The Strong Institute is a research and therapy center offering brain stimulation CDs and programs for people with neurological disorders. Our clients come to us with conditions such as ADHD (ADD, AD/HD), autism, anxiety disorders, sleep disorders, mood disorders, PTSD, TBI, Tourette’s Syndrome, and others.
We work with people all over the world using the technique I developed, called Rhythmic Entrainment Intervention (REI). We currently have 11 CD titles and the REI Custom Program, the world’s only completely custom-made home-based brain stimulation program. Since 2004, we have built an Authorized Provider network of over 2,000 trained professionals (we offer a training program and CUE’s for Occupational Therapists).
A Little Background
I originally formed the Strong Institute as the REI Institute with Beth Kaplan in 1994 (we changed the name in 2010) immediately after my first clinical study on Rhythmic Entrainment Intervention (REI).
This study was conducted in the White Bear Lake School District in Minnesota with children on the autism spectrum. As you may or may not know, it’s very difficult to get a study in a public school system, so that in and of itself was a big deal. However, the results were quite astounding. We saw very definite responses to the drumming from the first live session, and significant improvements with the recordings each child listened to over the course of eight weeks.
Because of the results of this study and the location/environment is was conducted in, I received several requests to present this research at autism conferences. At this pont there wasn’t even a paper yet. Heck, we hadn’t even finished parsing all the data when word spread and requests to speak rolled in. The first two conferences, and most important to the direction of my work, were the annual conference of the Minnesota Autism Society and an international conference for autism researchers sponsored by the Center for the Study of Autism based in Beaverton, Oregon.
Imagine speaking to 300 seasoned autism professionals and researchers the first time out. I was not a clinical researcher. Up to this point I had been researching in one of the softest sciences – ethnomusicology – and was living the life of a drummer, complete with national tour dates, late night recording sessions, and drumset and hand-drum students. Now I had to shed the motorcycle jacket, cut my hair, and put on a suit (sport’s coat and dockers, actually) and talk to the “establishment”.
Talk about culture-shock!
All my years of performing in front of audiences paid off (speaking to 300 people was easy after playing for as many as 30,000). I kept it simple and focused on the effects we saw on calming – 15 of the 16 students were calmed most of time while the recording played (the 16th student ended up not being on the autism spectrum), a real big deal if you know anything about anxiety levels in people with autism, especially as they present in a school environment.
Lucky for me, the feedback I received from experienced professionals and the relationships that developed from these conferences led me in a direction that has held steady for almost 20 years – children and adults on the autism spectrum represent more than half of the clients we see today.
After my initial study we continued doing clinical research for the next ten years. We did studies on ADHD, autism, Tourette’s Syndrome, chronic pain, and anxiety disorders, among others. Our goal was to see were REI was effective and how to get the best results. This was a fairly daunting task, but we collected a lot of data and develop a very good understanding of how auditory rhythms could impact the central nervous system.
Our clinical research took two forms:
- Me playing live for each client and tracking their experience. This was a one-on-one approach that matched the traditional way of doing things. I played for well over a thousand people and recorded and had detailed notes taken on the rhythms I played and the responses we saw. From each live session we created custom recordings that were then played daily between live sessions. Because of the many variables in each person’s live and recorded sessions, we weren’t able to do any “scientific” double-blind studies. Regardless, the effects we observed and the data we collected enabled us to created our current REI Custom Program and Brain Shift Radio. Several studies have been conducted and research has been presented and published from this approach. I have a new study with adults with autism living in a residential facility that was recently published.
- Double-blinded studies using generalized recordings. We received a lot of pressure to conduct controlled studies. These studies satisfied the scientific method of research but removed the variability that became essential for Rhythmic Entrainment Intervention to work. This research did allow us to develop our generalized CDs (Calming Rhythms, specifically), so it wasn’t all lost. From a publishing stand-point, however, we saw such a significant difference in results between this approach and the live tracking that we decided not to bother submitting any papers. There have been some third-party studies published using this method, including this study on REI for focusing.
Today we are working on finding ways to use our custom recordings in scientific/quantitative research. With our new REI Custom Program software and Brain Shift Radio, we have begun doing the type of quantitative research that will allow us to further develop, test, and prove the efficacy of our work.
As part of this initiative we integrated a quantitative test for focusing on BSR using a Continuous Performance Test (CPT) to track attention with and without music. So far, the results have been exciting: Thousands of tests have shown a median improvement of 36.7% in error rates for the REI music over silence.
Building a Provider Network
In 2004, we felt confident in both the basic therapeutic approach and, more importantly, the specific protocols necessary to make this therapy work in a broader clinical network. So we launched our Authorized Provider Training Program (REI AP Training) and began training professionals how to implement our CDs and REI Custom Program.
We held one training in Santa Fe in November 2004 and trained a whopping three people.
Not the most auspicious start.
However, over the next two years, I traversed the country and held 26 trainings, enabling us to build a network of over 500 REI providers. We have been slowing growing every since (we are now past 1,600 trained providers).
In 2007, we moved our training online. We did this for two reasons:
- I was too busy creating programs. At this point each REI Custom Program was hand-made by me. Just me. And each one took quite a bit of time to make. I was working my tail off just to keep up with demand. The good news was we were helping more people than ever. That bad news was that I had no time to create anything new.
- We felt there was sufficient infrastructure to make this work. Web 2.0 was well underway and we wanted to continue breaking ground (we were the first auditory stimulation company to develop an online training program). Again, this is a good news/bad news situation. The good news was that, indeed, the technology was solid and we were able to create a cool online video training system. The bad news was that our people weren’t ready. Some lacked bandwidth, some lacked technical skills, but what most lacked was the time and focus to follow through on a self-paced program. In this case self-paced meant easily forgotten.
Fortunately, the slowing pace of training providers and developing a better way to create programs coincided in a way that kept me sane. Even if it meant that we didn’t grow at the same pace as we had been.
(Here’s a good business lesson – fast growth isn’t all good. Sometimes it makes more sense to let your business plateau for a while so you can get your ducks in a row and prepare for more sustainable growth in the future).
As it turns out, during the time that we built our REI Custom Program software, people became more comfortable engaging in online education (and as a result became more committed to finishing). We also became an approved CEU provider for our core provider type – occupational therapists – so are now able to offer them, not just a good education and a great program for their clients, but also necessary continuing eduction requirements.
Our Current REI Custom Program
In 2007, at the time of the switch to the online training system, we started developing the algorithms necessary to move the creation of our REI Custom Program online. This took us several years, though the actual building of the software only took a few months. The difficulty was in creating the logic to be able to respond to each person’s real-world experiences.
I should note here that our REI Custom Program is custom-created in a dynamic, evolving way. Each person completes an intake form and receives their first recording. Then we track how they respond and create each subsequent recording as they go along. This ensures the most appropriate stimulation for each person and most closely resembles the way we started when I played live for each person. It also provides much better results.
At this point we offer our REI Custom Program in one form: a 12-track program that lasts 6 months. This seems to be the optimal duration for most people and, because we are able to adjust it for each person, it’s extremely rare that we don’t achieve significant benefits for each person. You can learn more about this program here: REI Custom Program.