Category — ADHD: Video Games

PART TWO OF THREE

Entertainment vs. learning
Entertainment is usually a passive act that includes an activity which provides a distraction to everyday events or provides amusement. A good example of entertainment is watching a movie or concert. However, one may also actively participate in recreational entertainment  such as playing video games or sports. One does not participate in an entertaining activity to be educated. That is far from the goal of entertainment. In fact, we participate in entertainment to be relieved of having to work, having to learn, or having to be actively engaged for those purposes. We seek entertainment for fun and pleasure.

Entertainment is a vast industry. The modern American video game industry made about $18.85 billion on video-game hardware, software, and accessories in 2007. That’s nearly twice what movie theaters made and triple what the video game industry made in 2000. Most authorities on video games estimate that 70 to 80 percent of boys and approximately 20 percent of girls play video games daily.

Learning is on the other end of the spectrum from entertainment. In order to learn, we need attention, challenge, and deliberate practice. We need to be actively engaged. To apply the mind with the intent of long-term retention, assimilation, and application of new information. This implies both effort and commitment. While we may employ some of these elements, the purpose is far different in a learning environment. The purpose of learning in Star Trek: Bridge Commander is to keep the ship from exploding by using the controls correctly.  Learning is there to benefit your game play.  While this takes some reasoning and trial and error, is this useful in the classroom or at the office? Not likely. It’s not likely transferrable or to generalize either unless your child’s job is commanding Star Fleet.

If I may paraphrase the late martial artist and film legend Bruce Lee, you cannot learn to swim by kicking your legs and stroking with your arms on land. You have to jump in the water. You cannot learn to run a marathon by jogging around the track. 

In other words, if we want to learn something, it has to be taught with a purpose or aim, and we have to practice it deliberately to improve. If we closely examine what video games our spouse, child, or clients are playing, then we might just be alarmed at the violence, the lack of humanity, and gratuitous sex involved.

The most popular video games are those that are visually intense and graphically frenetic. It’s important to mention here that paying attention to visually stimulating and frenetic activity is another hallmark of an ADHD individual. Offer a 3-ring circus and their brain is quite capable of attending to it. Ask them to clean their room, a much less stimulating activity, and it’s very difficult. This predisposition towards highly stimulating activities seems to involve the brain’s reward and gratification systems as well as its processing and other regulatory systems.

Thus, a high stimulation Xbox or Play Station game is quite satisfying; ADHD individuals can hyperfocus on these games for hours on end. What does that teach? Research tells us that people who play these games do learn visual recognition skills, i.e. they can rapidly determine the number of opposing characters on screen far faster than the average human being. So, if the only thing they’re going to be is a fighter pilot, then these games might be suitable.

Other research tells us that if one chronically plays these games (chronically would be classified as one hour or more per day), one is more likely to report lower grades at school, diminished attention at school, and a greater probability of being addicted to these games or the Internet itself. Good Japanese research also noted that entertaining, highly stimulating video games that involve little else than pointing and shooting can lower both the metabolic rate and EEG in the frontal lobes of the brain. The frontal lobes, among other capacities, govern attention, aggression, and impulsivity. This is important to know especially if you have an ADHD person in your household using these games.

It seems that most ADHD children and adults are prewired to pay attention to overly stimulation things. That seems to be a hallmark of the trait. They frequently become hyperfocused on them for hours at a time. Taking these games away is probably not practical. However, limiting play time is quite sensible.

If one is to learn skills, techniques, or methods that will strengthen the brain, then the video game must be quite different than the Xbox or Play Station most popular list.

Upcoming, part 3, Play Attention vs. off the shelf video games.

PART ONE OF THREE

This blog is partially based on material I presented to the International Atomic Energy Agency of the United Nations in Vienna, Austria.

Playing vs. learning
What’s the difference between playing and learning? Sometimes there is no difference. People can learn through play. Educators have known this for years. Grade school teachers often try to teach using games. Games engage, excite, and motivate students. However, there is a significant difference between games that simply entertain and games that facilitate learning.

