Transcript B - Interactive Metronome

Addressing Hemispheric
Imbalances with Interactive
Metronome
This course introduces the certified
Interactive Metronome provider to
the concept of Hemispheric
Imbalances in children and adults and
how to address these imbalances
using the Interactive Metronome.
By Heather Cross,
OTR/L
What is Hemispheric
Imbalance?
Dr. Robert Melillo wrote a book
called: “Disconnected Kids:The
Groundbreaking Brain Balance
Program for Children”
According to his book, hemispheric imbalance or
functional disconnection is “an imbalance in the
connections and function between and within the
hemispheres of your child’s brain…”
What are the
responsibilities of
each hemisphere?
Your Right Brain
 Gives you the big
picture
 Non-verbal
communication
 Large muscle control
 Comprehension
 Math reasoning
 Interpreting information
 Unconscious actions
Negative emotions
Low frequency sound
High frequency light
Interpreting auditory
input
 Understanding abstract
concepts
 Cautious and safe
actions
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Your Left Brain
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Small picture
Verbal communications
Small muscle control
IQ
Word reading
Math Calculations
Processing information
Conscious actions
Positive emotions
High frequency sound
Low frequency light
Receiving auditory input
Linear and logical
thinking
 Curious and impulsive
actions
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What are the symptoms or
behaviors exhibited when
there is a weakness in one
hemisphere?
Examples of behavior for
right side weakness
 Poor muscle tone
 Odd gait
 Poor balance, rhythm,
and coordination
 May trip and fall for no
reason
 Odd in social situations
 Impulsive and anxious
 Making inappropriate
comments and not
understanding why they
are inappropriate
 Picky eater
 Good reading skills, but
poor interpretation
skills
 Decreased attention,
compulsive
 Auto immune
disorders(allergies/asth
ma)
Examples of behavior for left
side weakness
Shy or withdrawn
Sullen/Sad
Difficulty with speech
Difficulty with
handwriting
 Prone to chronic
infections such as ear
infections
 Arrhythemia
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 Possible learning
disabilities
 Difficulty with
organization
What measures can
you use to check for
imbalances?
Melillo Brain Checklist
Dr. Melillo developed a check list for parents or adults to fill out to help
identify hemisphere weaknesses. This check list can be found in his book as
well. The Melillo Brain Checklist is a master checklist that contains 200
characteristics – 100 signify a right brain deficit and 100 signify a left brain
deficit. The checklist helps a therapist know if there is “Functional
Disconnect” in the sides of the brain and which side of the brain is causing it.
The greater the number of checkmarks, the more severe the brain
imbalance. The total number of checkmarks give an indication of the
severity of the problem as a whole: 0-50 checks = Mild; 50-100 checks =
Moderate; 100 or above = Severe Imbalance. The checklist is filled out by
one or both parents, and helps the therapist tailor the plan of care to
specifically address the weaker side of the brain. The checklist is subjective
and answers are based on typically developing children of the same age. The
total with the highest score is the side that is weaker.
When answering these questions, answers should be based on a comparison with
typically developing children of the same age. Also, if your child is on medication,
answer based on how the child would compare when not on the medication.
