Interactive Metronome

Taylor, Jennifer, Cassy, Bailly, Brittany

What is Interactive Metronome?

IM is believed to improve brain neuroplasticity by
increasing the brain white matter tract communication
system.
May also be useful in promoting academic skills and
decreasing aggression in younger boys diagnosed with
ADHD.
Intervention aimed at improving attention, balance,
bilateral coordination, fine and gross motor skills, motor
planning, timing, sequences, coordination, sequencing
for ADLs and IADLs, self control and sensory integration.
IM home program-can be conducted just about
anywhere because it is portable

How does IM work?

It is a type of software that generates steady beat to
help produce rhythmic movements of hand and feet in
response to auditory stimuli
The software analyzes the movements according to
speed and accuracy.
It will then give interactive, visual feedback allowing for
adjustments with the timing, rhythm and
synchronization
Movements include clapping 1 or both hand, or toe
tapping, or alternating between both
There are 15 sessions with instructions to perform,
including movements to accommodate for the user

Why use IM?

It has beneficial effects on motor, cognitive and
academic performances.
The underlying theory is that rhythm provides
information of timing of organizing and sequencing
thoughts and movements. Without internal sense of
timing there is no foundation of functionally to organize
and sequence. (Sabado, J., & Fuller, D. 2008).
With rhythm it turns on improvement of CNS motor and
cognitive processing (motor planning, motor sequencing,
concentration, thinking, interacting) needed to attend
and to learn. (Sabado, J., & Fuller, D. 2008).
IM is also an effective complement to other interventions
used

Who can it benefit?

People with learning disabilities
ADHD
Central auditory processing disorder
Autism
Down Syndrome
Cerebral Palsy
TBI
Apraxia of speech
People with motor planning and cognitive processing
difficulties

History
IM is a PC based version of a traditional music
metronome originally developed for improving timing
and accuracy in musicians
Developed in the early 1990s
Approved by AOTA

http://www.youtube.com/watch?v=u1vSIBKudAg

Tasks Used in IM
1. Both Hands
2. Right Hand
3. Left Hand
4. Both Toes
5. Right Toe
6. Left Toe
7. Both Heels
8. Right Heel
9. Left Heel
10. Right Hand/Left Toe
11. Left Hand/Right Toe
12. Balance Right Foot/Tap Left
13. Balance Left Foot/Tap Right

Where is IM seen?
All ages
Inpatient
At home assisted by caregiver
Therapy Gym
Schools
Sports medicine

 Equipment Needed:
Must be certified to
conduct:
Educators
Speech Language
Pathologists
Occupational Therapists
Physical Therapists
Athletic Trainers
Musicians

Laptop
Hand Triggers
Foot Triggers
Two headphones

Article Findings:
Sequencing alone is not enough; it must be done within
the context of correct timing. A dancer may perform all
the steps perfectly, yet if the dance is not to the beat,
the piece is disjointed (Koomar 2001).
Different from sensory integration approach, but
expected outcomes are similar
Occupational therapists often report that children with
sensory integration dysfunction have a great deal of
difficulty with daily tasks because of the conscious
control needed to do many things that same-aged peers
do easily and automatically (Koomar 2001).

Article Findings:

It is hypothesized that our "internal clock" may be

responsible for timing and that IM training can help with
improving out timing which is important for coordination
Noticeable changes in behaviors in children from their
parents has been observed and documented after
receiving IM training. Behaviors such as motor planning
and organizational skills.

Article Findings:
-Study of 56 boys diagnosed with ADHD
-Randomly assigned to 3 different groups
1. Participants received 15hrs of Interactive Metronome
exercises
2. Participants received 15hrs of intervention on selected
computer games
3. Participants received no intervention
-Purpose: to determine the effects of IM on selected aspects of
motor and cognitive skills in groups with ADHD
-Areas assessed: attention, motor control, language processing,
reading, and ability to control aggression
-Results: Both IM and video games groups had significant
improvements but those of the IM group showed stronger
improvements

Article Findings:
Children with language impairment are more likely to
experience difficulty in reading achievement, including
reading fluency, then typical language learners.
Children who have a reading disorder not only have
deficits in the language system but also have dysfunction
in timing.
Over the last 3 decades, a substantial body of research
has provided evidence that reading impairments in many
children, including deficiencies in phonological processing,
may be associated with nonlinguistic, rapid temporal
auditory perceptual problems. (Berninger, Raskind,
Richards, Abbott & Stock).
Interactive metronome is a neuroscience-based
intervention for improving rapid temporal auditory
processing and achievement in other modalities through
the use of a synchronized metronome tapping.

Article Findings cont.

