nature girl Posted August 30, 2015 Share Posted August 30, 2015 I think it's one of the therapies our OT does, and the more I read about it--including amazing testimony from people who've done it at home without investing in the actual IM system--the more intrigued I am. I've searched here and see that Heather has done it (at home, right?) Have the effects held up? Anyone else? I really want to try, but I know it'll be a lot of effort and take a lot of motivation, and I have no idea how I'll ever be able to convince DD to keep at it for the amount of time it'll take. Is there any way to make it fun? (We do have an old version of Rock Band somewhere in the attic, with a drum set. Is it possible that might be at least partially effective, since it uses both hands and a foot and enforces rhythm? Or what about piano practice with a metronome?) Quote Link to comment Share on other sites More sharing options...
Soror Posted August 30, 2015 Share Posted August 30, 2015 listening along, I'd like to try this with ds... I've looked into some but then get overwhelmed with everything. Quote Link to comment Share on other sites More sharing options...
nature girl Posted August 30, 2015 Author Share Posted August 30, 2015 You might want to scan through this if you want motivation. (Several people in these threads tried and seemingly had amazing success. They're adults, though. I have no idea how to convince a child to sit and clap for 20 minutes, let alone 50!) http://www.addforums.com/forums/showthread.php?t=60674 Quote Link to comment Share on other sites More sharing options...
PeterPan Posted August 30, 2015 Share Posted August 30, 2015 You're assuming the OT implements it the way you're seeing online. Sometimes they will shake it up, doing other things, then 10 minutes of IM, then other things, then another 10 of IM. Yes, IM can be helpful, because it directly targets the EF portion of the brain. When I checked into it, I found as many dissatisfied, discontinuing practitioners as I did those who were using it. I think it's not *as* powerful as they claim, but it is useful. I think it's more important to do it as part of a total process. So discontinuing OT would leave you missing the other things the OT would be doing and her total package approach. Also your dd might not even be ready to go do IM. My ds, before we started working on it very carefully, couldn't even just clap one time. He'd do this hyper-clap. I had to do a lot of pre work to get him ready and slowly introduce the concept. So it just depends on where she's at. IM works because you're making effort to work to the rhythm (engaging that portion of the brain), not because you're hitting something. You don't need a drum set, but you need need a metronome app. Anything you do like that is fine. All that would happen is she'd be able to hit the IM skills more easily and get through the OTs goals more quickly. You're not likely to do enough at home to replace what she's doing and you're not doing all the OTHER things she'll be doing. It's a total approach. Quote Link to comment Share on other sites More sharing options...
nature girl Posted August 30, 2015 Author Share Posted August 30, 2015 Thanks, OhE. She's able to clap along with songs (not precisely, but reasonably close) so I think she might be able to at least start with IM and improve rhythm with it. I wonder if both of us clapping along with songs would be enough? I'd probably be able to get her on board with that, since she likes music. Or does it have to actually be clapping to a metronome? (Off the top of my head, Berkner's We Are the Dinosaurs has a nice, slow rhythm we could work with...We could dress up and be clapping, stomping dinosaurs. :) ) Quote Link to comment Share on other sites More sharing options...
Tiramisu Posted August 30, 2015 Share Posted August 30, 2015 Our OT recommended IM. It would be included with other therapy during the sessions and the sessions there are $160 per hour! I wanted to make sure if we ever do it that we do it in a way that is meant to work. I'm not seeing a lot of evidence that once a week sessions will be successful. I think the studies I've seen are much more intensive, as in a few times a week. My dd has been doing metronome stuff with her vision therapy homework. It's basically reading charts along with the metronome so the eye movement is timed/regulated/ordered. And we've seen huge changes in her since VT started, in the sensory stuff most of all. This week she started a new kind of chart with the metronome and for the first time she's been crying with the homework. She's more than two months into it, and I don't think you usually see this kind of negative response this far out. In my mind, this is challenging her and if she keeps at it, we're going to see results. Already the doctor re-evaluated her and told dh, she's seventy percent better and everything should be corrected in less than two more months. Anyway, if the metronome with VT is indicative of what kind of results you get from IM, it could be very helpful. But dd is faithfully doing VT six days a week, one session at the office and five days of homework a week, not just once a week. One thing I've been thinking about is doing piano lessons with a really good teacher who stresses metronome work instead of IM. Over the years, we only worked with one piano teacher who stressed using the metronome, and she was also the one who emphasized theory as well. Both of my older dd's couldn't deal with her for more than a year because she tended to be mean and scary, but I'd like to find someone like that again with a gentler personality. Both of those dd's continued in their musicianship and both have overcome a lot of sensory issues. I think piano could do the same thing, would be a lot cheaper, and they'd get something special from it that could be used in their lives. The question is whether she has enough organization to successful pursue this without some work ahead of time. Maybe the VT will be enough. We'll see. And it might be dh who needs to tell her that he'd like her to try it. ;-) She's been much better but we've had some set backs this week. I've had two grandparents in the hospital in the last week and my MIL is dying, so that would explain a lot. Quote Link to comment Share on other sites More sharing options...
