JP2004500591A - Method and apparatus for improving learning ability - Google Patents

Abstract

A method and apparatus for improving a user's learning ability includes generating a reference signal at time intervals and receiving a trigger (4) operation by a user (6). The temporal relationship (7) between the operation of the trigger (4) by the user (6) and the generation of the reference signal (2) is determined. A guidance signal (8), which is a function of the temporal relationship (7), is generated and provided to the user (6) from time to time (9).
[Selection diagram] Fig. 1

Description

　　　　　　　　　インタラクティブメトロノーム効果
生後間もなく発達し始める注意能力は、学習、集中、思考、他人との交流及び基本的な学力の習得などの技能に不可欠な要素である（Ｇｒｅｅｎｓｐａｎ ＆ Ｌｏｕｒｉｅ， １９８１； Ｇｒｅｅｎｓｐａｎ， １９９７； Ｍｕｎｄｙ ＆ Ｃｒｏｗｓｏｎ， １９９７）。注意の持続、競合する衝動（ｃｏｍｐｅｔｉｎｇ ｉｍｐｕｌｓｅ）の抑制及び共同注意（ｊｏｉｎｔ ａｔｔｅｎｔｉｏｎ）への参加における相対的な欠陥は、注意、学習及び発達の障害に見られる。これらの欠陥は注意欠陥障害（ＡＤＤ）、広汎用性発達障害（自閉症スペクトル障害）、言語障害、運動障害及び読み書きや算数に関連する特定の学習障害等を含む臨床的障害のいくつかである（Ｍｕｎｄｙ， １９９５； Ｂａｒｋｌｅｙ． １９９７ａ）。
運動のプランニング並びにシーケンシング、リズム感、及びタイミング等の広範な要素が注意力問題に関連することは、増々増加する数の証拠が示唆している。Ｂａｒｋｌｅｙ（１９９７ｂ）の主張によると、運動パターン及び行動の調節及びシーケンシング等の抑制及び遂行機能における欠陥は、注意欠陥多動性障害（ＡＤＨＤ）を理解するために重要であるとされている。抑制（Ｓｃｈｏｎｆｅｌｄ， Ｓｈａｆｆｅｒ ＆ Ｂａｒｍａｃｋ， １９８９）、速さ、リズム、協調及びオバーフローを含む運動調節の様相と注意との重要な関係は、数人の研究者（Ｂａｒｋｌｅｙ， Ｋｏｐｌｏｗｉｔｚ， Ａｎｄｅｒｓｏｎ ＆ ＭｃＭｕｒｒｙ， １９９７； Ｄｅｎｃｋｌａ， Ｒｕｄｅｌ， Ｃｈａｐｍａｎ ＆ Ｋｒｉｇｅｒ １９８５； Ｐｉｅｋ， Ｐｉｔｃｈｅｒ ＆ Ｈａｙ， １９９９）が主張している。Ｇｉｌｌｂｅｒｇ（１９８８）は（ＤＡＭＰ症候群と名づけた）注意、運動制御及び知覚における欠陥を有する子供のグループについて報告した。近年の研究において、Ｋａｄｅｓｊｏ（１９９８）は注意欠陥と運動の不器用さとの間には相当共通する部分があることを見出した。この子供のグループにおいては、注意に関する問題と運動に関する問題の両方をもっている場合には予後が悪化する傾向があった（Ｈｅｉｉｇｒｅｎ， Ｇｉｌｌｂｅｒｇ， Ｇｉｌｌｂｅｒｇ ＆ Ｅｎｅｒｓｋｏｇ， １９９３； Ｈｅｉｉｇｒｅｎ， Ｇｉｌｌｂｅｒｇ， Ｂａｇｅｎｈｏｌｍ ＆ Ｇｉｌｌｂｅｒｇ， １９９４）。最近、Ｐｉｅｋ（１９９９）は、ＡＤＨＤ患者の注意散漫症状の重症度は、協調運動の困難性を予測する重要な要素であることを報告した。さらに最新の研究では、発展性協調運動障害を持つ全子供の約半数は中度から重度のＡＤＨＤの症状を有し、７歳時にＤＣＤと診断されることと１０歳時に読解力が不足することの間には関連があることを示唆している（Ｋａｄｅｓｊｏ ＆ Ｇｉｌｌｂｅｒｇ １９９９）。
ダイナミックシステム理論（ｄｙｎａｍｉｃ ｓｙｓｔｅｍｓ ｔｈｅｏｒｙ）（Ｓｍｉｔｈ ＆ Ｔｈｅｉｅｎ， １９９３； Ｇｒａｙ， Ｋｅｎｎｅｄｙ ＆ Ｚｅｍｋｅ， １９９６ａ， １９９６ｂ）用いて子供の適応・不適応行動を理解する発育の個人差関係（ＤＩＲ）モデル（Ｄｅｖｅｌｏｐｍｅｎｔａｌ Ｉｎｄｕｖｉｄｕａｌ−Ｄｉｆｆｅｒｅｎｃｅ Ｒｅｌａｔｉｏｎｓｈｉｐ ｍｏｄｅｌ）（Ｇｒｅｅｎｓｐａｎ １９９２； Ｇｒｅｅｎｓｐａｎ ＆ Ｗｉｅｄｅｒ， １９９９）によると、子供は、学校や家庭における多行程行動への参加及びその実行等の複雑な適応パターンを構築するために、運動のプランニング及びシーケンシング等の各種のユニークな処理能力を物理的環境や他者との対話に利用している。さらに、ＡＤＨＤに関係する神経ネットワークと運動プランニング及びタイミングの調節とはかなり共通する部分がある。これらのネットワークは脳の前頭前部及び線条体領域に関連する。ファンクショナルＭＲＩ評価を用いた最近の研究は、ＡＤＨＤを伴う子供の場合、高度な運動制御に係わる前頭前部系における活性が通常より低いことを報告している（Ｒｕｂｉａ ｅｔ ａｌ．， １９９９）。
運動調節と注意及び遂行機能との関係は、運動のプランニング、シーケンシング、タイミング及びリズム感の強化を目的とした技術が注意及び学習能力を改善するのに役立つ可能性があることを示唆している（Ｇｒｅｅｎｓｐａｎ， １９９２）。１９９２年に開発された従来のミュージックメトロノームを改良した特許取得済のＰＣベースのインタラクティブ型ミュージックメトロノームであるインタラクティブメトロノーム^Ｒ（Ｃａｓｓｉｌｙ， １９９６）は、運動調節に関連すると仮定されている中枢神経系の多くの基礎的な能力を促進する新しい教育技術を提供する。インタラクティブでないメトロノームは１６９６年にＥｔｉｅｎｎｅ Ｌｏｕｌｉｅによって発明されて以来、時間的教育のツールとして用いられてきた。インタラクティブメトロノーム^Ｒ（ＩＭ）は、最新のコンピュータの能力を利用してこの伝統的なツールにインタラクティブな要素を取り入れた初めてのものである。ユーザが自分の時間的精度をユーザ自身が精神的に評価しなければならなかったのに対し、ＩＭはユーザが一連の指示された動きを行う際に、ユーザ自身の時間的精度を表すためにユーザに正確な（０．５ミリ秒以内）リアルタイムガイド音を提供する。トーン及び空間的に変化するガイド音により、ユーザは、プランニング及びシーケンシング及びタイミングの誤差が生じた場合、その誤差を着実に修正することができる。　予備研究は、運動調節のプランニング、タイミング及びリズム感を伴うＩＭにおける個人パフォーマンスレベルが、発育、学習及び注意障害の重度、学力の改善及び在学中の年齢相応のパフォーマンスの変化と相関関係があることを示した（Ｋｕｈｌｍａｎ ＆ Ｓｃｈｗｅｉｎｈａｒｔ， １９９９）。ＩＭでトレーニングした様々な発育及び学習障害持つ特別教育学級の子供達は、このようなトレーニングを受けなかった同様のグループが同じ期間中に何ら回復を示さなかったのに対し、運動パフォーマンスの回復を示した（Ｓｔｅｍｍｅｒ， １９９６）。
近年の研究においては、ＩＭトレーニングがゴルファーの運動制御、集中力　及び運動能力を改善できることを示した（Ｌｉｂｋｍａｎ ＆ Ｏｔａｎｉ， １９９９）。現在の研究は、ＤＳＭ−ＩＶ（ＡＰＡ， １９９４）の注意欠陥障害の基準に当てはまる子供のグループに対して行うＩＭトレーニングの初めてのコントロールされた臨床トライアルである。この研究の目的は、ＡＤＨＤと診断された子供のグループの認知スキル及び運動の選択された様相に関するインタラクティブメトロノームの効果を確認することである。
研究デザイン
この研究は実験的プレテスト・ポストテスト測定デザインを用いた（第１図参照）。
【表１】

被験者
対象者は、この研究が行われた大メトロポリタン地域内のＡＤＨＤを伴う６〜１２歳の男子から選抜された。地域の学校区域、内科医、精神分析科医、精神科医及び地方新聞での広告を介して、地元の小児科医、小児科のサブスペシャリスト及び／又は精神科医／精神分析科医によりＤＳＭ−ＩＶ分類で注意欠陥多動性障害にあてはまる臨床診断の証明を持つ７５人のボランティアを採用した。テスト管理者は、無作為に特定された子供をそれぞれ審査し、プレテスト及びポストテストを行った。全てのテスト及び治療は、対象者の保護者に金銭的な負担をかけることなく行われた。全テスト管理者は、それぞれのテストを管理する資格を付与された職業精神測定士又は免許をもつ作業療法士（ＯＴＲ）である。テスト管理者は研究の目的及び誰が何の治療を受けたかを知らされなかった。
上記のスクリーニングの結果、１９人の対象者は、臨床又は研究の規準に合わない、又は、重度の学習欠陥、認知欠陥、神経性障害、不安症若しくは鬱症を有するため、ボランティアの集団から外した。この群において合格した５６人の被験者は、人口統計的に、６〜１２．５歳で８６％が白人、１４％が他の人種であった。対象者の親又は保護者の内、３２％は＄４０，０００未満、３８％は＄４０，０００〜＄６９，０００、３０％は＄７０，０００以上の所得があった。８０％の対象者は大学教育を受けた親を有した。
保護者及び子供の両者には、この研究の目的が「ＡＤＤ／ＡＤＨＤの治療及び対処における非薬学的方法の使用の調査」及び「この研究に用いられる治療はインタラクティブなコンピュータベースの治療プログラム」であることが伝えられた。また、両者は最終的に全ての被験者が全ての治療を受けることを伝えられた。そして、この研究に関するこれ以上の情報は、治療及びポストテストが完了するまで提供されなかった。一人の対象者は管理者に対し好戦的であったため、二日目の後、研究から除外された。調査が完了した後、ビデオ群及びコントロール群の両方の被験者はＩＭ療法を受けた。
手　段
４つの主要なパフォーマンス分類を評価対象とした。尚、評価手段は心理学、作業療法及び教育団体において最も一般的に使用されているものから選択した。信憑性及び有効性が示された評価手段のみを使用した（各手段の参考文献を参照）。下記手段のサマリースコア及びサブテストスコアを、以下の分野を評価するために用いた。
注意力及び集中力　１）Ｔｅｓｔｓ ｏｆ Ｖａｒｉａｂｌｅｓ ｏｆ Ａｔｔｅｎｔｉｏｎ（ＴＯＶＡ）は２５分間のコンピュータベースの試験であり、ＡＤＨＤの客観的判定に最も広く使用されている手段の一つである（Ｇｒｅｅｎｂｕｒｇ ＆ Ｄｕｐｕｙ， １９９３）。　２）Ｃｏｎｎｅｒｓ’ Ｒａｔｉｎｇ Ｓｃａｌｅｓ−改訂版（ＣＲＳ−Ｒ）教師・親用は親及び教師が答える質問表であり、ＡＤＨＤの主観的判定に最も広く使用されている手段の一つである。（Ｃｏｎｎｅｒｓ， １９９０）。　３）Ｗｅｃｈｓｌｅｒ 子供用知能テスト−第３版（ＷＩＳＣ−ＩＩＩ）は子供用知能テストとしてよく知られており、広く受容されている（Ｗｅｃｈｓｌｅｒ， １９９２）。　４）Ａｃｈｅｎｂａｃｈの子供の行動チェックリストは、保護者が質問表に答え、内在化した問題及び外面的行動を測定する（Ａｃｈｅｎｂａｃｈ， １９９１）。
臨床機能（ Ｃｌｉｎｉｃａｌ Ｆｕｎｃｔｉｏｎｉｎｇ ）　１）Ｃｏｎｎｅｒｓ Ｒａｔｉｎｇ Ｓｃａｌｅ。　２）Ａｃｈｅｎｂａｃｈの子供の行動チェックリスト。　３）感覚プロフィール‐聴覚、視覚、活動レベル、味覚／嗅覚、身体／位置、動き、触覚、感情／社会機能を評価する（Ｄｕｎｎ ＆ Ｗｅｓｔｍａｎ， １９９５）。　４）Ｂｒｕｉｎｉｎｋｓ−Ｏｓｅｒｅｔｓｋｙの運動効率テスト（Ｂ−Ｏ）（選択されたサブテスト）は両側の協調運動、上肢の協調運動、及び上肢の速さと器用さを評価する（Ｂｒｕｉｎｉｎｋｓ， １９７８）。
学力及び認知力　１）Ｗｉｄｅ Ｒａｎｇｅ Ａｃｈｉｅｖｅｍｅｎｔ Ｔｅｓｔ − ３（ＷＲＡＴ３）（読み書き）は読解（ｒｅａｄｉｎｇ ｄｅｃｏｄｉｎｇ）、スペリング及び算数計算を評価する。　２）言語表現テスト（ＬＰＴ）は基礎言語を評価する。
投薬スケジュールと日周性を制御するために、一日の同じ時刻に、プレテスト及びポストテストを対象者に行った。等価な形式を提供したテストに関しては、異なるフォームがポストテストに利用され、その後プレテストに利用された。プレテストとポストテストとの間の期間は４〜５週間であった。
ＩＭ治療及びビデオ治療コントロール群の管理者
ＩＭ及びビデオ群被験者は、両群の被験者を治療する雇われた管理者に無作為に割り当てられた。管理者は大学院学生、大学生、及び／又は上位の学位を有さず、正式の治療や教育の経験のない個人であった。各管理者は、ＩＭとビデオゲームの両方に関して、等しく六時間の教育を受けた。
ＩＭ群とビデオ群、両者のための環境と治療スケジュールを対等なものにした。管理者は、セッションの構成、会話に費やされる時間及び与えられる激励の量を制御する、両群の対象者のための毎日の治療養生法ガイドブックレットに従った。対象者は、自分の経験を他の対象者と分かち合わないように要求された。
治療−インタラクティブメトロノーム^Ｒ及びビデオゲーム
インタラクティブメトロノーム ^Ｒ 装置
