okay guys as promised my IM experience.

I thought I would share our experience with Interactive Metronome too. Last summer, our then 13yo dd completed 16 sessions. She had a beginning score of 200ms and an ending score of 32ms. Prior to IM, she was always kind of a klutzy kid: falling down or tripping up the stairs, twisting an ankle, barking a shin, stubbing a toe or running into a doorframe (occuring multiple times each day before IM). She no longer does this! Also, she no longer spills her food all over herself. She almost never made it through a meal without staining her clothes but she rarely spills since completing IM! Prior to IM, she couldn’t keep time to music or clap her hands to the beat. Now she can clap her hands accurately to the beat, she can sing the words with the correct tune and rhythm to pop music, she has become a terrific dancer, she catches items I toss to her and she can even do “The Monkeys” walk for the very first time. Amazing! Her ability to focus definitely improved but did not reach “normal” levels (IM recommends an ending score of 19ms - hers was 32ms).

This spring, she completed an additional 8 sessions of IM in order to further improve her ability to focus. At that time, she was also completing Master the Code’s reading program. As her MTC trainer, I witnessed an improvement with fluency during MTC’s reading drills as a direct result of being able to stay better focused.

IM has definitely been an important therapy in improving my dd’s quality of life. I highly recommend it.

Blessings, momo

I have really appreciated hearing your experiences with IM. I have some questions. It sounded like your kids were older, pre-teens or teenagers. Is this suitable for younger kids. My daughter is soon turning 9, 3rd grade, ADD, not classified as LD but has some difficulties in math, reading, spelling and writing. She is holding her own, but not really excelling. Her attention/concentration is better since being on concerta, but she still is one of the last to turn in her classwork and homework takes longer than it should. She does well in her ballet class, but had difficulty staying on beat, can’t clap on beat, not very coordinated. I’m afraid that as she gets older, more will be required of her and she will not have the capacity to manage time, organize, concentrate, have the academic skill, etc. I have considered different tutoring programs, PACE, Brainskills, MTC, vision therapy and now IM. Any thoughts? Thanks

My son was only 7 when we initially had him evaluated for IM. His age was never mentioned as a factor and I spoke to several providers.

I would do IM before PACE or Brainskills. You have to be able to keep time to do those programs.

This sounds so much like my 9 year old daughter!! I cannot tell you the multiple bumps and bruises this child has obtained. And food spills, i use more stain remover than detergent. Is IM covered by most health insurance plans?? Do I need to ask aa behavioral therapist about it? Pediatricians are just ignorant of all ADD issues, at least the ones I have encountered. I seem to hve come to an impass with doctors on the subject of medication and am struggling to find alternatives.

Hi Andrea,

I really don’t know if there are any insurance companies that cover the cost of IM therapy. A good friend of mine, who is an occupational therapist specializing in hand therapy, trained to become an IM provider in order to work with her ds and my dd. I would assume if I had had a doctor’s prescription for IM, my insurance company would have had to seriously considering paying the cost of therapy. I have yet to find a doctor, though, that is knowledgeable about any of the newer therapies. Because my husband and I are self-employed, we have to pay exorbitant premiums for health insurance coverage. Consequently, we have a $2500 deductible in an attempt to keep premiums manageable so I never even pursued insurance reimbursement.

Blessings, momo

I know my won’t but then it won’t cover any speech, audiology, or OT. If you have insurance coverage for OT and can find an OT to deliver the services, you might have a chance. In my area, IM is delivered by audiologists, OTs, educational psych. types, sports therapist—a whole slew of types of people.

Hi Nancy,

I don’t know the recommended minimum age for IM, but I do know our provider has worked successfully with at least two 8-9 year olds. She attempted to work with her 5yo dd but she was too young.

