Creator of Rhythmic Entrainment Intervention™
"Rhythmic Entrainment Intervention is the best intervention we‘ve tried for our son. Thank you for making this therapy available!" - Helen G. Mother of a 9 year-old with autism
How we process sensory information dictates how we interact in the world. Whether we are overwhelmed or are unable to perceive or discern sensory input, those of us with sensory processing issues are often unable (or in some cases unwilling) to function easily in the world.
We avoid difficult situations. We act out. We are at the mercy of stimulus we cannot control.
Anybody who has sensory issues is going to fall into one of two camps:
1. Hypersensitive: To be anxious or overwhelmed or shut down and retreat from sensory input.
2. Hyposensitive: To be under-responsive and unable to discern the subtleties of sensory input.
Everyone with sensory sensitivities is in one of these two camps. And sometimes, we are in both of these camps; we might have hypersensitivity in one area, hyposensitivity in another area.
You find yourself (or your child) becoming overwhelmed or reacting negatively to certain types of sensory stimulus. You could be hypersensitive if:
• You are bothered by certain sounds - vacuums, alarms, toilets, etc.
• You have difficulty hearing in noisy environments.
• You have poor penmanship.
• You use too much force when handling objects, often breaking or spilling things.
• You are bothered by clothes against your skin, especially tags on shirts.
• You respond negatively to light or unexpected touch.
• You are slow moving, inactive or refer sedentary activities.
• You are uncomfortable or fearful of elevators or escalators, or of walking in stairs or uneven ground.
If you find yourself (or your child) unresponsive to or unaware of sensory input. You could be hyposensitive or have sensory discrimination issues if:
• You are unresponsive when spoken to or are oblivious to sounds in your environment.
• You play music or video very loud or talk loudly.
• You often misunderstand what people are saying.
• You seek out highly physical activities involving bumping, jumping, and crashing into things.
• You are unresponsive to touch.
• You seek out objects or activities with a strong sensory input.
• You have difficulty with fine motor tasks such as buttoning, zipping or tying.
• You engage in high risk or dangerous activities.
• You have poor gross motor control or are uncoordinated.
The REI Custom Sensory Processing Program evaluates each of your sensory responses and addresses them one by one.
If a client is hypersensitive, for example, we will first establish a calm neurological state so that she can become more receptive to sensory input. We will then address the intricacies of her hypersensitivities. Perhaps the sensitivity is auditory, where loud noises, unexpected sounds, or just a lot of noise, as in a restaurant, sends the child over the edge. The noise doesn’t have to be loud; but it may, nevertheless, be too much to filter and discriminate from. Or perhaps, the sensitivity is tactile, where certain textures are uncomfortable and certain clothes too tight fitting. Or perhaps, a client struggles with proprioception or vestibular sensitivities.
The presentation of sensitivities is unique to each individual client. Your custom tracks will reflect your unique needs.
At the Strong Institute, we begin with calm. We use musical rhythm to bring the nervous system to a calm neurological state so that we can then influence the brain and behavior.
Our initial clinical research on Rhythmic Entrainment Intervention (REI) looked at the key components of ancient drumming techniques found around the world. We asked, what happens if we remove the cultural influences? Does rhythm still have an impact? What is going on with the brain in response to musical rhythm?
The history of REI may have its roots in ancient drumming techniques, but the transformation of these techniques into a contemporary therapeutic tool began with my own struggles.
I have ADHD. When I was first studying how rhythm has been used therapeutically around the world, I was struggling in college. I began to experiment with rhythms, filtering them through the lens of my own inability to focus, my hyperactivity, my anxiety, and, as well, my sensory processing issues. I found that certain rhythms helped me immensely: I was focused, calm, and able to navigate sensory stimulus.
Through the years, I came to understand that these symptoms commonly co-exist; nearly anyone who has ADHD also has sensory processing issues and anxiety. We are either overwhelmed by sensory input or we are under responsive to certain cues in our environment. REI has addressed this spectrum of sensory processing for over 25 years, and our clients present the full rainbow of sensory challenges.
Whether you experience anxiety or overwhelm, or feel disconnected from your sensory environment, we will create the optimal program to help you accomplish your goals.
The REI Custom Sensory Program is a home-based auditory brain stimulation program that uses musical rhythm to stimulate and re-pattern neurological function. A unique blend of modern advances in brain research and ancient rhythmic techniques, REI facilitates long-term improvement in sensory processing.
Custom created for you based on your unique sensory processing profile: this is the key to our program. Whether you experience auditory or tactile sensitivities, poor coordination or balance, or issues with spatial orientation, we deliver the proper stimulus to achieve your goal of proper sensory integration and a more functional life.
Once you begin, the REI Custom Program's interactive online platform and tracking ensures that you are always getting the stimulation that you need based on your real-world performance. Each new track of your program is dynamically engineered in response to your weekly progress.
