Amy Vega, MS, CCC-SLP

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Amy Vega

Amy Vega

Amy Vega, MS, CCC-SLP received her master’s degree in Speech-Language Pathology from the University of South Florida in 1994 and holds the Certificate of Clinical Competency from the American Speech Language & Hearing Association (ASHA). In clinical practice, she specialized in adolescent and adult rehabilitation for patients diagnosed with traumatic brain injury, stroke, epilepsy, brain tumor & and other disease processes that affect communication, cognition, and behavior. She currently serves as Director of both the Clinical Education Department and the Clinical Advisory Board for Interactive Metronome, Inc. and is their Continuing Education Administrator. She provides clinical support to Interactive Metronome (IM) providers globally, serves as Editor in Chief for IM’s educational publications, develops IM certification & training materials, and is the master-trainer for IM certification instructors.

Blog entries tagged in IM Supporting Research

A bit of research: Fast thinking

Cognitive psychologists theorize that the faster we are able to process information (or think), the more intelligent we are, and the more readily we can learn and demonstrate what we’ve learned. There are many recent studies that support this view, including this one published in the journal Intelligence. Each individual is born with a certain amount of resources for attending to and processing information. How well a person allocates those resources appears to be a major factor in determining intelligence. Taub et al (2007) demonstrated that Interactive Metronome (IM) training has a significant positive effect on reading achievement (affecting 4 of 5 critical pre-reading skills) in elementary school students. They proposed that IM training was primarily improving “processing [thinking] speed,” which in turn improved the students’ ability to allocate resources for attending and holding information in working memory … all essential for fluent reading.

Ben-Shakhar, G. and Sheffer, L. (2001). The relationship between the ability to divide attention and standard
 measures of general cognitive abilities. Intelligence, 29: 293-306.
Taub. G., McGrew, K.S., and Keith, T.Z. (2007). Improvement in interval timing tracking and effects on reading
 achievement. Psychology in the Schools, 44(8), 849-863.

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A little more science than usual: Great research on intelligence

In the literature, psychologists describe two forms of intelligence that each contributes separately to our ability to perform tasks. These are “fluid intelligence” and “crystallized intelligence.” Whereas crystallized intelligence is the information and knowledge about things we have learned over the years, fluid intelligence is our ability to strategize and problem-solve. In the example of taking a test, we would recall knowledge about facts and information we learned from class and from studying our notes to answer the test questions (crystallized intelligence), but we may need to answer the questions in a strategic way like crossing out all multiple choice responses that clearly are not the answer and narrow the choices down to the two most possible, working from there to get the correct response (fluid intelligence). Stankov et al. (2006) studied the physiological neural oscillations (or rhythmic, repetitive neural signals between brain regions in the central nervous system) involved in human intelligence, or what we know is our ability to learn, access what we’ve learned, and problem-solve. They discuss the importance of synchronicity in brain activity to intelligence and propose that the degree of synchronization in brain activity may account for differences between individuals’ cognitive processing abilities. In a small pilot study completed in 2004, Dr Alpiner demonstrated under fMRI that individuals who’d received training for timing and rhythm using the Interactive Metronome demonstrated more synchronous activity in the brain when compared to individuals who did not receive this training. Other researchers (Taub et al., 2007) who studied the effect of IM training on reading achievement theorized that synchronized metronome tapping (via Interactive Metronome) increases the efficiency of the brain’s timing (or synchronicity of neural oscillations), thus improving the ability to process, store, and retrieve information.

Stankov, L., Danthiir, V., Williams, L.M., Pallier, G., Roberts, R.D., and Gordon, E. (2006). Intelligence and the tuning-in of brain networks. Learning and Individual Differences, 16, 217-233.