PeterPan Posted August 30, 2015 Share Posted August 30, 2015 Tiramisu, that's really high in our area for private OT. It's usually expensive, but more around $100 an hour for private. Hospital OTs will be triple that. I think if the OT is doing it as part of a mix, it can be really good. I got *profound* shifts with dd in the time following our metronome work. No, I don't think piano lessons will cut it, not when a dc has a serious issue. Most places that do it once a week will encourage you to rent the unit and do it at home as well. That's just so passe, considering you can get a metronome app for FREE. Heathermomster's OT blended it, doing the $$ machine in sessions and the less perfect (but still useful) free app at home. She has posted what her homework was and given instructions on how to do it. Even those things are too hard for my ds, so there is this customization aspect to it, knowing where your dc is starting from and what he needs to do first. Doing some metronome work yourself using Heathermomster's instructions would bring the piano metronome work more in-reach. Remember, if your dc is using the actual IM unit, s/he is getting feedback and pushing harder, working harder. That's all good. I think, and this is just me, that I would be cool having IM as 10 minutes of a 50 minute session, where it's all woven in and the OT is using it in a really targeted, intentional way. But if it's just the OT plunking them in front of the screen for a long period of time, no I wouldn't pay $160 an hour for that, obviously. But metronome work was really good for my dd and is so profoundly out of reach for my ds that it's definitely worth doing. I just think there's that issue that the technology has no motivation to keep up with changes. If you'll do it yourself intensely for 20 minutes a day, where the price is free, then missing the feedback (ie. not quite as intense) might not matter to you. Sure didn't to me. You can also do BalavisX, where it's the same thing, with them listening for the hits of the balls and trying to time it. 1 Quote Link to comment Share on other sites More sharing options...
Heathermomster Posted August 30, 2015 Share Posted August 30, 2015 DS performed IM with an OT and had homework for 20 minutes, 5 days per week. DS did this for maybe 6-7 weeks over the summer prior to 7th grade. His trumpet tutor noticed a change in son's engagement/sustained attention and was so impressed that he called me at home to say so. I don't regret the therapy; however, the OT overlooked some significant balance and coordination issues, which were not resolved until we discovered a pediatric PT. I expect that IM is just one step in a larger process of OT. One of the regular members of the board (dmmetler maybe?) was involved in some sort of music therapy and recommended this book for young children. I'm not sure that young children can even clap at 54 BPM or if it is even developmentally appropriate. The book linked would likely make a better resource until your child is older. Quote Link to comment Share on other sites More sharing options...
Tiramisu Posted August 30, 2015 Share Posted August 30, 2015 I'm very curious about what a reasonable price for IM is? I've been lazy about calling around. Quote Link to comment Share on other sites More sharing options...
Heathermomster Posted August 31, 2015 Share Posted August 31, 2015 I don't remember the costs. I want to say it was $35 per week with insurance. Quote Link to comment Share on other sites More sharing options...
Tiramisu Posted August 31, 2015 Share Posted August 31, 2015 I don't remember the costs. I want to say it was $35 per week with insurance. I may have to get serious and search for an OT who takes insurance and offers IM, because there is a big difference between $35 and $160! Quote Link to comment Share on other sites More sharing options...
PeterPan Posted August 31, 2015 Share Posted August 31, 2015 Tiramisu, if you're paying cash and looking for a new OT, find someone who does BalavisX (and Zengar, my other new love!) and do the metronome work yourself at home. 1 Quote Link to comment Share on other sites More sharing options...
