Running head: VIDEO GAMES USED TO TREAT ADHD

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Video Games Used to Treat ADHD David T. Michalkiewicz English Composition II Professor Tolu O. Idowu Keiser University May 23, 2011

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Abstract Attention Deficit Hyperactivity Disorder is a condition that affects millions of Americans, both children and adults (Centers for Disease Control and Prevention, n.d.). The traditional methods of treating this condition include medication and behavior therapy, or a combination thereof (Center for Disease Control and Prevention; National Institute of Mental Health, 2008). However, flying in the face of claims that video games contribute to the development of ADHD as well as other attention and behavioral conditions (Daily Mail Reporter, 2010; Freer, 2008; Reuters, 2010; Shute, 2010; Swing, Gentile, Anderson and Walsh, 2010), a technology first developed by NASA is poised to revolutionize the treatment of ADHD (Bair, 2001; Jenks, 2006; Jones, 2011; Prescott, 2005; SmartBrain Technologies, n.d.; Szalavitz, 2011). Neurofeedback devices, based upon technology NASA originally used to train the minds of test pilots and coupled with off-the-shelf video games and consoles, are training the minds of afflicted children and adults alike (Jones). These devices allow brainwaves, when properly focused, to control the difficulty of a normal video game, conditioning the operators mind to remain in a state of concentration (Jones, Szalavitz). The application of neurofeedback in the field of ADHD treatment is still relatively new, but it is showing promising results (Szalavitz).

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Attention Deficit Hyperactivity Disorder (ADHD) is one of the most prevalent childhood disorders (Centers for Disease Control and Prevention, n.d.; National Institute of Mental Health, 2008; National Resource Center on ADHD, n.d.). It is considered to be a lifespan disorder (National Resource Center on ADHD) which means that it is not just a childhood condition, as was once thought (National Resource Center on ADHD). ADHD can affect individuals from early childhood into adulthood (Centers for Disease Control and Prevention; National Institute of Mental Health; National Resource Center on ADHD). Symptoms of ADHD include difficulty paying attention, daydreaming, inattentiveness, forgetfulness, squirming and fidgeting, and the inability to remain quiet, just to name a few (Centers for Disease Control and Prevention; National Institute of Mental Health). Currently, between 5 and 8 percent of school-age children and 2 to 4 percent of adults suffer from ADHD (National Resource Center on ADHD). Traditional treatments for ADHD include medication, behavior therapy, education, or a combination thereof (Centers for Disease Control and Prevention, National Institute of Mental Health). Medications aim to quell hyperactivity and impulsiveness, and to improve the patients ability to focus (National Institute of Mental Health). Behavior therapy aims to reinforce desired behaviors through positive or negative feedback, or through structure and routine (National Institute of Mental Health). New treatments, such as brain imaging, are coming to the fore, allowing for more effective treatment and prevention (National Institute of Mental Health). An innovative approach involving the use of video games coupled with neurofeedback technology, first developed by NASA for use in the training of test pilots, shows promising results (Bair, 2001; Jenks, 2006; Jones, 2011; Prescott, 2005; SmartBrain Technologies, n.d.; Szalavitz, 2011), though there are those who would doubt such claims (Daily Mail Reporter, 2010; Freer, 2010; Reuters, 2010; Rosen and Weil, 2001; Shute, 2010; Swing, Gentile, Anderson, & Walsh, 2010).

