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heartlikealion

If your child did/does IM...

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The OT established a benchmark that they wanted DS to reach.  Son was 11 yo at the time.  We went into the office at least once per week, and son reached their goals in 4-5 weeks.  DS practiced IM at home 5 times per week at 20 min per session.  I’m not recommending IM.  People say that IM bumps wm scores; however, we did not find that statement to be true.  It did help DS to improve his focus, but he still needed to work with a ped PT later to address balance, bilateral coordination, and other motor issues.  IM people claimed those issues would be sorted, but we did not realize those benefits either. 

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Ah. Thank you. 

Well so far I’ve just been told that the program is meant to be done 2-3x per week for about 20 sessions. He has not done an IM eval yet but based on my consultation and his OT eval they are wanting to do it. He still has to go back for the IM eval and they hadn't scored his OT test but just talked to me about that they had seen. Doing stuff at home is ok but they want you using the computer program at least 2x per week in the office I think? Supposedly studies push 3x a week  (their words) but I don’t see myself driving 3x a week to this office 45 min away. 

As for balance or bilateral integration he’d been given exercises to do at home for that from his behavioral optometrist. We slacked on those after a while but I’ll get him doing some again. A balance board was suggested for both children. I need to fix ds’ because I initially got the wrong size screws. Dd has a mini one we found at a consignment store. However they are supposed to use them with their glasses and dd lost a lens the other day ugh. 

I guess I don’t quite understand where a PT is required vs an OT. Ds has fine motor issues but I think gross as well. She said he could catch a ball but sorta acts scared of it l. I nodded and said when I got the Zoom toy to help him he didn’t like it when it pinched or hit his fingers so I told him try to zoom it back before it gets that close to your fingers. Instead he kinda freaked and droppped the zoom handles when it came toward him. He has some level of anxiety at play I think. No pun intended. 

One of the biggest red flags I see eithds is he sticks out like a sore thumb in martial arts classes. He’s always doing the opposite of others. I think the teachers are facing him and he’s mirroring instead of using the right/left like they want. He did this for a year when he was enrolled between age 4-5 in kung fu and again when he did a summer trial around the time he turned 10 at a TKD studio. 

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Lion, your pediatrician could screen and give you a referral for PT. Kids with dyspraxia will often be referred for PT and you can do OT and PT. 

1 hour ago, heartlikealion said:

She said he could catch a ball but sorta acts scared of it l. I nodded and said when I got the Zoom toy to help him he didn’t like it when it pinched or hit his fingers so I told him try to zoom it back before it gets that close to your fingers.

You're describing convergence issues. What's your status with the behavioral optometrist?

1 hour ago, heartlikealion said:

As for balance or bilateral integration he’d been given exercises to do at home for that from his behavioral optometrist. We slacked on those after a while

Did anyone test for retained reflexes? 

For midline issues, try BalavisX. You can do it at home for free with stuff you've already got. I used homemade bean bags and old tennis balls. Imperfectly will still get you results!! We later did it with an OT who was really good, but we made a lot of progress just doing it ourselves too. It's AMAZING for midline issues and it's free. You might be able to get the book through your library or find videos online. I'll put a link at the end to get you started.

1 hour ago, heartlikealion said:

He has not done an IM eval yet but based on my consultation and his OT eval they are wanting to do it. He still has to go back for the IM eval

Ok, so they're going to eval for that first? My dd was ready to just do metronome work, but my ds struggled even to do a single clap but would hyperclap instead. Those are radically different starting points. There is evidence base for saying rhythm work improves behavior. It's targeting the EF (executive function) portion of the brain. Frequency is usually important in therapy, yes. However I think it's also ok to say something isn't the most important thing right now or that imperfect would be good enough or that it could wait for later. Sometimes OTs have pet programs that they throw at everyone as a cure-all. If a dc has eyes not converging (meaning his visual processing and visual memory are affected) and retained reflexes, I can't see where metronome work is the absolute most important thing. Maybe it is? You can decide that for yourself. Sometimes therapists are like used car salesman with all these great things they want to offer you, and you can say nope, not where I need to put my time right now, or yes that would be really pivotal and get us a lot of mileage! 

Right now, working on metronome is really good for my ds. It's evidence-based that working on rhythm and metronome will improve behavior. He's getting it in music therapy, and it's very fatiguing but fun for him. IM would not have been the right starting point because his impulsivity was THAT BAD. And we did it after we got most of his reflexes integrated and after we were sure his eyes were converging. But could there be a situation where metronome work is really pivotal and should be done earlier? Personally I think reflexes should be integrated first, because they cause the midline issues. I think the eyes should be converging first, because the ability to read and use their eyes is of primary importance for a school age child.

