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Interactive Metronome with the Bramhall NDT Practice

Bramhall is a small suburb of Stockport in the north-west of the UK and is home to the Bramhall Neuro-Developmental Therapy Practice. The practice is run by Lyn Wells who uses a variety of techniques to help children and adults with learning difficulties. I travelled up to Bramhall to see first-hand a treatment that intrigued me.
Interactive Metronome is a treatment for ADHD and other learning difficulties that involves developing the child’s or adult’s  sense of rhythm. This connection between learning problems and poor rhythm is strong but not obvious.
fMRI studies are used to show what areas of the brain are working the hardest when performing specific task. This technology was used to study the brains of music professions whilst they played various pieces of music and scales on the piano. One of the areas of the brain strongly linked to rhythm is the cerebellum, an area of the brain that has been repeatedly linked with learning difficulties.  Several treatment programs such as DDAT and Brain Gym focus on training the cerebellum through physical activity to improve academic performance. This approach seems to work, at least for some people with learning difficulties. Interactive Metronome attacks problems with the cerebellum with a double-whammy. Physical movements such as clapping train up the areas of the cerebellum the control the gross-motor skills whilst simultaneously the rhythmic aspect train the self-control and timing area of the cerebellum. These in turn have an impact on general coordination, mental processing speed and the ability to focus your attention.
The Interactive Metronome system consists of two sensors, one for the hands and one for the feet, headphones and a computer. The computer plays via the headphones a regular beat, sounding rather like a cow-bell. The user claps their hands or taps their feet in time with the beat. The sensors detect this and feed the information into the computer which analyses whether the clapping or foot-tapping was early, late or spot on.
The first step of any treatment is an assessment of your current capabilities. This included fourteen different tests including simple hand clapping, clapping whilst balancing on one leg, and alternating clapping with one hand on the thigh whilst tapping the opposite foot. This last one is a real test of cross-lateral ability.  For each test the average number of milli-seconds between when the beat was and when you reacted was reported. Anything within 15 milli-seconds is counted as spot-on.
My results showed an average inaccuracy of 90.1 milliseconds across all the tests. This places me in a below-average category. I’m sure a few years ago I would have been much worse but my DDAT treatment and subsequent practice with Bop-It and various Playstation games such as Eye-Toy Groove have helped.
The treatment process with Interactive Metronome is adapted to the individual but will generally consists of fifteen hours using the equipment split into three sessions a week over a number of weeks. In total a treatment program will consist of approximately 35,000 claps.
A training session is very similar to the assessment process except the user gets feedback through the headphones and visually. When you hit a beat spot-on a sound plays in both ears. If you are early a different sound is played into the left ear only and if it is late, another sound is played into the right ear. These sounds are matched by visual feedback on the computer monitor. The feedback guides the user so that their claps or toe-tapping gets closer to the metronone’s beat. This feedback is introduced slowly and learning to integrate it is important in developing concentration, sensory integration and focusing attention.
Unfortunately there are relatively few practitioners around (the Interactive Metronome web site has a list) so finding one may be pot luck. The practitioners also have to be good because the basic mechanics of the training, e.g. clapping, could be dull. So its important, especially for children with attention difficulties, for the practitioner to engage the child and keep their attention. 
Overall Interactive Metronome is a treatment well worth considering. It is not silver bullet to education and behavioral problems but it can help. If you are in the UK then Bramhall NDT can provide a friendly and effective centre for treatment. 

Research: Neural Basis of the Comprehension of Musical Harmony, Melody, and Rhythm [ PDF ].
Also on Myomancy:  Rhythm and Dyslexia, Cerebellum More Than Just a Motor, The Cerebellum and ADHD


  1. lynne

    Could you let me know how to find a list of practitioners for the interactive metronome treatment. We live in suffolk so are too far a way from you. You mention a website but not the address…I would be so grateful

  2. Lyn Wells

    The list of providers is available via the IM website ( click on ‘find nearest IM Provider’ then ‘Find a list of international providers’ there is someone in London and Lincoln (as well as myself in Bramhall, Stockport near Manchester)

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