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For years, NASA has used neurofeedback and biofeedback technologies in the training of test pilots (Bair, 2001; Jenks, 2006; Jones, 2011; Prescott, 2005; SmartBrain Technologies, n.d.). This technology was found by NASA researchers to increase a pilots ability to concentrate and attention span during flight simulations (Jones; SmartBrain Technologies). This technology gave birth to what is known as Extended Attention Span Training (EAST) (Jones). EAST is a modification of the original NASA technology, a video game that responds to both conventional joystick input and electrical activity in the operators brain (Jones). There are several companies that claim to make use of this NASA developed technology in the treatment of ADHD. Those companies include the Asheville, North Carolina based Unique Logic and Technology with their Play Attention system (Play Attention, n.d.; Prescott), and the Richmond, Virginia based Attention Getters (Bair). There is only one company, however, which is officially licensed by NASA to use their technology, the Plymouth Meeting, Pennsylvania based company CyberLearning Technology, LLC (SmartBrain Technologies; Jones). In 2003, CyberLearning Technology, LLC released the Self Mastery and Regulation Training (S.M.A.R.T.) BrainGames System, a direct descendant of EAST (Jones). The S.M.A.R.T. system, originally compatible with the Sony PlayStation console (Jones), has since been reworked to include compatibility with the PlayStation 2, the PlayStation 3, and the original Xbox consoles. The S.M.A.R.T. system is not yet compatible with the Xbox 360 console (SmartBrainTechnologies). S.M.A.R.T operates by using neurofeedback to cause an off-the-shelf video game to respond to the electrical activity in an operators brain (Jones). As the operators brainwave patterns come more in line with an optimal setting, S.M.A.R.T. responds, making the game easier to control (Jones). If the operators brainwave patterns drift from optimal, the game becomes harder to control (Jones). The theory is that the brainwaves of those with ADHD tend to remain in the theta frequency,

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rather than the beta frequency; the theta frequency being associated with tuning out and the beta frequency being associated with a state of attention (Szalavitz, 2011). The S.M.A.R.T. system trains its operator to relax and focus, maintaining their brainwaves in the beta frequency (Jenks; SmartBrain Technologies; Szalavitz). Research done by NASA in conjunction with the Eastern Virginia Medical School showed a marked improvement in s ubjects attention spans and decreased impulsiveness and hyperactivity (Jones). Additional studies are currently being funded by the National Institute of Mental Health and conducted at Ohio State University (Szalavitz). Although current studies are not conclusive the body of evidence being collected is promising and shows that the approach is a viable option in the treatment of ADHD (Szalavitz). Many people, however, would seem to disagree with the claims that video games could be used to aid in the treatment of ADHD. Certain studies have claimed to show that video games have been linked to ADHD (Daily Mail Reporter, 2010; Freer, 2010; Reuters, 2010; Rosen & Weil, 2001; Shute, 20101; Swing, Gentile, Anderson, & Walsh, 2010). One of the most wellknown of these studies points to the fact that some children and young adults seem to experience more problems related to behavior and attention with increased amounts of screen time (Swing et al.). A study conducted by California State University and Human-Ware, LLC seems to support these observations (Rosen & Weil). Others claim that the constant stimulation and everchanging environment depicted upon the screen conditions the brain to desire such input (Daily Mail Reporter). This, effectively, makes it difficult for an individual whose brain has been conditioned in such a fashion to concentrate on mundane tasks, such as classroom activities (Daily Mail Reporter; Rosen & Weil).

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The issue with these arguments is not the data that is presented, but how that data is gathered and interpreted (Freer, 2008; Freer, 2010). Unfortunately, the methods used tend to be decidedly difficult to interpret. For example, a study conducted by the National Institutes of Health derives its conclusions not just from video game usage, but from the use of cell phones, the Internet, and television and movie viewing (Freer, 2008). When data from multiple sources is massed together in such a fashion, it is not accurate to make a statement that one particular portion of that data is responsible for any one effect of the whole (Freer, 2008). For the data to be considered accurate, each component of the whole must be considered and studied, individually. When considering those studies which do target video games, specifically, another factor must be taken into account. Individuals affected by ADHD tend to be better able to concentrate upon rapidly changing stimuli, and less well equipped to concentrate on mundane tasks (Freer, 2008). This raises the question of whether or not the subjects cond ition led to more screen time, or whether more screen time led to the subjects condition. Of the two choices, the former is the more likely (Freer, 2008). Miriam Muslow, an expert on ADHD, claims that it is very unlikely that video games lead to ADHD or any other attention related issue (Reuters, 2010). Even some of the experts who compiled the reports on the correlation between video games and ADHD admit that nothing is definitive and that the condition cannot be attributed to just one cause (Daily Mail Reporter, 2010; Reuters). Consideration must be given to both the theory behind the use of video games in the treatment of ADHD and the arguments that video games are a major factor in the development of the condition. While the long-term results are still unproven (Szalavitz, 2011), the use of video games in the treatment of ADHD is based upon sound, scientific reasoning (Jenks, 2006; Jones, 2011; Szalavitz), and backed by NASA research (Jones; SmartBrain Technologies, n.d.). The