Heathermomster Posted August 31, 2015 Share Posted August 31, 2015 I may have to get serious and search for an OT who takes insurance and offers IM, because there is a big difference between $35 and $160!So much has happened since DS had IM, and both kids have had therapies plus 3 out of state children's hospital visits. The weekly numbers were no greater than $50 with insurance. 1 Quote Link to comment Share on other sites More sharing options...
geodob Posted August 31, 2015 Share Posted August 31, 2015 Though do you want work on tempo or rhythm? As IM just focuses on tempo, and different regular timing. But doesn't develop rhythm. The drum set you mentioned, would be more effective for developing rhythm. Quote Link to comment Share on other sites More sharing options...
BlsdMama Posted August 31, 2015 Share Posted August 31, 2015 I do specific metronome work but it isn't "Interactive Metronome" officially. 1 Quote Link to comment Share on other sites More sharing options...
LaughingCat Posted August 31, 2015 Share Posted August 31, 2015 For us, the problem with just using a metronome itself is the lack of feedback. I have successfully used a tramp and dribbling a ball to create a bit of beat work (ala geodub -- not really rhythm -- although I do think it has helped DD's 'sense' of rhythm) but DD still struggles with following a metronome itself -- and I think the difference is the feedback. She doesn't really seem to get any feedback from the metronome on how close she is (also fwiw, although I do like bal-a-vis-x quite a lot-- it doesn't really help DD with beat work -there is too much control for her in speeding up/slowing down just the tiniest bit -- I can see in a school setting as the manual describes that would be different because your sound would stand out but on her own or just 1 other person [me] doesn't do it for DD ). Just got a Rock Band set myself recently -- and I do think the feedback factor (failing/score) has helped DD -- and that is just on guitar (still 2 hands but no feet - she doesn't like the drums and we have just been doing it 'for fun'). It is too early to really tell though. Also Dance Dance would work in the same way for feet only (although that has been too hard for DD so far). As a side note on geodubs comment -- just playing a drum set by itself I would not expect to help with beat (vs the Rock Band game drum set). DD plays the flute beautifully (with a lot of hard work) ... but her ability to follow a beat still stinks. She cannot set the metronome and then follow it even by clapping much less use it to 'set her beat' when playing. IMO she is keeping the beat by ear from repetition (practice over and over until she knows what it should sound like ) and then speeding up or slowing down until her teacher is happy -- rather than playing to the beat of the metronome. ( I suppose this does mean she actually has a problem with beat and not rhythm similar to how geodub described it -- I never thought about it that way before). There is also an app called Rhythm Cat that is supposed to work on rhythm/timing/beat -- but I could never get DD to play it very much. Quote Link to comment Share on other sites More sharing options...
LaughingCat Posted August 31, 2015 Share Posted August 31, 2015 At the IM site, just found this study that describes something very similar to what I did with the ball: bouncing along with skip counting-- called Hardy Brain Training! Haven't researched it past that though. Quote Link to comment Share on other sites More sharing options...
PeterPan Posted September 1, 2015 Share Posted September 1, 2015 With the BalavisX, I really think it helps to have gotten the training. The OTs I know who are doing have gone to *multiple* training workshops. It's something you get better at the more you do it. The therapist has to get good enough at it that they can do it themselves and keep the precision of all the elements. It's very challenging. I don't think how accurate you are matters as much as the *effort* she is making to get there. I think, and this is just me, that as she makes effort, with time she *will* improve in accuracy. It just seems like some of our kids start really deep in the hole with lack of rhythm, kwim? My ds was hopeless pretty much, with no ability even to clap once. Seriously. So for him it was a lot of hands over hands, doing it together. With your dd, it sounds like there's enough of a gap there I'd be tempted to do that. Also, handslapping games would be very age-appropriate and engaging. I really don't think the precision of the feedback is going to make that much of a difference, because I think they're just SO far behind that it's going to take radically longer than for other kids to get to the same place. That's just my opinion, and I could be all wet. ClapBox (an app) has feedback. I did it some with my ds and he liked it. Some of the more advanced steps of BalavisX involve auditory matching and there's rhythm the whole way. Thing is, it's so challenging to implement you'd have to have somebody really good at it to get there. I don't even try. I tell the OT that's why I'm paying HER, lol. BalavisX is actually wicked powerful, just very calming and recentering on my ds. I think that ClapBox app was free. We had a whole thread on apps for metronome work a while back. Quote Link to comment Share on other sites More sharing options...
