Prefrontal Cortex Important for Changing Rules/Memory

Quotes from the article:
"Rules that people must actively remember are controlled primarily through the prefrontal cortex."

"...obsessive-compulsive disorder and attention deficit disorder, (are) conditions in which a person's ability to remember and change such rules is impaired."

The prefrontal cortex seems to be a significant area in attention issues. See the complete article. How Memory Deals with a Change in Plans

TIming and Learning Disabilities

Learning Disabilities and Timing Article: A quote, "Abnormal brainstem timing may serve as a reliable marker of a subgroup of individuals with learning disabilities. ....faulty mechanisms of neural timing at the brainstem may be the biological basis of malfunction in this group." Read the whole article. Brainstem timing and literacy.

Left Hemisphere versus Right Hemisphere

If you are interested in a great video from a brain scientist about the functions of the left and right hemisphere, this video is awesome. Dr. Jill Bolte Taylor experienced a stroke, leaving only one hemisphere in tack. She shares how her brain worked differently and how fascinating that was for her as a brain scientist. Very uplifting and powerful. Stroke of Insight

Left Hemisphere Neglect

Occasionally I see clients that tend to "neglect" the left side of their paper during the visual processing pretest. They don't see or circle pairs on the left side of the paper nearly as frequently as they do on the right. This may indicate a weakness in the right hemisphere of the brain. In training children with this pretest behavior, I usually choose to target tasks with the left hand or left foot as the student becomes able to handle the challenge. I just found an article that said, "...left hand movements produced a significant reduction in the severity of neglect only when these movements were made on the left side of space." This seems to suggest simple left handed/footed tasks. Sometimes I add crossing midline with the left hand, adding movement of the left hand in the right hemisphere space. Though this path is important, I'm not sure that it's indicated for left hemisphere neglect. See article abstract.

Left Hemisphere Neglect Article

Another IM Blogger

You may be interested in what another IM provider is blogging about. Check it out here.

OT, Self Regulation and Autism

FAQ: What does Parent/Child Team IM look like?

How do I provide IM to the younger client (8 years and under) while keeping costs down. In the past I saw the younger child one on one only, but that is more costly for parents. Group modes make IM much more affordable, but younger children can not work independently enough to succeed in a group format.

This is how I'm solving the problem.

The child and the parent become a team. Together they try to reach various IM goals that I give them. In actuality, it's the parent that's learning the IM program and the child is going along for the ride! I've used this hand-over-hand approach for as young 3 years (other providers for as young as 18 months) with great results. An added benefit is that the parents gain from the IM program, too. Parents need to be close to average in their own timing to qualify for this format.

As the child develops a sense of rhythm and moves towards independence, the parent falls away gradually, leaving the child doing IM on their own. Kindergartners through 2nd graders usually work in this format. Kindergartners seldom become totally independent in 15 sessions; 2nd graders often become independent about half-way through. Children with significant auditory, sensory or timing issues often need some synchronization (hand over hand) training even as old as 10 or 11 years.

I provide parents with a full line of specific coaching goals to help you along. You may still be concerned that your child and you have too much history - a very valid concern. In reality, the biggest challenge to this format of IM is that about half of the children don't actually work well for their own parents. Therefore, at the first sign of frustration (from you or the child), I swap parents. You may actually end up working with another child while another parent works with yours. I have found this very effective and works for most children.

Feedback from a first grader's mom the first time I tried this has encouraged me to keep fine tuning this format. She was so pleased with the gains her son had made! And keeping the cost down by working in a group mode had helped them afford the program. She urged me to keep offering IM in parent-child teams, so I have. Parents, what you say does have power. Speak your mind!

Note: If the parent needs to take off work to do IM, the monetary savings may not be as great. Individual mode may be just as good of an option, though I think parents enjoy the program and challenge as much as the children in groups.

Note 2:  Sometimes mom or dad could benefit from IM too :) One mom recently shared not just how much she was enjoying the gains her son had made, but that her husband (doing hand over hand with the son) now was picking up more after himself - something she was thrilled about. :)  

Data Speaks - School 1 Spring 2008

Below is a link to another group of students in a school setting. Students were all trained in group mode format. The younger students had their parents with them the first week or so. This spreadsheet includes what the children say, what parents say and what teachers say. Hear how others express gains from IM training in initiation, attention, frustration level, completion of tasks, etc. Check it out. 2008 School 1

Note: You will notice some children have a lot of notes, others less. This varies according to different children/parents and teachers. How comfortable are they, how self aware they are, how often I see the parents or teachers, etc. I think children gain in different areas and at different levels but overall it seems they gain an average of 10 - 15% in the 15 sessions. If that means every day of IM brings a child's mental processing up about 1%, that's huge! When a child misses a day, I try very hard to try to make it up. Every session is important!