1 hour ago, heartlikealion said:

He has some level of anxiety

No doubt he does! And if his convergence issues are as bad as they sound, he probably feels like the world is constantly about to him him, which would make it worse!! So then why is metronome work the most important thing? Why does it have to be a priority right now to do it 3X a week, when his eyes don't converge properly and he has significant midline issues and retained reflexes? Why not something imperfect while you focus on something more important?

If you do the metronome 3X a week, then the things the metronome work can improve will improve. But, like Heathermomster said, if those things weren't pivotal, if they weren't your biggest problems, then you still have those big problems. Therapists are used car salesman and will sell you what they've got on the lot. Make sure they're selling you what you NEED. 

I would ask questions. Will the IM be covered by insurance? Will it be integrated or done in long sessions? Are they testing for retained reflexes? Would it be *harmful* to wait on IM? Do they have things they could do to support what the behavioral optometrist is doing to get his eyes working better first? (Please, let them tell you IM will make his vision better. I've had OTs stuff woo stuff like this, kind of vague promises.)

Just as an aside, to get you pissed off, convergence (that whole thing with him feeling like things are coming at him and scaring him) should improve in 2-3 months with good vision therapy. So why should IM be more important than getting his eyes working well??? Makes no sense to me. 

**Be the driver of your car, and let your kid be the co-pilot.*** Therapists offer things, lots of things, and you can be the driver and say what you want to focus on first, what direction you want to go. All these things are good, but if you're driving to Texas when you need to be driving to CA, you're going the wrong direction. And it's really up to you, knowing your dc, to decide that.

Here's a clip about BalavisX. We did it imperfectly and got noticeable improvement in midline issues. Emphasis on the imperfectly, lol. Don't be afraid to do something you can afford, something you can do consistently, and just do it imperfectly.

 

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Ds has a new ped. Both kids, do. We switched practices not long ago because of issue with front end at other practice. I’m not impressed with the guy though. He totally brushed me off when I tried to discuss the WISC test and the type of dr ds should see/should have seen for his eval at the Children’s developmental Clinic. He said he knew the drs and they held the same titles (but that’s not what the website says so I’m like are you sure?). I don’t feel confident he’d help me much. He did have to sign a referral for the OT after my consultation. It was faxed to him and he signed so ds could do his initial OT eval. The OT eval did include retained reflexes testing and they said he tested positive for one. The optometrist already noted retained reflexes as a concern but never specified what. I asked the OT if he has issues browsing midline. She admitted she didn’t specifically test for that but will look into it at next visit. I don’t even know if we’d get same OT. She said it’s based on scheduling and there are 3 OTs we could end up with. She was not the one I had the consultation with but the one I had the consultation with looked right out of college/first kid on the way (she told me) so I was actually ok with the more experienced one. 

I noticed ds awkwardly apply deodorant one day which made me question midline but then another day I saw him doing it normally so I have no idea. 

I tested him myself for a few retained reflexes in the past but I had no comprehensive list and the few I tested he passed. 

I don’t really understand convergence. But I’ll learn. All I know is the optometrist said he was very near sighted and could use OT for retained reflexes, bilateral integration and visual motor coordination. I told all this to the OT during consult.

Sadly the optometrist no longer works at both offices and she’s 2 hrs. away now. I like her a lot though and her other office is for vision therapy with almost all patients being children with the exception of adults with specific issues (ie. recovering from a stroke). So if need be, I’ll make the drive but we’ve slacked in excercises. Children got assigned same exercises but have different vision issues. Dd has an eye turn(s) and is very far sighted. Ds is very near sighted, no eye turns. Dd is supposed to wear glasses all day. Ds is supposed to remove them for up close work/close screens. 

They haven’t done the IM test but I suspect he’ll be slightly off. He was initially tested at the CDC (see upthread) for ADD/ADHD and for criteria but it was unclear if it really applies to him. He’s mostly mellow these days. He was very hyper when he was younger. He does seem to have focus issues but also has a working memory of short term memory issue as shown in testing at a university speech clinic. So I don’t know what to focus on. We’re all over the place. But I do think OT would be good. Not sure how much OT and PT overlap in areas he needs work. 

