http://www.usnews.com/usnews/nycu/health/articles/010416/nycu/learning.b.htm
News You Can Use 4/16/01
THEY’VE GOT RHYTHM
Clapping away attention deficits?
Ryan Lunt, 11, spends an hour every day after school clapping his
hands and stamping his feet. He’s doing this not to get attention but to
learn to give it. Ryan, who has attention-deficit disorder (ADD), is
participating in a program called Interactive Metronome, in which he
claps and taps in time with a computerized metronome. Several weeks
of daily sessions at the Cassily Clinic in Grand Rapids, Mich., should
improve his concentration as he works to stay on the beat. Or so say
the developers of the patented program, which has spread to more than
200 clinics in two years.
The notion that the 3 percent to 5 percent of U.S. children with attention
deficits could simply clap them away may seem as far-fetched as
clicking a pair of red shoes to transport Dorothy back to Kansas. But
the concept “could make sense,” says Rebecca Landa, associate
professor of psychiatry at Johns Hopkins School of Medicine in
Baltimore. By focusing on staying in sync with the sounds, “it seems
the children are honing their self-monitoring skills,” she says.
A study in the current issue of the American Journal of Occupational
Therapy offers some support, showing that after 15 hours of training with
this program, 6-to-12-year-old boys with attention disorders were able to
stay focused longer, had improved motor control, and showed less
aggressive behavior than those who got no training. But the study was
too small and preliminary to convince some experts, who say parents
should think twice about shelling out $1,000 to $1,500 for the program,
which many insurance plans won’t cover.
Child psychiatrist Stanley Greenspan, a clinical professor at George
Washington University who is an adviser and shareholder in Interactive
Metronome, says the program is meant to supplement drugs such as
Ritalin, not replace them. The regimen is simply “a very efficient way of
practicing motor planning and sequencing,” he says. Wearing
earphones, children listen to a computerized metronome timed to 54
beats a minute and try to clap or tap their toes in time to the beat. If
they are off by more than 15 milliseconds, a tone tells them to speed up
or slow down. Staying on beat requires constant attention and screening
out distractions, skills that will carry over to everyday activities, says
James Cassily, the audio engineer who invented the metronome
system.
Making it happen. Deb Crews of Madison, Wis., is a believer. Her
10-year-old daughter, Erica, has ADD. Before the metronome program,
says Deb, “I could never give her a two-step direction like ‘Put away your
backpack and come to dinner.’ She’d get maybe half of one of the
[instructions]. Now, I can say, ‘Come in, put away your backpack, and
get ready for dinner. You’re in charge of silverware and you’ve got 10
minutes to read.’ And all those things will happen.”
Skip Baker, a behavioral pediatrician in La Canada, Calif., who sees
many ADD kids, says the program has made a “significant difference”
for the 10 children he has treated with it. “We have been able to reduce
the amount of medicine,” he says. But he hasn’t used Interactive
Metronome long enough to know whether the improvements will last.
Indeed, there’s no good evidence that the program works, says Russell
Barkley, a professor of psychiatry and neurology at the University of
Massachusetts Medical School and an ADD expert. “This is, at best, a
highly experimental treatment,” he says. His own five-year study of other
behavioral interventions showed that improvements are limited to the
setting in which they are learned, such as the classroom, and are
short-lived.
Greenspan says that the program doesn’t work for all attention-deficit
kids. But he says it lives up to its promise for those like Ryan, who have
trouble planning and sequencing actions. After 18 sessions, “he’s
staying focused a lot better,” says his mom. Ryan, too, has noticed a
change. “I can work more diligently,” he says. And “this morning I
remembered to feed the fish.” -Katy Kelly