By Interactive Metronome, Bricole Reincke - February 25, 2020

Celebrate International Women’s Day – March 8th, 2020

International Women’s Day (March 8) is a global day celebrating the social, economic, cultural and political achievements of women. Over the past 20 years, many people have helped to shape Interactive Metronome, and this month, we want to showcase some of the women who have worked to understand IM’s efficacy as a therapeutic modality for rehab & therapy professionals around the world!

Here is a collection of publised studies and white papers of those women:

YEAR: 2019


AUTHOR: Silvia Bonacina, Jennifer Krizman, Travis WhiteSchwoch, Trent Nicol, and Nina Kraus

Simply drumming to an isochronous beat had no impact on recall of rhythmic patterns. Children who performed better at drumming to the beat of music were better at both drumming to a beat and remembering rhythmic patterns. However, children who were able to clap in time with a steady beat with the least amount of variability in their synchronization (due to real time millisecond feedback from Interactive Metronome) demonstrated better ability to drum to a beat, recall rhythmic patterns & drum to the beat of music. According to Dr Nina Kraus, rhythm is complicated, there are several rhythm intelligences, & Interactive Metronome, by itself, impacts all of these vital rhythms that are so important to the development of language and literacy. “Several clinical populations exhibit timing deficits that co-occur with to language deficits; for example, individuals with reading impairment often struggle to tap along to an isochronous beat. It is conceivable that clapping in time to feedback could be a viable intervention for populations with distinct rhythmic deficits (such as one group who struggles to synchronize to a beat and another who struggles to remember rhythmic patterns).” The authors hypothesize that the perception & production of rhythm begins as a global skill early and becomes more specialized later in life. This is in line with previous IM research and the IM Indicator Table data.


  • n=68 typically developing children between 5 – 8 years of age
  • n=46 children were re-assessed 1 year after conclusion of the study to monitor development of rhythmic skills
  • first study of its kind to provide evidence of the interconnections among rhythmic skills in school-age children
  • assessed via 4 different rhythmic tasks:
    • 3 tasks used a conga drum, with a trigger to register drum hits:
      1. Drumming to an Isochronous Beat: listen and drum to an isochronous pacing beat presented through in-ear headphones
      2. Remembering and Repeating Rhythmic Patterns: listen to 3 repetitions of a rhythmic sequence without drumming and then drum out the sequence during a pause, producing the sequence exactly when it would have occurred had it repeated a fourth time
      3. Drumming to the Beat of Music: listen to a musical excerpt through speakers and tap to the perceived beat
  • 1 task involved clapping in time and was completed using Interactive Metronome (IM)

YEAR: 2018


AUTHOR: Silvia Bonacina, Jennifer Krizman, Travis WhiteSchwoch, & Nina Kraus

The Children who were able to clap in sync with an auditory beat during Interactive Metronome (IM) assessment with the least variability in timing & rhythm demonstrated more advanced neurophysiological responses associated with language skills. Further, those children that demonstrated greater rhythmic ability (or the least variability in timing) while receiving visual feedback for millisecond timing feedback demonstrated superior literacy skills in the areas of processing speed, phonological processing, word reading, spelling, morphology, and syntax. “These results suggest that rhythm skills and literacy call on overlapping neural mechanisms, supporting the idea that rhythm training may boost literacy in part by engaging sensory-motor systems.”


  • n=64 typically developing children ages 5-7
  • beat synchronization was assessed using IM:
    • without feedback (just the metronome beat)
    • with feedback (the metronome + visual guidance for millisecond timing)
    • participants did not practice prior to the assessment
  • 4,000 artifact-free FFRs (frequency-following responses) were elicited from each child – this measures the microsecond
    precision of auditory processing and is used a measure to explore the connection between motor & auditory systems

    • other assessments included: intertrial phase-locking consistency, intertrial stability, verbal intelligence, phonological awareness, morphology & syntax, basic reading, processing speed

YEAR: 2015


AUTHOR: Tracy M. Shank & Wendy Harron

Children who participated in Interactive Metronome (IM) training demonstrated statistically significant improvements in timing skills, behavior, & hand function in both the dominant and non-dominant hand.


  • n=48 children, 41 boys and 7 girls ages 6-17 (average 9 years) with mixed motor and cognitive impairments, completed
    an average of 14 1-hour long IM training sessions over a period of 8.5 weeks in an outpatient therapy setting. Diagnoses

    • 14 – ADHD
    • 5 – CP/Hemiplegia
    • 9 – Coordination Disorder
    • 10 – PDD/Autism
    • 5 – rare neuromuscular disorders
    • 5 – neurologic conditions such as seizures/concussion
  • retrospective analysis of pre/post assessments, including:
    • Interactive Metronome (IM) Long Form Assessment for timing skills
    • Jebsen Taylor Test of Hand Function
    • Parent questionnaire for behavior

YEAR: 2012


AUTHOR: Michaela Ritter, Karen A. Colson & Jungjun Park

The experimental reading and language intervention group that also received Interactive Metronome (IM) training demonstrated far greater gains in reading rate/fluency and comprehension compared the control group that received the same reading and language interventions alone.


