By Amy Vega - July 23, 2014

IM training and the fight or flight response



I’m working with an 11 year old boy who has autism. He can’t follow directions or attend well. I am providing total hand-over-hand assistance during IM training. I have placed a splint on his arms due to low tone in the wrists. The last few sessions he is very rigid in his arms and I feel like he’s fighting me. Do you have any suggestions?


Due to sensory processing disorder (a comorbidity of autism), any one of the following may be contributing to over-reaction of his sympathetic nervous system, thereby triggering anxiety and a fight-flight response that is outside of his conscious control, including:

  • – The splint on his arms
  • – Your proximity
  • – Your contact
  • – The headphones
  • – The IM hand glove/trigger
  • – The volume of the reference tone/guide sounds

The fight-flight state is not optimal for learning, so it is important to try to prevent it. When working with an individual who is on the autism spectrum, especially those with ADHD (also a comorbidity) or sensory processing disorder (SPD), it is important to employ strategies to facilitate comfort and more appropriate sensory modulation. IM training is best administered along with sensory integration techniques for individuals with SPD. For more information on convenient, online continuing education opportunities to better serve individuals with SPD, please visit

Interactive Metronome, through IM University, also offers several on-demand webinars (1 hour each) for CEUs on the following topics:

Beyond the Fifth Sense: The Effectiveness of IM on Sensory Processing Disorders

Integrating IM into Interventions for SPD and Dyspraxia

Using IM for Sensory Integration: Special Considerations

Is it Neurological Reorganization or Sensory Overload?

Tips for Treating Children with ADHD and SPD



Amy Vega, MS, CCC-SLP

Interactive Metronome, Inc

Clinical Education Director

Clinical Advisory Board Director

Clinical Education Administrator

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