I know ins won’t matter really because we haven’t reached deductible. I have been putting these charges in flex spending card. The sessions are like an hr but they don’t sit in front of the IM computer the whole session. I’ll send you a PM with more info on this office. He was a bit fatigued after the OT eval. I was in the waiting room with dd and he didn’t tell me too much about it. Picking up objects etc. 

He didn’t wear glasses until last summer around the time he turned 9. He’s 10 now. He had no idea he needed glasses but he did poorly on the bender gastalt test and sometimes complained of headaches after school the year he went to private. His seat was already close to the teacher. Then I found that particular optometrist and we saw her. Since then they have added s couple more drs to the COVD site for our state but she still may be the closest and I like her. 

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It sounds like you could continue with their intake eval process and see who they assign you to and whether you like the OT they assign you to. Does your deductible start all over in January? If you like the OT and want to do multiple sessions a week,  you might do that starting in January and just do weekly until then. Does your insurance have limits on how much OT they'll cover?

If the OT checked for retained reflexes and the person they assign you to can work on them, that's really good!! Usually people who know to work on those will know to work on other things too. 

If your insurance has caps on the amount of OT and if you're having to charge all this, then maybe talk about doing IM once a week and having homework. 

Do you have other options for a developmental optometrist? You might see how far you can get with the OT, working on the reflexes, the midline issues, etc., then try the vision end again. Doing the body work will make the vision work more effective. The IM is more of a stretch to say it would help vision. Anything for midline issues helps midline, doesn't have to be $$$$ sessions. 

Well you've got a really hopeful thing if you've got an OT practice where they actually test for and treat retained reflexes. It sounds like they're trying to sort through everything. Hopefully you'll be really happy with them and able to work out a plan. 

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We used a ped PT because she came highly recommended and was trained in several styles of therapies.   A former member of the WTM board worked with a sports medicine person to help sort her child's motor/sensory issues.  Since OT had not helped us fully, I actively sought a sports medicine person with a heart and understanding for son's motor issues.  

OT assigned 20 min of homework clapping at 54 BPM.  It's been a while, but we may have seen the OT twice per week.  DS always completed the homework because he knew that he had to complete the exercises to make them stop.

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If I’m not mistaken the female owner (a couple owns the place) is both a PT and OT and trains all her staff. They seem pretty comprehensive but I haven’t received ds’ score/paperwork yet from initial eval. 

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2 hours ago, PeterPan said:

 

 

 

Ok, just looked at this video.  DS did something similar with a basketball for homework with IM set to 54 BPM.  He completed a variety of stomping, hand clapping, and ball bouncing.

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We purchased the home IM system for 850  for 42 sessions from a private provider. We do 45 minute sessions and she adjusts them as needed. I was told when I trained with her that most kiddos only need between 15 to 20 sessions. She confided in me that most patients only completed 15 sessions and the goal is to get to an accuracy of 19%. I will look up what that data actually means. We completed 6 sessions in one week and even in that short amount of time my son made huge gains in guitar rhythm. I noticed it a few weeks afterward , maybe his brain needed to consolidate the information. Then we put M aside and worked on some other highly important therapies. Now we will come back to this December 1st. I am going back to the trainer over Thankgiving and paying for my son to have a session with her while I observe. Once we added the feet we hit a road block so I think a boost from her will help. If you have any questions I can take to her I am happy to ask. 

Edited by exercise_guru
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I asked if the OT could tell me goal percentage or something and she said it will vary what their goals are based on age etc. She hasn’t done the IM assessment yet, just the other OT eval. His IM assessment is scheduled for early Dec. He scored very low on other assessment. She’s mailing me some data. I’m going to present to school district to push for school eval. It does affect him in the classroom setting at least a little imo. 

Thats amazing you got equipment for home. I don’t know if they sell different kinds/models? 

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The lady who I get IM from is 6 hours from me so you certainly could get the IM package from her she has been an SLP for like 15 to 20 years. She works with people remotely quite often. I am sure she would chat with you for a few minutes by phone and find give you advice.

Also on the IM eval my vision therapy place makes a fortune off of IM and didn't offer IM home. That is why I found a provider who would. You can search your location on the IM site to see if you have someone near you who offers it.

 

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Thank you. These comments help. IIRC the cost was around $130/session and they want like 20. That’s so expensive! They see the initial eval as the first IM session and intend to schedule more after but I think I should put my foot down and say you know what can I just get results from it and get a regime to do at home. They already offered to help with at home stuff and scale back from 3 sessions a week to 1-2 but Dh doesn’t want to pay for IM at all and thinks he’d help ds at home. I was honest with dh and said but you’ve been planning on doing archery with him for what, 2 years? And still haven’t taken him outside to learn. Dh said but this is therapy. It’s different. 