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A bit of research: Timing as an essential part of social communication

Timing in the brain is critical for communicating effectively or participating in group activities (i.e., sports, music, play). Some individuals wait until just the right moment to act, while others have a tendency to “jump the gun.” This may manifest in a penalty for a false start if playing football or social difficulty if a person constantly interrupts others when they are speaking. Miyake et al (2004) describe the neurological underpinnings of the tendency to make “anticipatory” timing errors like these in a paper published in Acta Neurobiologiae Experimentalis. Once we’ve learned a task or situation, we tend to respond as if on automatic pilot (without consciously thinking about it). But sometimes, something changes ever so slightly in the situation, and we must adapt and recalibrate our response. How well we do this depends upon our brain’s ability to perceive time…even in small increments like milliseconds. During the initial phases of Interactive Metronome (IM) training individuals with these timing-related problems often clap or move too fast (milliseconds ahead of the beat instead of on it), but soon become more in sync with the beat and with their peers.

Miyake, Y., Onishi, Y., and Pöppel, E. (2004). Two types of anticipation in synchronization tapping. Acta
 Neurobiologiae Experimentalis, 64, 415-426.

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A bit of research: Central Auditory Processing Disorder (CAPD)

Individuals with language-learning disabilities show slowed or delayed timing in the brain (in particular in the brainstem), so that they are not processing the timed or temporal elements of speech quickly enough to decipher sounds accurately and comprehend what is being said (also called temporal processing). Auditory Processing Disorder is at the heart of language-learning disabilities and is the leading cause of problems with learning to read and write. But there is hope!! Research shows that auditory processing (or the brain’s ability to understand speech & language) can be improved (Kraus & Banai, 2007). Interactive Metronome training targets the underlying problem with timing in the brain. Once mental timing is improved, the brain can process information in the speech stream more timely and accurately, leading to development of phonological skills that are so vital for auditory comprehension, reading and writing.

Kraus, N. and Banai, K. (2007). Auditory-processing malleability. Current Directions in Psychological Science, 16(2), 105-110.
 

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A bit of Research: The influence of timing in children with ADHD

A recent study by the Kennedy Krieger Institute (2011) showed that areas of the brain that control thinking and motor skills are different (smaller) in children with ADHD compared to other children. The specific regions of the brain that were mentioned are known to be involved in mental timing. Mental timing (AKA timing in the brain) is vital for many of our thinking skills and for good motor coordination. Studies have shown that timing in the brain is disrupted in children and adults with ADHD, leading to problems with focus, other cognitive abilities, and motor skills. Interactive Metronome, a patented non-medical treatment for ADHD, is the ONLY program that simultaneously works on thinking AND motor skills by specifically addressing and improving the areas of the brain responsible for mental timing.

Kennedy Krieger Institute (2011, June 10). Brain imaging study of preschoolers with ADHD detects brain differences linked to symptoms.
 

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A bit of Research: Autism Spectrum Disorder

There is still controversy over whether Autism Spectrum Disorders result from some interaction with environment after birth (i.e., toxic exposures, immune-modulation post-vaccination, etc) or whether they result from genetic defect(s). Some would argue both are contributing factors, that certain individuals are born with a genetic predisposition and that exposure(s) in the environment turn on or off certain genes that may contribute to the development of Autism Spectrum Disorders. In this study, researchers provide a strong argument for a genetic defect in the “clock genes,” genes that control our perception of time and with genes for a process called “methylation” that controls the turning on and off of our genes or how they are expressed (ultimately how they control our abilities). Individuals on the Autism Spectrum demonstrate numerous symptoms resulting from an impaired perception of time from circadian rhythm (sleep/wake/appetite) to millisecond timing required for speech-language, social/behavioral, cognitive, motor, and visual skills. The Interactive Metronome (IM) is a training program that is administered under the guidance of a certified professional. It is designed to improve the basic timing skills necessary for development of speech, language, cognitive, and motor skills. Many parents and professionals also report decrease in aggressive behavior, improved social skills, and better sensory processing following IM training.
Wimpory, D. (2002). Social timing clock genes and autism: A new hypothesis. Journal of Intellectual Disability Research, 46(4), 352-358.

