Kid's Work Therapy Blog

Efficacy of Synchronized Metronome Training: Interactive Metronome Program


By Marie Foster

Kid’s Work is committed to providing state of the art Occupational Therapy to children experiencing self-regulation difficulties.  One of the interventions we offer is Interactive Metronome (IM). 

 “Interactive Metronome, otherwise known as IM, is a training tool to improve brain ability for the information processes, attention, and executive functions by increasing the capacity and speed of the integrated nervous system to perform the rhythm training accurately and repeatedly. The training consists of thirteen total tasks, divided into hand, foot, and hand-foot coordination tasks. These tasks are performed by touching or tapping the trigger with the user’s hand or foot according to the sound of a constant interval from the headset.”

– Sung-Min Son, 2021

There’s a multitude of evidence-based research showing how IM helps children. This blog shares how Interactive Metronome helps children with  a variety of self-regulation diagnoses focus and accommodate their needs better.

Interactive Metronome and ADHD

Children with ADHD often have trouble paying attention to reading materials. IM helps strengthen neurological pathways relating to an internal rhythm, inducing the connection of the motor and sensory nerves in the brain (Son, 2021, 5351). Essentially, IM training helps organize the cognitive process, through motor planning, sequencing, and attention. 

One study consisted of 16 children, mean age of 11, with ADHD over an 8-week period. Students received IM 3 times a week. The researcher measured reading fluency with the Basic Academic Skills Assessment: Reading (BASA-R) and assessed the accuracy and ADHD levels with the ARS assessments, a diagnosis checklist of criteria for ADHD. Both visual attention and reading fluency greatly improved after IM training and the students were able to focus on tasks for longer times, more consistently (Son, 2021, 5354). 

A different clinical trial of 56 boys aged 6-12 years old diagnosed with ADHD also demonstrated a pattern of improvement for students working with the Interactive Metronome system. This study tested a control group (no treatment), an IM training group (15 hours of Interactive Metronome), and a non-violent video games group. This trial was performed to determine the effectiveness of IM vs games that involve eye-hand coordination, advanced mental planning, and task sequencing (Shaffer et al., 2001, 159). 

While both the video game group and the IM group demonstrated significant improvements, the IM group had stronger scores on more test categories. Parents of the IM group rated their children as significantly less aggressive than when they started the training, whereas children in the video game category showed decreased performance in areas involving control, concentration over time, reaction times, and overall attention (Shaffer et al., 2001, 160). Overall, students with ADHD who received the training improved more in areas of their motor control, language processing, attention, and reading skills than the other study participants (Shaffer et al., 2001, 160).

Interactive Metronome and High School Student and Language & Reading Skills

For high school students, another study found that after a 4-week session of intense IM training, students’ language fluency and reading comprehension were significantly improved when compared to a non-treatment control group (Taub et al., 2007). The researchers tribute this improvement to the students’ faster-processing speed and higher levels of visual attention. Since IM training accesses and exercises both hemispheres of the brain, IM supports students with developmental dyslexia, promoting more neural plasticity efficiency and forging new connections (McGrew, 2012). 

Interactive Metronome and Mental Health

While there aren’t available studies on Interactive Metronomes efficacy in treating depression and histories of self-harm, there are many personal stories like Natalies’ that describe how her symptoms of depression including weepiness, agitation/irritability, and fearfulness in the morning dramatically decreased while training with Interactive Metronome (Castellano, n.d.). One patient named Natalie suffered from depression for over 20 years before trying IM training. She was on a low dose of antidepressants but didn’t feel normal. After starting IM training, Natalie was able to regain control during a panic attack by remembering the “cowbell” tone of the IM system. After 4 months on her IM protocol, Natalie reported that she felt like she was living out of “survival mode” and able to plan ahead for her future, one of her main goals when starting IM (Castellano, n.d.).

Ricky was a 10-year-old boy diagnosed with ADHD, Asperger’s syndrome, anxiety, and fine motor delays. After his third IM visit, his mom reported that he was starting to sleep through the night, an accomplishment he had never experienced before. After his training was complete, Ricky was scoring well within his appropriate age range scores, and in some tests, Ricky was scoring as exceptional (Harron, 2012). 

In conclusion,

Interactive Metronome (IM) is an innovative tool that has been shown to be effective in improving various cognitive and motor skills in individuals with neurological conditions. This literature review highlighted the benefits of IM in increasing attention, memory, and coordination, as well as reducing impulsivity and hyperactivity. IM has also been found to improve fine and gross motor skills, as well as language and communication abilities. Overall, the use of IM in Occupational Therapy has been shown to lead to meaningful improvements in the functional abilities of individuals with neurological conditions, making it a valuable addition to any occupational therapy treatment plan. This why we here at Kid’s Work Therapy use it to improve our children’s lives. 

Other Links and References For Further Consideration:

White Paper: Profound Effects of Interactive Metronome and Brain Balance Exercises on a Subset of Children with ADHD

Dyslexia: Gaining Clarity with Natural Timing and Rhythm

Effects of Visual Hemisphere-Specific Stimulation vs. Reading-Focused Training in Dyslexic Children

The Integration of the Neurosciences, Child Public Health, and Education Practice: Hemisphere-Specific Remediation Strategies as a Discipline Partnered Rehabilitation Tool in ADD/ADHD

Enhancing Motor Skills of Children with Autism Spectrum Disorder: The Potential of an Interactive Metronome Approach

Effects of Interactive MetronomeTraining On Timing, Attention, Working Memory, and Processing Speed in Children with ADHD: A Case Study of Two Children


Castellano, E. (n.d.). Removing the Cloud of Depression With IM. Interactive Metronome. Retrieved November 11, 2022, from

Harron, W. (2012, October 29). Ricky – ADHD, Asbergers, Anxiety and IM. Interactive Metronome. Retrieved November 11, 2022, from

Lee, H. K. (2022, June 28). A review and meta-analysis of interactive metronome training: Positive effects for motor functioning. Perceptual and motor skills. Retrieved January 13, 2023, from 

McGrew. (2012). The Science Behind IM – Interactive Metronome. Interactive Metronome -. Retrieved November 11, 2022, from

Shaffer, R. J., Jacokes, L. E., Cassily, J. F., Greenspan, S. I., Tuchman, R. F., & Stemmer Jr, P. J. (2001). Effect of Interactive Metronome® Training on Children With ADHD. American Journal of Occupational Therapy, 55, 155-162.

Son, S.-M. (2021, May 20). Changes in Visual Attention and Reading Fluency of the Children with ADHD through the Interactive Metronome Training. Annals of the Romanian Society for Cell Biology, 25(5), 5350-5359.

Song, J. (2013). Enhancing motor skills of children with autism spectrum. Retrieved January 13, 2023, from 

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