Yeah. Ok. I’ll believe it when I see it. Dh doesn’t help with vision therapy. 

You guys, this is why I seek outside help. But I hate the idea of spending so much, too. We resorted to using our credit card this month. We’re trying to avoid that. Then Dh and I went on a date. Movies were covered by gift card but he insisted on buying a beer at the theater. I called him out on it and he does what he always does... digs his heels in that he works hard and deserves it. I almost let that transaction sour the whole night. I said you told our financial advisor you would no longer buy concessions at the movies... and he replied yeah like candy. !!!!???!!!! 

This is what I’m dealing with 

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I want to reach out to the person you mentioned. Can you pm me contact info or a link? Or just ask her if she could work with me in Mississippi? I can pm you my zip code if you need that. I don’t think I was ever on a major IM website, just my local office so I don’t know if I’d find the right person. 

I might not even need my initial appt. that we have scheduled. 

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1 hour ago, heartlikealion said:

I said you told our financial advisor you would no longer buy concessions at the movies... and he replied yeah like candy. !!!!???!!!! 

This is what I’m dealing with 

This is super frustrating. I'm sorry. Money is my #1 source of stress, and I get anxiety just thinking about having financial discussions. It's especially tough trying to decide if something like IM is "worth the money," because if it does't work, you've got all sorts of money stress/guilt added on. I get it!!

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We just got back from a boost session with my son. I go see our home IM coach when we are near my moms house. She lives out of state. The first thing I would do is go to Interactive metronome and search providers. See if there is someone that offers IM home.  That way you could purchase the program through her and get training. 

BTW there is also a less expensive home program that only uses hands ( does not have the footpad) that is only $350 ( at least that is what I thought it was you would have to search) I think it is called Beatbox. My provider told me it is like 20-25 sessions hands only. If you believe that IM will help your child then it is definitely worth it. 

I know that paying for yet one more program to help my kiddo stretches me to the limit. The providers see IM and Fast Forword, cogmed and ILS as a chance to differentiate themselves and since insurance doesn't cover it the bill can extreme. I have been fortunate in that I have found good people willing to train me to do therapy at home, they have provided the materials at an affordable cost and I go to the therapist for boost sessions if we are getting off track. 

There are many reasons why I think it is difficult to do IM without the program. The first is that in one session my son gets 1700 repetitions. The computer takes care of all the calculations and provides the interface. The second is it is near impossible for me to see if my son is making progress. the IM program gives statistics and metrics that I record at the end of each session. The coach gave me a recording sheet and because of that, I can clearly see that he is improving. The third reason is the ability to push my son to finish the full 1700 repetitions. The computer program breaks each set down into so many reps ( usually between 100-300) then tracks it and if my son is getting tired I can say " 60 more keeps going" or " one more minute you're doing great!" Fourth I can reward my son for a session and know that he accomplished a goal of getting through the entire repetition. The research tells us that to learn a new skill you need a minimum of 10,000 repetitions so my son is getting that in 6 sessions. 

IM is the perfect example of the old movie "The Karate Kid" Daniel has to paint the fence and wax cars to learn the Karate moves. IM basically finds a way to track how many times my son is "painting the fence" It is like a treadmill for rhythm, the brain, and the hand. 

My experience may not be as helpful for many of you. As disclosure, I did Fast Forword level 1 and 2 then saw huge growth. Put my son in the audiology booth and saw great progress in Auditory processing. My son still distracted and would check out if he was getting too much auditory information in class or lessons. We did 6-8 sessions of IM before vacation. It was every day and I rewarded handsomely. Then he just relaxed over vacation. When school started I did not put him on any medication and his teacher feels he is doing great and has very few concerns about his cooperation. I decided to do the Fast Forword  literacy pack because it expired December 1st then we will do IM all through December and January. I plan 3 times a week for a total of 18 sessions. The IM home does not expire so I have as long as needed to fit it in . 

The improvements I have seen are related to focus and attention. I do therapy for my son everyday for 45 minutes but I do not homeschool. so far none of these programs have "fixed" my son but even the 6 sessions of IM that we did created a huge jump in my sons emotional regulation and focus. 

send me a pm and I can put you in touch with providers for IM, cogmed, or fastforword. I work with them over the internet and skype then implement the lessons at home. First see if you can find someone in your area because having a few training sessions especially with IM is incredibly helpful. 