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A Bit of Research: The important of timing in Speed Skating and the use of the Interactive Metronome

The important of timing in Speed Skating and the use of the Interactive Metronome

Researchers at Korea University College of Medicine (Park et al, 2012) recently conducted a neural imaging study of elite speed skaters to investigate whether training of complex motor skills resulted in structural changes to the cerebellum. The cerebellum responds to intense, repetitive training with increased brain mass in areas critical for skilled motor movement, in this case for control of balance, precisely coordinated movement, and visually guided movement. The authors compared the cerebellums of professional speed skaters to individuals who did not engage in regular exercise. They found that the specific skills required for speed skating that were trained repetitively resulted in structural changes to the brain that enhanced balance and coordination. They also found that the particular side of the cerebellum that was exercised repeatedly was affected (i.e., the right side due to maintaining balance on the right foot during turns). Of note, the cerebellum is also a central part of the brain’s internal timing network. The timing and synchronization of neural signals ultimately controls balance and coordination...

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A Bit of Research on TBI

The front portion of the brain, or frontal lobes, are particularly vulnerable to damage during accidents. Individuals with traumatic brain injury frequently have what is called a “frontal lobe injury.” This is significant because this area of the brain is responsible for so many important skills for successful community reintegration: our personality and mood, our ability to plan and organize events, to manage and monitor time, to focus our attention and problem-solve, to sequence and coordinate motor movements, and the list goes on and on...

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Have you ever heard that ADHD is genetic?

Have you ever heard that ADHD is genetic? Ever notice that children with ADHD seem out of sync? Here is a research study by Nanda et al (2007) that supports this view and does so by showing that not only is timing in the brain disrupted in children with ADHD, but that it IS ALSO slightly disrupted in their siblings who do not have ADHD (when compared to children from families with no diagnosis of ADHD). From this and other studies, evidence shows that the more the brain’s timing skills are off, the more symptoms like impulsivity, hyperactivity, inattention, lack of organization, poor time-management, or difficulty with reading and other academic work are evident. The Interactive Metronome is a relatively easy, non-medical treatment program for ADHD that improves the brain’s critical timing skills and is tailored to each child’s specific needs.

Nanda, N.J., Rommelse, M.S., Oosterlaan, J., Buitelaar, J., Faraone, S.V., and Sergeant, J.A. (2007). Time reproduction in children with ADHD and their nonaffected siblings. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 5.

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A bit of Research: The role of Temporal Processing

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. 

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A bit of Research: The ability of Adults with ADHD to maintain a rhythm with a faster or slower tempo

Here is an interesting study by Gilden and Marusich (2009) published in Neuropsychology that looked at the ability of adults with ADHD to maintain a rhythm with either a faster tempo (less demand on focus, self-control, and working memory) or a slower tempo (more demand on focus, self-control, and working memory). Persons with ADHD had MUCH more difficulty when the tempo was slower, requiring them to estimate a longer time interval between beats, maintain the time interval in their memory, and restrain themselves from hitting too soon. This study, like many others, points to the direct relationship between timing in the brain and its command center “working memory.” Researchers theorize that Interactive Metronome is affecting this critical “control center” for timing in the brain and thereby improving many of the time-related symptoms of ADHD.

Gilden, D.L. and Marusich, L.R. (2009). Contraction of Time in Attention-Deficit Hyperactivity Disorder. Neuropsychology, 23(2), 265-269.

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Does IM really help with ADHD?

Dr. Stanley Greenspan, a noted expert in autism and child development/disorders, and his team of researchers conducted a study to see whether Interactive Metronome (IM) was a beneficial treatment for children with ADHD. They compared boys who received IM to boys who received either no treatment at all or boys who only played video games to try to improve their ability to focus. They found that those children with ADHD who received IM did far better than those that did not, with significant improvement in the areas of attention, motor skills, language processing, reading, and self-control (i.e., less aggressive behavior).

