Franklin is Happy and Smiling with IM Training

Franklin is a 4 year-old little boy who was born premature and demonstrates developmental delays. Prior to IM training, Franklin only made fleeting eye contact and was very easily overwhelmed with his classroom environment, which often resulted in crying, anxiety, fear responses and self-stimulatory behaviors. Franklin was overly attached to objects and became upset when he was encouraged to transition away from his preferred object. He demonstrated interest in toys but tended to roll them between his hands, exploring them visually and manually rather than playing with them in the manner in which they were intended. Franklin required extensive amounts of time to manage his sensory needs in his classroom. Franklin was very sensitive to noise and frequently covered his ears. He sought out deep pressure sensory experiences as well as linear movement experiences like swinging and rocking. His teachers and therapists reported significant difficulty engaging him in any type of structured task or play.

Franklin was unable to be evaluated using a standardized assessment, as he was unable to follow instructions. Some of Franklin’s general training goals were to increase independence in classroom routines, expand his variety of play, increase participation in functional fine motor and gross motor activities, and improve non-verbal communication.

Franklin required hand-over-hand assistance to activate the IM switch due to his cognitive level, and was therefore not given a pre-test. During his first treatment, Franklin briefly performed gross motor rhythmical movements to the beat of the metronome set at 54 beats per minute, but did not activate the switch independently. As soon as the beat of the metronome began, he instantly calmed and was no longer agitated in any setting in which the metronome was used, including his classroom.

Over the next 3 months, IM training and a standard metronome were used with Franklin 2 times a week during therapies, and Franklin’s teacher and his mother used a metronome when needed to calm him throughout the day and during nap and bedtime. Within one month, Franklin began to follow some of his classroom routine. Two months after starting IM, Franklin began making eye contact for several seconds at a time and was finally smiling and laughing. He began to increase his exploration of toys and even held a marker to produce horizontal scribble for several seconds. His teacher reported improvements in his ability to wash his hands. His Physical Therapist reported that Franklin had remained in a calm state for a full 30 minute treatment session, making eye contact numerous times for as long as 3-5 seconds at a time. His mother reported improved interaction and play at home with his sisters. He was climbing through a tunnel with them and physically interacting with them. She reported that he is better able to understand simple language such as “no”. Since she began using a metronome at home he has shown improvements in his bedtime routine and sleep habits as well.

Three months after starting IM, Franklin was able to imitate crumpling paper with one or both hands after demonstration. He also imitated tapping two sticks together during a song, then made eye contact with this therapist and reached forward as a gesture for help. He even appeared joyful with smiles and laughter quite often. Upon seeing his Occupational Therapist, Franklin willingly went with her without a transition toy, walked into the room and sat in a chair without cues of any type. He played purposefully with toys and demonstrated basic problem solving skills.

The most significant changes have been in his level of interaction and engagement with others, his ability to achieve and maintain a calm state, and his ability to participate in functional tasks and play. Improvements in these areas have led to improvements in his motor abilities and greater participation and toleration of classroom routines and transitions. Overall, Franklin is more animated and happy and he continues to surprise those around him with his growth and accomplishments.