face looking towards their mother or caregiver. Starting low and slow, gently swing to the right and then to the left, providing soft ‘end points’ to mark the beat. Movements may also include up and down, with cushions or a mattress beneath the infant. Tempo should be no higher than 54 bpm, and if the infant shows signs of distress, skip to every other beat for consistency. Follow the infant’s tolerance and lead. A soft song or lullaby can be sung in sync to the beat.

  19. Secure rhythmic engagement to the metronome beat

  20. Example of a net hammock used on the beat

  21. Key systems influenced by regulating to a beat • Breathing • Engagement • Autonomic nervous system responses • Vagus nerve • Audition

  22. Which in turn can help with: Down regulation Up regulation Respiration Digestion – reflux (GERD) Feeding – colic Sleep – sleep apnea Alert state and regulation of primary functions.

  23. Wearing a hat to decrease sensitivity to headphones

  24. Contained sitting to increase attention

  25. Combine with favorite and ‘safe’ places to increase frequency and duration

  26. Allow manipulation of headphones – also consider using speakers…

  27. Provide positive support and hand over hand assist

  28. If a child wants to use celery as a drumstick….

  29. Then let them!

  30. Introduce headphones as part of play and sensory diet

  31. Include passive metronome beats and rhythms to daily activities such as:

  32. And ultimately…

  33. Case study: Katie

  34. Areas commonly identified for treatment in children with low cognitive and neurological capacity NEUROLOGICAL: • Developmental delays – genetic • Developmental delays – environmental • Developmental delays – acquired

  35. Use of media to record initial performance and timing tendencies Movie: slide43-usingmedia.mp4

  36. Considerations… • Long repetitions to increase tolerance to hearing the beat in the environment • High energy prompting and hand over hand assist to generate pockets of engagement.

  37. Feeling the beat together • Hand over hand assist • Containment and postural support Movie: slide45-feelbeattogether.mp4

  38. Considerations… • Hand over hand assist • Containment and postural support • Headphones vs speakers

  39. Independent in supported sitting Movie: slide47-supportedsitting.mp4

  40. Considerations… • Adapt environment to support attention; posture; switch access.

  41. Keeping the beat at the right pace Movie: slide49-keepingthebeat.mp4

  42. Considerations… • Match tempo to child in the moment. • Continue to apply rhythm to handling; games; movement activities.

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