Occupational Therapy Integrated is committed to delivering diverse, effective and well researched treatments. We offer specialised treatments such as Interactive Metronome, Therapeutic Listening and D.I.R. Floortime and are successful in delivering results.

Interactive Metronome

Interactive Metronome (IM) is an assessment and treatment tool used by certified therapists for clients with neurological conditions that affect cognitive and motor functioning. IM provides an objective method for measuring deficits and for tracking improvement. IM is an auditory and timing based intervention effective with individuals who experience difficulty with motor planning and sequencing and other neural timing difficulties, which impacts on learning, physical and functional performance. Occupational Therapists have long understood that motor planning and sequencing are key facets in the development of functional skills. The IM program suits all age ranges and can be used for a variety of conditions including for example; ADD/ADHD, Cerebral Palsy, Traumatic Brain Injuries, Autism/Asperger’s, CVA/Stroke, Multiple Sclerosis, Motor Neurone Disease, Parkinson’s Disease, Dementia, Alzheimer’s Disease and Cognitive Impairment.

Interactive Metronome® is a computer–based version of the traditional music metronome. Many studies have been undertaken noting some promising areas. From this research, we have been able to identify some of the specific improvement areas which includes; motor planning and sequencing difficulties, rhythmicity and timing difficulties, primary motor control problems, language and speech difficulties, learning difficulties, cognitive problems, and social and communicative difficulties. Stanley Greenspan, a psychiatrist and clinical professor of psychiatry at the George Washington University Medical School, was the Director of Research for the Scientific Advisory Board of the Interactive Metronome® before his recent passing in 2010.

The Interactive Metronome® program provides a structured, goal-oriented process that challenges the client to synchronize a range of hand and foot exercises to a precise computer-generated reference tone heard through headphones. The client attempts to match the rhythmic beat with repetitive motor actions. A patented auditory-visual guidance system provides immediate feedback measured in milliseconds, and a score is provided.

Over the course of the treatment, change can be expected for clients in the following areas:

  • Focus and attention for longer periods of time
  • Increase physical endurance and stamina
  • Filter out internal and external distractions
  • Improve ability to monitor mental and physical actions as they are occurring (increase impulse control)
  • Progressively improve coordinated performance

More detailed review of current research can be found at www.interactivemetronome.com.

IM is an evidence-based, engaging therapeutic modality that improves cognitive and motor skills. The design of the program ensures clients can recognise progress as it is occurring, increasing their motivation and ultimately their recovery.

Therapeutic Listening

Therapeutic Listening (TL) is an expansion of Sensory Integration. It is an auditory intervention that uses the organized sound patterns inherent in music to impact all levels of the nervous system. It is based on Dr Jean Ayres’ research and is described as a whole of body experience.

Auditory information from Therapeutic Listening CDs provides direct input to both the vestibular and the auditory portions of the vestibular-cochlear continuum. The emphasis of TL is on blending sound intervention strategies with other activities so as to sustain grounding and centering of the body and mind in space and time.

Therapeutic Listening utilizes numerous CDs that vary in musical style, types of filtering, and level of complexity. The music on Therapeutic Listening CDs is electronically altered to elicit the orienting response which sets up the body for sustained attention and active listening.

The Therapeutic Listening Program is used by thousands of therapists around the world, Therapeutic Listening is a highly individualized, music based tool that activates listening to help people tune-in to and respond to their world.

It uses high quality music, recorded specifically for Therapeutic Listening, is altered to exaggerate the sounds that naturally capture attention and tap into the parts of the brain involved in regulating bodily functions, relating to others, and organizing behaviour.

What is listening?

Listening is a whole brain, whole-body experience that connects us to the outside world. Listening is the basic precursor to interaction, speaking, reading, and writing. Listening relates and links closely to arousal, attention, focus, vigilance, and concentration and it assists us to integrate sensation. Listening plays an important role in keeping us oriented in our world of space and time. Listening is the process of detecting, organising, and integrating sound and involves both conscious and unconscious processes.