This comprehensive 30-day anxiety-busting program consists of:
• 6 Custom-created REI Audio Tracks. One track per week for six weeks, these custom tracks employ progressive stimulation techniques made just for you and your responses to the music. Just as no two people are the same, you require unique stimulus to achieve the best results.
• Unlimited client support to make sure that you are indeed getting the best stimulation for your needs. We work closely with you to make certain you see significant improvements.
• 7 Brain Shift Radio audio downloads that can be used anytime you want additional benefits. These tracks include: Noisy Room Sleep, Revving-up Focus, Energy Boost, PowerNap Mix, Memory Boost, Big Round Calm, and Mood Lifter.
• Jeff Strong's Different Drummer book download to give you an understanding of how REI developed and how to best implement your program.
The REI Custom Calm Program requires no training or special equipment.
Play Your REI Custom Calm track once a day.
You can stream or download from your phone, tablet or computer. Tracks average between 22 and 26 minutes.
Play the track quietly in the background.
There is no need to actively listen to the music or to use headphones.
Check in with us at the recommended intervals.
You will receive an email every seven days asking you to complete your track adjustment feedback.
Creator of Rhythmic Entrainment Intervention (REI)
Jeff Strong is the creator of Rhythmic Entrainment Intervention™ (REI) and the Director and CEO of the Strong Institute, a research center and provider of evidence-based custom auditory brain stimulation programs. He is also the co-founder of Brain Shift Radio, a streaming music site containing personalized music to enhance brain function.
Jeff is a percussionist, composer, recording engineer, researcher, clinician, and a sought-after expert on the therapeutic use of rhythm. He is the best-selling author of eight books, including AD/HD For Dummies and Different Drummer: One Man’s Music and Its Impact on ADD, Anxiety, and Autism.
If you can watch a video on You Tube or Netflix, download a song on iTunes, or listen to internet radio, such as Pandora, you are technologically savvy enough to succeed with the REI Custom Program online format. All you need to do is visit our website and log into your account. Our website and your computer or mobile device will take care of the rest.
Generally, yes. For most people hearing someone else's REI Audio has a calming effect. However, there are some instances when we don't recommend others hearing your REI Audio tracks. One case is when a secondary listener has more profound issues that the person the REI program was made for, such as in the case of a teenager with attention issues, whose program is heard by a young child with autism.
Another case is when the listener doesn't hear as well as other people who may be in the room while the REI Audio plays through speakers. In this case the volume may need to be too high for others when set properly for the intended listener to hear.
There is no required time of day to listen to the REI Program Audio. We do find that most clients develop a daily routine to play their session. For children, parents often play the session after school or before bedtime. Adults often play their sessions in the morning before work or in the evening.
As the only 'No Listening Required' auditory program, we are providing a very specific stimulus for the client's central nervous system. Presenting a very low volume of this stimulus encourages the client's brain to seek out this novel stimulus. If the volume is high (and this is a relative term - high means a volume that is competing with a normal speaking voice) the REI Audio can become overstimulating. Most individuals respond to over-stimulus with the presentation of anxiety, agitation or sleeplessness.
Yes. In fact we recommend it. Though you may choose to stream your REI Audio tracks each day, we suggest that when a new track is made that you download it and put it on a media player. This way you have a back-up and long-term access to your REI Audio files. Keep in mind that when your new REI Audio track is created your old one no longer exists on our server, so if you want to have access to it you need to download it before submitting your weekly feedback form.
Yes, Even though the REI Custom Program doesn't require headphones to be effective, you are certainly welcome to use them if you choose. If you do use headphones we suggest not using noise-cancellation or isolation headphones. Remember, REI is the only 'No Listening Required' auditory program.
Ear buds or open-back headphones that allow some ambient room noise to be heard is your best option. As well, when using headphones be very aware of your listening volume as it's much easier to play the REI Audio too loud. If you see any of the side effects listed in this document, it's an indication that the volume is too high.
Optimally, your Custom Program is played every day. But to err is human, as is missing a day here or there - or encountering illness or travel where a you meet a week's absence. The online format will keep you to the current session until you complete all 7 days of playing. Therefore, a new track adjustment will not be initiated until you listen to all 7 sessions. If you have downloaded the track and are playing it independently of the online format, we recommend you simply pick up where you left off if you've only missed one day. If your absence grows toward a week or more, we recommend that when you begin again you play a full 7 days of the existing track before you initiate a new track adjustment.
If you find yourself having trouble keeping to the REI Custom Program schedule, give us a call and we'll help you find a schedule that works for you and the program.
REI is the only 'No Listening Required' auditory program. REI does not require active listening. It is best if your child has the freedom to self-regulate and move freely around the room while the track plays. There is no need to have him sit and listen to the music; in fact REI is designed for the listener's brain seeks out this novel stimulus while involved in another activity - playing, listening to a story, working, reading, etc.
Following are a series of articles and videos exploring how REI is used for sensory processing issues.
This is an excerpt from Jeff Strong's Different Drummer book exploring how he approaches sound sensitivities.