IM Parent Letter - Data Speaks

A letter I received today. Back ground: This mom had two children go through IM with me last summer. The young boy was falling behind in school and struggling - he's timing began in the poor range, ended more average. Some more IM is planned for him. The sister went through IM at the same time because 'IM is good for everybody', her beginning score was more average and she moved up to the superior/elite range. Here's the note:


Just a quick thank you. As you said-IM is not a fix all but it really has made a difference in our lives. (Middle school girl) made honor roll the entire year last year (because she did it not her MOM :) ) She is very organized. Completes tasks on time. She was the most consistent hitter in softball. She has done just great!

(Upper grade school boy) has done better but obviously still needs work. He could hit the ball better but still struggles a little bit with timing and with completing tasks. He still gets distracted very easily. Will let you know how that goes.

Book: Delivered from Distraction

Dr. Edward Hallowell's 2006 book, Delivered from Distraction, has some great quotes about cerebellar stimulation - Interactive Metronome, the Dore Method and Brain Gym being the three types of cerebellar simulation he mentions.

These quotes are from Chap 29: Cerebellar Stimulation

"Cerebellar stimulation is a treatment that might help you or your child profoundly, perhaps getting to the root of the problem instead of treating the symptoms". p239

He also shares his own personal story about his son Jack. Jack hated to read! In 2003, after he and his wife had taken the steps that should have solved Jack's problems, they found themselves asking what else could they do. Remember, Dr. Hallowell is an EXPERT - I read his book in the 90's when my son was struggling. He knows the best practices for children who struggle, writes books about them! His quote, that I totally can relate to, "A parent just wants to find help for her child. The more I listened to parents, the more I was roaming outside the usual boundaries of child psychiatry in my search for help for Jack." p230

In time Dr. Hallowell tried cerebellar stimulation for Jack, the Dore Method mentioned above. His son Jack went from hating to read to loving to read, a very common gain I see with IM. "I was elated that we had found a treatment that worked." p232 Another quote, "The cerebellar exercises were able to help in a way that no other intervention had." p.233

The progression of his thoughts: "The whole idea of gaining access to emotion and cognition through physical movement seemed strange to me at first, but the more I learned about it, the more sense it made." p233 He quoted Scientific American stating "The cerebellum may play an important role in short-term memory, attention, impulse control, emotion, higher cognition, the ability to schedule and plan tasks and possibly even in conditions such as schizophrenia and autism." Look at my data speaks graphs - through my experience,those are exactly the tasks that parents notice gains in after IM training!

He ended the chapter, "Whenever I see my son Jack happily reading a book, I feel glad I gave this treatment I had never heard of a chance." p 239

The future of cerebellar interventions: "I felt frustrated knowing how long it will take to produce the studies we need. I had read enough and learned enough and seen enough to recommend that people give it a try." p235 All the research will take years, but I think, and Dr. Hallowell thinks we are on to something good!

Thank you Dr. Edward Hallowell for sharing your own story of success and looking outside the box!

FAQ: What do the IM Millisecond (ms) Scores Mean?

IM tasks are measured in average milliseconds away from the beat. A student is asked to move their body to a slow rhythmic beat, usually 54 beats per minute. The computer measures exactly when the student actually makes the move compared to when their ears actually heard the target sound. The difference is measured in milliseconds - 1000 ms per second - and displayed on the computer. Averaging all the hits together will give a ms average for that task. Generally I have discovered that with different averages, students display different emotions and thoughts. Here's a picture of what I see in terms of IM performance:

100 ms or larger - Students often loose the beat and can not figure out how to get back into the rhythm. They often require what's called hand over hand help. The IM provider will help them find the beat.

60 ms - 100 ms - Student begins to be able to do task independently, but when they lose the beat they may require help to refind it. 60 ms can be quite frustrating for some. 60 ms is right in the middle of the average range for adults who are not IM trained so it is very common..... but when you are actually scoring a 60 ms, you feel 'off'. The computer gives you such direct, quality feedback, that you can definitely see 60 ms is not 'on the beat.' But... because gains are often made fairly quickly from when the individual becomes independent to 30 ms, students often feel a great sense of accomplishment during this part of training.

30 ms - Student are now just beginning to feel some confidence that they can do it. Plateaus frequently happen here. The younger child, under 9 years or so, may end here, though some young students are able to make it into the 20's or even teens.

20 ms - Here is when a student begins to have internal confidence. They trust in their ability to be successful and this often generalizes into the world outside of IM. IM become self rewarding, external motivators are no longer needed. My goal is to get as many tasks as possible under the 20 ms mark. When a student reaches 20 ms, they often experience a huge amount of functional gains.

15 ms - Students that score here enter an almost meditative state, extreme focus in a relaxed, yet highly motivated mental state. You simply can not reach this level with out three key factors - focus, motivation, and relaxation. You are 'in the zone' so to speak. There is a major difference between 15ms and 25ms though it's only 1/100th of a second difference. Those who have gone from 25ms down to 15ms definitely express that the peaceful, relaxed, focused state of 15ms is worth the effort! 15 ms is FUN!