When learning through games or other modalities, three fundamental catalysts are necessary for the brain to create and grow a neural pathway facilitating long-term retention. These catalysts are attention, challenge, and deliberate practice.

Attention 
A student must pay enough attention to incoming stimuli to even begin the learning process. Too little attention causes the student to constantly redirect attention to other stimuli.  Picture your ADHD child trying to learn multiplication tables. While the teacher is teaching 2 x 2, he’s paying attention to the bird outside the window. Little chance that multiplication tables will be learned soon. So, attention is crucial, in fact, it’s the core to all learning. For an ADHD person, the ability to direct attention and sustain it without distraction is impaired.

Challenge
If the teacher can get a student to pay enough attention to multiplication tables, the student must then be challenged. Challenge arrives when the brain confronts something it doesn’t quite understand. The brain attempts to place the information into a tenuous relationship with information it already possesses. If the brain already knows the information, it simply retrieves the data from its storage bank. So, if the teacher presents 2 x 1, and the student knows immediately the answer is 2, then there’s no challenge and little is learned. However, if the teacher presents 2 x 7561, then the student is challenged and must use all of his pre-existing knowledge to find a solution. Attention and challenge spark creation and growth of new neural pathways for long-term retention. However, long-term retention is not guaranteed until we practice.

Deliberate practice
Educationalists have known that haphazard studying or practice results in haphazard learning. Deliberate practice is a term coined by Dr. Anders Eriksson, a professor at Florida State University (http://www.psy.fsu.edu/faculty/ericsson.dp.html). He studied how people become experts in their fields and found that the length of time they practiced and their use of deliberate practice greatly influenced their expertise. 

Let’s use multiplication tables again to describe deliberate practice.  Chances are that you learned your multiplication tables by practicing one group at a time; multiplying by 1, by 2, by 3, etc. In many years of teaching, I never saw a student learn multiplication tables by learning 2 x 3, then 7 x 9, then 6 x7. We learned in a sequence that was deliberately practiced until mastered.

When I was learning to multiply by 6, I had difficulty with 6 x 7, 6  x 8, and 6 x 9. So, my teacher made special flashcards for me with these specific problems written on the cards. I used these cards, blocks, and other devices to practice these difficult sequences. If I didn’t get the right answer, I got immediate feedback that I was incorrect. I used this feedback to make changes to my strategy in attempting to find the correct solution. That’s deliberate practice; sorting out the difficult elements that we have not learned, developing strategies to learn them, getting feedback regarding correctness or incorrectness of these strategies, and practicing them correctly and  long enough to attain long-term retention.

Most people do not  use deliberate practice. We just practice, i.e. we just repeat the same thing over and over without taking the time or making the effort to work on the elements that are most difficult for us. We often only practice things that are easy or that we’re already good at performing. We avoid the difficult elements that don’t provide immediate reward, and that seems to be the line that clearly distinguishes expert from amateur.

Coming soon, part two: Entertainment vs. Learning

The journal, Psychological Science (May, 2009 Douglas Gentile. Pathological Video Game Use among Youth 8 to 18: A National Study) sampled youth aged 8 to 18.

Iowa State University Assistant Professor of Psychology, Douglas Gentile, found that 8.5% of the gamers to be pathological players. Gentile bases his statistics on standards established for pathological gambling. So, while parents often cite that their child is ‘addicted’ to video games, Gentile’s standards necessitated that video game play actually caused family, social, school or psychological damage due to video game playing habits.

“What we mean by pathological use is that something someone is doing – in this case, playing video games – is damaging to their functioning,” Gentile said. “It’s not simply doing it a lot. It has to harm functioning in multiple ways.”

On average, the pathological gamers in the study played video games at least 24 hours per week. This is nearly twice as much as non-pathological gamers. Parents of pathological gamers also allowed their children to have video game systems in their bedrooms far more often than non-pathological gamers. 

