The front portion of the brain, or frontal lobes, are particularly vulnerable to damage during accidents. Individuals with traumatic brain injury frequently have what is called a “frontal lobe injury.” This is significant because this area of the brain is responsible for so many important skills for successful community reintegration: our personality and mood, our ability to plan and organize events, to manage and monitor time, to focus our attention and problem-solve, to sequence and coordinate motor movements, and the list goes on and on...

Have you ever heard that ADHD is genetic? Ever notice that children with ADHD seem out of sync? Here is a research study by Nanda et al (2007) that supports this view and does so by showing that not only is timing in the brain disrupted in children with ADHD, but that it IS ALSO slightly disrupted in their siblings who do not have ADHD (when compared to children from families with no diagnosis of ADHD). From this and other studies, evidence shows that the more the brain’s timing skills are off, the more symptoms like impulsivity, hyperactivity, inattention, lack of organization, poor time-management, or difficulty with reading and other academic work are evident. The Interactive Metronome is a relatively easy, non-medical treatment program for ADHD that improves the brain’s critical timing skills and is tailored to each child’s specific needs.

Nanda, N.J., Rommelse, M.S., Oosterlaan, J., Buitelaar, J., Faraone, S.V., and Sergeant, J.A. (2007). Time reproduction in children with ADHD and their nonaffected siblings. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 5.

ADHD as a brain network dysfunction—IM as a tool to “fine tune” and control this network.

The explosion of research on large scale brain networks, and the “resting state” or “default mode or default network” in particular, has been dizzying.  I previously reviewedkey brain network research describing the interaction between the default, salience (attention) and executive controlled networks.  The most important conclusion, which was reinforced by my personal experiencewith Interactive Metronome (IM), is that problems with controlled attention (focus) may be responsible for a number of the behavioral symptoms of ADHD—and this is due to the poor ability to suppress the random self-talk “background noise” of the default brain network.  [Click herefor related IM-HOME ADHD posts; click herefor ADHD- related Brain Clock.]

Temporal processing (or the timing of neural oscillations/transmissions) plays a critical role in coordinated motor movement. In this paper published in Science, the authors distinguish between “continuous” motor tasks, which involves moving steadily and smoothly at a certain pace, versus “discontinuous” motor tasks, which involve a succession of stops and starts as a person accomplishes each step of an overall goal (i.e., picking up a plate, walking it over to the table, and setting it down). They discuss the role of the cerebellum in each of these types of motor tasks and how the timing control for each differs in terms of the brain structures used, arguing that the cerebellum is involved only early on in setting the timing goal for continuous, smooth movements, but that the cerebellum is involved throughout the movement when it is discontinuous or involves several starts and stops by setting several, successive timing goals. Timing in the brain may be disrupted due to developmental disorder, trauma, or illness resulting in uncoordinated movement and/or cognitive impairment. The Interactive Metronome is a treatment program that measures and improves temporal processing, or timing in the brain, that is critical for movement and thinking.

Spencer, R.M.C., Zelaznik, H.N., Diedrichsen, J., and Ivry, R.B. (2003). Disrupted timing of discontinuous but not continuous movements by cerebellar lesions. Science, 300(5624), 1437-1442. 

Here is an interesting study by Gilden and Marusich (2009) published in Neuropsychology that looked at the ability of adults with ADHD to maintain a rhythm with either a faster tempo (less demand on focus, self-control, and working memory) or a slower tempo (more demand on focus, self-control, and working memory). Persons with ADHD had MUCH more difficulty when the tempo was slower, requiring them to estimate a longer time interval between beats, maintain the time interval in their memory, and restrain themselves from hitting too soon. This study, like many others, points to the direct relationship between timing in the brain and its command center “working memory.” Researchers theorize that Interactive Metronome is affecting this critical “control center” for timing in the brain and thereby improving many of the time-related symptoms of ADHD.

Gilden, D.L. and Marusich, L.R. (2009). Contraction of Time in Attention-Deficit Hyperactivity Disorder. Neuropsychology, 23(2), 265-269.