“Brandon can hear the Fed Ex truck coming from miles away,” his mother, Jenny, told me. “He has super hearing. On the flip side, he is easily overstimulated by the noise. It’s good that we live in the country, otherwise he’d probably be screaming all the time. Is this something you can help with?”
“A lot of my clients have sound sensitivities. So, I think I can help,” I said. Brandon’s sound sensitivities remind me of Steven, a child from my study at a public elementary school. Theresa, one of the teachers helping with the study, had warned me that if I played my drum in the small room where I had successfully played for every other kid, Steven would run out of the room screaming. He didn’t. In fact, he was less bothered by sounds after listening to a recording of me playing for two months. So I was confident that I could help Brandon. This is why I was willing to drive forty miles to his home in a tiny town on the St. Croix River in Wisconsin.
I arrived and Brandon was standing on the porch, dancing excitedly on his toes.
“Hi Brandon. Do you like drums?” I asked.
I handed him a case and had him follow me into the house.
We went into the living room and I started to set up my equipment when a plane flew overhead. Brandon’s hands flew up to his ears and he started rocking and groaning. Jenny grabbed him and held him, soothingly. I sat by my drum and watched as Brandon reacted to the sound of the airplane. It was flying low and it took a while for it to get far enough away for Brandon to calm down.
“Does the airplane scare you, Brandon?” I asked.
He looked at me and didn’t say a word, though I thought I detected a slight nod.
“The planes don’t come very often,” Jenny told me. “There is a small light aircraft terminal a few miles from here and sometimes a plane will land or take off over us. When it happens Brandon gets anxious.”
“Do any other sounds bother him?” I asked.
“Anything sudden or unexpected will do it. He also hates the vacuum, lawn mower, and hair dryer.”
“How about loud noises? Are they a problem in general or is it only unexpected or droning noises?”
Not all loud noises bother him. He can handle loud music. He actually prefers his music loud. I think it’s mostly sounds that carry on.”
I turned to Brandon. “Do you mind if I play the drum?” I asked.
“Brandon, why don’t you sit down next to Mr. Jeff,” said Jenny.
Brandon came over to me and sat as I started to play. As you might expect, I started slowly and quietly, using mostly muted tones with some soft open tones and bass punches thrown in as I built the volume. I wanted to see how loud I could play before he began getting uncomfortable.
For about five minutes I increased the volume and added slap tones, which are the loudest most piercing sounds this drum can make. By the end of these five minutes, I was playing as loudly and intensely as I ever had. Brandon sat next to me watching my hands hit the drum. He was not bothered in the slightest.
This has been my experience with the live drumming for people who are extremely sound sensitive. In every case, they could tolerate what I was playing and none showed any signs that they were uncomfortable. No covering of their ears, no screaming or crying, no recoiling or shying away.
This is often not the case with a recording of the drumming. If the volume is too loud for someone with a sound sensitivity, he will cover his ears, complain or leave the room. But with the live drumming, this has never happened.
So, knowing that my drumming wouldn’t bother him, I settled down a bit and focused on playing rhythms that I have used for other kids who had similar sound sensitivities. I played a series of rhythms with more subtle differences between the lower and higher notes, creating more of a droning patter. Brandon shifted in his seat. I increase the repetitive nature of the rhythm and Brandon shift again, this time leaning away from me.
More repetition and Brandon stood up and left the room. I increased the volume and, as Brandon brought his hands to his ears, I dropped the volume and played a five beat rhythm heavy on bass tones. These rhythms and textures were in large contrast to what I had been playing. Brandon dropped his hands from his ears.
Next, I switched to a 73-beat rhythm that I played once before when a young girl was covering her ears as a plane flew overhead. This rhythm settled her down. And now, I wanted to see if it would relax Brandon as well. Testing a rhythm this way is what allowed me to develop the databases of rhythms related to symptoms.
After a minute or so with this rhythm, Brandon was next to me again. I eased off on the volume a bit and added a few more muted tones to the pattern. Brandon sat down. I added some more bass tones and played for several minutes before Brandon put his hands on the side of the drum.
It is common for kids to place their hands on the drum when I play a combination of bass and muted tones. The bass is deep and resonant. And it’s inviting. The physical sensations of the drum are palpable. You feel it in your chest.
Brandon held onto the drum as I played for several more minutes. Then I stopped. He continued holding the drum. I tapped out a simple bass pulse and asked if he wanted to join me. His hand slowly moved from the side of the drum to its head. He held his hand on the head as I kept pounding the bass pulse.
Soon he tapped in time with me. I kept the bass pulse going with the right hand and with my left added simple syncopations encouraging him to keep playing with me. We played together for a while before I stopped again. His hand remained on the drum for a minute or so. Then he lifted his hand, got up, and walked out of the room.
Satisfied with the session, I packed up and left. I made a tape for him and sent it to his mother the next day. I also asked her to specifically note how often and how severely he reacted to sounds in his environment.
I checked in with her after four weeks.