研究に用いられた特許製品であるＩＭ装置は、ペンティアム（登録商標）コンピュータとＩＭソフトウェアプログラムと２つのヘッドフォンと２個の接触感知トリガからなる。一方のトリガ（掌側に接触センサが取り付けられた特殊なグラブ）は、手拍子をする際にトリガをつけた手がもう一方の手と接触すること、又は、一方の手が腿をタップすることを正確に感知する。他方のトリガ（床に置かれた平らなプラスチックパッド）は、つま先や踵がトリガをタップすることを感知する。
被験者がヘッドフォンからの聞こえる安定したメトロノームの基準ビート音に合わせて手足をタップしたとき、トリガはケーブルを介して信号をＩＭコンピュータプログラムに信号を送る。ＩＭは基準ビートを基準にタップの発生時点を正確に分析し、瞬時にタイミング情報をガイダンス信号に置き換える。被験者は各タップが発生する度にこのガイダンス信号を聞くことができる。ガイダンス信号音のピッチ及び左から右へ変化するヘッドフォン位置は各タップの精度に応じて精密に変化した。ＩＭプログラムは、画面上にミリ秒単位で表示されるプランニング及びシーケンシング精度スコア（ＩＭスコア）を発生し、被験者の応答がどの程度基準信号に合っているかを、その発生と同時に管理者に表示する。各エクササイズの後、被験者は各自のＩＭスコアを見ると、彼らはもっと上手くなりたいという意欲を持つようである。
ＩＭトレーニング　ＩＭ治療の目的は、被験者が能力を向上し、内面的な思考や外部からの撹乱による割込みなしに長い時間選択的に注意できるように助けることである。単純な手足の動きのエクササイズは、基礎となる精神集中向上プロセスをシステマティックに外部から促進するために用いられる。各対象者は１時間のＩＭトレーニングセッションを１５回（１日１回）、３〜５週間にわたって行った。各セッションは、毎日のレッスンブックレットに指示される４〜８エクササイズを特定の回数繰り返すことからなる。エクササイズは１分間に５４回繰り返すプリセットされたテンポで行われ、１エクササイズ中の繰り返し回数は第１セッションの際の２００回から、第９セッションの際の最高２０００回まで増加した。
１３種のＩＭ治療用エクササイズは、被験者の新しい身体運動の技術を発達させるためでなく、被験者が精神集中の向上に努力を傾けることを助けるようにデザインされた。これらエクササイズは、手拍子、大腿上部に片手のタップ、フロアトリガにつま先で交互のタップ、踵で交互のタップ、片方のつま先又は踵だけのタップ、大腿部に一方の手のタップとフロアトリガに反対側のつま先のタップを交互に行う、片足でバランスを取りながらの他方のつま先のタップを含む。
第１回のＩＭ治療セッションを開始する前に、ＩＭ被験者はタイミングパターンを認識する能力、選択的に一つのタスクに注意する能力及び単純な動作修正を行う能力を評価する自動ＩＭプレテストを与えられる。また、ＩＭプレテストは、被験者がＩＭ治療の初期段階で検討が必要となる１個以上のプランニング及びシーケンシング障害パターンを有するか否かを示した。ＩＭ治療の処方はデイリートレーニングガイドブックの指令に応じてデザインされ、段階的に行われる。
第１段階においては、管理者は被験者がＩＭプレテストにより認識された現在有するプランニング及びシーケンシング障害パターンを打破するように助ける。最も多く認識された６種のプランニング及びシーケンシング障害パターンは：（１）解離（Ｄｉｓａｓｓｏｃｉａｔｉｖｅ）（応答は混乱的で無作為及びビートとは全く関係ない−３人）；（２）反同調（Ｃｏｎｔｒａｐｈａｓｉｃ）（対象者の応答は数ビートの間に常にビートからはずれビートの中間に移動する−６人）；（３）超バリスティック（Ｈｙｐｅｒｂａｌｌｉｓｔｉｃ）（対象者は不適当なす早い衝撃的な動作を用いる−１６人）；（４）過度予測（Ｈｙｐｅｒａｎｔｉｃｉｐａｔｏｒｙ）（応答が継続的に基準ビートのかなり前で発生する−１８人）；（５）過少予測（Ｈｙｐｏａｎｔｉｃｉｐａｔｏｒｙ）（応答が継続的に基準ビートのかなり後で発生する−１人）；（６）聴覚過敏（Ａｕｄｉｔｏｒｙ Ｈｙｐｅｒｓｅｎｓｉｔｉｖｉｔｙ）（対象者は、最後のテストタスクの際ヘッドフォンミックスに追加されたコンピュータが発生するガイド音によって異常に撹乱され、彼らのＩＭｍｓスコアに示されるように、このタスクのスコアはガイド音が無い前の１３エクササイズのスコアより２〜３倍精度が落ちている−７人）。
最初のＩＭ治療セッションは、被験者が被験者自身の動作によりトリガされた音と安定したＩＭメトロノームビート音とを区別する方法の学習を助けることのために費やされた。被験者は、繰り返しパターンをビート間のどの時点でも止めず継続的に反復する、スムーズ且つ制御された手足の動きをするように指示される。被験者は、彼ら自身の思考や周囲で起こることに割込みされず、メトロノームのビートに焦点を合わせるように繰り返し指示される。被験者が、被験者の有するプランニング及びシーケンシングパターンを打破し、処方ブックレット中に指示されているＩＭミリ秒スコア平均を達成した場合、彼らは、ＩＭ治療プログラムの第２の異なるフェーズを始めるために必要な、適切な制御及び精度を達成したと考えた。
ＩＭ治療の第２段階では、被験者は、安定した基準ビートだけに注意の焦点を合わせ、彼らのトリガにより発生するガイド音や内面的思考や周囲の無関係な刺激を無視するように指示される。また、彼らは、全く意図的な調整なく、彼らの動作パターンを繰り返し続けるように指示される。このようにした結果、通常被験者のスコアに明らかな改善が得られ、努力をせずにビートに合い続けるという楽しい体験は、積極的な動機付け効果を有するようである。セッションごとに、被験者は中断なしにメトロノームビートに選択的に集中できる時間が長くなり、それに対応するように彼らのＩＭプログラムスコアは向上する。ほとんどのＩＭ被験者は、彼らのトレーニング処方の際、できる限り良いスコアを達成するように強い意欲をもつように見受けられた。ＩＭトレーニングのスコアによれば、ＩＭ群の各被験者は全員、彼らのプランニング及びシーケンシングを改善し、彼らのトレーニングが終わる頃には、著しく長い時間、中断なしにタスクをやり続けることができた。
ビデオコントロール群のプラセボコンピュータゲームトレーニング活動
市販のＰＣベースのビデオゲームから５つの非暴力的ゲームが、ビデオコントロール群のプラセボ治療に用いられた。各ゲームは、目と手の協調運動、高等な精神プランニング及びマルチプルタスクシーケンシングに関連する。各ゲームにおいて、対象者はコンピュータプログラミングを相手にプレイし、新しいレベルに入る毎に、プレイが次第に難しくなる。
管理者は、ＩＭ処方ブックレットの場合と同様にデイリービデオ群トレーニング処方ブックレットに従った。ブックレット中の指示はＩＭ群が受けるような監視、注意及び補助の形式を提供する。各対象者は１時間のビデオトレーニングセッションを１５回（１日１回）、３〜５週間にわたって行った。各トレーニングセッションはいくつかのビデオゲームエクササイズを含み、対象者が各ビデオゲームエクササイズに費やす時間は、最初のセッションから最後のセッションにつれて一般的に長くなった。
分　析
サンプリングデザイン及び結果
全５６被験者のプレテスト完了に続いて、マッチドランダムアサインメントプロセス（ｍａｔｃｈｅｄ ｒａｎｄｏｍ ａｓｓｉｇｎｍｅｎｔ ｐｒｏｃｅｓｓ）が３つの治療群を形成するために用いられた。マッチングプロセスには３個の要素が用いられた：薬物投与量（ミリグラム／体重）、被験者の年齢、ＴＯＶＡ・ＡＤＨＤスコアにより測定されたＡＤＨＤの重度。これらの要素は、薬物治療の効果、発育年齢差、ＡＤＨＤの重度を制御するために選択された。これら３個のマッチング変数の分散の分析は、３つの比較群の間で、有意（ｓｉｇｎｉｆｉｃａｎｃｅ）レベルがｐ≦０．０５のとき有意差がないことを示した。３つの人口統計学的変数（対象者の人種、親が受けた教育、親の所得）のカイ２乗分析は上記ｐ≦０．０５で統計的有意差はないことを示し、３つの比較群は３つの社会経済学的要素について同等であることを示唆した。
５８個のプレテストの要素の分散の分析は、３つの比較群の間に１つだけ統計的に有意差があることを示した。有意差テストのためのサコダの表（Ｓａｋｏｄａ’ｓ ｔａｂｌｅ，（１９７４））は、５８有意テストの内のこの１つの有意差が偶然に発生する確率はｐ＞０．５０であると示し、この単一発生は偶然差異（ｃｈａｎｃｅ ｄｉｆｆｅｒｅｎｃｅ）であると推定する。残りの５７要素から得られたｐ値はｐ＞０．０５を超えた。
パターン分析
５８テストスコアのパターン分析は各群のプレ及びポストテストフェーズ間の平均差異（ｍｅａｎ ｄｉｆｆｅｒｅｎｃｅ）の全体的な方向を検査した。分析を行う際、各テストの平均（プレテスト＝Ｐ１、ポストテスト＝Ｐ２）が計算され、Ｐ１とＰ２との平均差異が求められた。各群の平均差異は、変化が各テストのための所望の方向における向上を又は低下を示すかによりに２分化された。たとえば、３群のウェスラーディジットスパン（Ｗｅｃｈｓｌｅｒ Ｄｉｇｉｔ Ｓｐａｎ）サブテストのＰ２−Ｐ１平均差異はそれぞれＩＭ＝＋０．４７３、コントロール＝−０．２７８、ビデオ＝−０．０５４であった。平均差異は、ＩＭ群のパフォーマンスは向上したのに対し、コントロール及びビデオのパフォーマンスは低下したことを示した。同様の分析は５８テストスコア全てについて行われた。
このパターンを統計的にテストするために、二項テストが用いられ、２分化対（ｄｉｃｈｏｔｏｍｏｕｓ ｐａｉｒ）（向上ｖｓ．低下）の割合が偶然発生であるか（但し、向上又は低下いずれかの確率は０．５０）、又は方向性割合（ｄｉｒｅｃｔｉｏｎａｌ ｐｒｏｐｏｒｔｉｏｎ）が非偶然事象を反映するほど異常であるかを求めた。二項テストを用いる根拠は、もし変数の多数が全体として異常な方向性の傾向（例えば、向上したパフォーマンス）を示す場合、これは変化全体のパターンが関心に値することを示すという仮定に基づく。二項テストは、個々の変数を一つずつ検討した場合には検出しない組み合わせ方向性パターンの検出が可能となる。
パターン分析は以下のことを示した。コントロール群では２８個の変数のスコアが向上、３０個の変数のスコアが低下した。この結果は、ｐ＝０．８９５５という高い偶然発生確率を有し、統計的に有意な組み合わせ方向性パターンは存在しないことを示唆した（Ｎｏｒｕｓｉｓ， １９９３）。ＩＭ及びビデオ群の分析は統計的に有意な向上／低下を示した。ＩＭ群においては、５８個中５３個の変数が向上を示した（ｐ≦０．０００１）。ビデオ群においては、５８個中４０個の変数が向上を示した（ｐ≦０．００５８）。両群は、コントロール群に対しパフォーマンスにおいて統計的に有意なパターン増加を示した。ＩＭ群は、ビデオ群より著しく良好な向上を体験し、ＩＭ治療がビデオコントロール群の体験を上回る統計的に有意な付加的な効果を発生することを示唆する。
有意差の分析
パターン分析の結果、テスト平均差異の全体的な向上／低下特性を認識できたが、これら差異の大きさは検討しなかった。プレテスト／ポストテスト反復測定デザインが用いられたため、反復測定の分散の分析（ＳＰＳＳ， １９８８）が５８個の変数のそれぞれについて行われた。このアプローチは、各テストスコアにおける３つの治療群の効果を別々に観察するために選択された。しかしながら、このアプローチの１つの不利な点は、タイプ１エラーが増加する可能性があることである。
分析された５８個のテストスコアの内、１２個は統計的に有意な相互作用効果（ｐ値の範囲が０．０４７〜０．０００１）を有し、幾つかの治療の組み合わせとサブグループ平均が異なること、及び／又は、統計的に有意なプレ−ポストテストの差があったことを示唆した。５８個の有意テストの内の１２個の有意差はｐ≦０．００１（０．０５信頼レベルにおいて、Ｓａｋｏｄａ， １９７４）であり、これらの差は偶然発生ではないことを示唆する。さらに、５８の個別の実験全体での起こり得るタイプ１エラーの数についてのケッペル（１９７３）の計算値は２．９であった。よって、これら１２の統計的有意差は、計算された起こり得るタイプ１エラーの数である２．９を遥かに上回り、これらの差異は実際に統計的に有意な差であることを示唆している。
上記の統計的に有意な効果の中に、七つの統計的有意差相間（ｂｅｔｗｅｅｎ− ｐｈａｓｅｓ）効果が見出された（ｐ値の範囲が０．０２３〜０．０００１）。この分析は、ＩＭ治療群が、概念間の類似性と差異を識別すること、及び彼等の親によって報告されているような攻撃的な行動の低下を経験することにおいて、彼等の能力に統計的に有意な向上を見出した。ＩＭとビデオ治療の両方が、三つの感覚プロフィール（Ｓｅｎｓｏｒｙ Ｐｒｏｆｉｌｅ）サブテストで統計的に有意な向上を生み出し、このことは、両群がこれ等の治療で提供される注意と活動から利益を与えられていることを示唆している。又、子供の行動チェックリストに基づく親の報告書により、攻撃的行動に関して、ＩＭ群では統計的に有意な低下を示し、ビデオ群にでは統計的に有意でない向上を示し、制御群では向上が見られなかったことがあきらかとなった。