 

Oh I thought of a third idea. If you feel you need the support and help of the therapist then see how much the Beatbox is for the home program. I know it was under 400 then go watch the therapist do the IM session with your son and then you do 2-4 sessions at home. Then you could do another session with the therapist( have her do hand exercises AND feet exercisies).  My son and I have had 2 sessions with the therapist then 6 on our own then 1 boost session then we are planning on doing the rest on our own. My son needs to develop cross body awareness so I invested in the full IM home so I could use the footpad as well. My total cost for all of the sessions will be (850 for IM home) and (3 sessions at 85 each $250 for the IM coach check in) so $1100 Still a ton of money but I can do up to 45 sessions for that cost. Less if I did hands only and did Beatbox. 

 

Edited by exercise_guru

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OH and I love the idea of that Bal a vis X it is just that I could not do it for 45 minutes to an hour to get enough reps and I only have me and my son. BUT I love the cross body motion and coordination. We will probably do that in the spring when we can go out on the deck or when I can get some consistency with that. I wish beyond belief that my son's school had that. It would help so many and certainly trains the temporal center of the brain. 

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EG, your therapist doesn't have you doing anything for midline with your IM???

1700 reps would be 31.5 minutes at 54bpm. In other words, if she does 10 minutes three times a day or 15 minutes twice a day or 20 minutes once a day (and says screw it), it all works and was free. And she could do midline.

It can be done for free and it can be effective for free. IM is an astonishing money maker. Look into getting qualified as an IM coach and see how little training they have and what a racket it is. We hear good results on the board with paid IM, sure, and compliance is always an issue, sure. But nothing I've heard has enough evidence to rise to the level of going into DEBT thousands $$$$$. If nothing else, turn on a free metronome app at 54bpm, do anything you want (clapping, cross body, catching balls, etc.), do that 20-30 minutes a day in chunks for a month or two, and then decide for yourself. That would be my two cents.

Therapies are such a drain on the finances and you have to be very careful about going into debt. It's worth trying the free approach first. 

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BalavisX is a really basic program, and you can figure it out just by watching online videos or snagging the book on it. Just do it with beanbags, squash balls, anything you have lying around. It was good, and we did it both with me and with a therapist. But certainly not earth-shattering, just good. Calming, good for midline, that kind of thing.

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We used to live in the state where Bal-a-vis-x is from, and it is very popular there.  

Regular classroom teachers or PE teachers could incorporate it with no particular training (training but like you could see from a book or video).

If a child cannot do the exercises without modification then that is where I think more goes into it.  But most kids, really, do not need that.  But some kids do.  Definitely using sand bags instead of balls is a modification!  Both of my sons had that.  

I have always heard that kids like it, too, which I think goes a long way!  

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Peterpan

I agree they keep the door closed on what actually goes on in an IM session but there is only one cross body exercise and that one hand on your thigh and tapping your opposite toe forward.  No I would not go into debt for IM. There are many many ways to incorporate that rhythm exercise without paying for it.  I am not sure that its exactly 1700 in an hour its around that ( plus or minus 100) and yes its a lot to get your kiddo to do it for that long. you basically do 6-9 sets of  exercises for around 100  to 300 repetitions ( 300 for hands 100 for feet)

for example

set 1: 100 right hand warm up

set 2 :100 left hand warm up

set 3: 300 both hands

set 4: 100 right toe 

set 5 100 left toe

set 6: 300 both hands

set 7:  200 tap hip with L hand and right toe on mat

exercises are

one hand on leg tap or both hands clapping

for feet it is  L/R and march toe tap or heal tap

combined is tapping the hand on the leg and tapping the opposite foot 

So the exercises are very basic and the interface is very non distracting. It really is just to get the child to "paint the fence" for 1700-2000 repetitions to get the brain to get the rhythm down. 

the computer gives stats on how early or how late the tap was and a % of each along with a % accuracy and a score that they made up in relation to what they would like to see for that age group. you graduate when you either do enough sessions or get your % in the appropriate age range. 

 

Hope that helps. 

Bal a viz X would be very cool in a group. My son and I like to do it and could do it for about 10 minutes so if I put that in our day it would be fun but we drop the ball and do not get enough accuracy to get it going consistantly to a rhythm. I also thought of putting my son in drum lessons as I could pay for one month what one session of IM is. That being said he has been in guitar for 3 years and made the biggest jump in progress after doing fast forword and that had no rhythm in it.... so who knows!!

