By Interactive Metronome - January 18, 2012

Behavioral Issues- How to adapt IM to work with children and adults


There has been more than one occasion when behavioral issues really impact the outcome of our IM sessions and the changes that can take place. Sometimes honestly the kids just aren’t interested in what you want them to do, and they want to do it their own way. Sometimes there are behavioral issues that have become intertwined in their environment, and they need a fresh start. This can definitely have an impact on the effectiveness of your IM sessions, and what progress you see both in the clinic, and in their other environments.

One of the ways I have gotten behavior to change is with a reward system. Most of the time, parents are eager to help me out. We have done systems that are so simple as to give a piece of popcorn, goldfish or sticker for each burst that they get and this is very motivating because they can usually end up with a shirt covered in stickers or a pile of popcorn! I do this by setting the burst level at 2, but then moving it up as sessions go on and they are getting a large amount of bursts (60 or more). This type of reward actually usually fades as the sessions go on, and the child doesn’t need them as much. With some of our older kids, we have a whiteboard in our IM room and the kids total their bursts at the end of each session and then get to post it on the board, and they have even been starting to leave messages and words of encouragement for each other!  Parents are a big key though. They are wonderful about providing trinkets for a kiddo who needs instant gratification or having their child earn points for a trip to the playground or to a movie. I like to put these systems into place even before we start our IM sessions.

There are also times when negative behavior has an impact on sessions, and you just can’t get the exercises or the amounts of repetitions accomplished that you’d like. This can be so frustrating for you as a trainer, the child and the parent who reports they don’t see any change.  With these patients, I tend to have them “help me” throughout the session. They seem to like having control, and I do what I can to give them control over parts of the session. This can be done by allowing them to help you change the exercises/repetitions on the computer screen, having them help you choose exercises or even having them “invent” some new exercises to try during the session. If I know one of my kids loves baseball, I’ll do what I can to have them participate in exercises that involve baseball!! Use a foam bat to tap a switch or pretend the foot switch is home plate! Bring your creativity into the mix and it will help a lot.

As far as improvements go, there have been several patients of mine who show great improvement in the clinical setting – improvements with scores, bursts and even just the way they are able to control themselves. It even seems like school is able to see an improvement before the parents. It’s always disappointing to me when a parent doesn’t see change. That is my highest hope, is that they will get to see the wonderful benefit of IM with their own children. What I usually do though is show the parents how their children “look” during our sessions. I help them see that their child is really capable of good focus and attention, but they need to learn to apply it in other settings. Let’s face it  – old habits die hard  -so those behaviors that the child has been doing for the past 5-10 years are difficult to change. I also ask that they try not to look for huge changes in all areas, but to try to be a cheerleader for any small changes that they may see – anything from getting their homework done a little more quickly to making a new friend at school. There have also been 1 or 2 occasions where we just had to stop attending IM sessions and get some help through a behavior clinic before the child was ready for IM. You are there to help and support the child in any way that you can, so be ready to provide family with other resources to help them! In the end it will help you too as they will come back to you ready to be challenged and in a much better place to learn what you will be teaching them! 

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