During treatment, participants listen to a reoccurring
metronome beat via headphones and match
tapping/clapping motions using hand and foot triggers to
the beat presentation.
While participating, they will hear auditory feedback
regarding how accurate they are with the beat. Different
tones indicate how closely their physical responses
correspond to the metronome beat.
The synchronized metronome tapping treatment is
designed to minimize the latency between the onset of the
regularly occurring beat and a participants expectancy
response to that beat and thereby promote improved
temporal processing. (Ritter, Colson, and Park 2013)

Article Findings
A number of studies have shown that IM treatment is
associated with improvement in motor control and
coordination and can have a positive influence on higher
level cognitive functioning, including reading. (Bartscherer &
Dole, 2005; Kuhlman & Schweinhart, 1999; Libkuman &
Otani, 2002; Schaffer et al., 2001; Taub et al., 2007)
Elementary-age children who were provided IM treatment
scored significantly higher on standardized test of word
reading efficiency and fluency than those in a nontreatment
control group.
It is possible that adding IM treatment to a traditional
language and reading intervention may produce clinical gains
on improving rapid auditory processing and reading
achievement in children with a language and reading
impairment. (Ritter, Colson, and Park 2013)

Article Findings cont.

The interactive metronome website states, Interactive Metronome
(IM) is an engaging, rewarding, and systematic program that
improves timing in the brain, thus improving the ability to learn,
retain, and apply new information in the academic setting and
beyond. IM is used in the schools to improve; Focus &
Concentration, Sequencing & Organization, Auditory & Language
Processing, Reading & Math Achievement, Handwriting, and SelfControl of Impulsivity and Hyperactivity (IM, 2012, para. 3).
* Results of the study
This exploratory study examined the potential benefits of IM
treatment when integrated with a traditional language and reading
intervention on the reading fluency and comprehension of schoolage children with a language and reading impairment. A major
finding of this preliminary investigation was that although both the
IM and control groups made significant gains in reading fluency and
comprehension, the extent of gain was larger in the IM group.

Article Findings
One study done on motor performance to improve a golf
swing and accuracy
6 women, 34 men- 25-61 years old.
Control and experimental group- one had intervention of
IM as other had golfing instructions.
Each group had 10 hours of training, in 12 sessions
lasting 50 minutes long over 5 weeks
Result: those who had IM training improved their swing
and accuracy more then those who did not. (Sabado, J.,
& Fuller, D. 2008).

Article Findings

One study done for cognitive abilities

56 boys- 6-12 years of age with ADHD
There were 3 groups: one had IM, one with no
treatment, and one played nonviolent video games.
There were multiple pre and post test.
Overall showed significant improvements for those who
received IM training in the areas of motor control and
cognitive abilities. (Sabado, J., & Fuller, D. 2008).

Article Findings

Study done on a 7 year old boy for 7 weeks with IM

training.
Was assessed before, during and after
Pretest showed performance well below same age of
peers
Had problems with concentration, coordination,
organization, fine motor movements
IM improve ALL of these as well as increased math and
handwriting skills.

Article Findings
Study done to see if IM had improvements on language processing
Female, 13 years old, Bulgarian decent with a language disorder
At 3 years didnt know her own name or age, couldnt run, skip, poor
gross motor, spoke 2-3 Bulgarian words was in orphanages and was
adopted at 4 by parents from US
At 5 found out expressive language skills were weaker vs. receptive
language skills- referred to speech language pathology and received IM
training.
7th grader reported problems with oral and written expressive language,
needed several special accommodations, social isolation due to language
difficulties.
15 sessions, 50 minutes long completed by body movements to audible
beats. Pre and post test compared an showed significant improvement
on language skills. Patients even said her mind was clearer and
lighters as well as IM helped decrease time in processing language as it
increased the ability to cope with frustration daily. (Sabado, J., & Fuller,
D. 2008. )

References
Bartscherer, M. L., & Dole, R. L. (2005). Interactive Metronome training for a 9year-old boy with attention and motor coordination difficulties. Physiotherapy
Theory & Practice, 21(4), 257-269. doi:10.1080/09593980500321085
Koomar, J., J. D. Burpee, V. Dejean, S. Frick, M. J. Kawar, and D. M. Fischer.
"Theoretical and Clinical Perspectives on the Interactive Metronome(R): A View
From Occupational Therapy Practice." American Journal of Occupational
Therapy 55.2 (2001): 163-66. AJOT. Web. 21 Sept. 2014. <www.ajot.aota.org>.
Ritter, M., Colson, K.A., & Park, J. (2013). Reading Intervention Using Interactive
Metronome in Children With Language and Reading Impairment: A Preliminary
Investigation. Communication Disorders Quarterly, 34(2), 106-119.doi:
10.1177/1525740112456422
Shaffer, R. J., Jacokes, L. E., Cassily, J.F., Greenspan, S.I., Tuchman, R. F., &
Stemmer, P. J. (2001). Effect of Interactive Metronome Training on children with
ADHD. American Journal of Occupational Therapy,55, 155-162.
Sabado, J., & Fuller, D. (2008). A preliminary study of the effects of interactive
metronome training on the language skills of an adolescent female with a
language learning disorder. Contemporary Issues In Communication Science &
Disorders, 3565-71.