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I thought about Peter Pan's post while I was doing IM with my son this morning. We could easily just set a metronome and put two large dots on the floor ( like twister size) and two dots on the wall.  then turn on the metronome to 54 bpm . For hands do 1 minute warm up and then build up to a 3 minute session. For feet keep it at one minute initially and build up to 2 minutes. The focus timer app for the ipad would be perfect as it is large and tells you how much time you have left. 

 Then after 10 -15 sessions or when your child was ready you could up the challenge. For example To be more advanced you could cross the midline with the taps. Left foot then right foot and also do left hand tap then right foot tap. 

IF you set it up for around 25 sessions 25 minutes each you would get the best of both worlds. you would get enough repetitions, have enough encouragement and provide incentive and it would all be for free. 

If you doubt your confidence just pay for one session and go and watch. 

I am going to actually do this for our last 5 sessions when we get there. Cross body motion is very important for my son and I can just put a pad on the wall and use the paddle they provide or I can put a color sticker on the mat for him to tap with his feet but really you would get a lot of benefit without the equipment. 

 

The key is cooperation and consistency. My son would never have cooperated before but now he certainly would.  You also have to do it 3-4 times a week to get the repetitions in. 

you could also just do an initial session then do  it at home 3 -4 times a week and after a few months take him back for a session. That would give you growth data without spending the big bucks to do this at the office or buying IM home. Now that I am trained I am thinking I spent too much money on this darn thing. Knowing what Know now I could easily have done it at home. 

Edited by exercise_guru
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17 hours ago, exercise_guru said:

Now that I am trained I am thinking I spent too much money on this darn thing. Knowing what Know now I could easily have done it at home. 

Oh EG, don't feel bad! You were happy with your results and the work got done. Therapy that GETS DONE is WORTH THE MONEY!!! Of course you could do it in hindsight. The only reason I could do anything on the cheap was because Heathermomster posted enough that I could put it together with my own experiences having kids in OT and figure it out. But it's not a waste of money if the therapy got done and you were happy with the results. I think it would be fab to have access to the tech. 

My goal was only to show alternatives and to suggest that it's wise to be careful about going into debt for it. If the parent has enough compliance from the dc and the question is can we make progress without going into debt, the answer is yes. And I LOVE that you're seeing these other paths, because I think people need options so they can decide what is best for them. There are people who don't want to deal with compliance issues and making up plans, so for them paying is better. There are lots of good reasons to pay and situations where doing it hack and calling it good enough will be the right choice.

I'm going to reread your ideas, because they sound really good! I love the concept of metronome work because it's so flexible and adaptable to the things you need to target.

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Thanks PP the hard thing about being a therapist for my son is I am only trained to help my son. I am still glad I got out of IM for around a thousand. They wanted me to pay 3-5 thousand for those sessions. Unfortunately my son needs the neuro- feedback from the computer. He is really lazy and would half tap  the paddle even with coaching. Then the IM computer screen shows him that he is off rhythm and he pulls it back and adjusts his tempo, He has horrible awareness to temporal feedback so in his case IM home was essential.

It was the same with Hearbuilder and with Fast forword. He needs the accountability of the computer and the coaching from his mom. The feedback helps him immensely . 

This thread would be very useful to parents considering IM. Thanks to the mom who started it. We all spend so much money and time trying to help our kiddos and there is no reason to go into the poor house for our kid to tap their foot to a metronome. 

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My son went for an IM eval today. Dh took him as I had a headache and he volunteered. The therapist did not see the retained reflex anymore so either it was corrected or he did something funny at the last appt. Ds said he was nervous last time. He did rank below average but Dh and the therapist agreed it could be fixed and things can be done at home. They had an option to rent something for the home but Dh will just download an app instead I think. 

I had issues locating dd’s dental costs printout so was not able to verify that last flex spending transaction and I think that’s why the flex spending card was rejected. Dh was very upset and had been insulted by the male owner... he used a horrible analogy on Dh comparing ds practicing IM work with Dh being told to exercise 2x a week and lay off the Kristy Kreme (Dh is overweight and doesn’t need that rubbed in his face. I would have been insulted as well). I got on the phone with the man and said I will pay him tomorrow if that’s ok. I think the card got flagged and I can fix it tomorrow. I will get the dental office to reprint the papers if I must. I gotta fix this. 

They were just guessing on prices and we’re still not positive of cost but looks like between the two appts it was $3XX. 