残る五つのテストは有意に異なる相互作用効果を有していた（ｐ値０．０００１から０．０４７の間で）。これら五つのテストはＷＲＡＴ−３読字サブテストとオミッシヨン（Ｏｍｉｓｓｉｏｎｓ）、ＲＴバリアビリティ（Ｖａｒｉａｂｉｌｉｔｙ）、ＲＴバリアビリティ（Ｖａｒｉａｂｉｌｉｔｙ）総合標準偏差（Ｔｏｔａｌ−ＳＴＤ Ｄｅｖｉａｔｉｏｎ）、及びＡＤＨＤ全スコア（Ｔｏｔａｌ Ｓｃｏｒｅ）を含む注意変数（Ｔｈｅ Ｖａｒｉａｂｌｅｓ ｏｆ Ａｔｔｅｎｔｉｏｎ）（ＴＯＶＡ）の四つのテストを含んでいた。有意な相互作用効果は、ポストテストＩＭパフォーマンスが、プレテストパフォーマンスより有意には向上していないが、それにもかかわらず、コントロールとビデオ治療のポストテストパフォーマンスに比べて統計的に有意なより高度なパフォーマンスを示したということを示唆する。五つのテスト全てに対して、差異のパターンは同等であった。即ち、ＩＭパフォーマンスは向上したが、コントロールとビデオ両パフォーマンスは低下した。
要約すると、パターン分析の結果、ＩＭとビデオ両群については、５８テストスコアに全体にわたって統計的に有意な改善パターンを経験したことが明らかとなった。更に、ＩＭ群はビデオ群よりも統計的に有意により強い改善パターンを有し、ビデオ群が４０であるのに対し、５３テストスコアで向上を示した。このことは、ＡＤＨＤ障害を伴う男の子供については、ＩＭトレイニングが、ビデオ群よりも強い向上パターンを生み出したという仮説を裏付けている。
テスト平均値の分析は、群と治療の種々の組み合わせの中で統計的に有意な量的変化を有する１２ファクターを見出した。ＩＭ群は、他の二つの治療群に比べて、プレテストに比べてポストテストで、類似性と差異の識別及び攻撃問題の減少において、統計的に有意な向上を示した。ＩＭとビデオ両群は、三つの感覚処理タスクと衝動／多動に関する両親の報告書において統計的に有意な向上を示した。しかしながら、ＩＭ対象者の両親だけが、他の二群の両親に比べて、治療期間の後に、かれ等の子供達を統計的に有意に攻撃性が減少した（ｐ≦０．００１）と評価した。更に、読字及び注意の四特性を計測する五つテストにより、他の二つの治療群に対するパフォーマンスに比べて、ＩＭ群が統計的に有意により高いポストテストパフォーマンスを有することが明らかになった。
議　論
結果は、ＩＭインターベンションを受けたＡＤＨＤを有する少年達は、ビデオ治療を受けている少年達やインターベンションを受けないコントロール群の少年達よりも、注意、運動制御、言語処理、及び読字の領域において、並びに攻撃を調整する能力に於いて有意により向上したことを示した。ビデオゲームのコーチを受けた少年達は、幾つかの尺度では、コントロール群よりも向上し、集中した知覚活動と支援だけで、機能の選択された領域に対して役に立つことを証明した。しかしながら、ビデオ群は又、集中力の一貫性、応答時間、及び全体的な注意力のような調整及び制御を伴う特定の領域ではパフォーマンスが明らかに低下した。
他方、ＩＭトレーニングは、誤差と散漫性の欠如、応答時間の一貫性、及び全体的な注意力を計測する一連のＴＯＶＡ注意力タスク、特定言語（即ち、類似性と差異）、学問的タスク（読字）、及び攻撃の制御に関して、ビデオ治療群よりも統計的に有意な正のゲインを含む向上したパフォーマンスを明白に示した。更に、パターン分析が、多数の数の評価を用いることの効果を制御するために使用され、複数の群のパターン間の差異は統計的に有意であると証明した。ＮＩＨ　Ｃｏｎｓｅｎｓｕｓ　Ｓｔａｔｅｍｅｎｔ（１９９７）は、ＡＤＨＤインターベンションに関する研究は、注意深い大人の相互作用の全体としての肯定的な効果だけのために、適切に制御しなければならないと主張している。ＮＩＨガイドラインと一致して、この研究における三群の内の二群は、治療期間に大人の注意を受けた。
この研究の方法論的な考慮と制約は以下のものを含む。定義された年齢範囲の男性だけが、年齢と性による変動を最小にするために含まれており、結果を女性及び他のＡＤＨＤ男性年齢群に一般化するのを制約している。評価によって計測される変数は、注意、運動制御、言語、認知、及び学習の選択された面に限られている。
この研究に於いて、ＩＭトレーニングは多くのパフォーマンス能力に影響を与えた。肯定的な変化に対する可能な説明は、これ等のパフォーマンス分野の各々に於いて、運動のプラニングとシーケンシングが中心的な役割であるということである。ダイナミックシステムモデル（Ｓｍｉｔｈ ＆ Ｔｈｅｌｏｎ， １９９３）では、活動をプランしシーケンスする能力のような重大な変数が、注意力などの広範な適応機能に影響を与える（Ｇｒｅｅｎｓｐａｎ， １９９２）。
現在の研究の結果は更なる研究のための方向を示唆し、その方向は、（メトロノームトレーニングに対する異なる応答パターンに関連する特徴の識別を可能にするであろう）より多くの人数に対して現在の研究を繰り返すこと、女性に対して現在の研究を繰り返すこと、及び異なる環境背景の潜在的な要素を観測するために社会経済的により多様な人々に対して現在の研究を繰り返すことを含む。又、更なる研究が、メトロノームパフォーマンスと子供の処理プロフィールの両方に基づいてサブグループを研究することを可能にするであろう。
又、ＩＭトレーニングプロセスの具体的なバリエーションを開発する必要があり、そのバリエーションは、セッション数、全般の繰り返し、時間的精度のゴール、及びフォローアップ時間の長さ（ＩＭ効果の安定性を観測するための）を増大させる事を含む。更に、ダイナミックシステムと運動調整に関連している基礎となっている中心神経システム機構の両方を理解すること、及びＩＭトレーニングがこれ等のプロセスに影響を与える方法をもっと充分に理解するためには、更なる研究が必要である。ＩＭは、種々の知覚運動プロセスでのタイミングに影響を及ぼすインターベンションの効果を比較するのに役立つ「タイミング」についてのデータベースと分類を作ることを可能にする始めての技術であろう。
結論として、ダイナミックシステムの全体像から（Ｓｍｉｔｈ ＆ Ｔｈｅｌｅｎ， １９９３； Ｇｒａｙ， ｅｔ ａｌ．， １９９６ａ， １９９６ｂ）、運動挙動のタイミングやリズム性等の多くのプロセスが運動プラニングに影響を与える。更に、運動プラニングは、学習機会と環境的要求等の他のファクターと相互作用し、家庭、学校に於ける、並びに仲間との自己調整及びファンクショニングのパターンに影響を及ぼす。最近までは、これ等の能力を強化するインターベンションは、教育又は治療の場での明白な又は表面だけの振舞を研究の対象にするように限られていた。本研究は、ＩＭトレーニングは、注意、運動、及び知覚運動機能、認知と学問的パフォーマンス、及び重大な注意問題を有する子供における攻撃の制御の面を向上させ得ることを示唆しており、それ故に、ＩＭトレーニングはこれ等子供達のための現存するインターベンションを補足することができる。
参考文献
Ａｃｈｅｎｂａｃｈ， Ｔ． Ｍ．， ＆ Ｅｄｅｌｂｒｏｃｋ， Ｃ． Ｅ． （１９９１）， 「子供の行動のチェックリスト（Ｃｈｉｌｄ Ｂｅｈａｖｉｏｒ Ｃｈｅｃｋｌｉｓｔ）」， Ｄｅｐａｒｔｍｅｎｔ ｏｆ Ｐｓｙｃｈｉａｔｒｙ， Ｕｎｉｖｅｒｓｉｔｙ ｏｆ Ｖｅｒｍｏｎｔ， Ｂｕｒｌｉｎｇｔｏｎ， ＶＴ．
ＡＰＡ ＤＳＭ−ＩＶ Ｔａｓｋ Ｆｏｒｃｅ （１９９４）， 「ＤＳＭ−ＩＶ診断及び統計の手引き（ＤＳＭ−ＩＶ Ｄｉａｇｎｏｓｔｉｃ ａｎｄ Ｓｔａｔｉｓｔｉｃａｌ Ｍａｎｕａｌ）」， Ｗａｓｈｉｎｇｔｏｎ， ＤＣ； Ａｍｅｒｉｃａｎ Ｐｓｙｃｈｉａｔｒｉｃ Ｐｒｅｓｓ
Ｂａｒｋｌｅｙ， Ｒ． （１９９７ａ）， 「注意欠陥多動性障害、自己調節および時間：より包括的な理論のために（Ａｔｔｅｎｔｉｏｎ−ｄｅｆｉｃｉｔ／ｈｙｐｅｒａｃｔｉｖｉｔｙ ｄｉｓｏｒｄｅｒ， ｓｅｌｆ−ｒｅｇｕｌａｔｉｏｎ， ａｎｄ ｔｉｍｅ： Ｔｏｗａｒｄ ａ ｍｏｒｅ ｃｏｍｐｒｅｈｅｎｓｉｖｅ ｔｈｅｏｒｙ）」， Ｊｏｕｒｎａｌ ｏｆ Ｄｅｖｅｌｏｐｍｅｎｔａｌ ａｎｄ Ｂｅｈａｖｉｏｒａｌ Ｐｅｄｉａｔｒｉｃｓ， １８：２７１−９
Ｂａｒｋｌｅｙ， Ｒ． Ａ． （１９９７ｂ）， 「行動抑制力、持続的注意力および実行機能：ＡＤＨＤの統一理論の構築（Ｂｅｈａｖｉｏｒａｌ ｉｎｈｉｂｉｔｉｏｎ， ｓｕｓｔａｉｎｅｄ ａｔｔｅｎｔｉｏｎ， ａｎｄ ｅｘｅｃｕｔｉｖｅ ｆｕｎｃｔｉｏｎｓ： ｃｏｎｓｔｒｕｃｔｉｎｇ ａ ｕｎｉｆｙｉｎｇ ｔｈｅｏｒｙ ｏｆ ＡＤＨＤ）」， Ｐｓｙｃｈｏｌｏｇｉｃａｌ Ｂｕｌｌｅｔｉｎ， １２１：６５−９４
Ｂａｒｋｌｅｙ， Ｒ． Ａ．， Ｋｏｐｌｏｗｉｔｚ， Ｓ．， Ａｎｄｅｒｓｏｎ， Ｔ．， ＆ ＭｃＭｕｒｒａｙ， Ｍ． Ｂ． （１９９７）， 「ＡＤＨＤをもつ子供の時間に対する感覚：持続、撹乱および刺激剤治療の効果 （Ｓｅｎｓｅ ｏｆ ｔｉｍｅ ｉｎ ｃｈｉｌｄｒｅｎ ｗｉｔｈ ＡＤＨＤ： Ｅｆｆｅｃｔｓ ｏｆ ｄｕｒａｔｉｏｎ， ｄｉｓｔｒａｃｔｉｏｎ， ａｎｄ ｓｔｉｍｕｌａｎｔ ｍｅｄｉｃａｔｉｏｎ）」， Ｊｏｕｒｎａｌ ｏｆ Ｉｎｔｅｒｎａｔｉｏｎａｌ Ｎｅｕｒｏｐｓｙｃｈｏｌｏｇｉｃａｌ Ｓｏｃｉｅｔｙ， ３：３５９−６９
Ｂｒｕｉｎｉｎｋｓ Ｒ． Ｈ． （１９７８）， 「運動神経向上のＢｒｕｉｎｉｎｋｓ−Ｏｓｅｒｅｔｓｋｙ試験：試験者手引き（Ｂｒｕｉｎｉｎｋｓ−Ｏｓｅｒｅｔｓｋｙ ｔｅｓｔ ｏｆ ｍｏｔｏｒ ｐｒｏｆｉｃｉｅｎｃｙ： ｅｘａｍｉｎｅｒｓ ｍａｎｕａｌ）」， Ｃｉｒｃｌｅ Ｐｉｎｅｓ， ＭＮ： Ａｍｅｒｉｃａｎ Ｇｕｉｄａｎｃｅ Ｓｅｒｖｉｃｅ
Ｃａｓｓｉｌｙ， Ｊ． Ｆ．， （１９９６）， 「神経学的葛藤の診断方法及び装置（Ｍｅｔｈｏｄｓ ａｎｄ Ａｐｐａｒａｔｕｓ ｆｏｒ Ｍｅａｓｕｒｉｎｇ ａｎｄ Ｅｎｈａｎｃｉｎｇ Ｎｅｕｒａｌ Ｍｏｔｏｒ Ｃｏｏｒｄｉｎａｔｉｏｎ）」， 米国特許第５，５２９，４９８号：１９９６年６月２５日
Ｃｏｎｎｅｒｓ， Ｃ． Ｋ． Ｐｈ．Ｄ． （１９９０）， 「コナーズの評価スケール‐改訂版（ＣＲＳ−Ｒ）．ＰＡＲ（Ｃｏｎｎｅｒｓ’ Ｒａｔｉｎｇ Ｓｃａｌｅｓ − Ｒｅｖｉｓｅｄ （ＣＲＳ−Ｒ）． ＰＡＲ）」， Ｐｓｙｃｈｏｌｏｇｉｃａｌ Ａｓｓｅｓｓｍｅｎｔ Ｒｅｓｏｕｒｃｅｓ， Ｉｎｃ．， ２２： ５ｆ
Ｄｅｎｃｋｌａ． Ｍ． Ｂ．， Ｒｕｄｅｌ． Ｒ． Ｇ．， Ｃｈａｐｍａｎ， Ｃ．， ＆ Ｋｒｉｅｇｅｒ， Ｊ． （１９８５）， 「注意障害をもつ失読症患児ともたない失読症患児の運動神経向上（Ｍｏｔｏｒ ｐｒｏｆｉｃｉｅｎｃｙ ｉｎ ｄｙｓｌｅｘｉｃ ｃｈｉｌｄｒｅｎ ｗｉｔｈ ａｎｄ ｗｉｔｈｏｕｔ ａｔｔｅｎｔｉｏｎａｌ ｄｉｓｏｒｄｅｒｓ）」， Ａｒｃｈｉｖｅｓ ｏｆ Ｎｅｕｒｏｌｏｇｙ， ４２： ２２８−３．
Ｄｕｎｎ， Ｗ．， Ｗｅｓｔｍａｎ， Ｋ． （１９９５）， 「知覚プロファイル研究、作業療法教育 （Ｓｅｎｓｏｒｙ ｐｒｏｆｉｌｅ ｓｔｕｄｙ， ｏｃｃｕｐａｔｉｏｎａｌ ｔｈｅｒａｐｙ ｅｄｕｃａｔｉｏｎ）」， Ｋａｎｓａｓ Ｃｉｔｙ， ＫＡ： Ｕｎｉｖｅｒｓｉｔｙ ｏｆ Ｋａｎｓａｓ
ＤｕＰａｕｌ， Ｇ， Ｊ．， Ｂａｒｋｌｅｙ， Ｒ． Ａ．， ＆ ＭｃＭｕｒｒａｙ， Ｍ． Ｂ． （１９９４）， 「ＡＤＨＤをもつ子供のメチルフェニデートに対する反応：内在化する症状との相互作用 （Ｒｅｓｐｏｎｓｅ ｏｆ ｃｈｉｌｄｒｅｎ ｗｉｔｈ ＡＤＨＤ ｔｏ ｍｅｔｈｙｌｐｈｅｎｉｄａｔｅ： ｉｎｔｅｒａｃｔｉｏｎ ｗｉｔｈ ｉｎｔｅｒｎａｌｉｚｉｎｇ ｓｙｍｐｔｏｍｓ）」， Ｊｏｕｒｎａｌ ｏｆ ｔｈｅ Ａｍｅｒｉｃａｎ Ａｃａｄｅｍｙ ｏｆ Ｃｈｉｌｄ ａｎｄ Ａｄｏｌｅｓｃｅｎｔ Ｐｓｙｃｈｉａｔｒｙ， ３３： ８９４−９０３
Ｇｉｌｌｂｅｒｇ， Ｉ． Ｃ． ＆ Ｇｉｌｌｂｅｒｇ， Ｃ． （１９８８）， 「注意力、運動制御および知覚障害（ＤＡＭＰ）をもつ子供：専門家による処置の必要性（Ｃｈｉｌｄｒｅｎ ｗｉｔｈ ｄｅｆｉｃｉｔｓ ｉｎ ａｔｔｅｎｔｉｏｎ， ｍｏｔｏｒ ｃｏｎｔｒｏｌ ａｎｄ ｐｅｒｃｅｐｔｉｏｎ （ＤＡＭＰ）： ｎｅｅｄ ｆｏｒ ｓｐｅｃｉａｌｉｓｔ ｔｒｅａｔｍｅｎｔ）」， Ａｃｔａ Ｐａｅｄｉａｔｒ Ｓｃａｎｄ ７７： ４５０−４５１
Ｇｒａｙ， Ｊ． Ｍ．， Ｋｅｎｎｅｄｙ， Ｂ．， ＆ Ｚｅｍｋｅ， Ｒ． （１９９６ａ）， 「職業へのダイナミックシステム理論の応用（Ａｐｐｌｉｃａｔｉｏｎ ｏｆ ｄｙｎａｍｉｃ ｓｙｓｔｅｍｓ ｔｈｅｏｒｙ ｔｏ ｏｃｃｕｐａｔｉｏｎ）」， Ｉｎ Ｒ． Ｚｅｍｋｅ ＆ Ｆ． Ｃｌａｒｋ（編）， Ｏｃｃｕｐａｔｉｏｎａｌ ｓｃｉｅｎｃｅ： Ｔｈｅ ｅｖｏｌｖｉｎｇ ｄｉｓｃｉｐｌｉｎｅ （頁 ３００−３２４）， Ｐｈｉｌａｄｅｌｐｈｉａ： Ｆ． Ａ． Ｄａｖｉｓ
Ｇｒａｙ， Ｊ． Ｍ．， Ｋｅｎｎｅｄｙ， Ｂ．， ＆ Ｚｅｍｋｅ， Ｒ．（１９９６ｂ）， 「ダイナミックシステム理論：概論（Ｄｙｎａｍｉｃ ｓｙｓｔｅｍｓ ｔｈｅｏｒｙ： Ａｎ ｏｖｅｒｖｉｅｗ）」， Ｉｎ Ｒ． Ｚｅｍｋｅ ＆ Ｆ． Ｃｌａｒｋ （編）， Ｏｃｃｕｐａｔｉｏｎａｌ ｓｃｉｅｃｅ： Ｔｈｅ ｅｖｏｌｖｉｎｇ ｄｉｓｃｉｐｌｉｎｅ， （頁 ２９７−３０８）， Ｐｈｉｌａｄｅｌｐｈｉａ： Ｆ． Ａ． Ｄａｖｉｓ
Ｇｒｅｅｎｂｅｒｇ， Ｌ． Ｍ． ＆ Ｄｕｐｕｙ， Ｔ． Ｒ． （１９９３）， 「注意力の変数の試験のコンピュータープログラムための解釈手引書（Ｉｎｔｅｒｐｒｅｔａｔｉｏｎ ｍａｎｕａｌ ｆｏｒ ｔｈｅ Ｔｅｓｔ ｏｆ Ｖａｒｉａｂｌｅｓ ｏｆ Ａｔｔｅｎｔｉｏｎ ｃｏｍｐｕｔｅｒ ｐｒｏｇｒａｍ）」， （Ａｖａｉｌａｂｌｅ ｆｒｏｍ Ｕｎｉｖｅｒｓａｌ Ａｔｔｅｎｔｉｏｎ Ｄｉｓｏｒｄｅｒｓ， ４２８１ Ｋａｔｅｌｌａ Ａｖｅｎｕｅ， ＃２１５， Ｌｏｓ Ａｌａｍｉｔｏｓ， ＣＡ ９０７２０）
