Squirrellies and Inhibition - A deeper look.

Wonderful question from a mom today (Nov of 2009 actually - when I began this post.) She had stayed during IM and watched her son in the squirrellies. He was swaying, moving his body non stop, looking out the window, etc - simply following every thought his brain had - NO INHIBITION what so ever.

Inhibition - Think about people you know who have good inhibition, versus those that don't inhibit anything.  What behavior is more 'mature' ? Take a few minutes and just think about this.

Here's a picture of a 7 yr old boy with in house 'squirrellies.' Today about every 1 to 10 seconds, this lad gave into some random sensory impulse, an overwhelming urge to move, much like an itch you just have to scratch.

Sensory Diet Link for Squirrelly Behavior

Can you give me a general idea of “squirrelly” ? Extreme silliness maybe? Emotional?  During IM, a good percentage of students have a day or two of 'squirrelly behavior, some times a week or two, worse case senario, the entire IM training, but this fades in a few weeks after IM is over.

A neuro-typical 12 yr old male - what does 'typical' look like?

One of the greatest blessings of my career in IM is the wide variety of individuals that I have an opportunity to see. People do not need to go to the doctor, have a diagnosis, or even struggle to go through IM with me. As a result, I see many neuro-typical (NT) people, both children and adults, and of all ages.

What do I mean by neuro-typical (NT)? I mean average, typical, having no neuro-developmental delays/disorders, no diagnosis ... just solid, healthy, typically functioning people. Most of the NT individuals that I see are family members of a child I saw for developmental delays. NT students move differently than the children with neuro-developmental delays. This video of one NT student I trained shows typical movement patterns.

IM Media Coverage

A Neuropsychologist talks about IM for children and adults.

IM at Notre Dame

IM and Stuttering:

IM and Learning Disabilities:

IM and ADHD

A Web MD video link

IM and the younger child - 6 yr old. Also 16 yr old. IM and Motor control.

IM and APD

IM and College Law Student

What do you do at assessment?

What do you do at the assessment? 

Assessment for the older child is usually done in the group, for the child under 10, individually.

FAQ: Should I give my child her meds when she comes in for assessment?

There is definitely a difference in mental processing when a child takes or does not take medication. Children gain faster in IM when they take their medication.  Even the effects of over-the-counter cold medications can often be seen in scores during IM. It is also important that pre-testing and post-testing occur in the same state of mind. For these reasons, I recommend children go through IM training on their prescribed medication. Parents may then experiment towards the end of training with your doctors permission to find the new, correct dosage.

Early and mid IM training, I can usually notice when a child has forgotten to take their meds on their very first task of the day. They perform about 10 - 30% worse typically. At the end of IM, if the child has reached the elite range of timing, solidly, sometimes then, I can no longer tell if a child has forgotten his/her meds. Their numbers do not seem to impacted by the medication any longer. They can maintain focus with out the medication now, some, not all.

Maybe half of my students reduce or get off meds eventually with IM training. Others do not, or need more sessions to get to that point. Some parents see enough gain that the child can function off medication well enough, though meds are still somewhat helpful. I can’t tell you how IM will effect your child's need for meds. Every child is unique and different. My own son, after 7 years of using various attention medications has not needed any medication since he went through IM in 2003.  To be truthful, we were aftraid to not use them at first and tried to maintain them the first 6 months post IM. We experimented and used them some, like on test days, but ended up deciding he didn't need meds any more. Please discuss medication change with your prescribing doctor.

FAQ: What time of day is the best for IM training?

Scheduling IM ( the biggest challenge )

8:00 - 9:15 am The preferred time for the child under 8 yrs old.
9:30 - 10:45 am Great for any grade school age child.
11:00 am - 1:00 pm (any 75 minutes)- Many parents like this slot; easier to transport and usually less academic information is missed.
1:30 - 2:45 pm Good for 8 and up that have average or better stamina. Students with low stamina will see more gain in the mornings typically.
3:00 - 5:00 (earliest 75 minutes that works) Reserved for Middle and High school.