Shaffer R.J., Jacokes L.E., Cassily J.F., Greenspan S.I., Tuchman R.F., Stemmer P.J. Jr. (2001). Effect of
Interactive Metronome on children with ADHD. American Journal of Occupational Therapy, 55, 155–162 

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Timing influences Auditory Processing and Speech

Timing skills play a pivotal role in the development of speech production and perception, or the ability to speak and understand the speech and/or intent of others (Kello, 2003). Not only must a child rapidly decipher the timing characteristics of each individual sound, syllable, word, and phrase in the speech stream, but for successful communication to occur there must be precisely timed coordination between centers of the brain for language and cognitive processing or thinking skills and the muscles and structures of the mouth and throat (or voice box). On top of that, a child must process and understand other information associated with what is said, such as demeanor of the person (Is he happy? Angry? Sad? ) or humor (Was he serious? Or was he joking?) Many children on the Autism Spectrum either don’t understand what you said, or don’t understand the unspoken social aspects of speech. All of this depends upon timing in the brain!!! That’s a bit like patting your head and rubbing your tummy at the same time! However, in normal development the brain’s “internal clock” functions very precisely so that children learn to speak intelligibly and understand you when you speak to them, including your mood and intent. Interactive Metronome (IM) training impacts the very critical timing centers of the brain necessary for effective communication & social skills.


Kello, C.T. (2003). Patterns of timing in the acquisition, perception, and production of speech. Journal of Phonetics, 31, 619-626.
 

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A bit of Research: Music and Rhythm in CAPD

Infants, before than can speak, are exposed to rhythmic sounds in the form of music and song. This research by Bergeson and Trehub (2006) shows that their little tiny ears and developing brains are already tuned just like an adult’s to hear the slightest changes in tempo, tone, and rhythm. They discuss the importance of the brain’s “internal clock” as it relates to how infants respond and move their bodies to music and other rhythms. IM providers who specialize in infant care and early intervention are reporting very good results when using the Interactive Metronome in the treatment of infants and young children who have developmental delays or disorders with improvements in the areas of: sensory processing, pre-speech/cognitive development, and motor skills. Case studies can be found at www.interactivemetronome.com

Bergeson, T.R. and Trehub, S.E. (2006). Infants’ perception of rhythmic patterns. Music Perception, 23(4), 345-360.

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A bit of Research: Children with ADHD have an impaired sense of time?

Humans perceive time. We use this ability to predict what is coming, to think about how we will react, and then to respond in a timely fashion. It is well-documented that children with ADHD have an impaired sense of time. Areas of the brain that control our perception of time are affected in children with ADHD (i.e., working memory). In an article published in the Journal of Child Psychology and Psychiatry, researchers found that children with ADHD who also have a Reading Disorder have even more difficulty with timing skills. Research has shown that Interactive Metronome, a training program that addresses the underlying problem with timing in the brain, improves symptoms of ADHD and reading.

Toplak, M.E., Rucklidge, J.J., Hetherington, R., John, S.C.F., and Tannock, R. (2003). Time perception
deficits in attention deficit/hyperactivity disorder and comorbid reading difficulties in child and adolescent samples. Journal of Child Psychology and Psychiatry, 44(6), 888-903.

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A bit of Research: Are timing genes in the brain in some way flawed in children with Autism?

Researchers (Nicholas et al, 2007) are asking whether genes responsible for timing in the brain are in some way flawed in children with Autism (including High Functioning Autism and Asperger’s). Individuals on the Autism Spectrum display a significant number of symptoms that show timing in the brain is severely disrupted, from difficulty with sleep to the brain’s ability to process information, to attention or the ability to switch from focusing on one thing to another (they often become fixated), to communicating & reciprocating in conversation, to sensory processing and integration, to motor coordination (including the muscles for vision and visual perception). The authors found that there is indeed a case to be made that “clock genes” are involved, however they urge further research. More and more professionals are including Interactive Metronome in their comprehensive treatment programs for children on the Autism Spectrum in order to improve the timing skills that are critical for development of speech & language, cognitive, social, and motor skills.


