By Amy Vega - July 11, 2014

Do you have a client stuck in Phase 1 of IM training?


How should I proceed with a client who requires total hands-on assistance and seems to be stuck in Phase 1 of IM training for a long time?


Interestingly, IM providers report that clients who display the most significant trouble with timing tend to make the most rapid progress. They also report that total hands-on assistance can be quite helpful and can lead to functional improvement. So, don’t be discouraged! 

Some strategies that have worked to progress a client who is stuck in Phase 1 and doesn’t appear to be learning to synchronize with the beat are as follows:

·         Turn off the guides sounds. A person who isn’t understanding how to get in sync with the Reference Tone may be confused by the Guide Sounds.

·         Whole body movement to the beat may be helpful – with total hands-on facilitation, of course! This can be accomplished by rocking a person forward and back to the beat as he lays prone on a large therapy ball. As he is rocked forward, you can help his outstretched hand make contact with a trigger that is attached to the floor in front of him (he will make contact with the trigger every other beat). The tempo will need to be adjusted to a slower pace – experiment to see what is most comfortable. You can accomplish whole body movement in other ways: rocking side to side while shifting weight from one foot to the other; sitting facing your client with a large sheet wrapped around his back and you holding each end…pull toward you on one beat, and allow your client to rock back on the next beat; in a hammock; in a rocking chair; etc…

·         Some clients may focus best in an enclosed space (i.e., makeshift “tent”) or with fewer distractions in the room.

·         Some clients may become “distracted” by your proximity or touch, or by the IM equipment or sounds due to Sensory Processing Disorder (SPD). If your client has SPD, you may need to make adjustments in your approach so that IM training is comfortable. Most individuals with SPD like the repetitive, rhythmical aspect of IM and find it calming; however, they may need the volume reduced, different headphones, etc. to achieve comfort.


Amy Vega, MS, CCC-SLP

Interactive Metronome, Inc

Clinical Education Director

Clinical Advisory Board Director

Clinical Education Administrator

Leave a Reply

Connect With Us

We’re social people – we invite you to keep in touch with us. Follow us and be the first to hear news, get updates, media stories, press releases, special offers and more!

  • AOTA Approved Provider - ASHA Approved Provider - GSA and CE Approved