Mom22ns Posted September 1, 2015 Share Posted September 1, 2015 I believe I paid my OT (who had her own practice) $25/half hour for IM. We live in a very low cost area and she had a full time gig and did some extras on the side, but her practice was certified with IM. She was actually amazing and the best OT in the region. She worked with us because she knew us outside of that setting and I don't know if we got a special rate. That said, IM was just so-so for ds. I do think it helped with motor planning and control. I wouldn't have paid $160 an hour though. We did other metronome work outside of IM and I think some of the other stuff might have been just as beneficial and didn't require a therapist at all. 1 Quote Link to comment Share on other sites More sharing options...
LaughingCat Posted September 1, 2015 Share Posted September 1, 2015 For clarity on the timing issue for my DD and Bal-a-Vis-x -- my DD does fine with timing as long as she is focused and not distracted. And I really like Bal-a-Vis-x for the fact that it seems to 'focus her in'. However my point is that it's very clear that any loss of focus means she gets 'off beat' and also clear that she doesn't notice -- she just pauses a split second or so extra when passing the ball from hand to hand. Whereas with dribbling a ball.... although it is probably not actually as nice of a steady beat (due to bigger/smaller bounces) ... it is also completely obvious if you 'miss' a beat. There is no ability to add a split second 'pause' in the second that your brain is processing (although of course you can do it ahead of time by slowing the bounce.... but that assumes you know ahead of time when your brain will 'glitch' ) Quote Link to comment Share on other sites More sharing options...
Heathermomster Posted September 1, 2015 Share Posted September 1, 2015 With IM provided at the OT, the patient wears headphones as they clap, bounce, and/or stomp to 54 BPM and is purposefully distracted. A beeping will occur in the headphones that indicates whether to speed up or slow down. What is interesting about the beeping is that the student has to remember which side indicates the increase or decrease with clapping to adjust to the 54 BPM. DS improved dramatically with his clapping accuracy. As others have mentioned, IM had no affect on rhythm. DS could focus better but that was about it. The same OT worked with my DD 2.5 years later and I was not nearly as impressed with her. It was almost as if IM was her main strategy for dealing with kids. I later discovered that the OT had overlooked some rather serious balance and developmental motor issues with each of my kids, but that is not IM's fault. I don't believe IM is worth $150 per office visit. 1 Quote Link to comment Share on other sites More sharing options...
PeterPan Posted September 1, 2015 Share Posted September 1, 2015 For clarity on the timing issue for my DD and Bal-a-Vis-x -- my DD does fine with timing as long as she is focused and not distracted. And I really like Bal-a-Vis-x for the fact that it seems to 'focus her in'. However my point is that it's very clear that any loss of focus means she gets 'off beat' and also clear that she doesn't notice -- she just pauses a split second or so extra when passing the ball from hand to hand. Whereas with dribbling a ball.... although it is probably not actually as nice of a steady beat (due to bigger/smaller bounces) ... it is also completely obvious if you 'miss' a beat. There is no ability to add a split second 'pause' in the second that your brain is processing (although of course you can do it ahead of time by slowing the bounce.... but that assumes you know ahead of time when your brain will 'glitch' ) There's a lot of that where a skillful OT might handle it differently from what you think. A lot of time the OT praises my ds on his *failures*. We are, as moms, looking for success, but they recognize this as a process where you keep trying. So when he gets off or loses it, she'll stop, say Good Job! and then give a little instruction (now let's try this, as if she had never told him to do that), and resume. Also, my ds is doing the BalavisX *after* a neurofeedback session. The nf is directly working on the attention and impulsivity. Right now, seeing the calmness and change in my house, I'm crazy keen on it. Quote Link to comment Share on other sites More sharing options...
PeterPan Posted September 1, 2015 Share Posted September 1, 2015 With IM provided at the OT, the patient wears headphones as they clap, bounce, and/or stomp to 54 BPM and is purposefully distracted. A beeping will occur in the headphones that indicates whether to speed up or slow down. What is interesting about the beeping is that the student has to remember which side indicates the increase or decrease with clapping to adjust to the 54 BPM. DS improved dramatically with his clapping accuracy. As others have mentioned, IM had no affect on rhythm. DS could focus better but that was about it. The same OT worked with my DD 2.5 years later and I was not nearly as impressed with her. It was almost as if IM was her main strategy for dealing with kids. I later discovered that the OT had overlooked some rather serious balance and developmental motor issues with each of my kids, but that is not IM's fault. I don't believe IM is worth $150 per office visit. Just to pick this up, when I was actively doing metronome work with my ds, I saw his coordination and timing on the tumbletrak (a running trampoline, about 30 feet long) improve. It's still not where I want it, so it's something we need to go back and work on more. In his case I'm able to compare him to a little class of agemates, but I'm also seeing him compared to himself. It *definitely* showed up in his timing for jumping. Before it was almost like he had no anticipation of when he would hit in order to use his power to JUMP and get higher. With the metronome work, you could see him intentionally landing, intentionally connecting and powering. That has nothing to do with your kids. :) It was just one of those curious things. It was so subtle, if he hadn't been on the tumbletrak so many times a week for so many months (actually 1 1/4 years now), I wouldn't have realized it was happening. 1 Quote Link to comment Share on other sites More sharing options...
