Originally created 07/23/01

Metronome seems to help hyperactive, children



WESTON, Fla. -- Left foot. Right foot. Left foot. Right foot.

Fifty-four times a minute, 8-year-old Patrick Vermillion steps onto an electronic pad in time with the computerized metronome beeping rhythmically in his headphones.

Patrick's goal is to step on the pad exactly on the beep. If he is more than a fraction of a second off, the computer switches the beep to a clank, telling him he's too fast or too slow.

Eighteen minutes later, he takes a short reading break and then is told to clap to the beat, his hands holding a sensor. Beep. Clap. Beep. Clap. Beep. Clap. Clank.

Patrick, a quiet, intelligent boy, underwent this three-times-a-week treatment called "The Interactive Metronome" because he is severely uncoordinated. Other children enter the program because they are hyperactive, have attention deficit disorder or mild or moderate autism. Adults who have suffered a stroke or have Parkinson's disease have also tried the treatment.

"It's a tough world when kids tease you," Kathy Vermillion said as she watched her son work with therapist Adrianna Laprea. Although Patrick is too shy to articulate how the Interactive Metronome has helped him - "It's good" is about all he can muster - his mother said his baseball skills have improved on the diamond since he recently completed the five-week program, and his confidence has increased.

"He's very shy, but he's now taking on everything thrown at him," she said. "But (the program) is a lot of work for a young kid."

Invented in 1990 by James F. Cassily, a former record producer who also has a background in child psychology, the Interactive Metronome is now being used in about 400 hospitals and clinics in the United States and Canada. They charge between $30 and $70 per one-hour session, with about two-thirds of the cases being covered by health insurance.

Use of the Interactive Metronome took off this year, following the publication of a company-funded study that concluded the device is an effective short-term treatment for attention deficit hyperactivity disorder.

The study, published in March in the American Journal of Occupational Therapy, showed that hyperactive children who underwent Interactive Metronome training had longer attention spans than either children who were given video game training by an adult or no treatment. A study of the Interactive Metronome's long-term benefit is under way.

Tom Eggleston, the company's president, said some hyperactive children who have undergone the treatment have been able to reduce, or altogether stop taking drugs such as Ritalin, which helps calm them down.

Eggleston was an executive with car retailer AutoNation seven years ago when his disabled son was the first boy to undergo Interactive Metronome. In January, he joined the company, which is based just west of Fort Lauderdale in Weston.

"This is the first non-drug intervention that improves human timing," Eggleston said. "I don't purport that there is a full explanation as to why (the device works), but major research is being conducted."

The basic theory behind the device is that children who are hyperactive, have coordination problems or are mildly autistic have an internal sense of rhythm that is off. That can be improved, the theory goes, if they are forced to repeatedly exercise their sense of rhythm under the supervision of a taskmaster - the computer - that can instantly tell if their attention waivers even slightly.

Dr. Stanley Greenspan, a George Washington University child psychiatrist who is the company's chief scientific adviser, said children with attention deficit hyperactivity disorder often can't visualize even simple actions that others don't even think about, such as standing up and walking out of a room.

Somewhere in the sequence of getting out of the chair, taking steps toward the door, opening it and going out, the plan breaks down, he said. The child is easily distracted, and correcting his behavior may trigger his frustration or worse, inappropriate behavior such as a temper tantrum.

The Interactive Metronome forces such children to think about what they will be doing for the next several minutes and then stick to it, he said.

"What I think we've shown is that (attention span) can be improved through systematic practice," Greenspan said.

Several therapists who use the Interactive Metronome said they have been impressed so far with its results, but cautioned that it is not for all children. Some have emotional problems that make it difficult for them to adapt to its rigid structure, they say.

Other similar treatments that might be used for hyperactive children include music lessons, while severely uncoordinated children might be placed in physical therapy. The Interactive Metronome is often supplemented with those treatments.

"The children who have Interactive Metronome training are more coordinated and their teachers and parents report that they're sitting still longer and obeying instructions better," said Marlene Schulefand, an independent therapist at the Dan Marino Center, a children's clinic that is part of Miami Children's Hospital.

"The one thing I always tell parents is that just like any another form of training, it might improve their child's life, but just because it works for somebody else it might not work for you," Schulefand said. "Nothing will fix something for everybody."

On the Net:

Interactive Metronome Inc.: http://www.interactivemetronome.com