Motor Characteristics
(A)
 Clumsiness and an odd posture
 Poor coordination
 Not athletically inclined and has no
interest in popular childhood
participation sports
 Low muscle tone – muscles seem
kind of floppy
 Poor gross motor skills, such as
difficulty learning to ride a bike
and/or runs and/or walks oddly
 Repetitive/stereotyped motor
mannerisms (spins in circles, flaps
arms)
 Fidgets excessively
 Poor eye contact
 Walks or walked on toes when
younger
(B)
 Fine motor problems (poor or slow
handwriting)
 Difficulty with fine motor skills, such
as buttoning a shirt
 Tends to write very large for age or
grade level
 Stumbles over words when fatigued
 Exhibited delay in crawling, standing,
and/or walking
 Loves sports and is good at them
 Good muscle tone
 Poor drawing skills
 Difficulty learning to play music
 Likes to fix things with the hands and
is interested in anything mechanical
 Difficulty planning and coordinating
body movements
Sensory
Characteristics
(A)
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Poor spatial orientation – bumps into things often
Sensitivity to sound
Confusion when asked to point to different body parts
Poor sense of balance
High threshold for pain – doesn’t cry when gets a cut
Likes to spin, go on rides, swing, etc. – anything with motion
Touches things compulsively
A girl uninterested in makeup or jewelry
Does not like the feel of clothing on arms or legs; pulls off clothes
Doesn’t like being touched and doesn’t like to touch things
Incessantly smells everything
Prefers bland foods
Does not notice strong smells, such as burning wood, popcorn, or cookies
baking in the oven
Avoids food because of the way it looks
Hates having to eat and is not even interested in sweets
Extremely picky eater
Sensory Characteristics
(B)
 Doesn’t seem to have many sensory issues or problems, such as a
sensitivity to sound
 Has good spatial awareness
 Has good sense of balance
 Eats just about anything
 Has a normal to above-average sense of taste and smell
 Likes to be hugged and held
 Does not have any oddities concerning clothing
 Has auditory processing problems
 Seems not to hear well, although hearing tests normal
 Delay in speaking was attributed to ear infections
 Gets motions sickness and has other motion sickness issues
 Is not undersensitive or over sensitive to pain
Emotional
Characteristics
(A)
 Spontaneously cries and/or laughs and has
sudden outbursts of anger or fear
 Worries a lot and has several phobias
 Holds on to past “hurts”
 Has sudden emotional outbursts that appear over-reactive
and inappropriate to the situation
 Experiences panic and/or anxiety attacks
 Sometimes displays dark or violent thoughts
 Face lacks expression; doesn’t exhibit much body language
 Too uptight; cannot seem to loosen up
 Lacks empathy and feelings for others
 Lacks emotional reciprocity
 Often seems fearless and is a risk taker
Emotional Characteristics
(B)
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Overly happy and affectionate; loves to hug and kiss
Frequently moody and irritable
Loves doing new or different things but gets bored easily
Lacks motivation
Withdrawn and shy
Excessively cautious, pessimistic, or negative
Doesn’t seem to get any pleasure out of life
Socially withdrawn
Cries easily; feelings get hurt easily
Seems to be in touch with own feelings
Empathetic to other people’s feelings; reads people’s emotions
well
Gets embarrassed easily
Very sensitive to what others think about him or her
Behavioral
Characteristics
(A)
 Logical thinker
 Often misses the gist of a story
 Always the last to get a joke
 Gets stuck in set behavior; can’t let it go
 Lacks social tact and/or is antisocial and/or socially isolated
 Poor time management; is always late
 Disorganized
 Has a problem paying attention
 Is hyperactive and/or impulsive
 Has obsessive thoughts or behaviors
 Argues all the time and is generally uncooperative
 Exhibits signs of an eating disorder
 Failed to thrive as an infant
 ***continue***
Behavioral Characteristics
(A) continued
 Mimics sounds or words repeatedly without really
understanding the meaning
 Appears bored, aloof, and abrupt
 Considered strange by other children
 Inability to form friendships
 Has difficulty sharing enjoyment, interests, or achievements
with other people
 Inappropriately giddy or silly
 Acts inappropriately in social situations
 Talks incessantly and asks the same question repetitively
 Has no or little joint attention, such as the need to point to an
object to get your attention
 Didn’t look at self in mirror as a toddler
Behavioral Characteristics
(B)
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Procrastinates
Is extremely shy, especially around strangers
Is very good at nonverbal communication