Listening for Adults & older persons

Therapeutic Listening has proven effective for persons experiencing Memory Loss, Cognitive Impairment and/or Dementia who present with difficulty functioning in their current environment. This may present as (and not limited to) aggression, challenging behaviour/s, sleeplessness, low affect/withdrawal from activity, refusing services and/or reluctance to participate in personal care tasks/grooming activities.

Target Areas for Adults

  • Postural activation/core body strength
  • Emotional tone/biological rhythms
  • Social engagement
  • Attention/attention in complex environments
  • Agitation/Aggression/Non compliance
  • Verbal and non verbal communication
  • Motor planning with spatial elements
  • Praxis
  • Timing and sequencing
  • Auditory and visual processing/distractions
  • Reactivity to sensation
  • Challenges with transitions
  • Spatial Awareness

What are the benefits?

  • Client has increased opportunity to connect with their world
  • Increased communications and understanding
  • Increased participation in ADL tasks
  • Decreased confusion and anxiety
  • Decreased physical and time demands placed on Carers & Community Services
  • Decreased frequency of agitation or challenging behaviours
  • Decreased combativeness & likelihood to abscond
  • Decreased use of psychotropic drugs & physical restraints

Listening for Babies and Children

Therapeutic Listening is tailored for children who present with difficulty functioning in their current environment.  This may present as (and not limited to) attention & concentration, poor classroom function, challenging and/or rigid behaviour/s, sleeplessness, toileting issues, difficulty with routines and bathing, grooming and general tasks of daily living.

Target Areas

  • Postural activation/core body strength
  • Emotional tone/biological rhythms
  • Social engagement
  • Attention/attention in complex environments
  • Verbal and non verbal communication
  • Motor planning with spatial elements
  • Praxis
  • Timing and sequencing
  • Auditory and visual processing/distractions
  • Reactivity to sensation
  • Challenges with transitions
  • Spatial Awareness

What are the benefits & Functional Outcomes for children?

Parents, teachers and TL Practitioners have seen significant results by using Therapeutic Listening including:

  • Decreased tactile hypersensitivity or defensiveness
  • Decreased oral hypersensitivity with increased exploration and acceptance of different foods
  • Improved self-regulatory behaviour such as a more regulated sleep cycle, more regulated hunger/thirst cycle
  • Regulated such-swallow-breathe pattern, more regulated respiratory control
  • Decreased stress
  • Improved balance
  • Improved coordination of movement within the environment
  • Increased postural organization
  • Increased motor skills, both gross and fine
  • Improved bilateral motor patterns
  • Emergence of motor planning
  • Improved spatial-temporal organization
  • Improved handwriting
  • Improved visual-motor skills
  • Improved timing of motor execution
  • Increased and more elaborate social interactions, with better timing
  • Discrimination of the dimensionality and directionality of spatial concepts
  • Improved components of communication such as greater range of non-verbal communication, improved/clearer articulation, greater emotional and verbal expression and improvements in pragmatic language

Parts adapted from “Listening with the Whole Body by Sheila M. Frick, OTR/L, and Colleen Hacker, MS. OTR/L.

DIR – Floortime™

DIR-Floortime™ was developed by Dr. Stanley Greenspan & Dr Serena Wieder. The Floortime™ model encourages you to follow a child’s leads and interest to get their focus and attention, engage them, and encourage two-way communication. Throughout these created play opportunities you are able to create ‘playful obstructions’ which challenge the child to progress through the developmental levels of typical socio-emotional development as outlined by the model.

The model considers each dimension through the DIR acronym in recognising the D – Developmental levels of social & emotional development a child typically progresses through, the I – Individual Differences of each child and the R – Relationship the child develops with parents and therapist to facilitate their progression through the developmental levels.

In using Floortime as a guiding treatment principle we are able to use play as a framework for interaction in which we are harnessing your child’s abilities and tailoring your relationship to their nervous system. This model is one of guiding treatment principles of our approach with children.

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