1. Slide 1 Accelerate Outcomes. Exceed Expectations.

2. Slide 2 Buzzer Rubber band twang Rubber band twang Buzzer High Pitch Rewarding Sound 1 second = 1,000 milliseconds 200100 40 15 0 40 100 200 0 - 15 ms Perfect 16 - 40 ms Above Average 41 - 100 ms Average Left Ear EARLY Right Ear LATE

3. Slide 3 Interactive Metronome  Assessment & Treatment  Evidence-based  Objective  Flexible  Engaging

4. Slide 4 IM Equipment  Software  Hardware Master Control Unit Hand Trigger Foot Trigger Headphones  Optional wireless equipment Hand Trigger Foot Trigger Gait Switch

5. Slide 5 IM’s Goals 1)To drive functional neuroplasticity 2)To improve mental/interval timing 3)To improve the brain’s efficiency and performance

6. Slide 6 Randolph J. Nudo, Ph.D. Director, Landon Center on Aging Professor, Department of Molecular and Integrative Physiology University of Kansas Medical Center Kansas City, KS "Synchronous activity drives dendritic growth."

7. Slide 7 To improve mental/interval timing IM… Based upon Scalar Timing Theory

8. IM Impacts Mental/Interval Timing Structures of the Brain

9. Slide 9 Hemiplegia Study Thaut et al. (2002): Published in Neuropsychologia  Investigated effect of rhythm on control of paretic arm movements  "the observed changes in timing and trajectory control strongly suggest that the structured time information in auditory rhythm added significant kinematic stability to the patient’s paretic arm reaching motions. These changes were not present during the non-rhythmic condition...Our data suggest, therefore, that auditory rhythm may offer an essential component of enhanced sensorimotor control to make hemiparetic arm training more effective." 21 hemispheric stroke patients

10. Slide 10 To improve the brain’s efficiency and performance  By improving:  Auditory Processing  Short Term Memory  Working Memory  Processing Speed  Cognitive Resources  Executive Functions  Motor Coordination  Sensory Processing

11. Slide 11 IM Research  First private research (1994)  Autistic children  Showed fine/gross/visual-motor improvements in coordination  Published in academic circles  IM came to attention of Stanley Greenspan, MD

12. Slide 12 Stanley I. Greenspan, MD Chairman, IM Scientific Advisory Board  Clinical Professor of Psychiatry, Behavioral Sciences, and Pediatrics at George Washington University Medical School.

13. Slide 13 Academic Correlation Study Timing in Child Development. High/Scope Educational Research Foundation Kuhlman, K. & Schweinhart, L.J. (1999)  585 students  Significant correlation between IM timing and academic performance  Reading, Mathematics  Oral/written language  Writing  Attention  Motor coordination and performance

14. Slide 14 ADHD Study Effect of Interactive Metronome  Training on Children with ADHD. The American Journal Of Occupational Therapy Schaffer et al., (2001)  56 boys, age 9-12  15 sessions  3 Groups  Treatment,  Video Game (Placebo)  Control

15. Slide 15 ADHD Study Effect of Interactive Metronome  Training on Children with ADHD. The American Journal Of Occupational Therapy  Statistically significant improvement:  Attention  Motor control and coordination  Processing speed  Language processing  Reading  Consistency of responses  Decrease in aggressive behavior

16. Slide 16 ADHD Study Effect of Interactive Metronome  Training on Children with ADHD. The American Journal Of Occupational Therapy Interaction Effect = 0.005

17. Slide 17 Academic Fluency Study Jacokes (2004)  1500 middle and high school students  20 different schools  Completed 12 sessions of IM  Participated in pre & post-testing via WJ-III  Reading fluency  Math fluency  significant increase in grade equivalent performance

18. Slide 18 2.21 GE Gain in Reading Fluency1.66 GE Gain in Math Fluency Academic Fluency Study 2.21 GE gain, n=718, Woodcock Johnson, 3 rd Ed.1.66 GE gain, n=703, Woodcock Johnson, 3 rd Ed.