Ｇｒｅｅｎｓｐａｎ， Ｓ． Ｉ． （１９９２）， 「幼児期および低年齢児期：情緒および発達障害の臨床アセスメントおよびインターベンションの実践（Ｉｎｆａｎｃｙ ａｎｄ Ｅａｒｌｙ Ｃｈｉｌｄｈｏｏｄ： Ｔｈｅ Ｐｒａｃｔｉｃｅ ｏｆ Ｃｌｉｎｉｃａｌ Ａｓｓｅｓｓｍｅｎｔ ａｎｄ Ｉｎｔｅｒｖｅｎｔｉｏｎ ｗｉｔｈ Ｅｍｏｔｉｏｎａｌ ａｎｄ Ｄｅｖｅｌｏｐｍｅｎｔａｌ Ｃｈａｌｌｅｎｇｅｓ）」， Ｍａｄｉｓｏｎ， ＣＴ： Ｉｎｔｅｒｎｅｔ， Ｕｎｉｖ． Ｐｒｅｓｓ
Ｇｒｅｅｎｓｐａｎ， Ｓ． Ｉ． （１９９７）， 「精神の成長と危機的な知性の系統（Ｔｈｅ Ｇｒｏｗｔｈ ｏｆ ｔｈｅ Ｍｉｎｄ ａｎｄ ｔｈｅ Ｅｎｄａｎｇｅｒｅｄ Ｏｒｉｇｉｎｓ ｏｆ Ｉｎｔｅｌｌｉｇｅｎｃｅ）」， Ｒｅａｄｉｎｇ， ＭＡ： Ａｄｄｉｓｏｎ Ｗｅｓｌｅｙ Ｌｏｎｇｍａｎ
Ｇｒｅｅｎｓｐａｎ， Ｓ． Ｉ． ａｎｄ Ｌｏｕｒｉｅ， Ｒ． Ｓ． （１９８１）， 「適応的および病理学的人格構成の分類への発達過程の構造言語学者的アプローチ：幼児期および低年齢児期への応用（Ｄｅｖｅｌｏｐｍｅｎｔａｌ ｓｔｒｕｃｔｕｒａｌｉｓｔ ａｐｐｒｏａｃｈ ｔｏ ｔｈｅ ｃｌａｓｓｉｆｉｃａｔｉｏｎ ｏｆ ａｄａｐｔｉｖｅ ａｎｄ ｐａｔｈｏｌｏｇｉｃ ｐｅｒｓｏｎａｌｉｔｙ ｏｒｇａｎｉｚａｔｉｏｎｓ： Ａｐｐｌｉｃａｔｉｏｎ ｔｏ ｉｎｆａｎｃｙ ａｎｄ ｅａｒｌｙ ｃｈｉｌｄｈｏｏｄ）」， Ａｍｅｒｉｃａｎ Ｊｏｕｒｎａｌ ｏｆ Ｐｓｙｃｈｉａｔｒｙ， １３８： ６
Ｇｒｅｅｎｓｐａｎ， Ｓ． Ｉ ＆ Ｗｉｅｄｅｒ， Ｓ． （１９９９）， 「自閉症スペクトル障害に対する機能発達アプローチ（Ａ ｆｕｎｃｔｉｏｎａｌ ｄｅｖｅｌｏｐｍｅｎｔａｌ ａｐｐｒｏａｃｈ ｔｏ ａｕｔｉｓｍ ｓｐｅｃｔｒｕｍ ｄｉｓｏｒｄｅｒｓ）」， Ｊｏｕｒｎａｌ ｏｆ ｔｈｅ Ａｓｓｏｃｉａｔｉｏｎ ｆｏｒ Ｐｅｒｓｏｎｓ ｗｉｔｈ Ｓｅｖｅｒｅ Ｈａｎｄｉｃａｐｓ （ＪＡＳＨ）， ２４：１４７−１６１
Ｈｅｌｌｇｒｅｎ， Ｌ．， Ｇｉｌｌｂｅｒｇ， Ｃ．， Ｇｉｌｌｂｅｒｇ． Ｉ． Ｃ．， ＆Ｅｎｅｒｓｋｏｇ， Ｉ． （１９９３）， 「大人になる直前のＤＡＭＰを有する子供；１６歳における一般的健康（Ｃｈｉｌｄｒｅｎ ｗｉｔｈ ｄｅｆｉｃｉｔｓ ｉｎ ａｔｔｅｎｔｉｏｎ， ｍｏｔｏｒ ｃｏｎｔｒｏｌ ａｎｄ ｐｅｒｃｅｐｔｉｏｎ （ＤＡＭＰ） ａｌｍｏｓｔ ｇｒｏｗｎ ｕｐ； ｇｅｎｅｒａｌ ｈｅａｌｔｈ ａｔ １６ ｙｅａｒｓ）」， Ｄｅｖｅｌｏｐｍｅｎｔａｌ Ｍｅｄｅｃｉｎｅ ａｎｄ Ｃｈｉｌｄ Ｎｅｕｒｏｌｏｇｙ， ３５：８８１−９２
Ｈｅｌｌｇｒｅｎ， Ｌ．， Ｇｉｌｌｂｅｒｇ， Ｉ， Ｃ．， Ｂａｇｅｎｈｏｌｍ， Ａ．， ＆ Ｇｉｌｌｂｅｒｇ， Ｃ． （１９９４）， 「大人になる直前のＤＡＭＰを有する子供；１６歳における精神及び人格障害（Ｃｈｉｌｄｒｅｎ ｗｉｔｈ ｄｅｆｉｃｉｔｓ ｉｎ ａｔｔｅｎｔｉｏｎ， ｍｏｔｏｒ ｃｏｎｔｒｏｌ ａｎｄ ｐｅｒｃｅｐｔｉｏｎ （ＤＡＭＰ） ａｌｍｏｓｔ ｇｒｏｗｎ ｕｐ； ｐｓｙｃｈｉａｔｒｉｃ ａｎｄ ｐｅｒｓｏｎａｌｉｔｙ ｄｉｓｏｒｄｅｒｓ ａｔ ａｇｅ １６ ｙｅａｒｓ）」， Ｊｏｕｒｎａｌ ｏｆ Ｃｈｉｌｄ Ｐｓｙｃｈｏｌｏｇｙ ａｎｄ Ｐｓｙｃｈｉａｔｒｙ ａｎｄ Ａｌｌｉｅｄ Ｄｉｓｃｉｐｌｉｎｅｓ， ２５：１２５５−７１
Ｋａｄｅｓｊｏ， Ｂ． ＆ Ｇｉｌｌｂｅｒｇ， Ｉ． Ｃ． （１９９８）， 「スウェーデンの７歳児における注意欠陥及び不器用さ（Ａｔｔｅｎｔｉｏｎ ｄｅｆｉｃｉｔｓ ａｎｄ ｃｌｕｍｓｉｎｅｓｓ ｉｎ Ｓｗｅｄｉｓｈ ７−ｙｅａｒ−ｏｌｄ ｃｈｉｌｄｒｅｎ）」， Ｄｅｖｅｌｏｐｍｅｎｔａｌ Ｍｅｄｉｃｉｎｅ ａｎｄ Ｃｈｉｌｄ Ｎｅｕｒｏｌｏｇｙ， ４０：７９６−８０４
Ｋａｄｅｓｊｏ， Ｂ． ＆ Ｇｉｌｌｂｅｒｇ， Ｉ． Ｃ． （１９９９）， 「スウェーデンの７歳児における発達性協調運動障害（Ｄｅｖｅｌｏｐｍｅｎｔａｌ ｃｏｏｒｄｉｎａｔｉｏｎ ｄｉｓｏｒｄｅｒ ｉｎ Ｓｗｅｄｉｓｈ ７−ｙｅａｒ−ｏｌｄ ｃｈｉｌｄｒｅｎ）」， Ｊｏｕｒｎａｌ ｏｆ ｔｈｅ Ａｍｅｒｉｃａｎ Ａｃａｄｅｍｙ ｏｆ Ｃｈｉｌｄ ａｎｄ Ａｄｏｌｅｓｃｅｎｔ Ｐｓｙｃｈｉａｔｒｙ， ３８：８２０−８
Ｋｅｐｐｅｌ， Ｇ． （１７７３）， 「設計と分析：研究者のハンドブック（Ｄｅｓｉｇｎ ＆ Ａｎａｌｙｓｉｓ： Ａ Ｒｅｓｅａｒｃｈｅｒ’ｓ Ｈａｎｄｂｏｏｋ）」， Ｅｎｇｌｅｗｏｏｄ Ｃｌｉｆｆｓ， Ｎｅｗ Ｊｅｒｓｅｙ； Ｐｒｅｎｔｉｃｅ−Ｈａｌｌ， Ｉｎｃ．， ｐ８７
Ｋｕｈｌｍａｎ， Ｋ． ＆ Ｓｃｈｗｅｎｈａｒｔ， Ｌ． Ｊ． （１９９９）， 「子供の発達におけるタイミング（Ｔｉｍｉｎｇ ｉｎ ｃｈｉｌｄ ｄｅｖｅｌｏｐｍｅｎｔ）」， Ｙｐｓｉｌａｎｔｉ， ＭＩ： Ｈｉｇｈ／Ｓｃｏｐｅ Ｅｄｕｃａｔｉｏｎａｌ Ｒｅｓｓｅａｒｃｈ Ｆｏｕｎｄａｔｉｏｎ． Ｉｎ ｐｒｅｓｓ．
Ｌｉｂｋｕｍａｎ， Ｔ， ＆ Ｏｔａｎｉ， Ｈ．， （１９９９）， 「タイミングの訓練によるゴルフの精度の改善（Ｔｒａｉｎｉｎｇ ｉｎ Ｔｉｍｉｎｇ Ｉｍｐｒｏｖｅｓ Ａｃｃｕｒａｃｙ ｉｎ Ｇｏｌｆ）」， Ｕｎｐｕｂｌｉｓｈｅｄ ｍａｎｕｓｃｒｉｐｔ． Ｍｔ． Ｐｌｅａｓａｎｔ， Ｍｉｃｈｉｇａｎ； Ｃｅｎｔｒａｌ Ｍｉｃｈｉｇａｎ Ｕｎｉｖｅｒｓｉｔｙ
Ｍｕｎｄｙ， Ｐ． （１９９５）， 「自閉症を有する子供における及び社会感情アプローチ挙動（Ｊｏｉｎｔ ａｔｔｅｎｔｉｏｎ ａｎｄ ｓｏｃｉａｌ−ｅｍｏｔｉｏｎａｌ ａｐｐｒｏａｃｈ ｂｅｈａｖｉｏｒ ｉｎ ｃｈｉｌｄｒｅｎ ｗｉｔｈ ａｕｔｉｓｍ）」， Ｄｅｖｅｌｏｐｍｅｎｔａｌ Ｐｓｙｃｈｏｐａｔｈｏｌｏｇｙ， ７：６３−８２
Ｍｕｎｄｙ， Ｐ．， ＆ Ｃｒｏｗｓｏｎ， Ｍ． （１９９７）， 「共同注意および早期社会的コミュニケーション：自閉症に対する介入の研究との関係（Ｊｏｉｎｔ ａｔｔｅｎｔｉｏｎ ａｎｄ ｅａｒｌｙ ｓｏｃｉａｌ ｃｏｍｍｕｎｉｃａｔｉｏｎ： Ｉｍｐｌｉｃａｔｉｏｎｓ ｆｏｒ ｒｅｓｅａｒｃｈ ｏｎ ｉｎｔｅｒｖｅｎｔｉｏｎ ｗｉｔｈ ａｕｔｉｓｍ）」， Ｊｏｕｒｎａｌ ｏｆ Ａｕｔｉｓｍ ａｎｄ Ｄｅｖｅｌｏｐｍｅｎｔａｌ Ｄｉｓｏｒｄｅｒｓ， ２７：６５３−７６
ＮＩＨ Ｃｏｎｓｅｎｓｕｓ Ｓｔａｔｅｍｅｎｔ （１９９７）， Ａｒｃｈｉｖｅｓ ｏｆ Ｇｅｎｅｒａｌ Ｐｓｙｃｈｉａｔｒｙ， ５４：８６５−７０
Ｎｏｅｕａｉａ． Ｍ． （１９９３）， ＳＰＳＳ ｆｏｒ ｗｉｎｄｏｗｓ， ｂａｓｅ ｓｙｓｔｅｍ， ｕｓｅｒ ｍａｎｕａｌ， ｒｅｌｅａｓｅ ６．０． ｐｐ．３９２−３９３． Ｃｈｉｃａｇｏ： ＳＰＳＳ， Ｉｎｃ．
Ｐｉｅｋ， Ｊ．Ｐ．， Ｐｉｔｃｈｅｒ． Ｔ． ＆ Ｈａｙ． Ｄ．Ａ． （１９９９）， 「注意欠陥多動性障害を持つ子供における運動協調性および運動感覚（Ｍｏｔｏｒ ｃｏｏｒｄｉｎａｔｉｏｎ ａｎｄ ｋｉｎａｅｓｔｈｅｓｉｓ ｉｎ ｂｏｙｓ ｗｉｔｈ ａｔｔｅｎｔｉｏｎ ｄｅｆｉｃｉｔ−ｈｙｐｅｒａｃｔｉｖｉｔｙ ｄｉｓｏｒｄｅｒ）」， Ｄｅｖｅｌｏｐｍｅｎｔａｌ Ｍｅｄｉｃｉｎｅ ａｎｄ Ｃｈｉｌｄ Ｎｅｕｒｏｌｏｇｙ， ４１：１５９−６５
Ｒｕｂｉａ， Ｋ．， Ｏｖｅｒｍｅｙｅｒ， Ｓ．， Ｔａｙｌｏｒ， Ｅ．， Ｂｒａｍｍｅｒ， Ｍ．， Ｗｉｌｌｉａｍｓ， Ｓ．， Ｓｉｍｍｏｎｓ， Ａ． ＆ Ｂｕｌｌｍｏｒｅ， Ｅ．， （１９９９）， 「高度な運動制御の際の注意欠陥多動性障害における前頭前部機能の低下：ファンクショナルＭＲＩによる研究（Ｈｙｐｏｆｒｏｎｔａｌｉｔｙ ｉｎ Ａｔｔｅｎｔｉｏｎ Ｄｅｆｉｃｉｔ Ｈｙｐｅｒａｃｔｉｖｉｔｙ Ｄｉｓｏｒｄｅｒ Ｄｕｒｉｎｇ Ｈｉｇｈｅｒ−Ｏｒｄｅｒ Ｍｏｔｏｒ Ｃｏｎｔｒｏｌ： Ａ Ｓｔｕｄｙ Ｗｉｔｈ Ｆｕｎｃｔｉｏｎａｌ ＭＲＩ）」， Ａｍｅｒｉｃａｎ Ｊｏｕｒｎａｌ ｏｆ Ｐｓｙｃｈｉａｔｒｙ， １５６：８９１−８９６
Ｓａｋｏｄａ． Ｊ． Ｍ．， Ｃｏｈｅｎ． Ｂ． Ｈ．， ＆ Ｂｅａｌｌ， Ｇ．， （１９７４）， 「一連の統計的検査についての有意性の検査（Ｔｅｓｔ ｏｆ ｓｉｇｎｉｆｉｃａｎｃｅ ｆｏｒ ａ ｓｅｒｉｅｓ ｏｆ ｓｔａｔｉｓｔｉｃａｌ ｔｅｓｔｓ）」， Ｐｓｙｃｈｏｌｏｇｉｃａｌ Ｂｕｌｌｅｔｉｎ， ５１：１７２−１７５
Ｓｃｈｏｎｆｅｌｄ， Ｉ．， Ｓｈａｆｆｅｒ． Ｄ．， ＆ Ｂａｒｍａｃｋ， Ｊ． （１９８９）， 「神経学的ソフトサイン及び学校の成績：持続的注意の仲介効果（Ｎｅｕｒｏｌｏｇｉｃａｌ ｓｏｆｔ ｓｉｇｎｓ ａｎｄ ｓｃｈｏｏｌ ａｃｈｉｅｖｅｍｅｎｔ； ｔｈｅ ｍｅｄｉａｔｉｎｇ ｅｆｆｅｃｔｓ ｏｆ ｓｕｓｔａｉｎｅｄ ａｔｔｅｎｔｉｏｎ）」， Ｊｏｕｒｎａｌ ｏｆ Ａｂｎｏｒｍａｌ Ｃｈｉｌｄ Ｐｓｙｃｈｏｌｏｇｙ， １７：５７５−９６
Ｓｍｉｔｈ， Ｌ． Ｂ．， ＆ Ｔｈｅｌｅｎ． Ｅ． （１９９３）， 「発達へのダイナミックシステムアプローチ：応用（Ａ ｄｙｎａｍｉｃ ｓｙｓｔｅｍｓ ａｐｐｒｏａｃｈ ｔｏ ｄｅｖｅｌｏｐｍｅｎｔ： Ａｐｐｌｉｃａｔｉｏｎｓ）」， Ｃａｍｂｒｉｄｇｅ， ＭＡ； ＭＩＴ Ｐｒｅｓｓ
Ｓｔｅｍｍｅｒ． Ｐ． Ｍ．（１９９６）， 「インタラクティブメトロノームを用いた学生の運動統合の改善（Ｉｍｐｒｏｖｉｎｇ Ｓｔｕｄｅｎｔ Ｍｏｔｏｒ Ｉｎｔｅｇｒａｔｉｏｎ ｂｙ Ｕｓｅ ｏｆ ａｎ Ｉｎｔｅｒａｃｔｉｖｅ Ｍｅｔｒｏｎｏｍｅ）」， Ｓｔｕｄｙ ｐａｐｅｒ ｐｒｅｓｅｎｔｅｄ ａｔ ｔｈｅ １９９６ Ａｎｎｕａｌ Ｍｅｅｔｉｎｇ ｏｆ ｔｈｅ Ａｍｅｒｉｃａｎ Ｅｄｕｃａｔｉｏｎａｌ Ａｓｓｏｃｉａｔｉｏｎ， Ｃｈｉｃａｇｏ， ＩＬ．
ＳＰＳＳ． （１９８８）， 「ＳＰＳＳ−Ｘユーザガイド、第三版（ＳＰＳＳ−Ｘ−Ｕｓｅｒｓ Ｇｕｉｄｅ， ３^ｒｄ Ｅｄ．）」， Ｐ． ５７６． Ｃｈｉｃａｇｏ， ＩＬ； ＳＰＳＳ， Ｉｎｃ．
Ｗｅｃｈｓｌｅｒ， Ｄ． （１９９２）， ＷＩＳＣ−ＩＩＩ． 「子供のためのＷｅｃｈｓｌｅｒ知能スケール−第三版手引き書（Ｗｅｃｈｓｌｅｒ Ｉｎｔｅｌｌｉｇｅｎｃｅ Ｓｃａｌｅ ｆｏｒ Ｃｈｉｌｄｒｅｎ− Ｔｈｉｒｄ Ｅｄｉｔｉｏｎ Ｍａｎｕａｌ）」， Ｓａｎ Ａｎｔｏｎｉｏ． ＴＸ： Ｔｈｅ Ｐｓｙｃｈｏｌｏｇｉｃａｌ Ｃｏｒｐｏｒａｔｉｏｎ． ｈａｒｃｏｕｒｔ Ｂｒａｃｅ Ｊｏｖａｎｏｖｉｃｈ， Ｉｎｃ． Ｗｉｌｋｉｎｓｏｎ， Ｇ． Ｓ． （１９９３） ＷＲＡＴ ３ Ｗｉｄｅ Ｒａｎｇｅ Ａｃｈｉｅｖｅｍｅｎｔ Ｔｅｓｔ Ａｄｍｉｎｉｓｔｒａｔｉｏｎ Ｍａｎｕａｌ． Ｗｉｌｍｉｎｇｔｏｎ． ＤＥ： Ｗｉｄｅ Ｒａｎｇｅ， Ｉｎｃ．
【図面の簡単な説明】
【図１】
本発明に係る学習能力を向上させる方法の図である。
【図２】
本発明に係る装置のブロック図である。
【図３】
（ａ）　基準信号の発生に対するトリガ作動の時間関係とガイダンス信号との関連の一形式を示す図である。
（ｂ）　基準信号の発生に対するトリガ作動の時間関係とガイダンス信号との関連の一形式を示す図３（ａ）と同様の図である。
【図４】
図２に示す装置により発生される視覚的表示の側面図である。
【図５】
図４の発生された視覚的表示の平面図である。
【図６】
図２に示す装置の他の態様の側面図である。
【図７】
もう１つの態様の図６と同様の図である。
【図８】
さらに別の態様の図６と同様の図である。
【図９】
図２に示す装置のさらにもう１つの態様の斜視図である。
【図１０】
他のトリガ装置の平面図である。
【図１１】
図２に示す装置をある程度詳細に示した図である。
【図１２】
他の態様の図１１と同様の図である。
【図１３】
さらに他の態様の図１１と同様の図である。
【図１４】
基準信号の発生に対するユーザのトリガ操作（即ち、応答）のタイミングシーケンス（ｔｉｍｉｎｇ ｓｅｑｕｅｎｃｅｓ）を示す図である。
【図１５】
データ作成及び入力機能のフローチャートである。
【図１６】
モード及びタスク選択機能のフローチャートである。
【図１７】
タイミング割込みプロセシング機能のフローチャートである。
【図１８】
時間的評価機能のフローチャートである。
【図１９】
ユーザ信号発生機能のフローチャートである。
【符号の説明】
２　　　基準信号
４　　　トリガ
６　　　ユーザ
７　　　時間的関係
８　　　ガイダンス信号
１０　　学習能力向上装置
１２　　コンピュータ
１４　　モニタ
１６　　媒体
１８　　トリガ
２２　　ヘッドフォン[0001]
This application claims priority from US Provisional Application No. 60 / 229,361 (filed August 13, 1999) and US Provisional Patent Application No. 60 / 219,321 (filed August 13, 1999). Claim the right. The contents of these provisional US patent applications are hereby incorporated by reference as forming a part of the present specification.