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equipment being produced by CyberLearning Technology, LLC is patented, FDA approved, officially licensed by NASA, and evolved from proven, NASA developed technology (Bair, 2001; Jenks, 2006; Jones, 2011; Prescott, 2005; SmartBrain Technologies). On the other hand, the argument that video games cause ADHD is based upon inferences derived from an ambiguous pool of statistics that is, arguably, irrelevant (Freer, 2008). Experts on ADHD claim the notion that video games cause ADHD is unlikely (Reuters, 2010), and even those conducting the studies being used to back the argument admit that screen time is unlikely to be the deciding factor in whether an individual develops ADHD (Daily Mail Reporter, 2010; Reuters). This new form of therapy is unlikely to be the definitive treatment method for those with ADHD. However, coupled with other forms of behavior therapy, it is certainly a step in the right direction.

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References Bair, J. (2001). New helmet getting attention of those with ADHD. Houston Business Journal, 32(28), 21-21. Retrieved from http://www.bizjournals.com/houston/stories/2001/11/26/focus1.html Centers for Disease Control and Prevention (n.d.). Attention-Deficit / Hyperactivity Disorder (ADHD). Retrieved from http://www.cdc.gov/ncbddd/adhd/facts.html Daily Mail Reporter (2010, July 08). Children who play video games for two hours a day may DOUBLE risk of getting ADHD. Retrieved from http://www.dailymail.co.uk/health/article1293044/Watching-TV-playing-video-gamesDOUBLE-risk-getting-ADHD.html Freer, P. (2008, December 04). The War on Video Games and ADHD. Retrieved from http://www.playattention.com/category/adhd-video-games/ Freer, P. (2010, July 06). New research on attention and video games. Retrieved from http://www.playattention.com/category/adhd-video-games/ Jenks, S. (2006, March 09). ADHD patients play video games as part of treatment. Retrieved from http://www.usatoday.com/tech/gaming/2006-03-09-game-therapy_x.htm Jones, J. (2011, March 02). A Real Attention-Getter. Retrieved from http://www.sti.nasa.gov/tto/spinoff2003/hm_2.html National Institute of Mental Health (2008). Attention Deficit Hyperactivity Disorder (ADHD). Retrieved from http://www.nimh.nih.gov/health/publications/attention-deficithyperactivity-disorder/complete-index.shtml

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National Resource Center on ADHD (n.d.). About AD/HD. Retrieved from http://www.help4adhd.org/en/about National Resource Center on ADHD (n.d.). Living with AD/HD: A lifespan disorder. Retrieved from http://www.help4adhd.org/en/living Play Attention (n.d.). Retrieved from http://www.playattention.com/ Prescott, J. (2005). Hey, play attention! Instructor (1999), 114(5), 8-8. Retrieved from ProQuest Dissertations & Theses Databases. Reuters (2010, July 07). Do video games cause attention problems in kids?. Retrieved from http://www.abs-cbnnews.com/lifestyle/07/05/10/do-video-games-cause-attentionproblems-kids Rosen, L. & Weil, M. (2001). Are Computer, Video and Arcade Games Affecting Childrens Behavior? An Empirical Study. Retrieved from http://www.technostress.com/ADHDVideoGames3.htm Shute, N. (2010, July 06). Do Video Games Cause ADHD? 3 Ways to Keep Your Kids Safe. Retrieved from http://health.usnews.com/health-news/blogs/on-parenting/2010/07/06/dovideo-games-cause-adhd-3-ways-to-keep-your-kids-safe SmartBrain Technologies (n.d.). Retrieved from http://www.smartbraintech.com/ Swing, E., Gentile, D., Anderson, C., & Walsh, D. (2010, April 15). Television and Video Game Exposure and the Development of Attention Problems. Pediatrics, 126(2), 214-221. Retrieved from http://pediatrics.aappublications.org/content/126/2/214.full

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Szalavitz, M. (2011, March 04). Can Playing Video Games Improve ADHD? Slower brainwaves than normal may be remedied by video games that use neurofeedback, researchers say. Retrieved from http://health.msn.com/health-topics/adhd/can-playing-video-gamesimprove-adhd

[Word Count: Cover, 21; Abstract, 150; Body, 1150; Citations & References, 597; Total, 1918]