General Patient Suitability Criteria
There are several general criteria that a candidate should meet in order to perform IM activities in a way that is most likely to bring about the desired outcome, regardless of diagnosis. They include:
- Tolerance for wearing headphones
- Sufficiently acute binaural hearing
- Ability to understand and follow simple directions
- Ability to initiate and sustain repetitive movements
- Ability to perform the IM exercises or reasonably modified versions of them
- Desire, or at least willingness, to participate in IM treatment
Specific Criteria for Children
The criteria for children who are candidates for IM treatment are largely the same as the general criteria discussed above. However, for young patients there are specific considerations:
- Tolerance for wearing headphones: If severe sensory integration issues are present and the child cannot tolerate wearing headphones the child is not yet ready for IM treatment. Forcing the issue will most likely make the IM session noxious to the child and therefore nonproductive.
- In such cases a good tactic is to assign the parents or caregivers the task of increasing the child’s tolerance to wearing headphones by having him/her wear them for a short period every day, increasing the periods until the child can tolerate wearing them continuously for 30 minutes. At that time, the child should be evaluated again for IM treatment.
- If the child can tolerate wearing the headphones but becomes uncomfortable when hearing the IM guide sounds, modifications should be made by initially lowering the sound volumes and slowly introducing the guide sounds. However if the child cannot tolerate the IM reference tone without the guide sounds present, it is not advisable to begin IM treatment. In such cases the problem can often be overcome by the parents or caregivers working with the child and using either music or story tapes to build up the child’s tolerance to sounds presented through headphones.
- Ability to understand and follow simple directions: Any child considered for IM treatment must be able to follow simple directions. Those directions may combine both a verbal and visual component and may even require some hand over hand guidance. Often children with auditory processing, or attention to task deficits do well with visual cues to complete IM tasks.
- A child who cannot follow simple directions is not likely to benefit from IM treatment. However, that child might become a good candidate following other therapy or further maturation.
- Ability to imitate simple gross motor patterns: The child must be able to perform simple gross motor tasks such as clapping hands, playing “patty- cake”, tapping feet, or doing the “hokey-pokey.” Prior to starting IM treatment the child’s movement may be poorly coordinated or unbalanced, but if he/she is able to understand the movements and attempt them he/she may well benefit from IM treatment with some modification of the exercises.
- Ability to attend to a single task for at least five minutes: For example, the child should be able to attend to a single task such as playing a video game or computer game, interacting with a peer, or playing a game like “Simon Says” for at least five minutes. If he/she is able to do this, the IM treatment plan can be individualized accordingly and the task durations will be progressively increased through the treatment sessions.