[0002]
TECHNICAL FIELD OF THE INVENTION
The present invention generally relates to a method and apparatus for improving learning ability. The present invention is useful to individuals of all ages, and can also be used by infants and young children, as it provides a technique that does not necessarily involve overt surface behavior of the individual.
[0003]
[Prior art]
The contents of U.S. Patent Nos. 5,529,498 and 5,743,744 are hereby incorporated by reference. The present inventor discloses an apparatus and a method for measuring and improving neuromotor coordination. The technique disclosed in the inventor's earlier patent generates a reference signal that is repeatedly generated at time intervals, and at least occasionally indicates the reference signal to the user, and the user with the trigger generates the last reference signal. Receiving a response that predicts the elapse of a predetermined time interval from. The temporal relationship between the user's response since the last reference signal generation and the predetermined time interval is determined and that relationship is used to generate a guidance signal that is a function of the temporal relationship. The guidance signal allows the user to match the timing with the generation of the reference signal.
[0004]
In view of the remarkable success in improving neuromotor function by utilizing the techniques disclosed in the inventor's earlier patents, the inventor has developed a method for planning and sequencing training that enhances an individual's learning ability. For this reason, we considered using such a technique. As will be described in more detail below, this concept was evaluated using a peer-reviewed research project.
[0005]
It is important to provide young children with the very useful ability of rhymicity training disclosed in the inventor's earlier patent. “Inside the Brain. @ Revolutionary Discovery of How the Mind Works” by Kotulak, R.Andrews & McMille PublishingAs described in (Andrews McMeel Publishing) (1997), the brain can learn for life, but is not comparable to activities that occur early in childhood. Children who are not completely independent can walk, talk, analyze, worry, love, play, explore in their first three years of life, and have a unique emotional personality Build a very complex new brain that forms
[0006]
While the technology described in the inventor's patents provides immense benefits to the user, the inventor has found that improvements in the above technology can increase this advantage.
[0007]
[Means for Solving the Problems]
In one aspect, the invention provides a method for improving a user's learning ability. The method includes generating a reference signal at a time interval, providing a trigger and receiving operation of the trigger by a user. The method also includes determining a temporal relationship between actuation of the trigger by the user and generation of the reference signal. It also includes generating a guidance signal that is a function of the temporal relationship and providing it to the user occasionally.
[0008]
An apparatus according to an aspect of the present invention includes a user operation trigger for receiving a user operation and a control unit. The control unit generates a reference signal at time intervals. Further, the control unit obtains a temporal relationship between the operation of the trigger by the user and the generation of the reference signal. Further, the control unit provides the user at least from time to time with a guidance signal that is a function of the temporal relationship. If the user's trigger operation is within a certain range, the guidance signal is not substantially provided to the user. The specific range includes the occurrence of the reference signal. Preferably, the particular range is from about 15 ms before the reference signal to about 15 ms after.
[0009]
An apparatus according to another aspect of the present invention includes a user operation trigger that receives a user operation. The apparatus includes a control unit that generates a reference signal at a predetermined time interval and determines a temporal relationship between a trigger operation by a user and the generation of the reference signal. Further, the control unit generates an instruction signal for instructing a trigger operation by the user. Preferably, the control unit generates the instruction signal to selectively instruct the user to operate the trigger either before or after the reference signal.
[0010]
According to a more specific aspect of the invention, the indication signal is provided by a visual output and indicates movement in a particular direction (eg, moving forward along a road, etc.). The instruction signal selectively instructs the user to operate the trigger either before or after the reference signal by alternately moving laterally with respect to the displayed direction of movement. Further, the instruction signal may indicate a user's response to the instruction signal, such as by changing the speed of the movement in a specific direction.
[0011]
According to another aspect of the invention, the control has an audible output supplied to headphones having left and right speakers. The auditory signal supplied from the control unit to the headphone speaker changes the spatial perception of the guidance signal in the user's brain. The guidance signal is generated such that the spatial perception of the guidance signal by the user changes as a function of the temporal relationship between the operation of the trigger by the user and the generation of the reference signal.
[0012]
An apparatus according to another aspect of the invention includes a trigger adapted for operation by a young child user and an output for providing a signal to the user. Further, the apparatus includes a control unit responsive to a trigger operation by a user for generating the reference signal at a time interval. The control unit further determines a temporal relationship between the operation of the trigger by the user and the generation of the reference signal. The control unit further provides a guidance signal, which is a function of the temporal relationship, to the user at least from time to time with the output.
[0013]
In one aspect, the trigger includes a body having a handle adapted to be held by a young child, such as a pre-toddler, and a motion sensor responsive to movement of the body. An output that is audible, visual, or both provides a guidance signal to the user. The motion sensor may include an accelerometer, and the output generates a reward signal in response to a child rhythmically activating the body and / or a child rotating the body. Further, the body may include an orientation member such as a spinning mass gyroscope, the orientation member being operable by a control to orient the body in a particular orientation. Useful to help children progress from random movements to rhythmic periodic rotational movements that are essentially non-impacting. In another aspect, the trigger is a member suspended above a place where a child plays or sleeps and a sensor responsive to movement of the member.
[0014]
The above and other objects, advantages, uses and features of the present invention will become apparent with reference to the following detailed description and drawings.
[0015]
BEST MODE FOR CARRYING OUT THE INVENTION
Referring now to the drawings and the exemplary embodiments depicted therein, a method (1) for improving a user's learning ability includes generating a reference signal (2) at time intervals, providing a trigger. (4) and receiving a trigger operation by the user (6). The method further includes determining a temporal relationship between actuation of the trigger by the user and generation of the reference signal (7) and generating a guidance signal that is a function of the temporal relationship (8). Guidance signals are presented to the user at least from time to time (9).
[0016]
Appendix A, Robert J. et al. Dr. Robert J. Shaffer et al., "Effect of Interactive Metronome."^R The article entitled "Training Children With ADHD" was selected as a comparative group with no intervention for 19 children who had received 15 hours of planning and sequencing training exercises according to the inventor's earlier patented invention principles for 15 hours. 7 is a result of comparison with a second control group trained in a video game. Schaffer et al.'S paper found statistically significant differences in the 12 components of performance in attention, motor control, verbal processing, and reading, and in parents' reports of improvements in regulating aggressive behavior. .
[0017]
A method (1) for improving a user's learning ability comprises a computer CPU 12 and a computer-readable medium 16 having a monitor 14 and a program loaded into the computer 12 to operate the apparatus 12, the learning ability improving apparatus 10 comprising: It is preferably performed above (FIG. 2). Computer 12 is preferably an IBM or equivalent computer with a Windows® '98 or '95 operation system, including a Pentium® processor of 100 megahertz or more and a RAM of 16 megabytes or more. Apple-based platforms may be used. The computer 12 may be a personal computer (PC), a network computer, a handheld computer such as a PalmPilot or Psion, a Nintendo Game Boy, a Nintendo PlayStation, a Sega Dreamcast, or the like. Preferably, computer 12 has a hard drive recording device that has at least 30 megabytes of free space. One or more triggers 18 can be connected to a serial port of a standard 9-pin connector of the computer 12. Computer 12 preferably has a stereo sound card (not shown) with MIDI and WAV capabilities. Computer 12 has an audible output 20 connected to a pair of stereo headphones 22. Further, the computer 12 may have a video output 24 to which a virtual reality headset 26 can be connected.
[0018]
In one aspect of Method 1, in order to change the spatial perceived location of the guidance signal in the user's brain, the audible output unit 20 uses a conventional stereo signal mixing technique to change the guidance signal. A signal is supplied to the speakers 22a and 22b of the headphone 22 so that the (guide tone) changes from the left speaker 22a to the right speaker 22b. The movement of the guidance signal can be shown as in FIG. If there is a response before the reference signal, the guide tone 8 is moved to the right side of the user's head, and if there is a response after the reference signal, the guide tone 8 is moved to the left side of the user's head. Note that the movement of the tone may be reversed. The movement of the guide tone from the left speaker to the right speaker of the headphone 22 can be performed by changing the frequency of the guide tone or by using another technique. As shown in FIG. 3B, the guidance signal 8 'is provided in a difficulty range. The guidance signal 8 ′ includes a guide tone 8 ′ a and a reference signal 2 generated when the user operates the trigger 18 within a “right-on” range before the reference signal 2 is generated. It includes a guide tone 8'b that occurs when the user activates the trigger 18 within the "exact" range after the occurrence. A specific range is set, called the "super right-on" range. This very accurate range includes the generation of the reference signal 2 and indicates that the operation of the trigger is very accurate. In the illustrated embodiment, the range from 15 milliseconds before the reference signal to 15 milliseconds after the reference signal is the difficulty range DR. However, the difficulty range DR may be wider or narrower. The difficulty range DR is set to recognize the operation of the trigger 18 by the user. If the operation of the trigger 18 by the user is performed in the range of "very accurate", the guidance signals 8 and 8 'are stopped as a reward to the user. If a "very accurate" response is made, the user will not hear any sound other than the reference signal. Alternatively, a "very accurate" response may provide a pleasant sound to the user. One example of a pleasant sound is a non-shock sound. Another example of a pleasant sound is a relatively low volume sound.
[0019]
When the response is made in the range of “exact” before the reference signal, the pitch of the guidance signal 8 ′ changes depending on how fast the user responds to the reference signal 2. In the illustrated embodiment, the guidance signal 8'a spans one or two octaves, but larger or smaller scales may be used. The guidance signal 8'b generated when responding to the reference signal within the range of "accurate" on the delay side has a higher pitch than the guidance signal 8'a. This guidance signal 8'b preferably spans one or two octaves, but may be on a larger or smaller scale. In the illustrated embodiment, the guidance signals 8'a and 8'b generated on opposite sides of the reference signal have a linear relationship. The purpose of the guide sounds 8, 8'a and 8'b is to naturally and subconsciously pull the user towards the reference signal.
[0020]
For the response (point VE) before the difficulty range DR, a sound is generated that can be distinguished from the guidance signal 8 'such as a human voice. Preferably, very fast responses say "ops" with a low tone in a human voice. Similarly, for a very slow user response (VL), a sound is generated that can be distinguished from the sound emitted by the guidance signal 8 '. For example, a human voice may say "ops" in a high tone, or vice versa. Other distinguishable sounds may be used outside the difficulty range. For example, a musical sound or a loud sound different from the guide tone 8 can be used.
[0021]
In the illustrated embodiment, the positions of the very early (VE) and very late (VL) sounds are adaptively set as a percentage of the user's average response lead time and average delay time. In the illustrated embodiment, the very early point is set to 110% of the average lead time of the user's trigger operation and the very late (VL) point is set to 110% of the average delay time of the user's late trigger operation. However, different ratios can be selected. The purpose of adapting the difficulty range to the user is to make the task sufficiently easy from the viewpoint of maintaining the motivation of the user, and to make the task sufficiently difficult from the viewpoint of continuing the challenge and improving the learning ability of the user. It is to be. If the user is able to respond in this "accurate" range several times in a row, multiple burst performance is observed. For example, goals are set so that a specific number of multiple bursts is obtained during 1000 iterations on the device 10.
[0022]
During the initial setup, the software on the medium 16 is loaded into the CPU 12, and a time card test is performed to confirm the accuracy of the time reproducibility of the time card included in the computer 12. If the time card works satisfactorily, software on the media 16 can utilize the time card to generate signals to feed to the headphones 22. Otherwise, as will be apparent to those skilled in the art, the software on the medium 16 generates tones to be supplied to the headphones 22 using MIDI files, WAV files, etc. included in the operating system of the computer 12.
[0023]
Triggers 18 may include a hand trigger 18a, a hand trigger 18b, and a foot trigger bar 18c, which allow a user to respond to a series of exercises using one or more triggers 18. Examples include clapping, clapping to a guide sound, tapping with a dominant hand, tapping with a non-dominant hand, alternate tapping with a toe, tapping with a toe of a dominant foot, tapping with a toe of a non-dominant foot, and alternating with a heel. Tapping, tapping with the dominant foot heel, tapping with the non-dominant foot heel, alternating taps with the dominant hand and non-dominant toe, alternating taps with non-dominant hand and dominant toe, balancing with dominant foot Tapping with a toe of a non-dominant foot, tapping with a toe of a dominant foot while balancing with the non-dominant foot, and the like, are not limited to these. Other exercises will be apparent to those skilled in the art. Further, the trigger can be attached to another object directly operated by the user, such as a golf club. When the user performs various exercises using the trigger 18, the reference signal and the guide signal are usually supplied via the headphones 22. However, the reference signal can be stopped from time to time, and the user can operate only the guidance signal. Other forms of guidance signals, such as the visual guidance signals described below, can also be used. Also, in certain routines, such as those used to measure the user's response to planning and sequencing training, the guidance signal may be omitted entirely.
[0024]
A tool may be added to the device 10 to further improve the timing accuracy of the user. Apparatus 10 generates an instruction signal 27 that is displayed on a visual display, such as monitor 14 or virtual reality headset 26. The purpose of the indication signal is to instruct the user to operate the trigger 18 in a manner different from the usual procedure of operating the trigger 18 as close as possible to the expected generation of the reference signal. One method of instructing the user to change the triggering operation is to intentionally instruct the user to continuously respond prior to the generation of the reference signal. Another instruction provided to the user is to intentionally continuously respond after the generation of the reference signal. In addition to providing the user with a tool for continuously performing a response close to the reference signal, intentionally performing a response before the reference signal or intentionally performing a response after the reference signal. By providing a tool for performing such operations, the user can improve the sense of the timing accuracy. The indication signal 27 is applied when the user is able to achieve a large number of "very accurate" multiple bursts within a given number of repetitions, for example 80 to 90 multiple bursts during 1000 repetitions. . Further, a disturbance signal may be provided to the user along with the reference signal to assist the user in mentally removing external disturbances and subconsciously focusing on the reference signal.
[0025]
FIG. 4 shows a “virtual tunnel” that includes an indication signal 27 in which the geometric shapes 28 (such as the stripes in the center of the virtual road) indicate a particular level of accuracy of the user response, eg, “extremely less than 15 milliseconds”. An "accurate" or "difficulty range", which is a fitting range such as an "exact" response, or another such value. The left side of the stripe 28 is surrounded by a zone 30 which is a part of a matching range indicating a response before the beat, and the right side is a zone 32 which is a part of a matching range indicating a response after the beat. Surrounded by Instruction signal 27 also includes out-of-range zones 34 and 36. Zone 34 represents a VE response in which the user's response is too fast for the reference signal to fall within fit range 30. Zone 36 represents a VL response in which the user's response is too slow relative to the reference signal to fall within compliance range 32. The adaptation ranges 30 and 32 preferably widen or narrow as the user response worsens or improves. If the user response enters either zone 34 or 36, a special sound is generated. Such special sounds include human voices such as "ops" and noisy negative responses ("boo", "gone", etc.) generated in headphones. The indication signal 27 is preferably generated using the computer 12 to provide a feeling of moving along the stripe 28. This sensation of movement can be caused by changing the shape of the tunnel, the characteristics of the tunnel wall (rocks, bricks, etc.), or by splitting the stripe 28 into a series of segments that appear to be moving. Will be easy for those skilled in the art. When the user generates a response in zone 28, the user appears to be moving at a particular speed (which may initially accelerate) along the scene defined by indicator signal 27. However, if the user responds to hit the "walls" of zones 34 and 36 more than a specified number of times in succession (eg, a few times), this action will slow down the movement along stripe 28. Or stop. Thus, if the user is able to respond continuously within the zone 28, the user will experience a sense of movement, and if the user collides with the "walls" 34 and 36, the user will receive a sense of being detained. The above operation allows the user to notice that the user's response is out of the standard, and thereby synchronize the user's response with the standard.
