Interactive Metronomes for Special Needs Kids
Even after children are diagnosed with ADD, ADHD or other difficulties with attention, coordination and timing, choosing the best treatment is not an easy decision for parents to make. For those interested in trying a non-drug approach, the interactive metronome (IM) is a safe option with proven success for both children and adults.
Sounds, Seconds and Scores
Filtering computer-generated beats through headphones, the program guides users to perform different repetitive exercises that are measured through hand and foot sensors. After each movement is completed, the computer attached to the sensors assesses the accuracy with which the user performs each exercise. This accuracy is essentially the difference between the metronome beat and the individual's response, which is measured in milliseconds. The goal of the IM is to lower the amount of time (in milliseconds) of this difference; thus, the lower the IM score, the more progress that is made.
According to Dr. Stanley I. Greenspan, chairman of the Interactive Metronome, Inc. Scientific Advisory Committee, a nationally recognized child psychiatrist and author of The Child With Special Needs (Perseus Publishing, 1998) and The Challenging Child: Understanding, Raising, and Enjoying the Five "Difficult" Types of Children (Perseus Publishing, 1995), the IM improves "motor planning and sequencing so that children can carry out a multi-step process. As timing improves, sequencing improves."
Dr. Greenspan also points to research that has shown the IM increases coordination, motor skills and attention span. Newer research indicates that the IM helps improve students' academic abilities, such as reading and math scores. Additionally, a clinical trial published in The American Journal of Occupational Therapy in March of 2001 illustrated significant gains in control of aggression and impulsiveness for boys with ADHD who used the IM program.
"The IM is not for a specific syndrome," says Dr. Greenspan. "It will help with ADHD, but it is for any attention problems, distractibility, poor motor coordination and kids without special challenges. It improves skills for many children."
Parents are advised to read the research, case studies and testimonials available on the IM Web site, www.interactivemetronome.com. A questionnaire, which Dr. Greenspan assisted in developing, helps parents identify their children's weaknesses and strengths in important areas of cognitive and social functioning. Questions address issues in relationship building, planning, problem solving, speech, coordination, learning and several other significant areas. After this assessment, interested parents can contact a local IM provider to learn more about the program and participate in a demonstration. Most IM providers are occupational therapists, physical therapists, clinicians and educators, all of whom undergo training in order to administer the program.
Patricia Holsclaw is an art therapist and a mother in Mebane, N.C., who decided to become an IM trainer as a way to help her three sons, ages 10, 8 and 6, work on various goals. She initially heard about the IM on a CBS Early Show segment and decided to look into the program further after finding out her oldest son, who has Tourette syndrome, also had ADD. Looking for alternatives to medication, Holsclaw went on the IM Web site, read the available research and articles for six months and then contacted a local IM provider to find out more. During this time, Holsclaw became interested in going back to work in the school system with children with special needs and thought becoming an IM provider might allow her more opportunities to help her children while simultaneously helping other students and introducing the IM to schools.
Although she has yet to return to the school system, Holsclaw went through training to become a certified IM provider last spring. This training involves using the IM program on two people for the complete 15, one-hour sessions each. The sessions typically span a three- to five-week period and progressively challenge individuals to improve their response time and accuracy. Holsclaw trained with her oldest son and another child who has ADHD, calling in each session's scores to an IM counselor, who would then give Holsclaw additional strategies, motivational techniques and games to improve the children's progress.
"I feel like I have the tools now," says Holsclaw, who would recommend using the IM in conjunction with other strategies. She feels the IM has helped her oldest son build his focus and attention span, learn more self-control and improve his internal timing. His athletic performance in golf, swimming and tennis has improved, although Holsclaw does not know for sure if that success can be attributed completely to using the IM. However, a golf study that showed IM-trained adult golfers improved their golf shot accuracy 20 to 40 percent over a control group that only read golf literature has been published in The Journal of General Psychology.
"It's low risk compared to medication," says Holsclaw. "With some kids, you're going to see dramatic results really fast, and with some, you're not going to see such huge results." Her oldest son not only has improved many attention-related skills, he independently asked to do additional sessions in order to progress more before going back to school. Holsclaw says his scores the second time around have been the same or better, and she definitely sees positive long-term effects of using the IM.
Natalie Mason-Fry, MS, OTR/L, is an occupational therapist at Emerge – A Child's Place, a pediatric occupational therapy provider in Chapel Hill, N.C. She has seen one child go from having a great deal of initial frustration and outbursts related to using the IM to gaining self-control and having no outbursts while using the program. The same child also improved his hand-eye coordination enough to hit a ping-pong ball back and forth 100 times and master musical timing while playing an instrument. Another girl who used the IM learned how to hula hoop – an activity she could not do before – after excelling at her specific movement coordination.
Time and Patience
While Mason-Fry would recommend the IM to parents, she feels the program applies to a limited population. "You have to have a reasonably high frustration tolerance and level of skill," she says. She would not suggest using the IM on a child younger than 6, because they do not follow directions as easily and lack the tolerance for monotonous activities, such as repeating specific hand and foot movements. However, if a child's initial IM score is extremely low, he or she can start with a remedial program first and then move into the regular IM program upon improving. Mason-Fry and Holsclaw both agree that the IM program, although rewarding, can be very monotonous and time-consuming, with a suggested usage minimum of three times per week.
"Towards the end, kids do 2,000 repetitions of one movement, so it's very monotonous," says Mason-Fry. "I think it helps to have some kind of movement reward." She suggests sticker charts, candy and time to participate in a favorite activity as incentives for completing the sessions. To juggle the time commitment, Holsclaw recommends doing the sessions after school, on weekends and during the summer/early fall so that kids can see their progress clearly throughout the school year. Mason-Fry adds that paying for sessions with an IM provider can be costly because parents are paying for both the therapist's time and the individual IM session time.
Greenspan, Holsclaw and Mason-Fry all have seen children who use the IM become more motivated to improve their scores, illustrating that competition often can be the best motivator.
Get Ready to Read!
As with attention disorders, proactive parents and early intervention are essential to recognizing and combating reading difficulties. The National Center for Learning Disabilities (NCLD) has developed an early literacy program called Get Ready to Read! whose "vision is that all preschool children will have the skills they need to learn to read when they enter school."
A wealth of activities, resources, research studies and information on early literacy are available on the program's Web site, www.GetReadytoRead.org, as well as a screening tool, which "investigates a child's skills related to print knowledge, emergent writing and linguistic awareness." These three areas have been identified as the most critical for learning to read. Visit the site to learn more about what you can do to help your child and to use the 20-question screening tool that takes just 12 minutes to complete.