A game as therapy for ADHD

After all the bad rep, games have been getting from the World Health Organisation declaring gaming an addiction and many people blaming the industry for increased violence and more unsavoury things. A game has received US-based Food and Drug Administration approval as a form of therapy for ADHD. I see that as a rather amazing development and salute the team of the Boston, US-based design company Akili Interactive Labs for creating it. I have been hoping for some time that trials and research would bring people around to some of the positive of games and the positive impact it can have for players. For some of us working in the games and gamification industry, this is a major big deal, and it is pretty much welcomed on every game channel I follow.

Screenshot of EndeavorRx (Photo: Business Wire)

What has been approved?

The prescription-only game, called EndeavorRx, aiming to help pediatric patients ages 8 to12 years old with primarily inattentive or combined-type ADHD who have demonstrated an attention issue. EndeavorRx is said to improve attention function as measured by computer-based testing.

Why is it so important?

It is the first digital therapy intended to improve symptoms associated with ADHD, as well as the first game-based therapy granted marketing authorisation by the FDA for any type of condition. The game is intended to be used as part of a larger therapeutic program assisted by doctors, potentially medication and education, all of which aim to address the further symptoms of the disorder.

“The EndeavorRx device offers a non-drug option for improving symptoms associated with ADHD in children and is an important example of the growing field of digital therapy and digital therapeutics,” said Jeffrey Shuren, M.D., J.D., director of the FDA’s Center for Devices and Radiological Health. “The FDA is committed to providing regulatory pathways that enable patients timely access to safe and effective innovative digital therapeutics.”

When an industry-first takes place, I feel we should all celebrate. There are probably some who would have wished it was their game, but hey, someone has got to have the first honours. I am delighted to see this evolution purely because we in our work see how games benefit people of all ages with all kinds of situations. The fact that the rigour of medical approval can approve a game as a therapy for me is the next level of where we all should be aiming for.

The video game encourages the player to make choices one which will help you reach your target and another which is meant to distract. Performance is measured, adapted and personalised to the individual to keep an adequate level of difficulty which is consistent in providing challenge whilst at the same time still tolerable. Progress is achieved by earning rewards and unlocking new environments to navigate and explore.

The results speak for themself

EndeavorRx was granted FDA approval based on data from five clinical studies in more than 600 children diagnosed with ADHD, including a controlled study published in The Lancet Digital Health journal, which showed EndeavorRx improved objective measures of attention in children with ADHD. After four weeks of EndeavorRx treatment, one-third of children no longer had a measurable attention deficit on at least one measure of objective attention.  About half of parents saw a clinically meaningful change in their child’s day-to-day impairments after one month of treatment with EndeavorRx; this increased to 68% after a second month of treatment. Improvements in ADHD impairments following a month of treatment with EndeavorRx were maintained for up to a month.

Encouraging development

I find it encouraging to read stories like these and I see the real results are also being found. It takes a combination of a great understanding of what is happening to the child with these disorders, good game design, technological advances in algorithms and an openness to try out new ways of treating the whole person. I hope that there will be plenty more of these games coming to the market and that we as an industry can keep learning from. We don’t all have the support of several universities and bodies to put their weight behind ventures like this, so when rigorous research is widely available it is great to learn from.


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