Like Beth, I would also recommend doing IM first, particularly in light of your dd’s difficulties with attention and timing. That is what IM is specifically designed to impact. Also, working with the IM metronome first definitely helped my dd’s progress with PACE. Has your daughter had a workup to rule-out LDs or other problems such a VPD and APD? The results of this workup would help determine which therapy(ies) would be most appropriate for your dd.

Blessings, momo

Thanks for the advise. My daughter had a full array of psych assessments, but I’m not familiar with APD and VPD, so I guess she did not. Can you tell me what you are referring to? We were told that because she did not fall below grade level, she was not applicable to LD. Also, on her assessments, her acheivement was not far enough below her IQ to diagnos LD. Appreciate your time.

Thanks for sharing the info about the Interactive Metronome - IM program. Appreciate it.

Years ago recall reading a book about ADHD with an unusual title, How to Cure Hyperactivity (1981) by C. Thomas Wild and Anita Uhl Brothers, M.D.
It was available through the non-profit Learning Disabilities Association of America.

It discussed this idea of fine motor control and ADHD and how several FDA approved meds temporarily improved the ability to balance and to use both sides of the body together in harmony.

Here’s the IM site:

http://www.interactivemetronome.com/default.asp?cate_id=1&pg_id=1

Interactive Metronome - IM - is presented as possibly being able to improve:
Attention and focus
Selected academic skills
Reading comprehension
Language processing
Coordination
Control of impulsivity

In my view the Interactive Metronome site is identifying an important aspect of ADHD which is often overlooked.

Regarding the idea of difficulty with fine motor control and ADHD, recall reading a book years ago about ADHD which had an unusual title: How to Cure Hyperactivity (1981) by C. Thomas Wild and Anita Uhl Brothers, M.D.

It reported a number of FDA approved medicines had a substantial temporary impact on fine motor control and coordination of both sides of the body (the medicines listed included several caffeine compounds as well as an anti-motion medicine). The book was available through the non-profit LDA.

That book is the most reliable one I can recall which reported temporary improvements to fine motor control and balance due to the right medicine; the medicines were described as being good yet imperfect.

The improvements in fine motor control were completely dependent upon the medicines, that is, they were temporary and lasted only as long as the medicines worked and then faded away. Again, it’s the only book about ADHD I can recall which even attempted to address some of the fine motor control issues which are associated with ADHD.

That’s my opinion.

Nancy - What term has your physician assigned to exactly what you describe, that is, did your physician use a special diagnostic term for the fine motor control difficulties your daughter has when you report: She does well in her ballet class, but had difficulty staying on beat, can’t clap on beat, not very coordinated.?

Does anyone know what the correct medical term for this difficulty staying on beat, can’t clap on beat, not being very coordinated is? Would it possibly be referred to as something like possibly “dyspraxia”? Or what? Anyone know?

pgd
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Author: nancy
Date: 10-25-01 12:55

I have really appreciated hearing your experiences with IM. I have some questions. It sounded like your kids were older, pre-teens or teenagers. Is this suitable for younger kids. My daughter is soon turning 9, 3rd grade, ADD, not classified as LD but has some difficulties in math, reading, spelling and writing. She is holding her own, but not really excelling. Her attention/concentration is better since being on concerta, but she still is one of the last to turn in her classwork and homework takes longer than it should. She does well in her ballet class, but had difficulty staying on beat, can’t clap on beat, not very coordinated. I’m afraid that as she gets older, more will be required of her and she will not have the capacity to manage time, organize, concentrate, have the academic skill, etc. I have considered different tutoring programs, PACE, Brainskills, MTC, vision therapy and now IM. Any thoughts? Thanks

My two boys are 11 and 12,there are many other children doing this who are younger. I was told a couple of things regarding programs,and which to do first.
1. If the child has any deficits in auditory processing,which mine do. BTW,the youngest who did better,has a diagnosis of CAPD. So we did Fastforword during the summer before this program.
2. We were told to do LMB “on cloud Nine” math program or any other remedial program after IM. The benifits from IM would help to initate a better outcome in the remedial program.

