Wouldn’t it be wonderful if playing video games could help kids with ADHD? New research suggests that playing a video game for 25 minutes a day may help with inattention. And that’s good news, because inattention, one of the core symptoms of ADHD, can be one of the most difficult to treat.
Attention Deficit Hyperactivity Disorder is one of the most commonly diagnosed pediatric neurodevelopment disorders. ADHD affects an estimated 6.1 million kids in the U.S., or 9.4% of U.S. kids. The impairment kids experience due to the ongoing challenges with attention, impulsivity and hyperactivity places a burden on them and their families.
While many kids with ADHD benefit from the medications and behavioral therapy that are the current standard of care, many continue to struggle. It’s not just school performance that’s affected—family life can also be difficult. The kids know it, too, and they often experience anxiety or negative self-image.
In a field of therapies, why a video game?
The ability to pay attention is a critical skill both for school and for social interaction. As a core deficit in ADHD, it’s an important target for therapy. Medications help, but they can be expensive and for some kids cause side effects. Behavioral therapy has been shown to be helpful but can be difficult for families to access.
What about cognitive training? Many different methods are available, but meta-analyses reveal that the studies on them have used inadequate methodology. In other words, we don’t know if they work. Meanwhile, some families spend thousands of dollars and countless hours on them, hoping to help their children.
In this environment, an intervention that families can use at home is a welcome one. Kids with ADHD are well known to love video games, so the idea of a video game-like treatment is exciting.
The video game intervention for ADHD
The new study in The Lancet has examined just that. The “video game” is AKL-T01, an investigational digital therapeutic developed at Akili Interactive Labs in Boston.
This game is designed to specifically target “cognitive interference,” or the inability to tune out competing stimuli. More and more we are thinking of kids with ADHD not as kids who can’t pay attention to one thing, but as kids who can’t stop paying attention to everything. It would be a real benefit if they could gain cognitive control to choose where to direct their attention when two things are competing for it.
According to the designers, AKL-T01 was “developed to engage pediatric users through video game graphics and reward loops and to use real-time adaptive mechanisms that continuously personalize intervention difficulty on the basis of the user's ability and progression. Specifically, AKL-T01 targets attentional control to manage competing tasks and to efficiently (flexibly) shift attention between tasks. Further, divided and selective attention systems are required to process several tasks simultaneously.”
That may sound complex, but any parent of a child with ADHD knows what it means when they consider homework time.
This study used what is considered the gold standard of study design: a randomized, double-blind, parallel-group, controlled trial. Three hundred and forty-eight kids between the ages of 8 and 12 with ADHD were randomized to either the video game intervention on a tablet or a control intervention. They were taken off any ADHD medications they were using. Then, the kids played at home for 25 minutes a day, five days a week for four weeks.
To evaluate whether it helped, the researchers measured the Test of Variables of Attention (TOVA). Specifically, they looked at the mean change in the Attention Performance Index (API), which is a composite score derived from the TOVA. The “mean change [SD] from baseline on the composite score from the TOVA API was 0.93 in the intervention group and 0.03 in the control group, adjusted p value 0.0060.”
That’s a small but significant effect in improving attention. And with minimal effort from parents or side effects. (A couple of kids got mild headaches.)
Where does that leave us?
As is always the case with studies like this, questions remain. Will this go the way of other interventions, which turn out to teach the child how to do well on the intervention but do not translate to other environments? In other words, will your child just get good at the video game, or will they get better at their homework? Will the results last or will the child have to keep playing the game every day?
Still, it’s a promising study. Parents will be asking, “Where can I get this?” Right now, the designers are going through the approval process with the FDA, which means AKL-T01 is not available to the public yet.
Kollins, Scott H., DeLoss, Denton J., Cañadas, Elena, et. al. (Feb. 24, 2020). "A novel digital intervention for actively reducing severity of paediatric ADHD (STARS-ADHD): a randomised controlled trial." The Lancet.