[0026]
As shown in FIG. 5, the virtual “tunnel” scene of FIG. 4 turns right or left as the user moves along the stripe 28. The relationship between the reference signal, the user response, and the guidance signal is constant with respect to the virtual space occupied by the geometric space 28. As the tunnel scene turns right, as shown by point A (FIG. 5), the user is forced to generate a response within zone 32 (ie after the reference) to avoid hitting a wall. As the tunnel scene turns left, as shown by point B (FIG. 5), the user is forced to generate a response within zone 30 (ie, after the reference) to avoid hitting a wall. Other "virtual" scenes (e.g., trying to raise a balloon above a mountain) can be used to generate the indicator signal. As noted above, the indication signal 27 is not only useful in improving the ability to respond interactively to a reference, but also in a state where the user has selectively controlled the user response before and after the generation of the reference signal. It can be seen that it provides a timing exercise that requires the ability to move. It has also been found that this can be extended to planning and sequencing training to improve learning abilities in areas such as the user's attention, language processing, reading ability, aggressive behavior control, and the like.
[0027]
The learning ability improvement device 40 includes a trigger adapted to be used by a young child such as an infant, a child before walking, a child walking, etc., and a trigger adapted to be operable by a user of the young child. (FIG. 6). In one embodiment, the child-operable trigger comprises a body 42 and one or more handles 54. A motion sensor 44 and a computer 46 that move with the body monitor the operation of the body 42 by the user. One or more outputs are provided to provide the user with a guidance signal at least from time to time, such as a speaker 48 that produces an audible output, a series of speakers 48 that produce various patterns of visual effects. Lights, preferably colored lights 50a-50f, and any visual display 52 (FIGS. 6 and 7), such as, but not limited to. The motion sensor 44 is an accelerometer, a motion sensing circuit, a solid-state multi-axis accelerometer, or the like. When the user grips the handle 54 of the main body 42 and moves the main body 42, the motion is sensed. Immediately after the child grips the device 40, even if the housing 42 is moved randomly, the device 40 performs a series of fun light displays on the indicators 50a to 50f and generates a series of fun sounds on the speaker 48. You may do so. As the child begins to move the device 40 further and the housing is moved in a constructive pattern (e.g., a rotating motion on a particular surface), such as a rhythmic, non-ballistic pattern, the child is additionally moved. Rewards are provided. When the user generates such a constructive pattern, a reference signal may then be generated and provided to the child, for example, using speakers 48. The reference tone may be generated from an average of the user's previous exercises. Alternatively, the reference tone may be generated internally by the computer 46 and provided to young children and infants. As the user begins moving the device 40 near the reference tone, the speakers 48 and / or visual indicators 50a-50f and 52 may provide the user with guidance tones and / or reward displays. After a period of time, the user can move the device 40 so that the speaker 48 and / or the visual indicators 50a-50f and 52 produce a regular and comfortable guide tone. In some cases, it may be preferable to perform the display on the display 52 and generate the audio portion from the speaker 48. For example, during a "training" session, a real or animated character may "talk" to the user to command the user accordingly.
[0028]
The other learning ability improvement devices 60a and 60b are separate units so that a child can hold each with one hand (FIG. 7). Each unit includes a single handle 54, speaker 48, and accelerometer 44. In the illustrated embodiment, the control 46 'is remote from the devices 60a and 60b and has communication links 62a and 62b between the remote control 46' and each device 60a and 60b. Communication links 62a and 62b are between transceiver 61 associated with control 46 'and transceiver 63a of device 60a and transceiver 63b of device 60b. Thus, control 46 'coordinates the response to both devices 60a and 60b and responds to a combination of the movements of both devices. This will be apparent to those skilled in the art. The communication links 62a and 62b are preferably wireless, and may be an infrared link or a radio frequency link using a Bluetooth protocol or the like. Further, each of the devices 60a and 60b may include an orientation device 64 such as a rotating gyroscope or an electric motor. Each orientation device 64 is under the control of a computer 46 ', which directs each body 42a, 42b of the devices 60a, 60b in a particular direction. This allows, for example, the computer 46 'to orient each device body 42a and 42b in the same direction as the body had when the previous user exercised. Also, the above-described ability of the computer 46 'to affect the orientation of the bodies 42a and 42b allows the computer to move the body so that the desired non-impacting rotational movement occurs in the plane in which the user is trained, If such a constructive exercise can be given to the main body, a reward is given to the user. After the user gets the reward with the help of the orientation device 64, the computer 46 stops using it.
[0029]
Yet another learning enhancement device 40 'has a housing 42' formed in the form of a baby rattle (rattle) with a handle 54 '(FIG. 8). Otherwise, device 40 'is similar to devices 40, 60a and 60b. Still another learning capability enhancement device 80 includes a trigger assembly 82 that is suspended above a playpen, baby couch or the like 84. Trigger 82 responds to contact by the child, such as kicking a series of members 86 that are supported above each other over a playpen, toddler's couch or the like 84. The member 86 is preferably of a primary color, and may have any geometric shape, animal shape, or the like. In response to the child kicking or tapping the member 86, an external speaker (not shown) or a flashing light (not shown) operates. When the user taps on element 86 in any manner of pattern, the operating intensity, frequency, etc. of the loudspeakers and / or flashing lights increase. The purpose is to guide the user so that he can continually improve his ability and operate rhythmically as he operates the element 86 of the trigger 82. The purpose of increasing the intensity and / or frequency of response is to keep the child's attention and to systematically motivate them to improve.
[0030]
FIG. 11 shows a more detailed diagram of the learning ability improvement device 10. The computer system 20 includes a mouse 150, a keyboard 152, and a printer 156 in addition to the processor 12 and the monitor 14. The hard disk 158 includes information such as client data, task summary data, task detail data, and other data.
[0031]
An alternative learning capability enhancement device 10 'includes a central processor 12a and a remote processor 12b (FIG. 12). The central processor 12a can be assigned to program management, task management, data management, time sequence generation, and the like. The remote processor 12b can manage the input / output functions for the triggers 18a, 18b and the user interface headphones 22. In addition, the remote processor 12b may serve to generate a reference signal, a disturbance signal, a guidance signal, and the like provided to the user. The central processor 12a and the remote processor 12b can be connected by a communication link 163, such as a wired, local area network, wide area network, or global network such as the Internet.
[0032]
In another alternative embodiment, the learning enhancement device 10 '' includes a central processor 12a 'and a remote processor 12b' '(FIG. 13). The remote processor 12b 'may include a keypad 160 and a display 162 in addition to processing triggers and headphone input / output. In this manner, the remote processor 12b ', the keypad 160, and the display 162 can be combined into a small portable device that can be carried by the user, such as to be mounted on a user's belt, etc. Then, the trigger 18a and / or 18b is operated. The remote processor 12b 'is connectable to the central processor 12a' via a communication link 164, which may be an infrared link, a radio frequency link such as the BlueTooth protocol, or any other known remote link. The central processor 12a 'can be used to modify the software of the remote processor 12b' and process the data generated by the remote processor 12b '. In other situations, the remote processor 12b 'may operate standalone.
[0033]
FIG. 14 shows an example of a timing evaluation performed by the learning ability improvement device 12. Referring to FIG. 14, a parameter I indicates a time at which a reference signal is generated. Parameter R refers to the time at which another reference signal is generated. If the user's response occurs in period "a", the response is slow relative to the reference signal occurring at I. If the user's response occurs in period "b", the response is fast relative to the R reference signal. The time interval shown in FIG. 14 is repeated for each sequence between the generation of the reference signal.
[0034]
If the user responds to the reference signal I for a period I + S, or responds to the reference signal R for a period RS, the user response is considered to be within a super difficulty range. . This is considered a very accurate response. This is also sometimes referred to as the "extremely accurate" range. When responding in the period I + D, the response is slow with respect to the reference signal I, but is within the difficulty range D. If the user responds in the range RD, the response is considered to be fast with respect to the reference signal R within the difficulty range D. If the user responds between I + D and R / 2, the user response is considered very slow relative to the reference signal I. If the user response is in the range R / 2 to RD, the response is considered very fast relative to the reference signal R.
[0035]
The program 164 executed by the learning enhancement device 10 begins with a data creation and input function including a graphical user interface 166 displayed on the monitor 14 where the user selects and activates the program at 168 (FIG. 15). . At 170, a screen or menu for creating and opening a file is displayed on monitor 14, and the user is prompted at 172 to select the function to be performed. If the user selects a new file at 174, the monitor displays a data entry screen at 176. Next, the program prepares at 178 to identify the therapist. If the user selects 172 to open an existing file at 182, the file is opened and at 180 a screen for selecting a mode is displayed. If the user selects to exit the program at 172, the program exits at 184 and returns to the graphical user interface at 166.
[0036]
Next, the program proceeds to a mode and task selection function that displays 180 screens to select a mode (FIG. 16). When a mode selection screen is displayed at 180, the user selects 182 from a short-form inspection routine 184, a long-form inspection routine 186, and a training routine 188. The short form inspection mode 184 provides a quick diagnostic entry tool with relatively low inspection / retest accuracy. The short-form inspection mode 184 includes a part of the inspection performed in the long-form inspection mode, such as applause of both hands without a guide sound or both hands with a guide sound. The short form test is performed at the beginning and / or end of each session, primarily by the user performing rhythmic training 188. The long form inspection mode 186 comprises a series of 14-16 tasks and is typically performed without providing a guide signal to the user. The long form test is primarily used when rhythm training 188 is not expected or before or after rhythm training. When the rhythmic training mode 188 is selected, the user is presented with both the reference tone and the guidance signal or only the guidance signal, and the user is provided with a hand sensor, preferably under the guidance of a trained instructor or therapist. The user is instructed to perform various operations of the foot sensor 18a and / or the foot sensor 18b. After the mode is selected at 182, at 190, the appropriate task is displayed on the monitor 14, and at 194 the user can select an operating characteristic at 192 based on the selected task.
[0037]
Next, the program 164 executes a timing interrupt processing function (FIG. 17). The user or trainer selects the "Start" function at 196 and the computer recalls the parameters D, S and R from memory at 198, 200, 202 and at 204 the I based on the recalled parameters. Calculate the value. At 206, 208, a timer interrupt is started and the program begins with I (210). Next, the program confirms at 212 the user operation of the trigger (18a, 18b). If a user input was received at 212, the user input is processed at 214 (FIG. 18). If no user response was received at 212, the program determines at 215 whether it is time to generate a reference signal. If it is determined at 215 that it is time to generate a reference signal, the program proceeds to FIG. 19 where it determines at 216 whether the reference signal (ON / OFF) has been activated and at 216 If the reference signal function is activated, a reference signal is generated, such as on headphones 22, and provided to the user.
[0038]
Next, at 218, it is determined whether the counter has been decremented to zero or if the trainee has selected the "stop" function. The counter is set at the beginning of each mode and generally has the length of the function of the selected mode. If the counter is not zero, the program proceeds to 208 where another tick is processed at 210 and the program confirms user input (212) and processes the reference tone (215). At 218, when the counter is zero or the trainee has selected the "stop" function, the program returns to the mode selection display screen (180).
[0039]
In FIG. 18, a temporal evaluation function is performed. Upon receiving user input at 214, the program reads the value of the processor tick (U) at 220 and calculates the elapsed time parameter (E = UI) at 222. At 224, parameter A is updated. Parameter A is the user's average response to the reference signal, which is maintained for a few milliseconds. The value of A may be displayed on monitor 14 for monitoring by a therapist and recording in a database. Illustrating the use of standard responses, the database may store all responses by the user several milliseconds earlier or milliseconds later. At 226, the parameter H is updated. Parameter H is the number of user inputs made during a particular test.
[0040]
Next, at 228, it is determined whether the value of E is greater than or equal to I and less than I + D. In that case, it is determined at 230 that a slow response has been received. Next, at 232, it is determined whether the parameter E is greater than I + S. If so, a guidance signal is generated at 234 and sent to headphones 22 when a particular mode requires presentation of the guidance signal to the user. The guidance signal is preferably generated during the optional training mode 188 but not during one of the tasks of the long form inspection mode 186 or the short form inspection mode 184. If it is determined at 232 that the value of E is greater than or equal to I + S, a slow response within the ultra-difficulty range has been received. Even in the case where the presentation of the guidance signal to the user is requested in the specific mode, it is preferable that the guidance signal is not generated due to the decrease in the response within the extremely difficult range. This allows the user to hear only the reference signal and not the guide signal, indicating that the user has responded within the ultra-difficulty range.
[0041]
If the requirements of 228 are not met, at 236 it is determined whether E is greater than I + D and less than R / 2. If so, at 238 it is determined that the user response is very slow, and if a particular mode requires generation of a guidance signal at 234, an appropriate guidance signal is generated. If the condition of 236 is not satisfied, at 240 it is determined whether E is greater than R / 2 and less than RD. If so, a determination is made at 242 as to whether a very fast response has been received, and if a guidance tone has been generated, an appropriate guidance tone is generated at 234. If the condition is not satisfied at 240, it is determined at 244 whether E is greater than RD and less than R. If so, at 246 it is determined whether an early response has been received, and at 248 it is determined whether the response is beyond the extreme difficulty range. If so, the appropriate guidance tone is generated at 234 if the guidance tone has been generated. If it is determined at 248 that E is between RS and R, no guidance tone is generated even if a guidance tone is generated. This indicates to the user that the response of the user is within the extremely difficult range.
[0042]
As described above, the learning ability improvement devices 10, 10 ', 10 ", 40, 40', 60a, 60b, and 80 provide users including young children with learning skills that do not involve the user's apparent or superficial behavior. Provide the ability to teach. This is particularly important to enable very young children who are not yet able to perform overt superficial behavioral tasks to benefit from the techniques described in our earlier patents. This is accomplished by appealing to the user's desire for learning and responding to the user with exciting stimuli. Also, if the user performs a constructive movement pattern, the user gets a reward. The devices 40, 40 ', 60a, 60b and 80 can also be combined with other devices (such as stuffed animals, mobiles, etc.) to further enhance the utility of the device. The devices 40, 40 ', 60a, 60b, and 80 provide more rewards to the child as the child lasts longer. This increases the child's ability to adopt and retain the multitasking function of the brain. Also, devices 40, 40 ', 60a and 60b are disclosed in commonly assigned U.S. Patent No. 60 / 219,321 (August 13, 1999), the disclosure of which is hereby incorporated by reference. (Neurological Conflict Diagnose Metric And Apparatus).
[0043]
Other variations will be apparent to those skilled in the art. The learning ability improving device 70 schematically shown in FIG. 10 has a trigger 72 constituted by a series of sub-triggers 74. The rest of the device is not shown, but is similar to that shown in FIG. The user is provided with a pattern of the sub-trigger 74 and instructed to operate the sub-trigger in a specific pattern as close as possible to the reference signal. The reference signal can be an audio or visual signal provided to the user, or an internal signal not provided to the user. If the user succeeds in operating the sub-trigger 74 in a pattern that is as close as possible to the reference, rewards for successful results will be provided in a manner that will be apparent to those skilled in the art.
[0044]
In the case of all the learning-enhancing devices 10, 10 ', 10 ", 40, 40', 60a, 60b, 70 and 80, the reference signal is generated internally by a control independent of the user's movement. Or in response to a previous sequence of movements by the user. For example, the user may operate the trigger 2 to 10 times or more without a reference signal. The controller analyzes this operation and generates a reference signal based on the average interval or tempo of the user's previous operation. The control section may continuously adjust the reference signal when the average tempo of the operation of the user changes. The guide sound is provided to the user in order to improve the user's ability to concentrate on the reference signal affected by the user's trigger operation. By using the same principle, in an interactive group of two or more users who operate individual triggers, the tempo of the reference signal can be set using the average of the combinations of the trigger operations of the groups. Alternatively, only one person in the group may be used to control the tempo of the reference signal. The reference signal may be provided to the user at all times or may be interrupted periodically to allow the user to respond strictly to the user's internal timing mechanism. The reference and guidance signals may be auditory, visual, or a combination of both.
[0045]
Changes and modifications of the specifically described embodiments depart from the principles of the present invention, which are intended to be limited solely by the appended claims, as construed in accordance with the principles of patent law, including the doctrine of equivalents. Can be done without.
[0046]
Attachment A

Interactive metronome effect
Attention that begins to develop shortly after birth is an essential component of skills such as learning, concentration, thinking, interacting with others, and acquiring basic academic skills (Greenspan & Lourie, 1981; Greenspan, 1997; Mundy & Crowdson, 1997). Relative deficits in persistence of attention, suppression of competing impulse and participation in joint attention are found in impaired attention, learning and development. These deficits are some of the clinical disorders including Attention Deficit Disorder (ADD), Broad Versatile Developmental Disorder (Autism Spectrum Disorder), Speech Disorders, Motor Disorders and certain learning disorders related to literacy and math. (Mundy, 1995; Barkley. 1997a).
Increasing numbers of evidence suggest that motor planning and a wide range of factors such as sequencing, rhythm, and timing are related to attention problems. Barkley (1997b) asserts that deficits in control and performance functions, such as regulation and sequencing of motor patterns and behavior, are important for understanding attention deficit hyperactivity disorder (ADHD). An important relationship between aspects of motor control, including suppression (Shonfeld, Shaffer & Barmack, 1989), speed, rhythm, coordination and overflow, and attention has been demonstrated by several researchers (Barkley, Koplowitz, Anderson & McMurry, 1997; Denckla, Rudel, Chapman & Kriger 1985; Piek, Pitcher & Hay, 1999). Gilberg (1988) reported on a group of children with defects in attention, motor control and perception (named DAMP syndrome). In a recent study, Kadesjo (1998) found that there was considerable commonality between attention deficits and motor clumsiness. In this group of children, prognosis tended to worsen if they had both attentional and motor problems (Heiigren, Gillberg, Gillberg & Enerskog, 1993; Heiigren, Gillberg, Bagenholm & Gilb 94). . Recently, Piek (1999) reported that the severity of distraction symptoms in ADHD patients is an important factor in predicting coordination difficulties. More recent studies show that about half of all children with developmental coordination disorders have moderate to severe ADHD symptoms, are diagnosed with DCD at 7 years of age, and have poor reading comprehension at 10 years of age. (Kadesjo & Gilberg 1999).
