Interactive Metronome: FAQ’s

Interactive Metronome

What does Interactive Metronome treatment look like?

Interactive Metronome (or IM) is a computer based program where a person attempts to clap to the beat of auditory sounds sent by a computer program over a pair of headphones.  The computer then measures to the millisecond how close the person is to matching the beat, providing constant feedback so that motor adjustments can be made to precisely match the computer’s rhythm.  Later, feet tapping and hand clapping that involve crossing the midline and speed are added as the guidance system progressively challenges the person to improve their motor planning, sequencing and rhythmic timing. The system uses electronic sensors that can be activated by pressing them with a hand or stepping on them.  The sensors for the hands are often small buttons that have Velcro on the back, allowing them to be strapped to the hand or placed onto a wall and pressed.  There are also sensors than can be found in a strip taped to the floor in order to activate by stepping down on it.

According to the official Interactive Metronome website the IM protocol is aimed at synchronizing timing in the brain and has been used since the early 1990’s to treat patients with learning disabilities and neurological disorders like ADD/ADHD, Autism Spectrum Disorder, and Sensory Processing Disorder.  Adults with a variety of neurological conditions like Stroke and Parkinson’s may also see improvements in their activity performance with the IM program.  Persons without a medical diagnosis may also benefit from the Interactive Metronome program. Colleges, universities and professional sports teams use IM for improving performance of athletes.

How does Interactive Metronome contribute to mental and physical performance?

Interactive Metronome improves temporal processing (mental timing) and improves the brain’s efficiency and performance.  The neuroplasticity of the brain gives it the ability to reorganize and repair itself.  Basically,” what is fired together is wired together.”

Motor planning and sequencing are core functions of the brain and do not occur separately.  They are actually the result of four neurological functions being exercised at once:

  1. Attention & Concentration
  2. Sensory Integration
  3. Functional Motor Control
  4. Synchronization

Motor planning and sequencing determine the simple ability to reach out for a glass of water, take notes while listening to a presentation, walking smoothly, arranging words in a sentence so that speech makes sense, and overall coordinating and sequencing physical and mental processes required for effective and adaptive everyday performance.

Now, clinicians can objectively measure motor planning and sequencing and assign a level of impairment in milliseconds (ms).  The ms average score provided for each IM task represents the patient’s ability to motor plan and sequence.  As the patient improves in his ability to motor plan and sequence, it is reflected in improving ms averages (or task average performance).

What improvements to mental and physical performance can we expect?

  • Longer attention span and improved focus and concentration
  • Improved coordination and internal timing
  • More efficient language processing skills
  • Improved academic performance
  • Decreased anxiety
  • Better behavioral regulation (lowered impulsivity and aggression)
  • Improved strength, stamina, and endurance
  • Smoother gait
  • Rapid acquisition of new athletic or eSporting skills

Studies show that the gains from IM training are permanent and benefit all activities.  Some people benefit more from IM than others. Results may vary depending on individual differences and capacity.

Where can I find more research about IM?

As a basis for the research being done, tightly controlled, randomized clinical research has led to the development of normative data for IM from age six through adult.  Please refer to the official Interactive Metronome website at 

for outcome research related to different diagnostic categories for children and adults. 

How long does the program last?

Participating in an Interactive Metronome protocol is intensive and requires a significant commitment of time, energy, and money.  Based on research, generally the most effective results for persons being treated for neurological conditions are achieved with 15 one-hour sessions completed within a five-week time period, with a Certified IM Practitioner.  Some individuals will need more sessions if they have unusually impaired rhythm and timing skills and/or sensory integration issues.   However, some people may require less than 15 sessions depending on their response to treatment.  VIOT’s basic general protocol for treatment is 12 sessions within a 6 -8 week period. The skilled IM provider will be able to customize treatment to each individual depending on the person’s response and desire to maximize peak performance.

Will health insurance pay for the program?

Health insurance companies in-network with VI Equicare will typically pay for 80% of the treatment, but only as a part of a skilled treatment plan ordered by a Physician for persons with approved medical diagnoses (like CVA, Parkinson’s, Guillain-Barre, Multiple Sclerosis, Balance Disorder, etc).

How much does the program cost?

Virgin Islands Occupational Therapy,LLC will bill the health insurance company as is usual for physician-ordered skilled occupational therapy treatment for approved medical diagnoses. IM training will be integrated into the patient’s treatment plan and may not be the only technique used to improve function, depending on the diagnosis. Patients are responsible for meeting deductibles and a co-pay amount depending on their insurance policy.

Medicare has a $1920 cap per calendar year on paying for skilled OT services (and a separate $1920 cap for Physical Therapy and/or Speech Therapy combined) regardless of diagnostic event.

Adult patients without health insurance will be charged a self-pay rate of $250 for the first skilled occupational therapy evaluation, program set-up, and plan of care. Each skilled occupational therapy treatment session after that is $150, according to an established plan of care, usually 10 to 12 sessions.

For clients without a medical impairment who want to improve academic or peak athletic or eSport skills, an initial evaluation will cost $150 for initial evaluation, set-up, analysis of findings, and an explanation of results.  If the client wants to continue with treatment after the initial evaluation, a typical minimal protocol of 10 skilled sessions of IM training will cost $1000, or $100 per session. One half of the payment ($500) is requested at the first treatment session.  The balance is due starting on the 6th session.  Payment is not refundable if the patient cannot attend all of the sessions within an 8 week time period. If additional sessions are desired, the price drops to $80 per session, which is due at the time of service.