“Brandon is much calmer than he used to be. He is less bothered by the lawn mower and vacuum cleaner. The other day I forgot he was in his room when I turned on the vacuum and went down the hall with it. When I had done this in the past he would come screaming out of his room with his hands over his ears and run outside. This time he stayed in his room and kept playing.
“I was surprised because after I finished vacuuming I went into his room to get his dirty laundry and there he was, playing on the floor. I asked if he heard the vacuum and he said he did. I asked, ‘didn’t it bother you?’ and he said, ‘yeah’. I asked why he didn’t leave the room and he said he was busy playing. I was shocked because any other time and he would have been crying and screaming. This is just one example of how he seems much less bothered by the noises that used to drive him crazy.”
This video shows how Jeff Strong uses fast, complex drumming rhythms to reduce sound sensitivities.
Sound sensitivity falls into two categories:
1. General overwhelm. Too much auditory input and competing sounds, such as those at a restaurant or school cafeteria, often result in shutting down or lashing out due to the inability to filter for important sounds.
2. Aversion to specific sounds. Certain sounds, such as that of a vacuum cleaner or blender, often elicit negative responses due to their specific frequency, intensity or volume.
Both require a progressive set of rhythms, tones, and levels of intensity and volume to help the nervous system learn to process and tolerate them.
This is an excerpt from Jeff Strong's Different Drummer book describing how he approaches sensory processing.
Sensory processing issues are common among the people I work with. In fact, sensory challenges are part of nearly everyone who falls into the developmental disability spectrum, including people with ADHD and autism. Sensory processing issues come in three basic forms: sensory-defensive, sensory-seeking, and poor sensory discrimination.
Sensory defensiveness is characterized by being easily overstimulated by sensory input. This is the child who recoils to touch, won’t wear shoes, covers his ears in response to loud noises, gets dizzy easily, or throws up in the car.
Easily overstimulated people constitute most of my clients with sensory issues. I work to reduce their sensitivity to stimulation by giving their brains more stimulation.
“What do you mean by stimulation?” Laurel asked. “Emily is always overstimulated. Why would you add more, and how could it calm her down?” This was one of the first questions she asked me after I began to work with her daughter, Emily.
From her very first track, Emily responded immediately and decisively to the drumming. After just one listening, her emotional outbursts increased and her sleep, already poor before the Program, deteriorated further. Upon her first night on the Program she needed to be held by her mother to calm down.
Laurel and I quickly discovered that Emily needed less stimulation, far less than a Program usually begins with. In fact, I had to step down the level of stimulation on her tracks to a point lower than what was on our ‘stimulation low enough for anyone’ Calming Rhythms CD. Once we determined a stimulation level she could tolerate, we were then able to slowly begin adding more stimulation and progressively build her tolerance to address her sensory issues.
“Stimulation is related to the complexity of the rhythms on the track,” I described to Laurel. “I have built a series of rhythmic structures, varying in their length and complexity, for each symptom.
“By complexity, I mean the difficulty needed to decipher the rhythm’s pattern. Think of the brain as a computer whose central job, when dealing with sensory stimulus, is to decipher and categorize the stimulation.
“Emily takes in sensory stimulus at a very high level. It’s as if her volume control is turned way up. Everything comes at her with an intensity that is higher than for you or me. And she can’t turn down the volume. A light touch may feel like a hard squeeze, or a normal voice level may sound like a shout. Our goal with the REI tracks is to teach her sensory system to turn the volume down and to learn to distinguish important from unimportant sensory input.
“With each track, we want to increase the level of stimulation we can give her so that she becomes used to it. Over time, she’ll develop the skills to be able to moderate the stimulation she receives.”
Before I made her first Program track, Emily, who was four at the time, wouldn’t wear clothes, preferring to only wear undies. Sometimes she would wear shorts or a skirt but she was never okay with a shirt. And don’t even think about a coat. She also slept poorly, often waking at night or early in the morning, unable to get back to sleep. Emily was also anxious, and Laurel needed to be with her at all times lest she have a melt down.
Laurel was one of my favorite parents. She was engaged and inquisitive. And the two years I spent working with her extremely sensitive daughter was one of the most satisfying—and sometimes perplexing—experiences of my career.
Emily mirrored many challenges exhibited by a six-year-old boy I worked with a few years before. Gerald had both tactile and auditory sensitivities. He wouldn’t wear shoes or socks and would cover his ears, or sometimes cry or scream, when someone turned on music, even if the volume was low.
He also tended to isolate himself from his family, preferring to be in his room alone, playing with toys by himself. If a sibling or cousin came in his room, he’d have a meltdown.
For Gerald, the Program was pretty straightforward. He responded within the first two weeks in all areas.
“Gerald is doing great with the Program,” said Jenna, his REI provider. Jenna, an occupational therapist in south Texas, was our first active provider and this was one of her first clients. We were both excited by Gerald’s progress, especially by his quick response to REI.
“He’s been wearing socks and shoes everyday, since the end of the first week. Yesterday he joined his extended family outside and played with his brothers and cousins. He now lets his mom turn music on in the car and he has also been rocking out to his own pop music in the house.”