Is well liked by other children and teachers
Does not have any behavioral problems in school
Understands social rules
Has poor self esteem
Hates doing homework
Is very good at social interaction
Makes good eye contact
Likes to be around people and enjoys social activities, such as going to parties
Doesn’t like to go to sleepovers
Is not good at following routines
Can’t follow multiple-step directions
Is in touch with own feelings
Jumps to conclusions
Academic Characteristics
(A)
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Poor math reasoning (word problems, geometry, algebra)
Poor reading comprehension and pragmatic skills
Misses the big picture
Very analytical
Likes “slapstick” or obvious physical humor
Is very good at finding mistakes (spelling)
Takes everything literally
Doesn’t always reach a conclusion when speaking
Started speaking early
Has tested for a high IQ, but scores run the whole spectrum; or IQ is above
normal in verbal ability and below average in performance abilities
Was an early word reader
Is interested in unusual topics
Learns in a rote (memorizing) manner
Learns extraordinary amounts of specific facts about a subject
Is impatient
Academic
Characteristics
(A) continued
 Speaks in a monotone; has little voice inflection
 Is a poor nonverbal communicator
 Doesn’t like loud noises (like fireworks)
 Speaks out loud regarding what he or she is thinking
 Talks “in your face” – is a space invader
 Good reader but does not enjoy reading
 Analytical; led by logic
 Follows rules without questioning them
 Good at keeping track of time
 Easily memorizes spelling and mathematical formulas
 Enjoys observing rather than participating
 Would rather read an instructions manual before trying something
new
 Math was often the first academic subject that became a problem
Academic Characteristics
(B)
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Very good at big picture skills
Is an intuitive thinker and is led by feelings
Good at abstract “free” association
Poor analytical skills
Very visual; loves images and patterns
Constantly questions why you’re doing something or why rules exist
Has poor sense of time
Enjoys touching and feeling actual objects
Has trouble prioritizing
Is unlikely to read instructions before trying something new
Is naturally creative, but needs to work hard to develop full potential
Would rather do things instead of observe
Uses good voice inflection when speaking
Misreads or omits common small words
Academic Characteristics
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Has difficulty saying long words
Reads very slowly and laboriously
Had difficulty naming colors, objects, and letters as a toddler
Needs to hear or see concepts many times to learn them
Has shown a downward trend in achievement test scores or school
performance
Schoolwork is inconsistent
Was a late talker
Has difficulty pronouncing words (poor with phonics)
Had difficulty learning the alphabet, nursery rhymes, or songs when young
Has difficulty finishing homework or finishing a conversation
Acts before thinking and makes careless mistakes
Daydreams a lot
Has difficulty sequencing events in the proper order
Academic Characteristics
(B) continued
 Often writes letters backward
 Is poor at basic math skills
 Has poor memorization skills
 Has poor academic ability
 Has an IQ lower than expected and verbal scores are lower than nonverbal
scores
 Performs poorly on verbal tests
 Needs to be told to do something several times before acting on it
 Stutters or stuttered when younger
 Is a poor speller
 Doesn’t read directions well
Common Immune
Characteristics
(A)
 Has lots of allergies
 Rarely gets colds and infections
 Has had or has eczema or asthma
 Skin has little white bumps, especially on the backs of the arms
 Displays erratic behavior – good one day, bad the next
 Craves certain foods, especially dairy and wheat products
Common Immune
Characteristics
(B)
 Gets chronic ear infections
 Prone to benign tumors or cysts
 Has taken antibiotics more than 10 to 15 times before the age of
ten
 Has had tubes put in the ears
 Catches colds frequently
 No allergies
Autonomic Characteristics
(A)
 Problems with bowels, such as constipation and diarrhea
 Has a rapid heart rate and/or high blood pressure for age
 Appears bloated, especially after meals, and often complains of
stomach pains
 Has body odor
 Sweats a lot
 Hands are always moist and clammy
Autonomic Characteristics
(B)
 Has a bedwetting problem
 Has or had an irregular heartbeat, such as an arrhythmia or a heart
murmur
Scoring
The highest number of check marks show
which side of the brain is weaker.
 Total Number (A) ________ Right side
 Total Number (B) ________ Left side
A weakness has been
identified…What now?