I’m not worried. I don’t think we’re returning so it’s not a huge dent in our plan. 

Edited by heartlikealion
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Yeah, that price is outrageous. They were charging you to try to sell you on charging you more. Glad your dh was able to cut and run. You can get plenty of progress just working at home and not spend a dime. You certainly should not go into debt for it. And yes, that was horrifically rude of them to say anything about weight to your dh!!!!!!!!!!!!!! 

On your flex account, are you able to access it through an app or online? Most banks now have an online banking option or an app. That way you could see the charges and any blocks. I know that's frustrating when the charges don't go through! 

Well that's good that the question got sorted out with less stress for you. I have a headache today too. They must be going around. :sad:

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Turns out there wasn’t much I could have done. Apparently they can’t validate the dental pre-pay (I had to pay ahead for the sedation. She won’t be knocked out completely) until the actual dental work has been done. Well the appt got rescheduled because she was sick. So now I can submit the cost of OP to go towards the sedation and unflag my card but what a mess. Her new appt was set for Jan this morning but then the dental office called right back and said we had a cancellation for tomorrow. I’ll take her tomorrow but the paperwork can’t be fixed fast enough to pay the OP today unless I submit his fees toward the sedation. I know he wants his money so I’m gonna pay him today. Normally the card isn’t useable til midnight but the employees at the flex spending office said they will manually fix the flag so I can pay him right away. 

Lesson learned... prepaying for anything with the card is dicey. I had to pay that fee, though. It was required by the dental office. They understand the headache and have been as helpful as possible. 

I left a message for the OP office stating that to pay them I first need a list of expenses to show the spending card people. Dh wasn’t given anything I guess since the card was declined yesterday. 

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Prepay dental?? I've never had to pay except time of service. So wisdom teeth out, you walk in the door, pay, they get yanked. Dentist does you and you pay. I can see paying your co-pay and the uncovered portions at time of service, but that seems really odd to me that they want you to pay AHEAD  of time, like a week ahead, for a service that hasn't been rendered. That's weird.

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Well for the sedation (sleepy juice they nickname it) there was a requirement to pay ahead. Now, I could have probably paid closer to the actual appointment, but dd was leaving the office for a second opinion when we made the appt. for the crown/fillings so I just paid it then. In my mind I was just using my flex spending card and it would make no difference when they swiped it. They called me back and said there was a cancellation. Dd is scheduled to go to the dentist tomorrow. I called back the OP office and asked the girl if they got my voice mail. She had not listened to it and said the man in charge of the billing stuff was not in. I said that's fine, just wanted you to know I will pay today or tomorrow. I didn't want to hold things up. She said she thought it would be fine either way. The flex spending people said everything will fix itself tomorrow after the dental visit as I can then officially validate the dental care charges and unflag the card. I would rather wait til tomorrow, but just hope there's no an a delay between bringing dd in and paying for her visit. I think I'll just resend her paperwork as soon as I arrive at the dental office and add a note that we are at the dentist having it done. 

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Maybe you could bump this to january anyway because your FSA would reset unless you were trying to max it out by years end. If so then just balance it out. Its a pain and you might have to track down on the phone. I have had my own FSA dramas and dental stuff so you have my sympathy. 

Maybe you could consider doing the home IM DIY version with your child for two months and then have him retested. My son also sticks out in soccer. Sometimes its that he isn't getting the right auditory coaching. Sometimes it is that his motor system is not cooperating because of noise distraction. I will say that doing metronome work has helped with that significantly.  I actually noticed improvements after 8 sessions and 6 of those were done at home with IM home so certainly you could do it. You know how to motivate your child just do it like any practice session and pick a time that is not distracting and when you both have a fresh attitude and a lot of patience. Build into it because there is a learning curve for the motor system. Start with a short 15 minute session with a 1-minute break to walk around or do some retained reflex work and then build up. 

Very easy to do. Also if you pm me I can try to share a video that I took with my son when he was doing IM so you can get an idea of what can be done and implement it at home. Its very basic. This is what our sessions were ( some combination of these atleast)

Beginning sessions: reward and praise then only hands for the first 5 sessions. We did a combination so we could keep up the endurance. Then 5-10 we added feet but did hands then feet because the feet are pretty challenging and one minute is a long time. We used a chair to balance so he could focus on the rhythm. Hands were between 1 minute and built up to 4 minutes . Feet is always one minute per set. 

Clap hands for 2 minutes to 54 bpm( I think thats right isn't it PP?)