geodob Posted September 1, 2015 Share Posted September 1, 2015 The reason behind 50 minutes a day of clapping with IM had me puzzled? But then I realized that the use of clapping is really a waste of time? As it uses a mirror movement of both arms/ hands at the same time. So that in terms 'timing', it involves developing a regular of both arms, out and back. While both arms need to take the same time, to make the movement. The actual time that each arm takes, has no overall reference point. Timing or a beat, uses 2 opposing points, to locate the last and the next beat. With timing being the space between each one. But this is where having 2 sides to our brain comes into play? Where each side of our body, is controlled by their own side of the brain. So that if you tap the table with your left hand, and then tap it with your right hand? You will be aware of the time between the left and right hand tap. As a repetitive process, the time between the first left/right tap, becomes the reference point. As a pendulum process, that swings back to the other hand and side of the brain. So that a regular tempo/beat, can use both hands to locate the opposing points, and the distance/time between them. As one hand taps, and then the other. But with 'clapping', and both hands brought together at the same time, at the mid-line? The brain can't use each hand to concieve of a timing, beginning and end point? Rather what clapping requires, is a controlled contraction of muscles in each arm. Which can vary from very fast, to very slow, at very general level. But has no real sense of timing. Which explains why this 50 minutes a day of clapping is required? As it is just trying to develop a controlled rate of muscle contraction. But as to using this to develop a sense of timing/ tempo? It is really a waste of time. Quote Link to comment Share on other sites More sharing options...
Heathermomster Posted September 1, 2015 Share Posted September 1, 2015 I don't understand the reasoning behind IM. I have always speculated that it trains the patient to focus deliberately. Perhaps, impulsitivity of the patient is redirected and brought into mindful control by clapping. I don't know..I met a women that told me her son with mixed ADHD son stopped most of his impulsive ADHD behaviors after IM but that he was still inattentive and required meds. Quote Link to comment Share on other sites More sharing options...
Princess Ariel Posted September 2, 2015 Share Posted September 2, 2015 My kids did IM a couple of times while they were much younger. I don't know the cost but it was covered by our insurance as part of their O T sessions. About the only benefit they had was bladder control which was great but unexpected. As I said they were young at the time and we were hoping for some good results with ADHD behaviors. The last time ds did it, he was a little older and he hated it and didn't even want to go to therapy, which he usually enjoyed. I think it proved to be very challenging for him and they were pushing him pretty hard. Quote Link to comment Share on other sites More sharing options...
CaitlinC Posted September 2, 2015 Share Posted September 2, 2015 My ds did an intensive IM programme in grade 4 through his tutoring centre, not through an OT. I had no idea of the link between OT and IM at the time, so OT came later for us. My ds swears by IM. He says that it really helped him with his timing and rhythm. He is convinced that IM triggered certain things that he did not have before, like an ability to play basketball. I am a little more skeptical. The formal evaluation that was done after the programme showed large gains in areas that were already strengths, and in areas that were weak, very little progression or even some regression. The truth is that it is really hard to sort out whether his progress is due to maturity, IM and/or some other intervention, or a combination of factors. Quote Link to comment Share on other sites More sharing options...
PeterPan Posted September 2, 2015 Share Posted September 2, 2015 Basketball definitely would respond, as there are issues with timing for dribbling. Quote Link to comment Share on other sites More sharing options...
Tiramisu Posted September 2, 2015 Share Posted September 2, 2015 I just found a place with IM that takes our insurance. I'm not completely up on our current OT coverage details so I'll have to check. There have been times in the past with therapy we've had co-pays and times when we haven't. This means dd will have to go through another eval. She heard me on the phone getting details and got upset. We'll see. Gotta finish VT first. 1 Quote Link to comment Share on other sites More sharing options...
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