Typically children come 3 days a week during the school year, avoiding Friday's if possible (children are just too worn out, especially the ones I see who work twice as hard to accomplish half as much). Many area schools are now familiar enough with IM that most teachers are fairly accommodating. They have confidence that the child will, post IM, have a better school year. Some parents try to recognize the teacher's accommodations and willingness to be flexible with a small baked item or personal thank you note. Summer training happens 5 days per week.

Scheduling IM can be challenging, but it's a short term commitment. When we went through various interventions with our son, everything was long term. Years of counseling, behavior modification programs, medication and a lot of cost. IM, relatively speaking, is extremely quick and inexpensive.

I am amazed how many grandparents help in transportation (and even the cost.)  I even have some groups of grandparents and kids together - loads of fun. Use the resources you have to help out. Some times people are honored to be asked.

FAQ: Can we do 5 days a week during the school year rather than just 3 days?

Though I know much of IM's research is based on training 5 days a week, my experience has led me to recommend 3 or 4 days a week when school is in session, especially for children with lower stamina. If students do 5 sessions a week during the school year, I find that on Friday I usually don’t see the gains that I do the other days. The combination of school and IM is just too exhausting!

During the summer, I do IM five days a week. No problem. When I am in a school, I also do IM 5 days a week. The teachers have helped to work out the schedules so the children won't have much make up homework and the children miss less class time with no travel time. I do notice some children in the schools are a little less efficient by Friday, but I don't have the flexibility to stretch the training out like I do in my office. I typically see very nice gains either way - 3 days a week or 5 days a week.

FAQ: My doctor doesn't recommend IM?

Last night a mom wrote:
"My Dr. wanted me to ask if you had any students, “clients”, that are willing to talk to me about their child’s success with IM." (Parent of 8 yr old boy)

I passed this email on to a few post IM parents and asked if they cared to respond."

Response 1:
"I have a now 13 year old boy that received IM last year. He has ADHD and is very impulsive and does have a mild form of the tic disorder Tourettes. IM did help him quite a bit. He is overall calmer and more focused. We still use meds but he can carry through several command instructions now that before he would only be able to do one or maybe two. He is better able to "stop" himself and redirect when asked. He still struggles but I truly have seen improvement with him. He also seems A LOT less frustrated. He is a happier child. I think IM helped him see the world in a different light. I am a foster parent and feel this therapy would be VERY beneficial to foster kids as well. It helps their brain "process" easier from what I see from my son anyway. Feel free to give me a call if you'd like. I am hard to catch but my number is XXX_XXXX (Name)
I have an 8 year old daughter that took it last year as well. My mom has said she is more verbal and communicates better. I have noticed she is more willing to read books outloud than before but that is all I have seen on her. I feel this tool is very helpful to kids that have special needs and somewhat helpful to kids that do not struggle as much. I do want to put my daughter through another round since I saw such improvements with my son. My daughter is somewhat uncoordinated and I think this could help her. Lori also directed me to a possible vision processing problem with my daughter. We had that checked out by an eye dr who said she does have some vision difficulties despite 20/20 vision but the next screening is pretty pricey so I have not finished the screening."

Response 2:
"I am the parent of a 17 year old Asperger/OCD/ADHD son. He has difficulty with organization, initiating homework and chores, finishing tasks, and social skills. We were at our wits end with him. We really didn't know what to do. Life was just not clicking for our son.

Then a friend of J-----'s at school recommended IM. We have gone thru 2 rounds of IM with Lori Schmidt. For us, the results have been pretty amazing. He is now initiating most of his homework. I will often walk into his bedroom and find him doing homework!!!!!! Before, we couldn't even find it! I would clean his room and find it stuffed in drawers, the trashcan, etc. He now does his chores without a fight, most of the time. He even volunteers to help his sisters (i.e. last night it was dark and my daughter L---- did not want to take the trashcan to the curb-she is kind of afraid of the dark). J----- did it for her. I didn't ask him to. He is doing kind things for others. The center of the universe is not J----- anymore - at least not as much as it used to be!

