Question:

I have a five year-old child with ADD or AD/HD characteristics. We have been working to help him through various solutions for at least two years. I do not feel encouraged about putting him on medication for many reasons, including his young age. I feel he is “high functioning”. My question to you is do you think “Interactive Metronome” is worth a shot? It is obviously costly, so I am trying to do plenty of research. I tried occupational therapy and other than a slight “calming” effect, I have not seen great improvement.

Many thanks. I appreciate your input.

Mary

Answer:

Dear Mary,

The Interactive Metronome (IM) is a computerized version of the metronome traditionally used to help musicians maintain a steady rhythm. The program, developed in the early 1990’s claims to be a neurological assessment and treatment tool that improves conditions such as:

• Autism Spectrum Disorders
• Sensory Integration Difficulties
• Parkinson’s Disease
• Motor sequencing and processing
• Limb amputation
• Multiple Sclerosis
• AD/HD

Regarding AD/HD, the theory is that impulse control, motor control, ability to follow multi-step directions, and concentration are linked to motor planning and sequencing abilities. IM providers claim the rhythm and timing, influenced by the processes of motor planning and sequencing, are core neurologically-based skills that can be improved through practice because of brain plasticity.

The client is provided with headphones and hand and foot sensors. After hearing an auditory stimulus through a set of headphones, the client repeats the rhythm by appropriately tapping the hands and feet. Feedback about the immediacy of reproduction is provided through the headsets as the client taps. Visual feedback is also available. The training program includes a mininmum of fifteen one hour sessions with a certified IM instructor. Instructors can be occupational therapists, speech therapists, psychologists, or other trained providers. As you mentioned in your e-mail, the treatment is quite costly.

Photo from: www.handrightingink.com

Regarding efficacy, to date, two scientifically controlled studies have been completed supporting the success of IM as a treatment for individuals with AD/HD. In contrast, stimulant medication has been used to treat AD/HD for fifty years with over 200 well-designed studies demonstrating success with individuals who have AD/HD. The Interactive Metronome is generally viewed as a “promising” but unproven intervention for children with AD/HD (National Resource Center on AD/HD, WWK#6). This means that some well-designed research has been done that shows the intervention can be beneficial for children with AD/HD, but not enough to prove that this is a reliably effective therapy. Of course the choice to treat with medication is a decision best made by a parent with input from a medical professional.

Your concern about the use of medication in a young child is understandable. Medication for children under the age of six years is generally not recommended (Dendy, et al). The National Institute for Mental Health (NIMH) is currently sponsoring the Preschool AD/HD Treatment Study (PATS). Preliminary evidence indicates that appropriate first treatment for this age group is intensive behavior management coupled with parent training. For those children with moderate to severe AD/HD who do not respond, initial reports indicate that medication can be safe and effective.

I wish you the best in your search for treatment for your young son. In your search for treatment, you might want to consider the following resources:

Dendy. C. Editor. (2006) CHADD Educator’s Manual. Lynchburg, VA: Progress Printing

Phelan, T.W. (2004)1-2-3 Magic, Third Edition and 1-2-3 Magic for Teachers. Parent Magic, Inc.

Interactive Metronome web references:

www.interactivemetronome.com

www.handrightingink.com

www.addsolutions.com

http://specialkidstoday.com/resources/articles/thebeat.htm