Pat his rt leg with his rt hand to the beat for 2 minutes 54 bpm

Pat his lt leg with his lt hand to the beat for 2 minutes 54 bpm

tap  his left toe on a dot forward and back on the floor for 1 minute at 54 bpm

tap  his rt toe on a dot forward and back on the floor for 1 minute at 54 bpm

holding a chair tap behind him with his heal

tap  his left heal on a dot forward and back on the floor for 1 minute at 54 bpm

tap  his rt heal on a dot forward and back on the floor for 1 minute at 54 bpm

Then alternate toes or heals for 1 minutes

intermediate sessions 10-15 add these elements

holding a chair tap behind him with his heal

tap  his left heal on a dot forward and back on the floor for 1 minute at 54 bpm

tap  his rt heal on a dot forward and back on the floor for 1 minute at 54 bpm

Then alternate toes or heals for 1 minutes

More advanced after 15 sessions

is tap your right hand on your hip then next beat tap you left toe on the dot 

even more advanced put the dots on the wall and have him tap right hand on the opposite dot and then the other hand

Then go to feet doing that. 

Edited by exercise_guru
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Speaking of dots, I bought dots!!! Amazon had them on sale for crazy cheap. I wasn't sure why I bought them (oops), but now I have a snazzy use! 

That would be really interesting to see if ds could do 2 minutes continuously. He might go CRAZY.

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That list is really, really good! I really think though that the metronome work could go even farther. That list is varied, but we're not crossing midline, not bringing in distractions, not pulling it together to accomplish a goal. I've talked about this, but I tried to think through all the areas my dd needed to have work together to create function. I tried to pull all those components into the metronome work. I wanted to improve her ability to get her thoughts onto screen, because that was wicked hard for her. I knew she needed to:

-use working memory

-handle distractions

-motor plan

-cross the midline to type or to get thoughts from one side of the brain to the other

-get out language

-organize the thoughts using EF

ALL that needed to happen, and we could target it ALL AT THE SAME TIME with metronome work! We did digit spans with distractions going on while doing motor planning that crossed the midline while talking while keeping time. It hit ALL those areas at once, and indeed that's what happened, that it improved her ability to get her thoughts out onto screen, boom. It was pretty magical.

I think you could target ANYTHING if you think through it in that way, looking for the component skills and working up slowly.

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PP for the initial sessions our coach SLP just started them with that beginner configuration. They tend to rush the tempo or lag it initially so it takes huge mental discipline to get time that metronome. She would do it with him and que ( again I am happy to show a little clip if someone pm's me)  If anyone wants to see a bit of that I can put it on our drive for reference. I believe IM ( I will just call it that but really any metronome work) the benefits come from keeping it simple and having them predict the beat. You or I can do this and adjust the timing of our brain but my kiddo needs at least 15 sessions keeping it very simple. Then he would benefit from 10 intermediate sessions using opposite foot and opposite hand. I am saving the last 15 sessions for more advanced work and cross body action once we have gotten to that point. Initially he was all over the place and really shut down if we did IM at home for more than 15 minutes. your ideas for the advanced section are very good. You could put colored dots on the wall and have them tap the color you say or the pattern you say with the rhythm. also build in distractions to help them ignore something and stay focused. I would do that at the very end of the series though once full mastery with on time timing has been achieved. For us this is built into Guitar's and Duets. Initialy we crashed early but now we have built up to where he can do the full 30 minutes to an hour

Edited by exercise_guru
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With IM, the student starts small and builds up.  I would never go past 20 minutes, and there are more pleasant, less mindnumbing ways to practice crossing the midline and working on bilateral coordination than using IM.  

Edited by Heathermomster
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The metronome itself is very challenging to stay disciplined and stay on beat. I think crossing the midline and such is really good for bal-a-vis-X and even ILS we did a ton of exercises listening to something and tossing a bean bag back and forth doing memory recall exercises. 

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3 hours ago, exercise_guru said:

You could put colored dots on the wall and have them tap the color you say or the pattern you say with the rhythm.

Ooo, I like that!!!

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Dd had her dental work done today. I fixed the card issues and paid the OT over the phone. He emailed me a detailed receipt I will submit for verification tomorrow. 

Our flex spending plan runs Sept-Aug. so the date was fine. Honestly I’m glad we fit it out of the way. No appointments looming after Christmas. 

I’ll try to sit down with dh and look at various at home exercises like those in this thread. Thank you. 

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