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. 

Is IM a shot of self-confidence?

When working with children with Cerebral Palsy and Asperger’s Syndrome it sometimes initially seems that they are overconfident when you are just speaking with them. But after a few physical challenges, hearing stories from their parents and actually getting the chance to talk with them and know them better, you tend to find that the trend in self-confidence goes down a quick spiral.  

Hemiplegic Cerebral Palsy

One of my favorite groups of patients to work with using Interactive Metronome^® are those affected by hemiplegia. These are my kiddos who either totally neglect one of their arms, or who only use their arm when absolutely necessary. They constantly hear “use both hands” or “use your helper hand” time and time again. There are other options for those affected with hemiplegia such as constraint-induced therapy, which can also be beneficial, but IM is a great way to get them to start using their affected upper extremity.

Some children with cerebral palsy have great difficulty with coordination and timing. They may have difficulty with their fine motor skills, catching a ball or walking smoothly. In watching these wonderful kids over the years, I have noticed 2 things, (1) that their timing can be off when they try to perform coordinated tasks. For example when they work on their ball skills they close their hands too early or too late to catch/bounce the ball and (2) that they sometimes lack self confidence in their physical skills making them less likely to practice them. Many of these kids have been in therapy for their entire life, and then when they reach 10, 11, 12 years old they grow tired and weary of the typical weekly sessions of practicing the skills themselves. While practice of skills is definitely necessary, I think we are learning to go a step further to address the underlying issues of timing and coordination with the Interactive Metronome program.