When Dr. Star Anthony and her husband, Larry Greenstein, welcomed their new baby boy Kevin into the world ten years ago, they didn't know that a new career for Anthony would be born as well. Interactive Metronome (IM), a computer-based training program that uses sound as a means of improving one's

Kevin was born with mild cerebral palsy, fine and gross oral motor issues and a visual disability, Anthony explains. "We knew right away that he was going to have issues, so we began seeking out appropriate treatment for him at an early age."

At first, they enrolled their then-eight-month-old in an early intervention program, but soon discovered it was not addressing his needs. Determined to find a treatment program that would, Anthony and her husband began investigating several early childhood development programs near their Port Washington, Long Island home. Subsequent to speaking with several of these program's directors, one director in particular suggested they get in touch with renowned child psychiatrist and author, Dr. Stanley Greenspan.

Greenspan currently has a practice in Bethesda, Maryland, where he works with a wide range of children. The 30-year medical veteran developed an interest in children who have special needs at the National Institutes for Mental Health.

Anthony and her husband became very impressed with Greenspan after reading his books and reviewing his credentials. They immediately set up an appointment for Kevin, and eight years later they still depend on him for guidance when it comes to their ten-year-old son.

Last spring, Greenspan suggested that Anthony and her husband should treat their son's physical, occupational and speech therapy difficulties, to name a few, through IM. Anthony and her husband immediately began looking into it, and learned why it was successful in helping to develop attentional and motor skills.

Timing May Really Be Everything

Recent research (particularly the study on "The Effect of Interactive Metronome Training on Children With ADHD," published in the March/April 2001 issue of The American Journal of Occupational Therapy) has shown that timing is a very important component of human development. It affects the ability to plan and sequence actions, which are both related to cognitive and physical achievement.

Greenspan explains, "Timing affects many areas of learning: the ability to write an essay, tie your shoes, sequence your ideas and socialize. These things all require some sequencing and planning." By exercising one's capacity for rhythmicity and timing, planning and sequencing improve and progress can be made in academics, motor skills and more.

It is important to note that IM is not a cure, but a learning enhancement tool. It is for those children and adults who have attention and/or motor control/ coordination problems, learning disabilities, traumatic brain injuries, cerebral vascular injuries (stroke), Parkinson's disease or autistic spectrum disorder.

Becoming an IM Trainer

Anthony and her husband did their research, came across a trainer on IM's web site, and took Kevin in for his initial assessment. The service provider wasn't sure exactly how much pre-training Kevin would need since his scores were outside the program's starting point. Anthony soon decided she wanted to be Kevin's trainer herself.

There are different kinds of IM service providers, and IM has strict provider qualifications in the area of healthcare. Once your credentials are deemed appropriate and you've undergone the essential training program, you can then order the package for $2700. Anthony was able to become an IM healthcare provider due to her 12-year background as a chiropractor, and she now holds the title of Clinical IM Trainer. For non-healthcare-related applications, a professional background is not required.

Anthony confesses, "Kevin is still in pre-training, but it's getting there. People at technical support and people I met at a recent IM conference have given me ideas on how to adapt the exercises to his special needs." For instance, because of his balancing difficulties, he often does the exercise lying down. Anthony's IM practice seems to be evolving.

Fellow Port Washington resident Andrea Scharf decided to put son Jamie, a classmate of Kevin's, into IM training with Anthony after the two spoke about it. "Jamie is classified as learning disabled. He's been receiving speech therapy since he was 17 months old and occupational therapy at about 26 months old, and he still receives both in school," Scharf explains. "We started his training in April of 2002 and he had more than 15 sessions, because he needed two or three pre-training sessions. I think [IM] definitely helped. With academics, there was less frustration and breaking down and while Jamie has always been a strong reader, I noticed an increase in his concentration on what he was reading." In addition, Scharf has also seen an increase in her son's gross motor skills on the baseball diamond.

Noting improvements Anthony sees in kids like Jamie inspires her to move away from her chiropractic vocation and concentrate more on her IM training. She claims, "A lot of these kids are not used to succeeding in things, but they gain a great deal of self-confidence through doing this because it is hard and challenging. You're learning something new and you're working hard at it and that's why I love it."

RELATED ARTICLE: What is Interactive Metronome?

The process includes the use of a set of headphones and computer software, along with hand- and foot-sensing triggers. One sensor consists of Velcro wrapped around the hand, and the other is a flat pad on which the foot can tap. Both devices have sensors inside which click, then send messages to the computer.