Therapeutic interventions that have had a positive effect
hemispheric imbalance:
TLP or other auditory programs
Interactive Metronome
BrainBuilder
Astronaut Program
Sensory Integration
Home Exercise Programs
Ocular Motor Program
Handwriting Programs
Cognitive Therapy
Behavioral Therapy
Specific exercises to stimulate
the right hemisphere
 Use Eucalyptus or Peppermint essential oil 3-5 times
daily to stimulate the right brain. One drop on the tip
of the right nostril is all you need. This will also help
with pulling his/her sensory system into sync.
 Listen to Albums 3-4 on the Listening Program, with
only the left ear plugged into the headphones. 15
minutes daily and then increase to 30 minutes as
tolerated. If the Listening Program is not available,
use music that has a lot of lower frequencies. This
gives the right brain auditory input.
Specific exercises to stimulate
the right hemisphere
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Spin in a Clockwise direction while seated for 30 seconds at a time (1
rotation should take 1-2 seconds). Look at the eyes and see if they are
moving involuntarily. If they are not moving, or if they only move for 5-8
seconds, repeat this exercise only faster and a little longer. The eyes
should move back and forth after spinning for 13-15 seconds. This will
target the Right Brain vestibular system.
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Do activities like balancing, jumping on one foot, throwing, pushing –
etc. with the left side of the body – LEFT arm, LEFT foot. This
stimulates the Right Motor cortex of the brain.
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Patch the Right Eye for small tasks (legos, blocks, puzzles, coloring) for
3-5 minutes at a time. This gives the right brain visual input through
his/her left eye.
Specific exercises to stimulate
the left hemisphere
 Use Lavender or Orange essential oil 3-5 times daily
to stimulate the left brain and improve clarity/focus.
One drop on the tip of the left nostril is all you need.
This will also help with pulling the sensory system into
sync.
 Listen to Albums 7-10 on the Listening Program, with
only the right ear plugged into the headphones. 15
minutes daily and then increase to 30 minutes as
tolerated. This gives the left brain auditory input. If
the Listening Program is not available, music that has
a lot of high frequency tones such as Baroque music
will work as well.
Specific exercises to
stimulate the left hemisphere
 Spin in a Counter Clockwise direction while seated for 30 seconds at
a time (1 rotation should take 1-2 seconds). Look at the eyes and
see if they are moving involuntarily. If they are not moving, or if they
only move for 5-8 seconds, repeat this exercise only faster and a little
longer. The eyes should move back and forth after spinning for 13-15
seconds. This will target the Right Brain vestibular system.
 Do activities like balancing, jumping on one foot, throwing, pushing –
etc. with the right side of the body – Right arm, Right foot. This
stimulates the Right Motor cortex of the brain.
 Patch the Left Eye for small tasks (legos, blocks, puzzles, coloring)
for 3-5 minutes at a time. This gives the right brain visual input
through his/her left eye.
Why Interactive Metronome?
Skills targeted through the use of Interactive Metronome:
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Ideas to incorporate hemisphere
stimulation to your IM program:
 Have the client wear an eye patch on the right eye for
right brain stimulation while watching the visual
training screen
 Have the client wear an eye patch on the left eye for
left brain stimulation while watching the visual
training screen
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Ideas to incorporate hemisphere
stimulation to your IM program:
 Focus exercises on the left side of the body
for right brain stimulation
 Focus exercises on the right side of the body
for left brain stimulation
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Ideas to incorporate hemisphere
stimulation to your IM program:
 Remove all visual from the clients sight and have the
guide sound only in the one ear that is on the opposite
side of the hemisphere you are trying to target. Turn
off all guide sounds for this exercise.
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Ideas to incorporate hemisphere
stimulation to your IM program:
 Add rotary motion to your IM exercises, focusing on
the direction that will stimulate the hemisphere you
are working on. Using a spinning board, platform
swing, or a sit and spin are easy ways to achieve rotary
motion.
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Conclusion:
Addressing Hemispheric Imbalances in your case load is
another tool you can use as a therapist to help your clients
achieve their maximum potential. Focusing on stimulating the
right or left hemisphere using your Interactive Metronome can
enhance your treatment sessions and help achieve desired
effects in a shorter time frame.
Any Questions?
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