Nicholas, B., Rudrasingham, V., Nash, S., Kirov, G., Own, M.J., and Wimpory, D.C. (2007). Association of Per1 and Npas2 with autistic disorder: Support for the clock genes/social timing hypothesis. Molecular Psychiatry, 12, 581-592.

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“Time is essential to speech”

“Time is essential to speech.” This study by de Cheveigne (2003) makes clear that in order to understand speech, the brain depends upon its internal clock (or what is known as temporal processing) to decipher at a minimum: 1) whether the left or right ear heard it first or which direction the voice came from, 2) pitch and intonation or WHO is speaking, 3) each individual sound within each word, 4) how the sounds blend together to make each word, including whether each sound is a vowel, consonant, voiced, voiceless, and 5) whether there are pauses between sounds and words that add emphasis or meaning. When timing in the brain or temporal processing is off by just milliseconds, a person may have difficulty processing and understanding speech. Interactive Metronome is a patented program that addresses the underlying problem in Auditory Processing Disorders, tuning the internal clock to the millisecond in order to more accurately perceive speech.

de Cheveigne, A. (2003). Time-domain auditory processing of speech. Journal of Phonetics, 31, 547-561.

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A good tip from research on ADHD

In order for a child to have good self-control (i.e., behavior), the timing system in the brain must be operating normally. Faulty timing is at the heart of ADHD. Researchers in Australia recently developed a set of questions for parents of children with ADHD that will help doctors and therapists better pinpoint whether there is a problem with timing skills and whether or not they are getting better with treatment. This is a valuable tool for professionals who use Interactive Metronome in the treatment of ADHD to measure and document the effect of the treatment, which improves timing in the brain.

Houghton, S., Durkin, K., Ang, R.P., Taylor, M.F., and Brandtman, M. (2011). Measuring Temporal Self-Regulation in Children With and Without Attention Deficit Hyperactivity Disorder: Sense of Time in Everyday Contexts. European Journal of Psychological Assessment, 27(2), 88-94.

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A bit of Research: Timing in the brain is critical for good focus and self-control

 

Timing in the brain is critical for good focus and self-control. Studies like this one by Ben-Pazi et al (2005) show that the brain’s timing mechanism is not working properly in children with ADHD, and that it is even worse in younger children with ADHD and those who lack self-control and are impulsive. Interactive Metronome is the only tool available today to effectively improve timing in the brain. By directly addressing timing skills at the level necessary for the brain to function more efficiently, the Interactive Metronome produces results.

Ben-Pazi, H., Shalev, R.S., Gross-Tsur, V. and Bergman, H. (2006). Age and medication effects on rhythmic responses in ADHD: Possible oscillatory mechanisms? Neuropsychologia, 44, 412-416.

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A Bit of Research on ADHD

Children with ADHD are frequently impulsive. Fortunately, researchers are trying to get to the bottom of this to determine the reason(s) why and what can be done about it. Authors of an editorial in the American Journal of Psychiatry (2006) remarked that watching the brain in action under MRI is helping researchers and doctors better understand the underpinnings of ADHD, or in other words, what is going on in the brain? Interestingly, the areas of the brain implicated in ADHD that are frequently targeted for study are ALSO part of the brain’s internal timing network. Timing in the brain is known to be disrupted in individuals with ADHD & has also been implicated in the ability to control one’s impulses and behavior. Interactive Metronome can be an important part of the treatment program for a person with ADHD by improving timing in the brain and addressing some of the areas of brain function mentioned in this article (i.e., working memory, ability to tune out distractions and pay attention to what is most important).

Casey, B.J. and Durston, S. (2006). From Behavior to Cognition to the Brain and Back: What Have We Learned from Functional Imaging Studies of Attention Deficit Hyperactivity Disorder? American Journal of Psychiatry, 163, 6.

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