1. Interactive Metronome
A Group Approach

2. Concept
Introduce IM in a group atmosphere and follow it with gross motor and fine motor tasks.
IM for first hour and gross and fine motor tasks second hour.
Group done in a single room to simulate class environment not SI gym environment.
Twenty-four sessions over eight weeks, three times a week.

3. Evaluations Evaluated as a group Bruininks IM LFT Handwriting sample
Review of previous Occupational Therapy evaluations.

4. Group Introductions Child 1 PDD-NOS Sensory Integration
Seeks proprioception and deep pressure
Seeks movement
Developmental Delays
Poor Group and Peer Relations
LFT 233 ms.

5. Group Introductions Child 2 PDD Perseverative Impulsive
Developmental Delays
Below Average Balance and Bilateral Coordination
LFT 376 ms.

6. Group Introductions Child 3 Bipolar Diagnosis Aggressiveness
Poor Motor Planning
Short Attention Span
Overfocuses on objects
LFT 247 ms.

7. Setup Parent information meeting The room and three computers
Auto Train
IM first hour
Second hour tasks

8. Using Auto Train Group Long Form Test Daily Short Form Tests
Phase One Tasks
Individualized as child moved through phases
Guide Sounds explained to group then used if appropriate

9. The Second Hour Handwriting Karate Gross motor tasks Balance tasks
Hand eye coordination tasks

10. Week One Day One Day Two Day Three Evaluation
IM conducted on three stations
Day Two
Full hour of IM
Completed 1,500 reps
Phase 1
Day Three
Continued IM on three stations

11. Week Two Guide Sounds introduced in Phase Two Resistance Children
Parents

12. Week Two Realization This is a group a different approach is needed
IM is adaptable
It is OK to have FUN

13. Program Change First 15 minutes IM over speakers
As a warm-up or gathering task
Conducted varied tasks as a group
Jumping and moving
Clapping and pattycake games
Catching or passing balls or beanbags
Taking turns tapping
Talking to the beat
Follow the leader

14. Motivation Stickers Rewards for increased freedoms during second hour
Reports to Parents
Behavior
Scores
Gross and Fine Motor tasks
Compare scores with peers if appropriate
Relation to sports training

15. IM Phases Each child on a different phase of IM Vacations
Weeks Three and Four
Weeks Five through Seven
Eighth week re-evaluations

16. Re-evaluation Bruininks Interactive Metronome LFT Child 1 LFT Child 2

17. Progress Report Child 1 Increased calmness Improved self control
Improved reading and spelling
Improved independence. Using Auto Train

18. Progress Report
Child 2
Less perseveration and oppositional behaviors more flexible in group
Improved balance and bilateral tasks on Bruininks
LFT Hands 63 ms. Feet 119 ms.

19. Progress Report Child 3 Improved sequencing Remained on Phase One
Remained in group setting 90% of time
Improved motor planning

20. Review IM can work in a group
LFT and SFT
Plan but be prepared to change those plans
Use the features of the IM such as Auto Train
It is OK to be less formal and make it fun!
Pass items to the beat
Jump over items to the beat
Group can do tasks together with or without switches

21. Changes to Make Next Time
Individual Long Form Tests and Bruininks
Start sessions with group tasks with IM over speakers
More adaptable plan for second hour
Possibly break IM into shorter segments