Gamified Interventions for ADHD

Individuals with ADHD are uniquely impacted by video games, screen time, and technology, which we know can fragment attention, increase distraction, and potentially worsen social isolation. But can digital technology be harnessed to expand working memory, increase concentration, and improve ADHD symptoms in children, adolescents, and adults? That is a key research question today.

As this exciting new area of research and clinical development gains speed, my practice in St. Louis has been exploring more than a half-dozen digital technologies and measuring their impact on patients with certain mental health conditions, including ADHD and depression. We are encouraged by what we, and other practitioners and researchers, are seeing.

How Digital Technology Eases ADHD Symptoms

In a recent meta-analysis of 31 studies spanning more than 2,000 participants, digital interventions were found to significantly improve attention, executive function, and working memory in children ages 4 to 17 who had been diagnosed with ADHD. According to the analysis, published in Frontiers in Psychiatry, digital therapeutics had a larger effect on inattentive symptoms than on hyperactive-impulsive symptoms.¹

Here’s a glimpse into a few interventions, some of which I’ve been involved in developing, that have recently come to market or are being explored. Some of these interventions are supplements to ADHD medication therapy, and some are used to predict, diagnose, or monitor other health conditions.

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NeuroTrainer

This “mental fitness system,” which utilizes the Meta Quest virtual reality platform, was designed to improve focus, decision speed, and situational awareness. Initially developed to help improve performance in athletes — and currently used by professional sports leagues including the NBA, NHL, and MLB, as well as the National Collegiate Athletic Association and elite athletes — this technology is being explored to improve concentration, focus, and academic performance in academically at-risk high school and middle school students.

Revibe Technologies’ Wearable Reminder System

As a school psychologist, Rich Brancaccio saw firsthand the benefit of subtle reminders and cues to help improve attention and on-task performance for children with ADHD. What followed was his “light bulb” moment of utilizing wearable technology to offer digital cues and coaching reminders. Brancaccio founded Revibe Technologies, a digital therapeutics company that is exploring smartwatch technology that measures on-task behavior, concentration, focus and distractibility.

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This adaptive technology sends coaching reminders and cues during off-task behavior to help a child regain focus and, thus, bolster academic achievement. An initial study of 706 children with ADHD, ages 7 to 18, found a more than 25-minute increase in attention span and a 19 percent increase in on-task/focus behaviors after three weeks of using the Revibe watch. ^{2, 3} A subsequent larger study is in development to gauge and measure similar improvements in children with ADHD throughout their school day.

Brain Training Programs by Lumos Labs

To help improve cognitive performance through digital interventions, this San Francisco-based lab is leveraging a massive data set of tens of millions of adults who have played several billion gamified cognitive tasks on the lab’s Lumosity platform. The lab is also harnessing this large database of participants to develop digital biomarkers to predict, diagnose, or monitor cognitive challenges stemming from ADHD, multiple sclerosis, and other conditions.^{4, 5}

The lab’s first adult ADHD trial evaluated a series of cognitive-enhancing games to improve measures of attention on a continuous performance test, and assessed improvement in executive function and overall functional capacity in participants not receiving medication treatment. A second ADHD study is currently evaluating whether its technology can improve ADHD symptoms, cognitive performance, and quality of life in adults who are being treated with stimulant or non-stimulant medication.

Akilli’s EndeavorRx for Children

This FDA-authorized video game, available by prescription for children ages 8 to 12 with ADHD, is meant to be played for 25 minutes, five days per week, for four consecutive weeks. In clinical studies involving more than 600 children with ADHD, EndeavorRx improved objective measures of attention, focus, and distractibility.⁶

EndeavorOTC for Adults

EndeavorOTC uses the EndeavorRx technology modified for adults with ADHD, and it does not require a prescription. A study of 220 adults using EndeavorOTC found improvements in ADHD-related symptoms, functional difficulties, and quality of life, the company said.^{7, 8}

Many doctors, scientists, and researchers agree that these exciting new developments using technology to improve mental health are only the tip of the iceberg of what is to come. Harnessing digital therapeutics to expand working memory, and improve focus and concentration, is at the forefront of clinical development and research.

Digital Therapeutics for ADHD: Next Steps

• Download: Learn the Facts About Neurofeedback
• Read: A User’s Guide to Digital Therapeutics for ADHD
• Read: How to Leverage Video Game Psychology to Improve Your Child’s Behavior

Greg Mattingly, M.D., is an associate clinical professor at Washington University School of Medicine. He serves on the Scientific Advisory Board at Revibe and has been a principal investigator in trials for Akilli, Lumos Labs, and other digital therapeutics.

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