  • n=49 school-age children (grades 2-5) diagnosed with co-occurring language and reading impairments and enrolled in
    summer language and reading program at Baylor University were randomly assigned to:

    • experimental group: 28 who received the IM training for 15 minutes per day, 4 days per week for 4 weeks in addition to language and reading interventions 4 days per week for 4 weeks
    • control group: 21 only received language and reading interventions 4 days per week for 4 weeks
  • pre-post testing included:
    • Dynamic Indicators of Basic Early Literacy Skills–6 Oral Reading Fluency (DIBELS-6 ORF)
    • Read Naturally Test to measure oral reading fluency
    • Gray Oral Reading Test–Fourth Edition (GORT-4) to assess rate, accuracy, fluency, and comprehension of reading
  • pre-treatment comparisons: no significant differences between groups existed before the interventions

YEAR: 2012


AUTHOR: Sara Rosenblum & Noga Regeve

The Significant differences were found in timing abilities (millisecond timing scores on Interactive Metronome, IM) between children with Developmental Coordination Disorder (DCD) and those who are typically developing (TD) with much slower response times in children with DCD. Temporal measures of handwriting performance between children with DCD and those who are TD yielded significant differences with far greater mean in-air time per stroke for all three tasks for the children with DCD. Additionally, moderate correlations were found between timing abilities (IM scores) and temporal measures of handwriting performance in each group. Timing abilities, as measured by IM, accurately predicted handwriting performance time among children with DCD. The authors strongly recommended consideration of IM as an evaluation and intervention tool for children with DCD.


  • n=42 children; ages 7-12 diagnosed with DCD (n=21) and those with typical development (n=21)
  • Assessment measures:
    • Interactive Metronome (IM)
    • Computerized Penmanship Evaluation Tool (ComPET)

YEAR: 2012


AUTHOR: Hannah Grossman & Mary E. Brenner

The group that received IM + ball training improved the most in the area of processing speed (2 years 9.5 months) compared to IM training alone and the control group. The group that received IM training alone improved the most in the areas of reading fluency (8 months) and math fluency (7.5 months) compared to the other groups.


  • n= 62 elementary students, grades 2-5, were divided into 3 groups:
    • experimental 1: 21 received only IM training
    • experimental 2: 20 received IM training plus ball training
    • control: 21 received basic Boys and Girls Club enrichment activities, such as homework help and game playing
  • pre-post assessment via Woodcock-Johnson: processing speed, reading fluency and math fluency subtests

YEAR: 2012


AUTHOR: Anna-Maria Johansson, Erik Domellof & Louise Ronnqvist

Two children with cerebral palsy (CP) demonstrated smoother and shorter bimanual movement trajectories, especially for the
affected side. Additionally, one child exhibited increased smoothness of the non-affected side. Noticeable improvement in motor learning occurred immediately post training and was maintained at 6 months post training.


  • n=2 children with hemiplegic CP (17 year old girl and 13 year old boy) underwent 4-weeks/12 sessions of IM training
  • uni- and bimanual upper limb movements were assessed via kinematic analysis
    • pre-training
    • post completed training
    • 6-months post completed training

YEAR: 2011


AUTHOR: Sarah C. Beckelhimer, Ann E. Dalton, Charissa A. Richter, Valerie Hermann & Stephen J. Page

The Two men in the chronic stage of recovery from stroke demonstrated reduced arm impairment (indicated by FM scores of 12.0 and 14.0) and increases in average functional ability (10.85 and 11.1 points on the AMAT), perceived quality of life (12.0 and132.0 points on the SIS), and perception of overall recovery (110.0 points for each participant on the SIS) following combination of Interactive Metronome (IM) training.


  • n=2 male subjects, 68 year old male 23 years post-CVA & 75 year old male 2 years, 2 months post-CVA
  • IM training was provided for 60 minutes, 3 days/week for 4 weeks
  • investigators that conducted assessments were blind the intervention provided in the study, including:
    • Fugl-Meyer Scale (FM) – upper extremity section
    • Arm Motor Activity Test (AMAT)
    • Quality of Movement Scale
    • Canadian Occupational Performance Measure (COPM)

YEAR: 2008


AUTHOR: Jessica J. Sabado & Donald R. Fuller

The An adolescent female diagnosed with LLD demonstrated substantial improvement in language skills following Interactive Metronome (IM) training.