“That’s pretty quick progress. Is he using CD #2 yet?”
“He just started the other day. So far the transition is going well.” The transition from CD #1 to CD #2, at this time in the history of the REI Custom Program, was sometimes difficult because of the jump in stimulation.
The first CD (and first track with the current Program) generally focuses on reducing anxiety and sets the foundation for improving sleep issues, if there are any. The subsequent tracks progressively build stimulation and broaden their focus to include other areas of concern.
When sensory sensitivities reduce during the first track, it usually means that they are related to anxiety. This was my assumption with Gerald.
I had no such assumption with Emily when she started the Program. This is because, even though she had a similar symptom makeup, she also had sleep issues and a more heightened response to overstimulating environments.
“We’ll start with trying to help Emily’s sleep,” I said to Laurel when we started the Program. “If she can fall asleep more easily and not wake up, we may also see some improvement in her sensitivities. Sometimes being tired, especially chronically, can increase the presence of these symptoms. Her overreaction to things in general suggests that this may be the case.”
“So, do I play the track at bedtime, then? Can I play it all night long to help her stay asleep or turn it on again if she wakes up?” asked Laurel.
“Yes, turn it on at bedtime. Just play it once through. If she wakes up, it’s okay to turn it on again, but only once. With any luck, she’ll be able to stay asleep after a couple of weeks of this pattern.”
Many of our clients wake up at night. In fact, falling asleep is often not a problem. It’s the night waking. And this is probably one of the most difficult things for a parent to deal with. Having your night interrupted, night after night, becomes wearing and leads to a host of problems.
The kids who wake up at night often wake up ready to go for the day. Getting them back to sleep can be exhausting. So, the first and most important thing for us to focus on is to help the child sleep so the parents can sleep, too.
“Emily slept all night the fifth night,” Laurel told me at her two week check in. “She slept through the night for the next week and started waking up again the last couple of nights. Do you think we need to change tracks?”
“It sounds like it.” I made a new track and waited to hear from Laurel again in another two weeks.
“Emily slept through the night again when we started the new track, but she started waking up again the last couple of days.”
And so a pattern started to emerge for Emily. Sleep was a barometer to how a given track was working for her. Every time I made a new track, Emily would sleep well for a while and then she’d start waking up again.
“How are her anxiety and sensory issues?” I asked after the third track, hoping that we’d now start seeing some changes there.
“Oh, I forgot to mention this because I’ve been so focused on her sleep, but she’s now letting me put on a shirt,” Laurel added, sounding like it’s not a big deal.
“Wow, that’s great! When you started, she’d melt down if you tried that,” I added, trying to help her see what a big change this was. When we first talked, Laurel was much more concerned with Emily’s tactile sensitivities than she was by her sleep, but our focus on the sleep issue seemed to make her not as aware of Emily’s tactile improvements.
“Yeah, I guess it is a big change. And come to think of it, she hasn’t been melting down as much,” she said as we talked about where Emily was before the Program started.
This isn’t uncommon. Many times people are so focused on playing the track and dealing with whatever is up that it’s hard for them to see the big picture, unless it’s pointed out to them.
This is one of the most helpful things about our REI providers. Since they can’t make the CDs or even mix-and-match pre-recorded CDs as is common in other auditory programs, many providers feel like they don’t have an important role in REI. The key to their role is their relationship with their clients: It is valuable not only to help me see what the real issues are, but also to help the client gain perspective on how much progress they’ve made.
Laurel didn’t always need to be reminded where Emily started. She became keenly aware. In fact, she was one of the most astute observers of her daughter’s progress with the REI Program.
“Emily has been weepy the last few days in this track,” Laurel told me a few more weeks into her Program. “She did fine for the first week then she started crying for no reason. It’s not like a melt down. She’s not reacting to anything going on around her. She’ll just stop and cry. Could it be the track?”
“I don’t know. It could be, I suppose. How is she sleeping? How are her sensitivities?”
“She’s sleeping okay. She has been a little fussy about clothes. She’ll only wear one particular shirt and she doesn’t want to wear shoes anymore. Do you think we should try a new track?”
“That’s what I’m thinking. I’d guess that this track is probably too stimulating for her.”
I made a new track. Laurel called a week later.
“She’s not weepy anymore and she wearing shoes again. What did you do with the new track?”
“I went back to rhythms we used in Track #2 and rearranged them. I looked at your current track (#3) and noticed that it had changed databases and drums. The Udu drum is much more stimulating than the Gonga, and I’m guessing that had an impact on her.”
“I noticed it sounded like a different drum. Why would that matter?”
“The Gonga drum has a pretty soft, rounded tone. The Udu is really sharp. As well, on the Gonga I tend to use rhythms that are less complex and carry a longer structural flow than those played on the Udu. The Udu tracks tend to be much more stimulating than the Gonga tracks because the drum’s sound is more pointed and the rhythms more complex. Someone as sensitive as Emily may find the Udu uncomfortable to listen to.”
