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Utilizing Integrated Listening in Conjunction with Interactive Metronome

The Interactive Metronome (IM) used in conjunction with the Integrated Listening Systems (ILS) has proven to be very beneficial for many children. They have both been proven to be very powerful interventions when the timing and candidacy is appropriate. The evaluation is essential to determine which children would benefit from a combination of the IM and ILS program. Depending on the child, a variety of evaluation tools are utilized for the evaluation.  The evaluation tools include: VMI, TVPS, Brunnicks, Sensory Profile, Clinical Observations, a comprehensive auditory processing evaluation which may include the SCAN, SSW Test, Phonemic Synthesis Test, and the Auditory Analysis Test, and an in-depth review of the child’s history with the parents.

We have found that the ideal candidate for the ILS programs is individuals with auditory/sensory processing disorders. These individuals need this work before an IM program because they are too overloaded by their environment, neurologically immature, and can not physically get the most out of IM program at that time. The ILS program has shown to make tremendous gains in foundational vestibular functions including muscle tone, balance, bilateral coordination, and overall regulation.  Additionally, the ILS program will directly train the ear and brain how to better analyze, sequence, and discriminate sound and auditory information. They are better able to filter out unnecessary information in order to focus on the primary message. After the clinician feels the foundational skills are at an improved level this is when the IM program can prove to be very beneficial to work on higher level skills. 

On the other hand, IM is an excellent program to use in conjunction (at the same time) with the ILS programs for individuals who have auditory processing issues, and have difficulty with endurance, coordination, and attention and focus. Children with a sensory processing disorder that is affecting their motor planning, sequencing, and organizational abilities are good responders to the combination of programs. Children with depressed processing in their vestibular/proprioceptive systems often present with disfluency in their movement patterns.  This is especially true with children that have made improvements in their bilateral coordination and muscle tone, but still present with a lack of fluidity in their motor skills.  The IM has shown to help not only the fluency of movement patterns, but also fluency is a child’s language and reading.  A significant jump in the child’s motor planning abilities is often reported for children who do both the ILS and IM programs. Additionally, we also observe a jump in the individual’s dichotic listening and interhemispheric communication abilities which improve attention, focus, and working memory.  It is observed in the clinic and reported by the children’s parents that children are performing tasks more automatically and therefore not requiring as much cognitive effort to complete physical and academic tasks. We have found the combination of IM and ILS utilized at the same time to be most effective for these individuals because you’re challenging and treating more areas of the brain.

Depending on what ILS program is utilized it is typically completed over a 3-4 month period of time. The IM program is completed in about a 5 week period of time. We have found that the IM program is best accomplished being carried out 3x a week for 5 weeks. This interval is based on our vast experience of using the IM with children with documented auditory/sensory processing disorders. For the child that does not present with auditory processing difficulties or foundational vestibular/ proprioceptive deficits, but have clearly presents with rhythm and timing difficulties we will recommend just the IM program. However, our best success over the 10+ years we have been utilizing both the ILS and IM comes when the programs are used in conjunction with one another.

As we know the results are due to the brains plasticity. When you are able to individualize a treatment, make the treatment challenging and intense you will see the biggest change. The consensus in brain plasticity research is that the individualized treatment has to be at the very least 3 times a week for at least a ½ hour a day and for at least 8 weeks. This duration is easily accomplished with the combination of ILS and IM.

Lisa Leyden, M.S., CCC-A

Michelle Herman, OTR/L

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