Interactive Metronome & Fast ForWord - which to use firs

My son has done both FFW and IM. We did FFW first, after first grade, and IM after 3rd. I never had heard of IM when we did FFW so I never faced the decision you do. A couple thoughts.

1. A number of people recommend doing sound therapy before either program for auditory processing problems. It seems to make progress more rapid. We used The Listening Program in between FFW and IM.
We saw improvements in auditory processing, specifically the ability to manipulate sounds, following TLP. We had a very hard time with FFW and if I had to do my therapy sequence over again, I would have done TLP first.

I know I once talked to an audiologist in Indiana who did a lot of sound therapy, primarily Somonas, and she always did it before IM. I am not sure she used FFW—we had done FFW at that point so I may just may not remember.

2. Seven may be too young for IM. I know there have been posts about age and the consensus was 6 def. was. My son was 9. He could have done it at 8. I don’t know about 7.

3. On the other hand, IM has been shown to help auditory processing so you may get spill over from IM to FFW, which is undoubtedly the logic being used. I don’t think there is spill over from FFW to IM. IM also made other therapy we were doing easier.

Logically, the best sequence it seems to me (because of one therapy spilling over to another) is TLP (or other sound therapy), IM, FFW. But your son’s age concerns me for IM, so I don’t know if I have been much help at all.

You might look at board Teaching an LD child for posts on IM. There was a discussion of age on there not too long ago.

Beth

My experience:

Ds also had auditory processing issues and TS-like symptoms. I say like because he was dxed at NIH with PANDAS (pediatric autoimmune neurological disorder associated with strep) at the NIH. I mention this because, at times he had severe ADHD and SID in addition to very severe tics. But all of this has pretty much gone away after five very long years as he has gradually recovered from the strep attacks. (He does have residual ADD, but H, SID, and tics symptoms are pretty much gone.) I urge anyone faced with TS, particularly with ADHD and SID to look into PANDAS because treatment methods will differ from those for conventional forms of those disorder. (BTW—one way to view SID symptoms is as a type of OCD, another symptom of PANDAS.)

That said, my ds also had language therapy for nearly two years before doing FFW at age 8. At age 10, when I learned about IM, we did that too. If I had to choose over again, I definitely would have done FFW first again. He made tremendous gains in language (much more than we saw with just language therapy) that were key to keeping him at least somewhat tuned in class and at home. The more language you miss, the farther behind you get and the more you have to catch up. TLP beforehand would be a good idea (didn’t do it as I didn’t know about it then), but if you only have a summer window, I’d go with FFW. (This would be a hard program to do while going to class all day.)

Many people have found success with IM. Personally, we did n’t notice much of anything with my ds except that he is now one of the greatest Extreme Bopit players around. However, he really didn’t have any issues with gross or fine motor skills or with the placement of his body in space—he’d always been very surefooted. His executive function is still not the greatest—bad at gaging the passage of time or how long something will take and not great at mental organization.

if for no other reason than the “spillover” effect mentioned. We have used Samonas sound therapy with no results that I can think of, although I’m not sure I ever had DS wear the headphones regularly. His previous OT used it with him and we even saw some deterioration in his hyperactivity, meaning he really was wild!

He will be 8 in October, so maybe we are close enough to be able to use either program. I wish we had a traditional summer break to do any of this; we are on year-round school and he starts second grade in July (he just finished first grade today). It is a two-week break.

This means we will be working on the therapies after school or on weekends. The breaks that he has spread throughout the year (next one is in August) are only 3 1/2 weeks long, so that wouldn’t help anyhow. It’s now or never, I think, especially since he needs SO much help. I’m not that concerned about the time commitment, as this has interfered so much in his life already, at least this would be a positive change.

I’ve checked into PANDAS somewhat, but the descriptions I’ve found don’t sound like they fit. Are there therapies for this that would help a non-PANDAS child with TS?

Thanks so much for the feedback! It is good to know that these programs tend to be effective, for the most part.

Just FYI, we did IM last summer when DS was 8 and he tolerated it very well - although he tends to be very compliant when he does therapy. I can’t comment on FFW , but I suppose one consideration is the scheduling. I know IM has to be done in a relatively short amount of time, unlike OT or speech that is spread out over 12 months or more, no more than 3 (?) days can pass between sessions and you are supposed to do several days in a row. We did IM over the summer for this reason - it would have been hard to do physically during the school year.

is to find and audiologist (preferably one who accepts your insurance) that is familiar with these programs.

My friend found a very good audiologist familiar with these programs who not only helped her decide the order of the programs but gave her a letter to bring to the school requesting a microphone and speaker to be used for her son by the teacher. Apparantly this helps the child tune out the extraeneous noise.

I think the order might vary depending on the child’s issues. Her son is motor gifted but has some sequencing/attentional issues so IM was suggested last. I think a child with motor issues might do IM before FFW. It does seem that TLP is usually done first. I thought IM was a great prep for other programs.

PS

My friend just called and said the school balked on the microphone and speaker system. Knowing my friend, I pity the school. :wink:

The first thing that can be done for Pandas that you would not do for ordinary TS is prophylactic antibiotic treatment to prevent further strep infections, as recurrences deepen the severity and chronicity of the problem. (This is controversial due to the more general concern about overuse of antibiotics—we do this because the severity of his problems after the last strep infection were so bad that another attack would probably have made it impossible for him to remain in school. And I have acquired a very high tolerance for weird behaviors.)

The other course of action that has a history of greater effectiveness for PANDAS than for conventional TS is cognitive behavior therapy. I really feel that this saved my son, as bad as it was to go through. I was unwillingly to accept the risks and side effects of the heavy gun TS medications, even though my ds reached the point where he was tic touching his skin so furiously and often that he was regularly breaking through the skin and bleeding. It was at that point that we tried CBT. (Seeing my child bleeding put me at the end of my rope.) Having seen what CBT can do, in retrospect I would have tried it much earlier when we thought we were dealing with conventional TS. CBT has more limited success for conventional TS, but it’s still definitely worth trying when your alternative is a neuroleptic.