An REI Custom Program will draw from eight databases and switch back and forth between the Gonga and Udu. Even though the Udu drum rhythms tend to be more stimulating, the stimulation is presented on a scale. So a particular database of Gonga rhythms may be more stimulating than another database of Udu rhythms. In fact, each database used for the Custom Programs are progressively more stimulating;, so even though database two is an Udu, the rhythms are less stimulating than the rhythms played on the Gonga in database three.
We discovered that Emily was never able to handle the Udu tracks. I had to alter her Program so that we never drew from the Udu databases. She could handle fairly high intensity Gonga rhythms, but not lesser stimulating Udu drums. Fortunately, I was able to accommodate her.
Over the course of almost two years, Emily made significant progress in her anxieties and sensory issues. Then Laurel offered me another opportunity.
“Are you ready to work with my other daughter?” she asked. “Lila is the polar opposite of Emily. She is a sensory sponge. She could spend all day in the swing.”
“Okay, let’s give it try.”
Like Emily, Lila was four-years-old when I started working with her. Unlike Emily, who withdrew from sensory stimulus, Lila was a classic sensory seeker. She was high energy, high activity.
Her response to her Program was also harder to track than Emily’s. For instance, Emily’s sleep would change when she was ready for a new track. She also made steady progress, as long as we changed tracks on her schedule.
Lila, on the other hand, could stick with the same track forever without showing any negative effects. With Lila, we needed to be more vigilant in changing her tracks on time in order to move her forward. She soaked up all the stimulation her Program would offer.
In some ways, a client like Lila is easy because I never have to contend with, or even worry about, overstimulation. Overstimulation generally causes sleeplessness, anxiety and agitation. Once we see overstimulation in a client, we tread pretty carefully from that point forward to ensure that she doesn’t become overstimulated again.
Someone like Lila, though, doesn’t react as strongly. Because she can handle so much stimulation, it takes more intense rhythms and more frequent changes to the tracks to ensure that she makes progress. If I’m not seeing tangible progress by Track #3, then I step up the stimulation further. If progress doesn’t happen even after adding more stimulating REI tracks, I’ll sometimes also ask that the REI tracks be played more than once a day.
Lila didn’t need these contingencies. Her sensory-seeking became less pronounced during her second track, about three weeks into her Program. She was sleeping better and was less anxious overall. Other than that, Lila was a hard to read. She didn’t react strongly to a track like Emily did. She showed a slow, steady pace. Laurel was used to reacting to Emily’s response to a track and felt a little lost when it came to knowing how Lila was responding.
“Lila is different than Emily in many ways, but the curious thing about the REI is that she just goes with the flow.”
“Sensory seekers tend to be more consistent than sensory defensive people,” I described. “I think that someone who is seeking sensory input tends to run at a pace that keeps them stimulated. They may not react to sensory input as much because they are still seeking more.
“A sensory defensive person, on the other hand, has a threshold that may change depending on how they feel. Different types of stimulus have different effects on them. So, unless they experience the same type and level of stimulation, you’re going to see some variability in their response to stimulus and, in turn, in their behavior.”
“That makes sense. I really see that with Emily. There are days when she can handle going to the grocery store, but there are other days when she melts down. Same thing with school. That’s the most difficult thing about Emily’s sensory issues: I can’t predict how she is going to respond to something. Just when I think she’ll be okay with going somewhere, she’ll have a meltdown.
“Lila, on the other hand, is always busy. This consistency, although it’s hard, is easier to handle because I can plan for how she’ll react to something.”
Though I see quite a few people who are sensory-seeking like Lila, more clients are on the sensory defensive side, like Emily. Either way, because I can fine-tune the stimulation for each person, I can accommodate their sensory needs and hopefully help them learn to more efficiently process sensory input.
In this video Jeff shows how he approaches the three types of sensory processing issues – hyper-sensitivity, hypo-sensitivity, and sensory discrimination.
He plays examples of various drumming rhythms to influence these sensory responses and describes how hyper and hypo sensitivity fits into an REI Custom Program.
This article, written by REI Creator Jeff Strong, was published in: Insights into Sensory Issues for Professionals: Answers to Sensory Challenges, edited by Kathleen Morris. MS CCC/SLP. 2010.(Originally published in SI Focus Magazine, Fall 2008)
Auditory rhythm has a long history of use for affecting neurological function, with the earliest uses being documented tens of thousands of years ago. These original techniques are some of the most pervasive therapeutic practices known to man, existing on every continent even among people who had no contact with one another (Harner, 1990). As an ethnomusicologist I was fascinated by the commonality in the techniques within such disparate cultures. I spent over a decade trying to understand how the same basic therapeutic approaches developed when so many other aspects of these societies were vastly different.
The answer, it appeared, was that the physiological mechanisms at work are so powerful that experimentation by each culture resulted in a common finding: You can affect consciousness, cognition, and behavior by employing only two specific rhythmic techniques. One consists of a repetitive pulse while the other employs complex rhythmic structures.