It is my understanding that many ADHD children have difficulty in motor planning,sequencing,and execution of motor skills. They might not have a documented disability in the motor area,but because of the impulsivity,which is really the basic symptom of ADHD,the planning and execution is off. They either are too fast or too slow. Not in sync with their own personal rhythm.

Both of my boys also have dysgraphia,which is severe. My youngest remains with letter reversals,and my oldest remains with ataxic movements,he presents with a fine tremors while having to use sustained writing. So it starts out relatively okay and becomes incredibly illegible. This being my main reason to try IM. After 7 months of OT using a handwriting program,the OT was pulling her hair out too.

The key is the child getting to a point of having the rhythm down to at least a 27-20 miliseconds score. What this does is changed or repath neurpathways. They are discovering more and more that these neurpathways can be rerouted. The basis of IM and PACE is to do this. In my sons post test the OT provided this explanation from metronome company.
It takes a fundamental IM score of 27-20 ms. to have the ability to:

1. recognize that rhythmic patterns exist in our surroundings.
2. Focus our attention long enough to recognize individual patterns within a group of simultaneously occuring patterns.
3. creat patterns(actions and thoughts) that are in sync(entrain) with other patterns.
4. adjust or stop our own patterns so they don’t interfere with the patterns of others.
5. learn from previous experiences.

It takes a score below 19ms. to have the ability to:
1. Stay fcused for extended period of time without interruptions
2. Unconsciously adjust our own personal rhythms when the waver.
3. Make faster and more precise corrections
4. create highly productive rhythm patterns that others follow (entrain with) and learn from.
5. more effectively learn from previous experiences,and
6. have exceptional experiences that can only occur as a direct result of having highly accurate rhythmicity(timing)
examples of exceptional experiences:
Steady vs. sporadic( conversation,better communication)
recognize self in enviroment( bumping into people) interactions.

School and job related success is based upon cummulative achievements. IM trainees will have to relearn certain previously missed fundamentals correctly before his or her daily work and work related performance can be expected to fully reflect their improved natural timing.
The OT went on to tell me that a high school football team in a private school in Fla. put all the players through this program,not only did it improve their performance in football,but the used the CAT pre and post and all had dramatic improvemnets in all academic areas.Math,Spelling,and reading. These were reg ed students. And even they improved in these areas. Hmmm

pgd:
Our daughter was evaluated by a school psych, found specific math ld, not ADD. Math has since become her best achieving area in school. Crazy. Unsatisfied, we scheduled with a private neuro psych and ed psych to do a battery of different test. These folks are credible and nationally known in the areas of ld and ADD. They diagnosised ADD, our pediatrician prescribed concerta. No one has diagnosed fine motor skill delays or anything else. We see these things at home (inability to clap on beat, concentration and focus problems even on meds, writing cramps, sloppy penmanship, reading difficulties - she sometimes reverses sounds in words while reading and spelling. So, when you ask who diagnoses, we are not sure who else to go to other than a developmental pediatrician. Our current pediatrician has never referred her to OT or any other type of therapy. Any thoughts?

Hi Nancy,

Those stand for Auditory Processing Disorder and Visual Processing Disorder. The SCAN (Screening Test for Auditory Processing Disorders) identifies APD and the TVPS-R (Test of Visual Perceptual Skills-Revised) identifies VPD. Even though your child did not test LD, the WISC might provide clues for any possible learning weaknesses. On the subtests, look for scores 3 or more points below the mean. The composite score could be masking a problem.

Blessings, momo

Wait until I tell you what score my kids got on their science test!

Okay my youngest,11 years old,who successfully graduated from IM? He got a 107%!!!!! Yes,aced it + extra points!!! My oldest,recieved a 45% until I spoke to his teacher about retesting him verbally. He retested him and he got a 87%. Hmmmm,one who finnished IM took a written test,multiple choice and fill in the blank,got 107% The one who hasn’t successfully finnished,didn’t do well with a written test,but still retained info enough to recieve a B when tested verbally? Interesting. Thought I would throw this out to you guys..