Developmental Individual-Relational (Dir) -dual-Dual-dual-Dual-dual-dual-Dual-dual-Dual-dual-Dual-Dual-dual-Dual-Dual-Dual-Dual-Dual-dual-Dual-Dual-Dual-Dual-Dual-dual-Dual-dual-Dual-Dual-Dual-Dual-Dual-Dual-Dual-Dual-Dual-Dual-Dual-Dual-dual-Dual-dual-dual-dual-d-al-d-al-d-al-d-d-e-d-e-e-d-e-e-d-e- (e-((t-((((((((((t, Fig. 197, FIG. 19, FIG. 10, FIG. 10). According to the Difference Relationship model (Greenspan 1992; Greenspan & Wieder, 1999), children can plan and sequence exercise in order to build complex adaptive patterns, such as participation in and execution of multi-stroke behaviors in schools and homes. Various unique processing capabilities such as singing are used in the physical environment and in dialogue with others. In addition, there is considerable commonality between neural networks involved in ADHD and motor planning and timing regulation. These networks are associated with the prefrontal and striatal regions of the brain. Recent studies using functional MRI assessment have reported that children with ADHD have less than normal activity in the prefrontal system involved in advanced motor control (Rubia et al., 1999).
The relationship between motor control and attention and performance functions suggests that techniques aimed at motor planning, sequencing, timing and rhythm enhancement may help improve attention and learning abilities. (Greenspan, 1992). Interactive metronome, a patented PC-based interactive music metronome that improves on the traditional music metronome developed in 1992^R(Casilly, 1996) provide new educational techniques that promote many of the underlying abilities of the central nervous system that are postulated to be involved in motor regulation. The non-interactive metronome has been used as a tool for temporal education since it was invented by Etienne Louise in 1696. Interactive metronome^R(IM) is the first to take advantage of the power of modern computers to incorporate interactive elements into this traditional tool. Whereas the user had to mentally evaluate his temporal accuracy himself, the IM was used to express his own temporal accuracy when he performed a series of indicated movements. Provide the user with accurate (less than 0.5 millisecond) real-time guide sound. The tones and spatially varying guide tones allow the user to steadily correct any planning and sequencing and timing errors that may occur. Preliminary studies show that personal performance levels in IM with motor planning, timing and rhythm are correlated with development, severity of learning and attentional disability, improved academic performance, and age-related changes in performance during school. (Kuhlman & Schweinhart, 1999). Special education class children with various developmental and learning disabilities that were trained in IM showed a recovery in athletic performance while similar groups without such training did not show any recovery during the same period. (Stemmer, 1996).
Recent studies have shown that IM training can improve a golfer's motor control, concentration, and motor skills (Libkman & Otani, 1999). The current study is the first controlled clinical trial of IM training performed on a group of children meeting the criteria for attention deficit disorder in DSM-IV (APA, 1994). The purpose of this study was to identify the effects of an interactive metronome on cognitive skills and selected aspects of exercise in a group of children diagnosed with ADHD.
Study design
This study used an experimental pre-test and post-test measurement design (see FIG. 1).
[Table 1]

subject
Subjects were selected from 6-12 year old boys with ADHD in the Greater Metropolitan area where this study was conducted. DSM-IV by local pediatrician, pediatric sub-specialist and / or psychiatrist / psychiatrist via advertising in local school areas, physicians, psychiatrists, psychiatrists and local newspapers We recruited 75 volunteers with evidence of a clinical diagnosis that by classification corresponds to attention deficit hyperactivity disorder. The test manager reviewed each randomly identified child and performed pretest and posttest. All tests and treatments were performed without any financial burden on the subject's parents. All test managers are occupational psychometers or licensed occupational therapists (OTRs) who are qualified to manage each test. The test manager was unaware of the purpose of the study and who received what treatment.
As a result of the above screening, 19 subjects were excluded from the volunteer population because they did not meet clinical or research criteria or had severe learning deficits, cognitive deficits, neurological disorders, anxiety or depression. . The 56 subjects who passed in this group were, demographically, between 6 and 12.5 years of age, 86% white and 14% other races. Of the parents or guardians of the subjects, 32% earned less than $ 40,000, 38% earned $ 40,000 to $ 69,000, and 30% earned $ 70,000 or more. Eighty percent had parents with college education.
For both parents and children, the purpose of this study was to "survey the use of non-pharmaceutical methods in the treatment and management of ADD / ADHD" and "The treatment used in this study was an interactive computer-based treatment program." I was told that there was. They were also informed that all subjects would eventually receive all treatment. And no further information on this study was provided until treatment and post-test was completed. One subject was withdrawn from the study after the second day because he was struggling with the caretaker. After the study was completed, subjects in both the video and control groups received IM therapy.
Means
Four major performance categories were evaluated. The evaluation means was selected from those most commonly used in psychology, occupational therapy and educational organizations. Only valuation tools that showed credibility and validity were used (see references for each tool). Summary scores and subtest scores from the following tools were used to evaluate the following areas:
Attention and concentration# 1) Tests of Variables of Attention (TOVA) is a 25-minute computer-based test and is one of the most widely used means for objectively judging ADHD (Greenburg & Dupuy, 1993). '2) Conners' Rating Scales-Revised (CRS-R) Teacher / Parent is a questionnaire answered by parents and teachers, and is one of the most widely used means for subjective judgment of ADHD. (Conners, 1990). # 3) Wechsler Children's Intelligence Test-Third Edition (WISC-III) is well known and widely accepted as a children's intelligence test (Wecsler, 1992). # 4) Achenbach's behavior checklist for children allows parents to answer questionnaires and measure internalized problems and external behavior (Achenbach, 1991).
Clinical function ( Clinical Functioning )# 1) Conners Rating Scale. # 2) Achenbach's child behavior checklist. 3) Sensory Profile-Assess hearing, vision, activity level, taste / olfaction, body / position, movement, touch, emotion / social function (Dunn & Westman, 1995). # 4) Bruininks-Ozeretsky exercise efficiency test (BO) (selected subtest) evaluates bilateral coordination, upper limb coordination, and upper limb speed and dexterity (Bruinks, 1978).
Academic and cognitive skills# 1) Wide Range Achievement Test-3 (WRAT3) (Read / Write) evaluates reading decoding, spelling, and arithmetic calculations. # 2) The Language Expression Test (LPT) evaluates the basic language.
Pretest and posttest were performed on subjects at the same time of day to control dosing schedule and diurnality. For tests that provided equivalent forms, different forms were used for post-test and then for pre-test. The period between pretest and posttest was 4-5 weeks.
Manager of IM treatment and video treatment control group
IM and video group subjects were randomly assigned to hired administrators to treat both groups of subjects. The manager was a graduate student, a college student, and / or an individual without a higher degree and no formal treatment or educational experience. Each manager received an equal six hours of education for both IM and video games.
The IM group and the video group, the environment and treatment schedule for both were equal. The administrator followed a daily treatment regimen guidebook for both groups of subjects, controlling the structure of the session, the amount of time spent in conversation and the amount of encouragement given. Subjects were required not to share their experiences with other subjects.
Treatment-Interactive Metronome^RAnd video games
Interactive metronome ^R apparatus
The patented IM device used in the study consisted of a Pentium computer, an IM software program, two headphones and two touch-sensitive triggers. One trigger (a special glove with a contact sensor attached to the palm side) is when the clasping hand is touching the triggering hand with the other hand or one hand tapping the thigh To accurately sense. The other trigger (a flat plastic pad placed on the floor) senses that the toe or heel taps the trigger.
When the subject taps on a limb to a stable metronome reference beat sound heard from the headphones, the trigger sends a signal through a cable to the IM computer program. The IM accurately analyzes the point in time of the tap based on the reference beat, and instantaneously replaces the timing information with the guidance signal. The subject can hear this guidance signal each time each tap occurs. The pitch of the guidance signal tone and the headphone position changing from left to right changed precisely according to the accuracy of each tap. The IM program generates a planning and sequencing accuracy score (IM score) that is displayed on the screen in milliseconds, and indicates to the administrator at the same time that the subject's response matches the reference signal. I do. After each exercise, subjects look at their IM scores and appear to be motivated to do better.
IM trainingThe purpose of IM treatment is to help subjects improve their abilities and gain selective attention for long periods of time without interruption due to internal thinking or external disturbances. Simple limb movement exercises are used to systematically drive the underlying mental concentration enhancement process from the outside. Each subject performed 15 1 hour IM training sessions (once daily) for 3-5 weeks. Each session consists of repeating the 4-8 exercises specified in the daily lesson booklet a specified number of times. Exercises were performed at a preset tempo that repeats 54 times per minute, and the number of repetitions during one exercise increased from 200 during the first session to a maximum of 2000 during the ninth session.
The thirteen IM therapeutic exercises were designed not to develop the subject's new physical exercise skills, but to help the subject focus on improving mental concentration. These exercises include clapping, one-hand taps on the upper thighs, alternating taps on the floor trigger, alternate taps on the heel, alternate taps on the heel, tapping on one toe or heel only, and tapping on one thigh and the floor trigger on the thigh. Alternate toe tap on opposite side, including tapping on the other toe while balancing on one foot.
Prior to beginning the first IM treatment session, the IM subject is provided with an automatic IM pretest that evaluates the ability to recognize timing patterns, selectively focus on one task, and perform simple motion modifications. Can be The IM pretest also indicated whether the subject had one or more planning and sequencing impairment patterns that needed to be considered during the early stages of IM treatment. Prescriptions for IM treatment are designed and staged according to instructions in the Daily Training Guidebook.
In the first phase, the administrator helps the subject break through the current planning and sequencing impairment patterns recognized by the IM pretest. The six most recognized planning and sequencing impairment patterns are: (1) Disassociative (response is messy and random and completely unrelated to the beat-3 people); (2) Contraphasic ) (Subject's response always deviates from the beat for a few beats and moves in the middle of the beat-6); (3) Hyperballistic (subject uses improper fast shocking action) (4) Hyperanticipitory (response continuously occurs long before the reference beat-18); (5) Hypoanticipiory (response continuously exceeds the reference beat) (1) which occurs later); (6) Auditory Hypersensitivity (subjects) were abnormally disturbed by computer-generated guide sounds added to the headphone mix during the last test task, and the scores for this task were unguided as indicated by their IMms score 2-7 times less accurate than the previous 13 exercise scores-7).
The first IM treatment session was devoted to helping the subject learn how to distinguish between a sound triggered by his own motion and a steady IM metronome beat sound. The subject is instructed to make smooth and controlled limb movements that repeat the repeating pattern continuously without stopping at any point between beats. Subjects are repeatedly instructed to focus on the beat of the metronome, uninterrupted by their own thoughts and surrounding events. If subjects break through the planning and sequencing patterns they have and achieve the IM millisecond score average indicated in the prescription booklet, they will be required to begin the second different phase of the IM treatment program We thought that we had achieved appropriate control and accuracy.
In the second phase of IM therapy, subjects are instructed to focus attention only on the stable reference beat and ignore guide sounds, internal thoughts, and extraneous stimuli that are generated by their triggers. They are also instructed to keep repeating their movement patterns without any intentional adjustment. This usually results in a clear improvement in the subject's score, and the enjoyable experience of staying on the beat without effort seems to have a positive motivating effect. With each session, subjects have more time to selectively focus on the metronome beat without interruption, and their IM program scores are correspondingly improved. Most IM subjects appeared to be strongly motivated to achieve the best possible score during their training regimen. According to the IM training scores, all subjects in the IM group were able to improve their planning and sequencing, and by the end of their training, continue to perform tasks without interruption for a significantly longer time .
Video control group placebo computer game training activity
Five non-violent games from commercially available PC-based video games were used for placebo treatment in the video control group. Each game involves eye-hand coordination, advanced mental planning, and multiple task sequencing. In each game, the subject plays computer programming, and each time he enters a new level, it becomes increasingly difficult to play.
The administrator followed the daily video group training prescription booklet as in the IM prescription booklet. The instructions in the booklet provide the forms of monitoring, attention and assistance that the IMs receive. Each subject performed 15 1 hour video training sessions (once a day) for 3-5 weeks. Each training session included several video game exercises, and the time subjects spent in each video game exercise generally increased from the first session to the last session.
Analysis
Sampling design and results
Following the completion of the pretest of all 56 subjects, a matched random assignment process was used to form the three treatment groups. Three factors were used in the matching process: drug dose (milligrams / body weight), subject age, and severity of ADHD as measured by the TOVA ADHD score. These factors were selected to control the effects of drug treatment, age at development, and the severity of ADHD. Analysis of the variance of these three matching variables indicated that there was no significant difference between the three comparison groups when the significance level was p ≦ 0.05. Chi-square analysis of the three demographic variables (subject race, parental education, parental income) showed that there was no statistically significant difference at the above p ≦ 0.05 and the three comparisons The groups suggested that the three socioeconomic factors were equivalent.
Analysis of the variance of the elements of the 58 pretests showed that there was only one statistically significant difference between the three comparison groups. The Sakoda's table for significance tests (Sakoda's table, (1974)) shows that the probability that one of the 58 significance tests will occur by chance is p> 0.50, A single occurrence is assumed to be a chance difference. The p-value obtained from the remaining 57 elements exceeded p> 0.05.
Pattern analysis
Pattern analysis of the 58 test scores examined the overall direction of mean difference between the pre and post test phases of each group. During the analysis, the average of each test (pretest = P1, posttest = P2) was calculated and the average difference between P1 and P2 was determined. The average difference for each group was dichotomized depending on whether the change indicated an increase or decrease in the desired direction for each test. For example, the P2-P1 mean differences for the Wechsler Digit Span subtests of the three groups were IM = + 0.473, control = −0.278, video = −0.054, respectively. The average difference showed that the performance of the IM group was improved, while the performance of control and video was reduced. Similar analysis was performed for all 58 test scores.
To statistically test this pattern, a binomial test is used to determine whether the proportion of dichotomous pairs (improved vs. decreased) is accidental (provided that the probability of either improving or decreasing is 0.50), or whether the directional proportion was abnormal enough to reflect non-accidental events. The rationale for using the binomial test is based on the assumption that if a large number of variables show an overall unusual directional trend (eg, improved performance), this indicates that the overall pattern of change is worthy of interest. The binomial test enables detection of a combined directional pattern that is not detected when individual variables are examined one by one.
Pattern analysis showed the following: In the control group, the scores of 28 variables improved and the scores of 30 variables decreased. The results had a high probability of random occurrence of p = 0.8955, suggesting that there were no statistically significant combined directional patterns (Norusis, 1993). Analysis of the IM and video groups showed a statistically significant improvement / decrease. In the IM group, 53 of the 58 variables showed improvement (p ≦ 0.0001). In the video group, 40 of the 58 variables showed improvement (p ≦ 0.0058). Both groups showed a statistically significant pattern increase in performance over the control group. The IM group experiences significantly better improvement than the video group, suggesting that IM treatment produces a statistically significant additional effect over the experience of the video control group.
Analysis of significance
As a result of the pattern analysis, the overall improvement / decrease characteristics of the test average difference were recognized, but the magnitude of these differences was not considered. Because a pretest / posttest repeated measures design was used, analysis of variance of repeated measures (SPSS, 1988) was performed for each of the 58 variables. This approach was chosen to separately observe the effect of the three treatment groups on each test score. However, one disadvantage of this approach is that type 1 errors can increase.
Of the 58 test scores analyzed, 12 had statistically significant interaction effects (p-value range 0.047-0.0001), some treatment combinations and subgroup averages Were different and / or there were statistically significant pre-post test differences. Twelve of the 58 significant tests had a significant difference of p ≦ 0.001 (Sakoda, 1974 at 0.05 confidence level), suggesting that these differences were not accidental. In addition, Keppel (1973) calculated 2.9 for the number of possible type 1 errors across 58 individual experiments. Thus, these twelve statistically significant differences far exceed the calculated number of possible type 1 errors of 2.9, suggesting that these differences are indeed statistically significant. I have.
Among the above statistically significant effects, seven statistically significant phase-phases effects were found (p-value range 0.023-0.0001). This analysis suggests that IM treatment groups have an ability to identify similarities and differences between concepts and to experience reduced aggressive behavior as reported by their parents. A statistically significant improvement was found. Both IM and video treatments produce statistically significant improvements in the three sensory profile subtests, which both groups benefit from the attention and activity provided by these treatments Suggests that Parental reports based on the child's behavioral checklist also showed a statistically significant decrease in aggressive behavior in the IM group, a non-statistically significant improvement in the video group, and no improvement in the control group. It was clear that I could not see it.
The remaining five tests had significantly different interaction effects (p-values between 0.0001 and 0.047). These five tests include the WRAT-3 reading subtest and Omissions, RT Variability, RT Variability, Total-STD Deviation, and ADHD Total Score. It included four tests of The Variables of Attention (TOVA). Significant interaction effects indicate that posttest IM performance is not significantly improved over pretest performance, but nevertheless is statistically significant higher than control and video treatment posttest performance. Suggests that they performed. The pattern of difference was similar for all five tests. That is, while IM performance improved, both control and video performance declined.
In summary, pattern analysis revealed that both the IM and video groups experienced a statistically significant pattern of improvement overall at 58 test scores. In addition, the IM group had a statistically significantly stronger pattern of improvement than the video group, with the video group showing 40 versus 53 test scores. This supports the hypothesis that for boys with ADHD disorders, IM training produced a stronger pattern of improvement than the video group.
