Fine-Tuning Focus: A Case Study on IM Training’s Impact on Pediatric ADHD Management

At age 4, Ikuya had difficulty playing nicely with other children at pre-school. He would only play with others if his teacher gently took him by the hand and encouragingly put him in play situations with his classmates.

As a 1st grader, he would stand up and ask questions in class so loudly that others could not hear the teacher.

In 2nd grade, his teacher reported that Ikuya was immature for his age, even babyish in how he related to the other kids. About this time, a new baby was born into his family. Ikuya’s teacher suggested that he might be reverting to babyish behavior in order to gain attention, but his mother thought otherwise.

By this time, Ikuya’s parents were quite concerned about his unnatural behavior. He would often repeat the same question over and over when it had just been answered for him.

When asked a question, rather than answering properly, Ikuya would talk on and on about something of his own choosing, until told to stop going on in that way.

When coming home from school, he would always play by himself without interacting with others.

At the time of his first assessment, Ikuya’s mother reported he had difficulties understanding instructions.

He was also disorganized, unable to keep things tidy and even though he was getting his homework done, it was often messy.

He had difficulty with his fine motor skills, handwriting and general coordination, particularly in activities requiring hand-foot synchronization.

IM Settings and Procedures

Ikuya began his IM training with a set of 15 one-on-one sessions with his IM provider.

His Initial LFA adjusted overall score was 164 ms and 4% “super right on” (SRO).

As a pre-training exercise, he performed several of the basic IM tasks while watching a prepared 25-minute practice video at home three times a week for 3-4 weeks.

As training began, even though Ikuya had done pre-practice exercises, he had a difficult time getting on beat with the rhythm.

Hand-over-hand was incorporated to assist him. As his timing on most of the tasks leaned toward the early side, adjustments in tempo were made for each task.

By session two, it started to be apparent that Ikuya was rather distracted by the enriched visual displays accompanying the guide sounds. Improved performance was noted when tasks were performed without the visual. During session four and following, audio only mode was used.

In session four, exercises in slowing down his timing were performed. These exercises help develop control of impulses also. By session five, Ikuya’s Early/Late ratio had improved. Tempo was slowed down to 54 bpm, difficulty set to 120, then to 100.

Realized Changes

Ikuya’s mother noticed the first changes after completing two weeks of IM training.

He was able to draw a straight horizontal line for the first time.

There was a noticeable improvement in his handwriting as well. His calligraphy teacher commented on his improved brush strokes.

From about the third week of training, Ikuya was no longer forgetting things at home or school.

When giving an irrelevant response to a question, he began to recognize he was not answering the question properly, would stop himself and restate his answer properly.

Whereas he previously showed no interest in going along to the grocery store or to outdoor events with his mother, she observed a widened scope of interest.

When asked if he’d like to go along to such-and-such, instead of responding with “no, that’s just a waste of time,” he might answer “sounds interesting, sure that might be fun.”

Ikuya continued training at home using the IM-Home after his in clinic sessions were completed.

Within a few weeks he was making even more advances.

Improvements at Home

Ikuya and his mother had an agreement that when he achieved a score of 100% on a test or quiz at school, she would allow him to choose a video to rent from the local video store.

One day while out with his mother, Ikuya suddenly remembered this arrangement and said, “I got 100% on my quiz today at school, so I want to rent a video today.”

Unfortunately, his mother did not have her video rental card with her at the time, so she told him, “I would have been glad to rent a video today, but I didn’t bring my rental card with me. If you had asked me before we left home, we could have rented a video.”

Ikuya grumbled in response.

In the past, he would have fussed and whimpered on and on about how he wanted to rent a video.

However, this time, he surprised his mother by stopping his fussing and saying, “Okay, I guess we’ll just have to rent one another day.”

What a marked improvement this was in his response!

Social Improvements at School

His 3rd grade teacher also commented that Ikuya is now better able to control his emotions.

In the past after school, he would run ahead of his classmates, coming home on his own because he didn’t really like one particular classmate.

He had difficulty understanding this classmate’s behavior.

However, after completing the IM training, Ikuya’s mother reported that he often walked home together with this same friend, and that he was making a deliberate effort to communicate with and understand his classmate.

This shows Ikuya’s newfound desire and ability to work through problems rather than simply avoiding them.

Ikuya's Improvement Numbers with IM