The user first undergoes a long form test. Under the guidance of an IM trainer, they listen for the beat produced by the IM computer software. After hearing it, they must anticipate the next beat by tapping one of the sensing triggers. Meanwhile, the IM program measures how much ahead or behind the user is to that beat in milliseconds. The closer someone is to the beat, the better their timing and the lower their score. By examining the milliseconds read by the computer, the IM provider is then able to design an appropriate program for that individual so they may improve their timing.

The program typically consists of 15 one-hour sessions over a three- to five-week period. Short tones can be added to the original beat to tell the user how far ahead or behind they are from the original beat, which sounds a bit like a cow bell. This helps users to accurately correct their timing. According to IM inventor/senior vice president, research and product development, Jim Cassily, the program can also be used by those with hearing impairments because the beat's vibrations can be felt through the headphones.

It is important to note that IM is not a cure, but a learning enhancement tool. It is for those children and adults who have attention and/or motor control/coordination problems, learning disabilities, traumatic brain injuries, cerebral vascular injuries (stroke), Parkinson's disease or autistic spectrum disorder.

RELATED ARTICLE: The history of IM.

When musician/record producer Jim Cassily had his own recording studio in Ann Arbor, Michigan during the 1960s and 70s, he noticed that some musicians had natural timing, while others did not. "We call it the `cook," he explains.

Although Cassily had used traditional metronomes--a pendulum-like instrument used to help musicians keep a steady tempo by listening to a click--he realized that in order to teach cook he'd have to make it interactive for two reasons. First, the regular metronome doesn't let you know if you're ahead or behind the beat. Second, the instrument acts as an anchor, because when musicians play with a person or group, they have a tendency not to listen or work with the other tempos.

In 1993, Cassily used a large box, complete with a built-in dedicated computer processor, and several pieces of professional audio processing equipment to create an interactive metronome. He began training several musicians. By chance, a doctor asked Cassily to try this new process on his friend, who had been in a car accident that resulted in brain injury. Cassily's additional background in child psychology made him eager to try it on children who had a variety of special needs, and did this with the help of Easter Seals. One of his first students was an eight-year-old named Jimmy Eggleston.

The young boy was born with no right leg, dislocated hips, no ligaments in his left knee, severe scoliosis and a diaphragmatic hernia which kept his lungs from fully developing. He also had a trache and oxygen tank and was unable to swallow whole food for the first five years of his life. "My wife is a pediatrician and had taken piano herself for a few years. She knew of the developmental value of music training and we both observed Jimmy's interest in music, so we thought lessons would be good for him," explains Jimmy's dad, Tom.

And so in the summer of 1994, before Jimmy was to enter the second grade, Cassily began working with him. By the third session, Tom and his wife Kathy began noticing a change--Jimmy's balance seemed to be improving. By the fifteenth session, Jimmy was able to walk without his walker. They also saw improvements in his piano playing, coloring, handwriting and attentional problems.

Soon after, Cassily met a child with autism, with whom he wanted to begin IM Training, though that child had been seeing Dr. Stanley Greenspan on a biannual basis for several years, so his mother wanted to make sure it was all right with Dr. Greenspan before proceeding. Greenspan gave his okay and by the next time he saw the boy, which was in 1995, he was so pleased with the results that he immediately got in touch with Cassily, who asked him to come on board as the Chairman of IM's Scientific Advisory Committee.

Although the interactive metronome Cassily had originally envisioned became available in 1999, it has only recently become a focus of the media and special needs community. A published study on "The Effects of Interactive Metronome Training on Children With ADHD," which appeared in the March/April 2001 edition of The Amercian Journal of Occupational Therapy, has given a big boost to the product's credibility. It proved that timing is an important component for planning, sequencing and focusing, and that these things are indeed relative to attentional problems.

Tom Eggleston became impressed with this therapy, and wanted to get more involved. In January of 2001, he resigned as senior vice-president of e-commerce for AutoNation, Inc., a billion dollar company, to become IM's CEO. "I have a real passion that this tool can touch and reach the lives of children as it has our own son," he says.

Today, IM is used in over 600 clinics, schools and hospitals. Eggleston hopes that network continues to grow, particularly in the realm of geriatrics, where he hopes IM will help elderly people regain their functioning. Dr. Greenspan, who retains his private practice in Bethesda, Maryland, sees continuing ambitious research as part of the future. Currently, studies are being done on Parkinson's disease, as well as unexceptional students and professionals.

For more information on Interactive Metronome, visit their web site at http://www.interactivemetronome.com.