  • n=1 13 year old female with diagnosis of LLD
  • participated in 15 sessions of IM training, 50 min each (no other language interventions where provided during the study)
    • pre-post assessments:
      • Expressive One-Word Picture Vocabulary Test (EOWPVT)
        • pre: SS 93, PR 66, AE 11 years, 4 months
        • post: SS 124, PR 95, AE >19 years
      • Oral and Written Language Scales (OWLS)
        • pre: SS 86, PR 18, AE 9 years, 6 months
        • post: SS 99, PR 47, AE 12 years, 9 months
      • post assessments were conducted 1 month following cessation of IM training

YEAR: 2005


AUTHOR: Melinda L. Bartscherer & Robin L. Dole

A young boy demonstrated significant improvement in fine and gross motor skills following Interactive Metronome (IM) training. His parents also reported greater flexibility, cooperation and attention span.


  • n=1,  9 year old boy with nine-year-old boy with developmental delay and trouble with attention
  • pre-post assessment via Bruininks-Oseretsky Test of Motor Proficiency (BOTMP)
    • pre: significant delay in both gross and fine motor skills, with the greater deficiency in  fine motor skills (below the 1st percentile when compared to children of similar age)
    • post: improved in most areas assessed by BOTMP, most notably to 14th percentile for fine motor skills
  • intervention: Interactive Metronome (IM) training for 7 weeks totaling 15 sessions (1,500-2,000 repetitions per session)

YEAR: 2003


AUTHOR: Susan J. Diamond

This author reviewed the literature pertinent to brain plasticity, hemispheric interaction, motor planning, attention, memory and language, the role of the evoked potential electrical signal, and the role of soft signs  to discover more about the brain interactions witnessed following IM training.


  • “Interactive Metronome (IM) likely increases speed of brain processing, and reduces “noise” or variability, making it more efficient as a signal processor. Efficient signal processing has been demonstrated to be associated with higher IQ scores and better task performance.”
  • some of the topics covered include:
    • brain regions activated by a precise menu of movements
    • intimate connection between motor planning and sensory processes
    • how learning acquisition and retrieval stages differ and are influenced by which side of body is engaged
    • how widespread brain activations occur with even simple movements, and affect brain activities including memory
    • and sequencing as well as sensory input areas
    • how motor routines alter hemispheric interactions in specific ways
    • the role of the corpus callosum
    • central nervous system inefficiency & motor deficits in ADHD
    • response inhibition deficits associated with ADHD, Tourette’s, OCD and other disinhibition syndromes
    • how response speed and the ability to inhibit responding appropriately are both associated with learning, with ADHD, and with developmental difficulties
    • how response times in discrimination tests can be improved by a movement program
    • brain activation processes involved in motor learning, and how early learning of skilled movements involves a subset of the same widely distributed brain network for motor execution
    • how movement plays a role in establishing patterns that go into long term memory

YEAR: 2003

PUBLICATION: WHITE PAPER presented at The Annual Meeting of the National Association of Elementary School Principals

AUTHOR: Dr. Cindy Cason

Students who received IM training performed significantly better on tests of reading & math fluency and improved 1-2 grade levels in reading comprehension and fluency as compared to matched controls.


  • n=80 subjects
    • experimental group: 40 4th and 5th grade students identified as Title I eligible and scoring in the lowest three stanines on the reading subtest of Stanford Achievement Test – Edition Nine participated in 12 sessions of IM training (1 hour each) in group setting with 4 students:1 trainer
    • control group:  40 matched peers based upon School Ability Index scores from the Otis Lennon School Ability Test
  • pre-post measures:
    • Woodcock Johnson III: reading and math fluency subtests
    • STAR reading assessment
    • Stanford Achievement Test results for the testing prior to training and post training were reviewed

YEAR: 2002


AUTHOR: Kristyn Kuhlman & Lawrence Schweinhart

Metronome timing was strongly correlated with motor control/coordination, the ability to sustain attention and concentration, age, and kindergarten achievement. Timing was discovered to be developmental with older children demonstrating better metronome and musical timing than younger children. Additionally, metronome and musical timing were significantly correlated with performance on the California Achievement Test (children at or above the 80th percentile had significantly better metronome timing than children at the 59th percentile or below). Metronome and musical timing were both more strongly correlated with a child’s ability to focus than household income or parents’ highest level of education.


  • n=585 4-11 year old children
  • objective measures:
    • Interactive Metronome: timing skills
    • High/Scope Beat Competence Analysis Test: musical timing
  • validity verified via:
    • parent questionnaires
    • teacher questionnaires
    • kindergarten-teacher child achievement reports
    • California Achievement Tests for grades 1 through 4

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