19. Harvard Learning & The Brain Presented by Taub, McGrew & Keith (2005) Study 1  Flanagan High School  283 9 th grade students  Control grp 151  Experimental grp 132  Pre/post testing: WJIII reading & math achievement tests Study 2  Nap Ford Elementary School  Title 1 school  86 students  Control grp 37  Experimental grp 49  Pre/post testing: WJ III & more detailed battery to examine pre-literacy skills

20. Blue = high school Black = elementary school IM Performance48 % CTOPP Letter Naming (RAN)20 % TOWRE (sight word efficiency)18 % National Reading Panel 15% WJ III Math Calculation12 % WJ III Math Fluency10 % WJ III Pair Cancellation (attn/conc)10 % WJ III Reading Fluency07 % WJ III Math Calculation 07 % WJ III Math Fluency 07 % WJ III Broad Reading07 % WJ III Math Calculation07 % Primarily elementary All secondary Dependent variable % Harvard Learning & The Brain Presented by Taub, McGrew & Keith (2005)

21. Slide 21 Neuro-imaging Study Presented at 65th Annual American PM&R Conference MEDIAL BRAINSTEM Neuro-Motor Pipeline BASAL GANGLIA Integrates Thought and Movement CINGULATE GYRUS Allows Shifting of Attention Cognitive Flexibility Alpiner (2004). Results from this pilot fMRI study show IM directly activates multiple parts of the “neuro-network.”

22. Slide 22 Parkinson’s Study Pending Publication in Neurology “In this controlled study computer directed rhythmic movement training was found to improve the motor signs of parkinsonism.” - Daniel Togasaki, MD, Parkinson’s Institute

23. Slide 23 Motor Study The Journal of General Psychology  Comparison of IM- trained golfers to a control group  Pre/post tested on computerized driving range  Significant improvements in golf shot accuracy

24. Slide 24 Motor Study The Journal of General Psychology  20% Overall Gain in Shot Accuracy  35% Increase for advanced golfers who had consistent swing mechanics

25. Auditory Processing Pilot Study Etra (2006) Applied Dissertation, Nova Southeastern University  8 children, 15 hours of IM training  SCAN-C 1.Filtered Words 2.Auditory Figure-Ground 3.Competing Words (dichotic listening) 4.Competing Sentences (dichotic listening)  Statistically significant gains  All subtests  Greatest Gains subtests 3 & 4  Strongly suggests IM affects auditory processing disorders by influencing neurological organization.

26. Slide 26 Ongoing Research  Drexel University: Durability & Generalization  University of Rochester: Visual Attention  University of Cincinnati: Hemiplegic Arm  East Carolina University: CVA  Veterans Administration: Cognitive, Behavioral & Motor Skills (normals & veterans with blast injuries)  Walter Reed Army Medical Center: PTSD, Sleep, Cognition

27. Slide 27 Buzzer Rubber band twang Rubber band twang Buzzer High Pitch Rewarding Sound 1 second = 1,000 milliseconds 200100 40 15 0 40 100 200 0 - 15 ms Perfect 16 - 40 ms Above Average 41 - 100 ms Average Left Ear EARLY Right Ear LATE

28. Analysis  What we see  Patient exercises four neurological functions at once:  Attention & Concentration  Sensory Integration  Functional Motor Control  Synchronization  “What is fired together is wired together”…Neuroplasticity

29. IM GAIT MATE http://www.interactivemetronome.com/IMPublic/GaitMate.aspx

30.  “Pre-gait” skills are important  Weight shifting  Unilateral stance  Limb Advancement  BUT  The only true way to practice walking is to WALK. IM GAIT MATE

31.  IM Gait Mate is an extension of IM  Expands IM's capabilities: Allows the patient to move freely AND receive continuous feedback during gait exercises.  Feedback will help the patient develop a symmetrical gait pattern.

32. 32 IM-HOME Therapy Extension

33. Continuing Education  Live Certification Courses  $15 off cost of course if you register within a week of this webinar. Contact Sales Representative.  Self-Study Certification Courses  Advanced Live Courses  Advanced Self-Study Courses  Webinars- Introductory & Advanced Levels Slide 33

34. Interactive Metronome Today  Currently provided by over 7,500 therapists  In 3,000 hospitals, clinics and universities

35. Questions Kelli Crovo (954) 385-4660 x240 kcrovo@interactivemetronome.com Slide 35