Discovering such commonality among traditional therapeutic rhythm practices prompted another, perhaps more important, question: Can these therapeutic effects sustain themselves outside of the cultural context in which they developed? I believed so, but many of my colleagues did not, believing instead that the rhythm was secondary to the rituals they were imbedded in (and is often attributed to the placebo effect). This led to an odyssey that began in 1992 and has continued to this day, culminating in the development of Rhythmic Entrainment Intervention™ (REI).
REI is a music-medicine therapy (Spintge & Droh, 1992) that stimulates and synchronizes the listener’s brain. REI is available as some generalized CDs This is a custom-made, program that optimizes neurological function.
Auditory Rhythm to Stimulate the Brain
REI is unique in several ways. First, REI employs auditory rhythm to directly stimulate the listener’s brain. Other auditory programs use modulated frequency (Tomatis, 1992), binaural beats (Oster, 1973), or simply classical-based music (Rauscher, Shaw, and Key, 1993).
As I developed REI, my first step was to identify the core mechanisms of the traditional techniques. It turns out that these mechanisms are simple, powerful, and easily understood. First, human consciousness can be directly affected by an auditory stimulus. This is called “auditory driving” (Goldman, 1992). Auditory driving states that a listener’s brain wave activity will synchronize with the pulsation of an auditory rhythm (provided certain conditions are met).
Traditional practitioners would employ a four-beat-per-second rhythm, which would in turn facilitate a corresponding four-beat-per-second pulsation in the listener’s brain, resulting in bilateral neurological synchronization and a shift in consciousness to a theta state (this is a meditative state)(Maxfield, 1994). With REI we double the tempo to synchronize a listener’s brain into a relaxed neurological state called alpha. This is the state of consciousness where sensory processing is optimized.
The second core mechanism involved in traditional therapeutic rhythm techniques consists of using complex rhythms to activate the brain (Scartelli, 1987; Shatin, Koner, Douglas-Longmore, 1961; Parsons, 1996). Here complex auditory rhythms stimulate the Reticular Activating System (RAS), a part of the brain that controls sensory input (Scartelli, 1992). Applying rhythm - especially complex rhythm – to activate the brain is one level of the stimulation provided by REI. As we conducted research we discovered another dimension to the rhythms: One that appears to be more important than just complexity. It seems that each rhythm produces a different response.
Once the core mechanisms were discovered the next step was to determine the best way to deliver the correct stimulus to aid in the areas in which I was interested. Traditional practitioners performed the rhythms live for each person and adjusted their rhythms based upon the responses they saw in their patient.
Daily Listening for Long-Term Change
This is where I started -- the first 1,000 people that REI was used for experienced this one-on-one, live stimulus. They also listened to a recording of one of their live sessions daily in their home. Daily listening was a departure from the traditions, but I felt that people needed the stimulation repeated consistently for a length of time in order for any long-term change to be expected.
One of the first children that I worked with in this manner was a seven-year-old girl on the autism spectrum. In this case, the girl, let’s call her Stephanie, was referred to me because of extreme anxiety. This anxiety impacted every aspect of her life: She wasn’t able to sleep in her own room and needed to be in constant contact with her mother; transitions and even minor changes in her environment were a point of crisis for her throughout the day.
She also had significant language and social delays. Her language consisted largely of repeating rote words and phrases. Although she had a large vocabulary, she was unable to communicate beyond her basic needs and desires. Socially, she lacked eye contact and wasn’t able to interact appropriately with her peers.
She calmed down within minutes during the first live session, and after the second session she remained calm and was able to sleep in her own room from that night on. Stephanie listened to a recording of her third live session everyday for eight weeks. At seven weeks she spontaneously described events in proper sequence for the first time. She was also developing social connections and had begun making friends.
She was mainstreamed at school (she was in a classroom with non-autistic children and had a one-on-one aide) and at 10 weeks the school psychologist evaluated Stephanie in her classroom and noted that she was “indistinguishable from the “normal” children in the class.” She continued listening to her recording for several more months and eventually no longer required her one-on-one aide.
Universal Calming Effects
This, and many other cases studies, led to a formal study conducted in a public school setting (Strong, 12). This study consisted of 16 children from age 6 to 12 who were on the autism spectrum. The results of this study showed almost universal calming effects (only one child was not calm most of the time, and this child ended up not being on the autism spectrum).
Long-term change was significant for anyone who heard the recording at least four times per week. This study caught the attention of several prominent autism professionals and led to a paper of this study being presented at several professional research conferences (including one organized by The Center for the Study of Autism led by Dr. Stephen Edelson, who went on to design all of our double-blind, placebo-controlled studies).
At this point my interest in exploring the therapeutic application of auditory rhythmic stimulation techniques deepened. I formed the REI Institute with Beth Kaplan with no intention of creating a “therapy” that would be available outside of a research environment. Our goal was simply to try to understand how auditory rhythmic could be used to enhance neurological function.