His social skills are still a challenge, but they are much more developed than they were even a year ago. He actually had his first girl friend this past year. And he had his first job this past summer. I was beginning to worry that he would even be able to hold a job when he graduated from high school. We have a long way to go, but we are very hopeful for the future."

Response 3:
"Dear Parent of the 8 year old boy,

I would like to tell you about my experience with IM. My daughter participated in it when she was 11 ½ years old. She attended 5 times a week for 3 weeks. We did this so that we could get it done as quickly as possible during the summer. I made an agreement with my daughter that if she did it without complaining then I would not make her work with a math or reading tutor over the summer. After about 4 lessons she told me it was easier to do dance spins on her left foot. (She is a competitive dancer.) I didn’t put too much stock into it at first. Then after she’d had about 10 sessions my dad saw her for the first time in 4 months. He said she didn’t have that “blank” look anymore when he talked to her. I noticed she started talking about things that were more detailed and more important (like telling me she was glad people were starting to care about the environment.) When we’d finished the program I waited a few days and asked her what she thought and she said this, “Well Mom, what I can tell you is this….I think now before I talk.”

Enough said….it was worth every penny! And, as if that wasn’t great enough, she improved on her MAP testing significantly over the summer without any tutoring. Family friends have noted she is more mature. She has better fine motor skills….loves to shuffle cards and was very frustrated by it before. Now she shuffles better than many adults. When she is playing a card game that requires her to keep track of lots of things at once and is based on speed, she can compete now with everyone playing and has even beaten me on more than one occasion. Before IM she needed an adult’s help to get her through it.

I know some of these examples may seem irrelevant. I’m a special educator realize that too often we judge success only on the academic scores. The truth is, IM has helped my daughter become ready to learn and in doing so she’s improving in all areas of her life. The improvements were seen in areas I didn’t even realize were issues until they suddenly were easier and my daughter’s self esteem was booming.

I urge you to give your child an opportunity to benefit from IM. Everyone’s results are unique and it may be that your doctor is basing “improvement” on a very narrow definition.

Best Wishes,
Parent of an 11 ½ year old girl."  

Response 4: A mom of a teen ager asked for some referrals and this is one she was sent. This mom carbon copied me in.

Hello, M------!

I heard from Lori Schmidt that you're considering Interactive Metronome for a teenager.  I'm happy to share my/our experience and to answer any questions you might have.

My daughter, M---- (!), did IM with Lori last summer.  M---- was 16 and an honor student.  She is also frightfully disorganized--seriously messy--and it had reached a point where I thought it could/would really impede her future.  --In jobs, in relationships, etc.  When I told M---- about the program, I thought she'd balk, but she was intrigued.

The program makes a lot of sense to me and as Lori will point out, you can't accurately predict exactly what kind of impact it will have on your child.  One thing I was concerned about was whether or not it would change her so much that she'd have a different personality altogether.  That did NOT happen, thankfully.

M---- loved the therapy.  She was very excited to see her own improvements and Lori's encouragement was amazing.  M---- was always looking for ways her improvement in therapy carried over into life in general.

Truthfully, I didn't see the organizational improvements I'd hoped for, but I would have to say there has been at least some improvement in that area.  She used her "cubbies" at camp for the first time ever.  She's started using her planner at school for the first time ever.  Even though her room still gets pretty messy, she doesn't battle me quite as much about picking up and she seems to complete the job faster than she used to.  She's started taking care of herself a little better...

I think the most notable improvement for M---- has been in mental processing.  This has evidenced itself in a number of ways.  On the lighter side, she was the "drill down" queen at her summer dance camp where she basically won every competition for learning drills the fastest.  She mentioned playing some card game that involved quick thinking.  She was playing better than ever and winning when she never had before.  Those things are fairly trivial and NOT why I sought out IM!  But she's a junior this year and took the PSAT.  This is the year it matters the most (for National Merit standings).  Although she'd done respectfully well last year, it was not even close to range for qualifying as a scholar this year.  But she had a HUGE jump in her scores this year (189 last year, 213 this year).  As a minimum she'll be a commended scholar and her guidance counselor thinks she has a good shot at becoming a scholar.  This is something I never would have expected and I have to think IM played a part in helping her get through the testing with more focus and quicker processing than last year.  And just by the way, M---- just doesn't fit any scholarly stereotypes.  She still has her very random, unconventional, bubbly personality.