Analysis of test means found 12 factors with statistically significant quantitative changes among various combinations of groups and treatments. The IM group showed a statistically significant improvement in discrimination of similarities and differences and reduction of aggression problems in the post-test compared to the pre-test compared to the other two treatment groups. Both IM and video groups showed a statistically significant improvement in parents' reports on three sensory processing tasks and impulsivity / hyperactivity. However, only the IM subject's parents rated their children statistically significantly less aggressive after the treatment period compared to the other two groups of parents (p ≦ 0.001). did. In addition, five tests measuring the four characteristics of reading and attention revealed that the IM group had a statistically significantly higher posttest performance compared to the performance for the other two treatment groups.
Discussion
The results show that boys with ADHD who have undergone IM intervention have more attention, motor control, language processing, and literacy areas than boys receiving video therapy or boys in a control group who do not receive intervention. And significantly improved their ability to coordinate attacks. The boys who received video game coaches demonstrated that, on some scales, they were better than the control group and that focused sensory activity and support alone were useful for selected areas of function. However, the video group also had a marked decrease in performance in certain areas with coordination and control, such as consistency of focus, response time, and overall attention.
IM training, on the other hand, is a series of TOVA attention tasks that measure errors and lack of distraction, consistency of response time, and overall attention, specific languages (ie, similarities and differences), academic tasks ( (Reading), and improved control, including statistically significant positive gains, compared to the video treatment group with respect to attack control. In addition, pattern analysis was used to control the effect of using a large number of ratings, and the differences between the patterns of the multiple groups proved to be statistically significant. NIH \ Consensus \ Statement (1997) argues that studies on ADHD interventions must be properly controlled only for the positive overall effect of careful adult interactions. Consistent with the NIH guidelines, two of the three groups in this study received adult attention during the treatment period.
The methodological considerations and constraints of this study include: Only men of a defined age range are included to minimize age and gender variability, limiting the generalization of results to women and other ADHD male age groups. The variables measured by the assessment are limited to selected aspects of attention, motor control, language, cognition, and learning.
In this study, IM training affected many performance abilities. A possible explanation for positive change is that exercise planning and sequencing are central in each of these performance areas. In dynamic system models (Smith & Thelon, 1993), critical variables, such as the ability to plan and sequence activities, affect a wide range of adaptive functions, such as attention (Greenspan, 1992).
The results of the current study suggest a direction for further study, which direction should be able to identify the characteristics associated with different response patterns to metronome training. This includes repeating the current study for women, repeating the current study for women, and repeating the current study for a more socioeconomically diverse population to observe potential elements of different environmental backgrounds. Further studies will also allow subgroups to be studied based on both metronome performance and children's treatment profiles.
It is also necessary to develop specific variations of the IM training process, including the number of sessions, general repetitions, the goal of temporal accuracy, and the length of follow-up time (observing the stability of the IM effect) To increase). Further, to understand both the dynamic system and the underlying central nervous system mechanisms associated with motor coordination, and to better understand how IM training affects these processes, Further research is needed. IM will be the first technology that allows to create a database and classification of "timing" to help compare the effects of interventions on timing in various sensory motor processes.
In conclusion, from the perspective of the dynamic system (Smith & Thelen, 1993; Gray, et al., 1996a, 1996b), many processes, such as the timing and rhythmic nature of motor behavior, affect motor planning. In addition, athletic planning interacts with other factors, such as learning opportunities and environmental requirements, and affects patterns of self-regulation and functioning at home, at school, and with peers. Until recently, interventions to enhance these capabilities were limited to studying explicit or superficial behavior in educational or therapeutic settings. This study suggests that IM training can improve aspects of attention, motor, and sensory motor function, cognitive and academic performance, and control of aggression in children with significant attention problems, and therefore , IM training can complement existing interventions for these children.
References
Achenbach, T.A. M. , & Edelblock, C.I. E. FIG. (1991), "Child Behavior Checklist", Department of Psychiatry,University of Vermont, Burlington, VT.
APA DSM-IV Task Force (1994), "DSM-IV Diagnostic and Statistical Manual", Washington, DC; American Psychatic Press.
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[Brief description of the drawings]
FIG.
FIG. 4 is a diagram of a method for improving learning ability according to the present invention.
FIG. 2
FIG. 2 is a block diagram of an apparatus according to the present invention.
FIG. 3
FIG. 6A is a diagram illustrating one form of a relation between a time relationship of a trigger operation with respect to generation of a reference signal and a guidance signal.
FIG. 4B is a diagram similar to FIG. 3A showing one form of a relationship between a trigger signal with respect to generation of a reference signal and a guidance signal.
FIG. 4
FIG. 3 is a side view of a visual display generated by the device shown in FIG. 2.
FIG. 5
FIG. 5 is a plan view of the generated visual display of FIG. 4.
FIG. 6
FIG. 3 is a side view of another embodiment of the device shown in FIG. 2.
FIG. 7
FIG. 7 is a view similar to FIG. 6 of another embodiment.
FIG. 8
FIG. 7 is a view similar to FIG. 6 of still another embodiment.
FIG. 9
FIG. 4 is a perspective view of yet another embodiment of the device shown in FIG. 2.
FIG. 10
It is a top view of another trigger device.
FIG. 11
FIG. 3 shows the device shown in FIG. 2 in some detail.
FIG.
FIG. 12 is a view similar to FIG. 11 of another embodiment.
FIG. 13
FIG. 12 is a view similar to FIG. 11 of still another embodiment.
FIG. 14
FIG. 4 is a diagram showing a timing sequence of a user's trigger operation (that is, a response) to generation of a reference signal.
FIG.
It is a flowchart of a data creation and input function.
FIG.
It is a flowchart of a mode and task selection function.
FIG.
5 is a flowchart of a timing interrupt processing function.
FIG.
It is a flowchart of a temporal evaluation function.
FIG.
5 is a flowchart of a user signal generation function.
[Explanation of symbols]
2 Reference signal
4 Trigger
6 Users
7 Temporal relationship
8 Guidance signal
10 Learning ability improvement device
12 Computer
14 monitor
16 medium
18 trigger
22 headphones

Claims (84)

A method of improving a user's learning ability,
Generating a reference signal at time intervals;
Providing a trigger and receiving an operation of the trigger by a user;
A method comprising determining a temporal relationship between actuation of said trigger by a user and generation of said reference signal, and generating and providing a guidance signal to the user at least from time to time as a function of said temporal relationship. The method of claim 1, wherein generating the guidance signal substantially stops the guidance signal to the user if the actuation of the trigger by the user is within a certain range including generation of the reference signal. The guidance signal has a first characteristic for a user to operate the trigger before the specific range and a second characteristic for a user to operate the trigger after the specific range. Item 3. The method according to Item 2. 3. The method of claim 2, wherein the specified range extends from 15 milliseconds before the generation of the reference signal to 15 milliseconds after the generation of the reference signal. The method of claim 1, comprising providing a stereophonic speaker and generating a stereophonic auditory signal at the speaker. The method of claim 5, wherein the speakers include headphones. 4. The method of claim 3, wherein the first characteristic comprises an auditory signal having a directional source directed to one side of the user, and the second characteristic comprises an auditory signal having a directional source directed to the other side of the user. . 9. The method of claim 7, wherein the direction of the directional source comprises varying with a lead or delay time of a user response to the reference signal. The method of claim 3, wherein the first characteristic comprises an auditory signal occurring in a first range of pitch, and wherein the second characteristic comprises an auditory signal occurring in a second range of pitch. The method of claim 9, wherein the pitches of the first and second ranges are substantially collinear and separated by the particular range. The method of claim 9, further comprising: generating a different sound if a user operates the trigger much before or after the reference signal. The auditory signal occurring in a first range of the pitch has a directional source on one side of the user, and the auditory signal occurring in a second range of the pitch has a directional source on the opposite side of the user. 10. The method of claim 9, comprising: The method of claim 1, comprising providing the reference signal to a user at least from time to time. 14. The method according to claim 13, wherein the reference signal is an auditory signal or a visual signal. 14. The method of claim 13, including generating a reference signal having a substantially constant tempo. 14. The method of claim 13, including deriving the reference signal from a previous operation by a user of the trigger. The method of claim 1, comprising deriving the reference signal from a previous operation by a user of the trigger. The method of claim 1, wherein the method is used to enhance at least one of user attention, linguistic processing, literacy, and aggressive behavior adjustment. A user operation trigger that receives an operation by the user;
A control unit for generating a reference signal at time intervals, determining a time relationship between a trigger operation by a user and the generation of the reference signal, and further comprising: Providing a guidance signal, which is a function, to the user at least from time to time,
An apparatus wherein the guidance signal is not substantially provided to the user when the operation of the trigger by the user is within a specific range including the generation of the reference signal. The guidance signal has a first characteristic for operating the trigger by the user before the specific range and a second characteristic for operating the trigger by the user after the specific range. Item 20. The apparatus according to Item 19. 20. The apparatus of claim 19, wherein the specified range extends from 15 milliseconds before the generation of the reference signal to 15 milliseconds after the generation of the reference signal. 20. The apparatus of claim 19, further comprising a stereophonic speaker that generates a stereophonic auditory signal. 23. The device of claim 22, wherein said speakers include headphones. 21. The apparatus of claim 20, wherein the first characteristic comprises an auditory signal having a directional source directed to one side of the user and the second characteristic comprises an auditory signal having a directional source directed to the other side of the user. . 25. The apparatus of claim 24, wherein the direction of the directional source varies with a lead time or a delay time of a user response to the reference signal. 21. The apparatus of claim 20, wherein said first characteristic comprises an auditory signal occurring in a first range of pitch, and wherein said second characteristic comprises an auditory signal occurring in a second range of pitch. 27. The apparatus of claim 26, wherein the pitches of the first and second ranges are substantially collinear and separated by the difficult range. 27. The apparatus of claim 26, wherein the audible signal includes a different sound for a case where a user operates the trigger much before or after the reference signal. The auditory signal occurring in a first range of pitch has a directional source on one side of the user, and the auditory signal occurring in a second range of pitch has a directional source on the opposite side of the user. Item 29. The device according to Item 26. 20. The apparatus of claim 19, wherein the reference signal is provided to a user at least from time to time. 31. The device according to claim 30, wherein the reference signal is an auditory signal or a visual signal. The apparatus of claim 30, wherein the reference signal has a substantially constant tempo. 31. The apparatus of claim 30, wherein the reference signal is derived from a previous operation by a user of the trigger. 20. The apparatus of claim 19, wherein the reference signal is derived from a previous operation by a user of the trigger. A user operation trigger that receives an operation by the user;
A control unit that generates a reference signal at a time interval and determines a temporal relationship between operation of the trigger by a user and generation of the reference signal;
The control unit generates an instruction signal for instructing a user to operate the trigger. The apparatus of claim 35, wherein the control unit provides a guidance signal to the user at least from time to time as a function of the temporal relationship. 36. The apparatus of claim 35, comprising an auditory output that provides an auditory signal to a user, wherein the controller supplies the reference signal to the auditory output at least occasionally. 36. The apparatus of claim 35, further comprising a visual output for providing a visual signal to a user, wherein the control supplies the reference signal to the visual output at least from time to time. 36. The apparatus of claim 35, further comprising a visual output for providing a visual signal to a user, wherein the control supplies the indication signal to the visual output. 36. The control unit, wherein the instruction signal selectively instructs a user to operate the trigger either before the generation of the reference signal or after the generation of the reference signal. The described device. 36. The apparatus of claim 35, wherein the control unit causes the instruction signal to selectively instruct a user to operate the trigger, sometimes before the reference signal, and sometimes after the reference signal. 40. The apparatus of claim 39, wherein the indication signal describes movement in a particular direction. 43. The instruction signal selectively instructs a user to operate the trigger either before or after the reference signal by alternating lateral movements with respect to the depiction of the movement in the particular direction. The described device. 44. The apparatus of claim 43, wherein the indication signal indicates a response of the user to the indication signal. The apparatus of claim 44, wherein the indication signal indicates a response to the indication signal of a user as a change in the movement in the specific direction. 36. The apparatus of claim 35, including a computer monitor, wherein the indicating signal is displayed on the computer monitor. 36. The apparatus of claim 35, comprising a virtual reality display, wherein the indication signal is displayed on a virtual reality display. The apparatus of claim 35, wherein the indication signal indicates a response to the indication signal of a user. 40. The apparatus of claim 39, wherein the indication signal indicates a response of the user to the indication signal. The apparatus of claim 39, wherein the visual output comprises a computer monitor. The apparatus of claim 39, wherein the visual output comprises a virtual reality display. The control unit provides a user with a guidance signal that is a function of the temporal relationship at least from time to time, and the guidance signal indicates that the operation of the trigger by the user is within a specific range including the generation of the reference signal. 36. The device of claim 35, wherein the device is substantially not provided to a user. The guidance signal has a first characteristic for a user to operate the trigger before the specific range and a second characteristic for a user to operate the trigger after the specific range. Item 53. The apparatus according to Item 52. 53. The apparatus of claim 52, wherein the instruction signal prompts a user to operate the trigger either before or after the specific range. A method of improving a user's learning ability,
Generating a reference signal at time intervals;
Providing a trigger and receiving an operation of the trigger by a user;
A method comprising determining a temporal relationship between operation of a trigger by a user and generation of a reference signal, and generating an indication signal indicating operation of the trigger by the user. 56. The method of claim 55, comprising generating a guidance signal that is a function of the temporal relationship and providing the guidance signal to the user at least occasionally simultaneously with the user's response. 57. The method according to claim 56, wherein the guidance signal to the user is substantially stopped when the operation of the trigger by the user is within a certain range including the generation of the reference signal. 56. The method of claim 55, wherein generating the indication signal comprises selectively instructing a user to operate the trigger before or after the reference signal. 56. The method of claim 55, wherein generating the indication signal comprises selectively instructing a user to operate the trigger, sometimes before the reference signal, and sometimes after the reference signal. 56. The method of claim 55, providing a visual indicator, and generating the indicating signal using the visual indicator. 61. The method of claim 60, wherein generating the indication signal comprises displaying a depiction of movement in a particular direction using the visual indicator. Generating the indication signal may be such that a user operates the trigger either before or after the reference signal by alternately performing a lateral motion with respect to the depiction of the motion in the particular direction. 63. The method of claim 61, comprising selectively indicating. 63. The method of claim 62, wherein generating the indication signal comprises indicating a user's response to the indication signal. 63. The method of claim 62, wherein indicating a response to the indication signal of a user comprises changing the movement in the particular direction. The method of claim 55, wherein generating the indication signal comprises indicating a response to the indication signal of a user. 56. The method of claim 55, comprising providing a visual indicator and generating the guidance signal using the visual indicator. 56. The method of claim 55, comprising providing an audible output and generating the guidance signal using the audible output. 56. The method of claim 55, comprising providing a visual indicator and an audible output, and providing at least the guidance signal from time to time on the visual indicator and providing the guidance signal from time to time on the audible output. 56. The method of claim 55, comprising generating the indication signal using a computer monitor or a virtual reality display. A trigger adapted to the operation of the young child user;
An output that provides a signal to the user;
A control unit that generates a reference signal at a time interval in response to a user's operation of the trigger, and generates a reference signal between a user's operation of the trigger and generation of the reference signal. An apparatus for determining a relationship and further providing a guidance signal at least from time to time to the user via said output, said guidance signal being a function of said temporal relationship. 71. The apparatus of claim 70, wherein the trigger includes a body adapted to be held by a young child and a motion sensor responsive to movement of the body. 71. The apparatus of claim 70, wherein the trigger comprises a member suspended above a play or sleeping place for a child, and a sensor responsive to movement of the member. 71. The apparatus of claim 70, wherein the output comprises at least one of an audible output and a visual output. 72. The apparatus of claim 71, wherein the controller generates the reference signal from a previous series of movements of the body. The apparatus of claim 74, wherein the motion sensor comprises an accelerometer or a motion sensing circuit. 72. The apparatus according to claim 71, wherein the control unit includes a microcomputer housed in the main body. 72. The apparatus of claim 71, wherein the control is provided remotely from the trigger and is connected to the trigger by a communication link. 72. The apparatus according to claim 71, wherein the control unit generates the reference signal as a periodic signal regardless of an external input. 73. The apparatus of claim 71, further comprising an orientation member for orienting the body in a predetermined orientation in response to the control. 80. The apparatus of claim 79, wherein the orientation member includes a rotating mass. 81. The apparatus of claim 80, wherein the orientation member comprises a gyroscope or a motor. 71. The apparatus of claim 70, wherein the controller generates a reward signal at the output in response to one of a rhythmic movement and a rotational movement of the body. A computer-readable medium containing program code for implementing an application for a processor system with a trigger operable by a user, wherein the application implements a method for improving a user's learning ability, the method comprising:
Generating a reference signal at time intervals;
Receiving the operation of the trigger by the user,
A medium comprising determining a temporal relationship between operation of the trigger by a user and generation of the reference signal, and generating and providing a guidance signal to the user at least from time to time as a function of the temporal relationship. A computer-readable medium containing program code for implementing an application for a processor system with a trigger operable by a user, the application generating a reference signal at time intervals;
Receiving the operation of the trigger by the user,
A medium for performing a method including determining a temporal relationship between a user's operation of a trigger and generation of a reference signal, and generating an instruction signal indicating operation of the trigger by the user.

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