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Do Video Games Exacerbate ADHD?

ADHD teenager with tablet while lying on the floor in the room

Resistance is futile; the future is digital.

Statistics from Common Sense Media show that more than 30 percent of children in the United States play with mobile devices while still in diapers. More than one-third of third graders own a phone. Tweens spend up to an hour a day texting. High school students spend 8 to 11 hours each day with digital technology, if you include multitasking. And, according to Pew Research Center, nearly 75 percent of 13- to 17-year-olds have smartphones they use “almost constantly.”

“Boys actually spend an hour more than girls on technology, especially in middle school,” says Jodi Gold, M.D., author of Screen-Smart Parenting: How to Find Balance and Benefit in Your Child’s Use of Social Media, Apps, and Digital Devices. “That’s mostly related to video games.”

Screens are a part of our children’s lives, and always will be. And this is not necessarily a bad thing. Technology offers a lot of benefits, but the fact is that — when left unsupervised and unlimited – it can also get in the way of exercise, in-person relationships and social skills, good eating habits, effective study habits, self-care, and more.

A 2009 study at Iowa State University identified a link between “pathological” video gaming and attention deficit disorder. The study was published in Psycho- logical Science and reports that 8 percent of American children between the ages of 8 and 18 who play video games fall into the category of “pathological” gamers. Pathological gamers spend an average of 24 hours a week playing video games — more than twice as much as non-pathological gamers — and received poorer grades in school.

They were more likely to be boys, and two times as likely to have been diagnosed with ADHD. The lead researcher on the study, Douglas Gentile, concludes, “One could interpret this finding as a predictable type of comorbidity, given that many addictions are comorbid with other problems and that ‘Internet addiction’ has been previously found to be correlated with attention problems.

The American Academy of Pediatrics (AAP) recommends that children age 6 and older consume no more than 2 hours of screen time each day. As your child grows and gains independence, this limit may feel impossible. But many families are able to set and live within healthy limits on video games and apps. “The goal is to have consistent technology rules, but also be flexible and individualized to the needs of that child,” says Dr. Gold.

Use these strategies to help your family strike a reasonable balance between the need for rules and the needs of each family member:

The Positive Side

Many of us worry that electronics are a distraction for our children. Criticism of the effect of screen time on children is everywhere, but little research focuses on the positive influence of technology on the lives of kids with ADHD.

“Digital technology in moderation improves cognitive abilities in school-aged children,” says Dr. Gold. “Digital technology can actually make your kids smarter, if it’s used wisely and it’s used in moderation. There are lots of good studies to support this.”

Dr. Gold feels technology is an asset for middle-school students, in particular. At that age, they stop imaginative play – they put away the toys because it’s no longer cool to play with LEGOs, even though they still have a desire for it. By playing online games such as Minecraft, they get to continue building and being creative and imaginative. There are certainly healthy places for play online.

Liz Matheis, PhD, a licensed clinical psychologist and certified school psychologist, advocates harnessing the iPad’s appeal and turning it into a tool for success. “Your child with ADHD loves his tablet, so why not use it to help your child achieve the very goals most important to his success at school – getting organized, remembering assignments, and handing in homework!”

When schools allow tablets as an assistive technology, children and adolescents can use them successfully to:

A Healthy Balance of Play

Balance video games with other types of play – that’s the advice of Randy Kulman, Ph.D., founder and president of LearningWorks for Kids, an educational technology company that specializes in using video games and interactive digital media to teach executive-functioning and academic skills. Rather than viewing video game playtime as negative, consider it part of a healthy overall plan for play.

If your child is spending a substantial proportion of his time engaged in outdoor exercise, socializing with friends, and completing his homework, then spending some time playing video games is not a bad thing. Video games can give kids things to talk about with their friends, sharpen their digital skills, and improve some critical thinking skills, as long as they don’t overdo it. Conventional wisdom calls video gaming a distraction that gets in the way of learning. But for tweens and teens with attention deficit, it may actually offer a way to enhance executive function.

Though many parents will argue that video games are distracting, and an obstacle to learning, research suggests otherwise. In his book, What Video Games Have to Teach Us About Learning and Literacy, James Paul Gee, Ph.D., notes that what makes a game compelling is its ability to provide a coherent learning environment for players. Not only are some video games a learning experience, says Gee, but they also facilitate metacognition (problem solving). In other words, good games teach players good learning habits.

Many video games that offer your child or adolescent the chance to have fun and to polish his executive skills at the same time. Here are four that are popular, entertaining, mentally rewarding, and cool: Portal and Portal 2, Starcraft and Starcraft II, the Zelda franchise, and Guitar Hero.

Kulman recommends Bad Pigges, Roblox, and Minecraft to help kids with ADHD improve focus, concentration, and planning skills. “Watch your child play for a few minutes,” says Kulman, “and you’ll see that he plans, organizes, and problem-solves while engaged in a video game — skills we’d all like our ADHD kids to develop.” Those game-playing skills can transfer to everyday tasks, by helping your child identify the thinking and problem-solving skills that are necessary to play the game, and by talking about how the skills they use in the game can be used in the real world.

Minimizing screen time increases a parent’s responsibility to devise other activities. This is tough for those juggling jobs, two or more children, or the zillion other daily tasks that make life the pressure cooker it can be. But Kilcarr sees a developmental advantage in cutting out TV and screen: Children get the chance to use time on their own. Getting to this point may take a while and it may require some prodding, but, ultimately, your child will develop ways to entertain himself. Everyone benefits.

As ADHD awareness increases and research into the effects of screen time on children progresses, experts may indeed find more definitive links. In the meantime, it’s essential to exercise caution where screens and kids are concerned. You may be surprised at just how little your children really miss the screens if you help them fill their time with more interesting activities that speak to their passions.


Strategies to Minimize Screen Distractions During Homework

By Randy Kulman, PhD

1) Ask your child to voluntarily to give up her cell phones for a set amount of time when engaged with homework. I actually learned this strategy from teens, who recognized that checking their texts and social-media feeds disrupts their focus and attention while doing homework. Once these teens recognized that it took them far longer to complete their homework with distractions, they became willing either to shut off their cell phones or to hand them to their parents. I typically suggest a 30- to 60- minute “handoff,” after which time your teen can check his phone for messages and then return to homework if necessary.

2) Keep computers and other technologies in public areas. This can make teenagers more aware of staying on task because others may see them goofing off. This approach is similar to sitting at the front of the classroom in an effort to be more focused on tasks.

3) Focus not on shutting down Minecraft, but rather on developing basic time-management skills. I encourage teenagers to read the time-management chapter from my book, Train Your Brain for Success: The Teenagers Guide To Executive Functions, and for parents to review some of our articles to learn more about time management.

4) Develop expertise with apps that help with focus and time management. Two of my favorites are “Timer Plus,” which gives a pre-set amount of time to complete a particular activity, and “30/30,” which creates categorized tasks and helps users keep track of how long they have dedicated to a particular project.

Updated on March 31, 2022

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