Nancy - Any thoughts? Well, appreciate you sharing the story about your daughter including the inability to clap on the beat/other fine motor challenges. Here’s a website which tends to acknowledge aspects of the kind of motor control challenges you describe:

http://www.dyslexia.org/corpus.shtml

Have not tried their program so cannot say anything about it; at least the webpage acknowledges subtle motor challenges in children.

Recall reading a book titled The Hyperactive Child by Domeena C. Renshaw, M.D. who reported that sometimes the right ADHD medicine (a stimulant/alerting agent) occasionally temporarily improved fine motor control a little in a few persons (not all).

Again, I do not know how physicians tend to label fine motor control challenges/difficulties - whether they call them “dyspraxia” or something else. It does seem (to me) that many physicians either do not observe these fine motor control symptoms or choose to intentionally ignore them for who knows what reason (ignored symptoms keep the costs to the parent insurance company down?). I do recall that fine motor symptoms sometimes are referred to as “soft signs” which are associated with some children/even adults with ADHD and related neurological challenges but I am still hoping to discover a little more specific medical term for the fine motor control challenges which you and others have reported.

pgd

–
Author: nancy
Date: 10-26-01 13:12

pgd:
Our daughter was evaluated by a school psych, found specific math ld, not ADD. Math has since become her best achieving area in school. Crazy. Unsatisfied, we scheduled with a private neuro psych and ed psych to do a battery of different test. These folks are credible and nationally known in the areas of ld and ADD. They diagnosised ADD, our pediatrician prescribed concerta. No one has diagnosed fine motor skill delays or anything else. We see these things at home (inability to clap on beat, concentration and focus problems even on meds, writing cramps, sloppy penmanship, reading difficulties - she sometimes reverses sounds in words while reading and spelling. So, when you ask who diagnoses, we are not sure who else to go to other than a developmental pediatrician. Our current pediatrician has never referred her to OT or any other type of therapy. Any thoughts?

Am I impressed! I read your post above about the different things you can do once you get your bpm down. I can see my son fitting the 20’s profile with Neuronet. It is a broader therapy than IM and I have been very pleased with it. It doesn’t get you the concentration that you are talking about it the teens though. I am seriously considering doing IM after we are done with NN and you certainly have helped push me that way.

My son had a test on bones that I complained about on the parenting bb. One thing that struck me later was that he was totally disinterested and just really didn’t concentrate. Perhaps IM would help with that.

Beth

How interesting! Do you think practicing an instrument would have any benefit to children with these problems? I’ve taught my son piano and coached him on the sax. It’s obvious that he’s out of synch. He can play be ear so well, but decoding the music is a struggle. I’m constantly reminding him to tap his foot. It just doesn’t come naturally. I’m sure IM is a laser compared to the flashlight beam of daily music practice. I’m just wondering if you see any similarities/benefits.

Thanks.

Joan

Beth,
Yes,this is the biggest thing I have noticed. Sustained attention.
Even with my oldest whom is not doing as well,kind of platued in the twenties,and can’t seem to break through as of yet.
I do know how much he studied. So when he didn’t do well,and I asked the teacher to test verbally,wasn’t surprised when he did much better.

I always ponder what “IT” is that has helped my boys so much. Only thing I can say is something has. It’s definitely worth looking into.