I have another daughter who is 3 years older than M----. More our "classic" scholar.  She would love to try IM just to see how it might help her.  I don't know if that will ever happen.  She doesn't struggle so much with organization and grades were never an issue for either of them.

M---- is still messy.  She still procrastinates a lot.  IM didn't erase my concerns.  But I do think it helped and was very worthwhile, and M---- absolutely loved Lori who (by the way) really makes IM work for her people.

Feel free to email me with questions.  I'm in Maryland this week and not checking email with great regularity, but I'll try to watch for any communication from you.

R----

My thoughts as to why Dr's might miss gains:
I like what the third parent said, 'the doctor might be basing improvement on narrow definitions, one of them being getting off meds. Many students do lessen their need for or even get off medications, but some don't.

Doctors also don't see the children enough to notice the changes. You are in their office a whole 10 minutes, maybe. Other parents or teachers would be better choices for references I believe. Many doctors are use to prescribing medications to impact focus. Even the thought of a movement based computer program impacting cognitive functioning is thinking outside the box for a good many of them. I think gradually doctors will be educated about the success of movement based, timing based interventions, but I expect it will take a long time to get there.

I find that even some parents look at just one or two annoying behaviors, and miss some of the more subtle but significant gains, especially if they are busy parents or themselves have lower than average timing. Many dad's are unable to label the specific changes though dad's will often say the child is 'maturing' post IM. I hear this statement very frequently from parents - "I don't know if it's IM or they are just maturing." Constantly! Because you expect a child to mature, sometimes it is hard to tell the difference. But quick maturation is a huge part of what IM does. IM methodically matures the neurological system. As a child ages, their internal timing improves. The whole concept behind IM is the improvement of the child's internal timing, moving their internal timing up a few years, in other words "maturing it". Noticeable 'maturation' is an IM gain.

FAQ: Is IM covered by Insurance?

IM is covered by insurance if your child qualifies for occupational or speech therapy. The Capper Foundation here in Topeka, Kansas, has occupational therapists that are IM certified. Please check them out if you have a child with a significant diagnosis.

I am an educator with a special education/early childhood background. The child I typically see is the child that falls through the cracks. The medical field knows IM works for learning struggles as is evidenced by its growing popularity for the special needs child as well as stroke and traumatic brain injury patients. In 2003, Kansas had 3 IM providers; today, 2008, nearly 40. Most of them serve the insurance covered population. The sad fact is that a huge number of our children could benefit from IM, but don't qualify for insurance coverage. I am here for that parent and child.

The average parent would be challenged to afford the cost of IM through an OT with out insurance. That challenge is significantly reduced by offering IM in groups, while still individualizing tasks for students. Most children over 8 yrs old and in a regular classroom setting can do IM in groups. The students often enjoy the camaraderie of others working along side them. I also offer parent/child teams for the child with more severe needs or the younger child. My goal is to make IM affordable to the masses of those who don't qualify for insurance. Through group mode training, costs can be cut in half or more. Some flexible spending plans are now beginning to cover IM too. Most parents find IM very affordable with three small monthly payments.

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. :)  

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!

FAQ: What are 'squirrellies' during IM Training

My child can't seem to focus on days that he's done IM, is that typical?

A certain percentage of children respond to IM training in a way that's seems just the opposite of what you are hoping to see, at first at least. Some children cry easily, or bounce off the wall, or nap all afternoon. They can not focus for the life of them, and you are doing IM to IMPROVE focus!

Parent Input

I have just sent a link to this site to my present IM parents. Parents, I want you to post comments on this site especially on the Data Speaks Spread sheets about your child's IM training. I would like to ask you to keep all information confidential. You may share age, sex, struggles, and definitely IM changes that you have seen, but no names of your children please. Think about what information would have been helpful for you to know and share that with others. Thank you so much. I will work on a way to organize your comments but in the meantime, just make random posts if you want. Thanks, Lori