Dr. Stanley Greenspan, a noted expert in autism and child development/disorders, and his team of researchers conducted a study to see whether Interactive Metronome (IM) was a beneficial treatment for children with ADHD. They compared boys who received IM to boys who received either no treatment at all or boys who only played video games to try to improve their ability to focus. They found that those children with ADHD who received IM did far better than those that did not, with significant improvement in the areas of attention, motor skills, language processing, reading, and self-control (i.e., less aggressive behavior).

Shaffer R.J., Jacokes L.E., Cassily J.F., Greenspan S.I., Tuchman R.F., Stemmer P.J. Jr. (2001). Effect of
Interactive Metronome on children with ADHD. American Journal of Occupational Therapy, 55, 155–162 

Timing skills play a pivotal role in the development of speech production and perception, or the ability to speak and understand the speech and/or intent of others (Kello, 2003). Not only must a child rapidly decipher the timing characteristics of each individual sound, syllable, word, and phrase in the speech stream, but for successful communication to occur there must be precisely timed coordination between centers of the brain for language and cognitive processing or thinking skills and the muscles and structures of the mouth and throat (or voice box). On top of that, a child must process and understand other information associated with what is said, such as demeanor of the person (Is he happy? Angry? Sad? ) or humor (Was he serious? Or was he joking?) Many children on the Autism Spectrum either don’t understand what you said, or don’t understand the unspoken social aspects of speech. All of this depends upon timing in the brain!!! That’s a bit like patting your head and rubbing your tummy at the same time! However, in normal development the brain’s “internal clock” functions very precisely so that children learn to speak intelligibly and understand you when you speak to them, including your mood and intent. Interactive Metronome (IM) training impacts the very critical timing centers of the brain necessary for effective communication...

Infants, before than can speak, are exposed to rhythmic sounds in the form of music and song. This research by Bergeson and Trehub (2006) shows that their little tiny ears and developing brains are already tuned just like an adult’s to hear the slightest changes in tempo, tone, and rhythm. They discuss the importance of the brain’s “internal clock” as it relates to how infants respond and move their bodies to music and other rhythms. IM providers who specialize in infant care and early intervention are reporting very good results when using the Interactive Metronome in the treatment of infants and young children who have developmental delays or disorders with improvements in the areas of: sensory processing, pre-speech/cognitive development, and motor skills. Case studies can be found at www.interactivemetronome.com

Bergeson, T.R. and Trehub, S.E. (2006). Infants’ perception of rhythmic patterns. Music Perception, 23(4), 345-360.

Humans perceive time. We use this ability to predict what is coming, to think about how we will react, and then to respond in a timely fashion. It is well-documented that children with ADHD have an impaired sense of time. Areas of the brain that control our perception of time are affected in children with ADHD (i.e., working memory). In an article published in the Journal of Child Psychology and Psychiatry, researchers found that children with ADHD who also have a Reading Disorder have even more difficulty with timing skills. Research has shown that Interactive Metronome, a training program that addresses the underlying problem with timing in the brain, improves symptoms of ADHD and reading.

Toplak, M.E., Rucklidge, J.J., Hetherington, R., John, S.C.F., and Tannock, R. (2003). Time perception
deficits in attention deficit/hyperactivity disorder and comorbid reading difficulties in child and adolescent samples. Journal of Child Psychology and Psychiatry, 44(6), 888-903.

Have you ever heard the saying “timing is everything?” Our brain keeps time – in microseconds, milliseconds, seconds, minutes, hours. This time-keeping function is critical for all of our human abilities and thinking skills. According to research, persons with musical training tend to consistently demonstrate better timing and rhythm than those who are not musically oriented. Children who play an instrument or are otherwise musically trained tend to also perform better in school, are focused, and complete projects on time. Here, Eck & Scott (2005) discuss the critical timing skills involved in the perception and creation of music. It is not surprising that musicians have better timing skills, and thus are more equipped to handle academic hurdles. Do you see the connection? If a child is struggling with school work, to focus or stay on task, has behavioral outbursts, is impulsive, or has trouble staying organized or managing time … the brain’s clock may be out of sync and areas of the brain may not be communicating efficiently or effectively, therefore the child may also be out of sync with other people and events in his/her environment. Interactive Metronome is the only treatment program that provides training and feedback in order to improve timing skills that are so critical to academic and social success.

Eck, D. and Scott, S.K. (2005). New research in rhythm perception and...