Boy, did my band teacher hate it when we tapped our feet!! :o) We would all tap different rythms, funny though, we sounded pretty good anyway. I have add wasn’t dxed until 38 yrs, I used to play well by ear but I had a terrible time reading notes past the 32nd notes(I was a flute player). I alway put it down to being terrible at multiplication :o) My brother always played the rythms for me, so even though I was reading the letter notes, the rythm I was still getting by ear. Obviously I didn’t do well on sight reading at band contest, thank goodness the score didn’t depend on me! Didn’t someone post above that IM was invented at first for musicians? Thinking I read that somewhere. Anyway, it sounds like a useful therapy judging by others’ results.

actually yes,the inventor’s name is Cassidy. He orignally invented this program to help musician’s learn better timing. his website www.timedoc.net/history.htm

clapping on beat, being uncoordinated, etc. all fall under the umbrella of delays in vestibular development. Vestibular development is assessed by an occupational therapist. There is some information about the importance of vestibular development to learning at the NeuroNet website, http://www.neuroacoustics.com.

Mary

I think momo was referring to auditory processing disorders and visual processing disorders. APD is best evaluated by an audiologist trained in CAPD assessment. VPD is best evaluated by a developmental optometrist. Often one or both of these assessments is not routine even in so-called “complete” work-ups. They are both highly specialized areas involving evaluations that go far beyond the regular hearing and eye exams we are all familiar with.

The best website I know of for CAPD information is http://pages.cthome.net/cbristol/

Websites with information about developmental vision include http://www.visiontherapy.org, http://www.vision3d.com, http://www.children-special-needs.org, and http://www.covd.org.

Mary

Beth, Just a thought about your comment about your son’s disinterest in naming the bones. I love IM and I am a big believer in IM but also, I want parents to be realistic about what IM can do.

IM teaches kids and adults how to focus. It gives them a tool that they never had. And just like any tool, you have to choose to use it. I tell my parents this analogy: You decide to hang the curtains in your house. You have never hung curtains before. You try to find the electric screw driver because you heard that it would work the best but you don’t remember what it looks like, so after you spend a lot of time hunting for it you finally settle for a hammer. You finally get the curtains hung but with a lot of time and not very neatly. Then, you go to this class and learn the correct way to hang a curtain and you find out how to use the electric screw driver and they even give you one to take home to use. So, the next time you are going to hang curtains, you get to decide. Do you use the new skill, the screwdriver, or do you use the old hammer? Either way, you get to decide. Most of us would choose to use the new skill but still, it’s a choice.

The wonderful thing about IM is that this skill can be used for more that just one thing. I did IM myself and I use these skills to listen better in boring meetings, to focus my thoughts when I need to speak in front of a group of people, and also to help me fall asleep at night.

IM is wonderful. It teaches kids a new skill. The program lets them practice and they even get to bring that new skill home with them. But, they have to decide to use it. So if a child really finds that knowing the names of bones is really boreing and really something they would rather not do, they may not use their new skills.

I just want parents to be realistic about what IM is about and what IM is because I find IM to be quite amazing myself!

Donna in MO

I see what you are saying. Well, I have already learned that nothing is a miracle cure but everything seems to help some, if carefully chosen.

I think I could use IM also. Three kids have really done my attention in.

When I first was looking into IM, I thought that I could probably teach my son rhythm by myself. Now, since seeing IM, I know that I could not even come close to what IM does. It is a very efficient program in teaching rhythm because you get immediate feedback to tell you if you are ahead or behind the beat and it measures in miliseconds. Plus, they learn it in about 15 hours of practice.

My two son, before IM, could not keep the beat when listening to music. Now, both of them can. Not because of anything I have done but because of IM. This has helped them both in sports. My one son decided to pitch soon after doing IM and he said that he felt that he could feel “the rhythm” when pitching and said that it was because of IM. (He brought that to my attention himself.)

They are finding that this program not only helps to improve focus for kids with ADD/ADHD but they are also finding benefits in jobs that need a lot of focus like professional sports, and surgeons. They are also finding it helpful in dancers. My last student told her Mom that she used the skill when swimming and her Mom said that she is now one of the fastest swimmers. All because of IM!

Donna in MO

Beth, I have no doubt that your son would benefit from IM. Let us know the report when he is done!

Donna in MO