Over the next 10 years the REI Institute conducted numerous studies and presented dozens of scientific papers on what we were learning. Two of the key discoveries of this period were that synchronization was universal when certain techniques were applied and that each rhythm used elicited a definite, observable response over time.
Specific Rhythms’ Observable Effects
In other words, we found that we could introduce specific rhythms to have a pre-determined effect on each listener. To date, we have documented over 600 rhythms that seem to correspond to symptoms and combinations of symptoms. As a result we found it was critical to use just the right rhythms for each person in order to have the greatest positive benefits for that person.
During the 1990s, the REI Institute conducted a series of double-blind, placebo-controlled studies to try to understand the best approaches to take in balancing auditory stimulation and synchronization. What we learned in a nutshell was that the custom-made CDs are more effective than CDs created for a broad user base.
Custom-made, Revisable CDs
This leads to the second unique aspect of REI: The REI Custom Program™ is custom-created for each person based on his unique characteristics. By custom-making each CD we can ensure that the correct level of stimulation is used for that person. In the event that we aren’t seeing the results we’ve come to expect, we also revise the CDs until we see the results we are looking for. The practice of revising the custom-made CDs is the third unique aspect of REI.
Because the REI Custom Program™ is created for each person, we are able to focus the CDs on the three or four main issues someone faces. As a result, everyone responds differently to his CDs, but we see the most significant benefits in some general categories. These include anxiety, sleep, self-stimulatory behaviors, language skills, sensory sensitivities and defensiveness, socialization, attention and focus, and aggressive or oppositional behaviors.
Another example of the results with the REI Custom Program™ (and one most relevant to this article) can be seen with a 10-year-old boy with severe sensory issues. Gerald, as I’ll refer to him, saw significant improvement within just a few days. Before he began the REI Custom Program™ he refused to wear shoes or socks, covered his ears whenever music was played, couldn’t tolerate headphones, and socially isolated himself from others, often retreating to a dark, quiet room.
Within the first week of listening to his CDs, Gerald was more tolerant of everyday sounds. He also spontaneously joined his extended family outside and began interacting with them. By the second week he was interacting with his siblings and cousins much more frequently, and by week four, according to his REI Provider, “… He is wearing socks and tennis shoes every day. He now not only allows mom to listen to music in the car, he often goes to his room and 'rocks out' to his own pop music. He has been more interactive and engaged in activities as well as initiating appropriate play with other children.”(Strong, 1996) He was also able to tolerate headphones for the first time.
This leads to the fourth thing that distinguishes REI from other auditory programs: REI is designed to be used in an open-air environment. That is, we don’t use headphones for the implementation of the therapy. The CDs simply need to play quietly in the background once a day (with the exception of the third week where the CDs are used twice a day). Having the stimulus in the background while the rest of the sensory input of life goes on forces the brain’s RAS to work hard to decipher the pattern in the stimulus while also ensuring that the listener doesn’t become over-stimulated by the rhythms.
In 2004 we began offering REI Custom Program™ through trained providers -– we now have hundreds across the U.S. This represented a monumental shift after 22 years of research -- research that simply started from my desire to understand why traditional therapeutic rhythm practices were so prevalent around the world.
In spite of our growth and the expansion of REI beyond just research, I am still personally involved in the creation of all the REI Custom Program™ CDs that leave our office and am still impassioned by learning more about how auditory rhythmic stimulation can impact individuals with neurological issues.
Goldman, J. (1992). Sonic entrainment. In R. Spintge & R. Droh (Eds.), MusicMedicine (pp. 194-208). St. Louis, MO: MMB Music, Inc.
Harner, M. (1990). The Way of the Shaman (3rd ed.). New York: Harper San Francisco.
Maxfield, M. (1994). The journey of the drum. ReVision, 16(2), 157-163.
Oster, G. (year, month). Auditory beats in the brain. Scientific American, 229, 94-102.
Parsons, L. M. (1996, October). What components of music enhance spatial abilities? Paper presented at the VI International MusicMedicine Symposium. San Antonio, TX.
Rauscher, Shaw, & Key (1993, October 14). Music and spatial task performance. Nature, volume, pages.
Scartelli, J. (1987, November). Subcortical mechanisms in rhythmic processing. Paper presented at the meeting of the National Association for Music Therapy. San Francisco, CA.
Scartelli, J. (1992). Music therapy and psychoneuroimmunology. In Spingte & Droh, (pp. 137-141).
Shatin, L., Kotter, W. L., & Douglas-Longmore, G. (September 1961). Music therapy for schizophrenics. Journal of Rehabilitation, 27, 30-31.
Spintge, R., & Droh, R. (1992). The International Society of Music in Medicine (ISMM) and the definition of MusicMedicine and music therapy. In Spintge & Droh, (pp. 3-5).
Strong, J. (1996, October). Rhythmic Entrainment Intervention (REI) as applied to childhood autism. Paper presented at the VI International MusicMedicine Symposium.
Tomatis, A. (1992). The conscious ear: My life of transformation through listening. Barrytown, NY: Station Hill Press.
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