According to Science Daily, Gentile found that pathological gamers reported having more trouble paying attention in school and thus received poorer grades in school, had more health problems, were more likely to feel “addicted,” and even stole to support their habit.

The study also found that pathological gamers were twice as likely to have been diagnosed with attention problems such as Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder.

“There is still much we do not know,” Gentile said. “We don’t know who’s most at risk, or whether this is part of a pattern of disorders. That’s important because many disorders are co-morbid with others. It may be a symptom of depression, for example. And so we would want to understand that pattern of co-morbidity because that would help us know how to treat it.”

Gentile is continuing his own research, currently conducting both longitudinal and clinical studies to determine risk factors and symptoms found in pathological youth gamers.

It is wise for parents to limit use of video games and TV. Treat them as you would dessert; limited portions used as a reward.

Recently, national media have declared war on TV, video games, and various other media.  Supported by a study performed by the National Institutes of Health (“NIH”), the news appears gloomy; these various media cause obesity, declining grades, etc.  I’ve even read some press that they may be related to childhood onset of diabetes (related to lack of exercise) and ADHD!

The NIH’s claims are alarming and necessitate a review of the method they employed to derive the claim they make that 80 percent of the studies reviewed have linked media use to negative health effects. I’ve said this before, when researchers review other researcher’s studies (study of study approach), generalizations are contrived that don’t necessarily convey actuality.  Granted, I’m not an advocate of chronic video game play, overuse of the Internet, TV, cell phone, or anything for that matter. Overuse is over use. Moderation is best. Overuse tends displace other healthier activities like taking walks, interacting with human beings face to face, or reading a good book.  So before chucking your Xbox out the window, let’s examine the flaws in this study a little more closely. Then, let’s discuss what actually is happening with video game use.

The NIH report was sponsored by sponsored by the nonprofit group Common Sense Media.  To be candid, I like this group.  It makes sense. Its mission statement reads:

Common Sense Media is dedicated to improving the media and entertainment lives of kids and families.

We exist because media and entertainment profoundly impact the social, emotional, and physical development of our nation’s children. As a non-partisan, not-for-profit organization, we provide trustworthy information and tools, as well as an independent forum, so that families can have a choice and a voice about the media they consume.

I’ve reviewed many of the 173 studies included in the NIH report. And while the NIH report conveys that media use impacts children’s health negatively, I am unable to find reliable data that justify this huge generalization.  This generalization was derived by lumping together research on movies, video games, cell phone usage, Internet usage, TV, movies, etc.  Unfortunately, when information is not disaggregated, it does not control for the way in which the media was used during the research or particular types of video games, movies, etc. For example, was the Internet use studied used for play, school research, or shopping?  Were the video games educational or entertainment? With the NIH’s method of aggregating data, we’ll never know.  Compounding this is the fact that research available on the impact of media like texting, social websites, etc. is nascent.

As I’ve noted many times before, children with ADHD tend to be pre-wired to concentrate on high stimulation and less able to control concentration on mundane tasks. This is neither a gift nor a blessing.  However, this coincides with the finding that children with ADHD had watched more TV as toddlers. This correlation often generates a great misconception (often propagated by the media) that TV-viewing causes ADHD. It would be more likely that the predication toward high-stimulation makes TV far more attractive to children with ADHD than playing with a stuffed toy or Legos.

The strongest correlations may be made with obesity and sexual behaviors.  Obesity is obvious; sedentary behavior (sitting in front of the TV or computer) would lead to obesity and many other diseases associated with obesity including diabetes.  Sexual behavior is obvious as well.  Watching others perform sexually whether under a mild TV-G rating or explicit pornography on the Internet, does impact the child watching. Most research indicates that children will experiment with intercourse or other sexual behavior in a correlation with their ability to access it via media.  Of course, what is not accounted for is the impact of parental influence (or lack thereof) and media exposure.

I’m frequently asked questions by parents about media and their children.  “Should I let my child play video games?” “How much TV is too much?”

Video games are not created equally. The most popular utilize compelling, sharp video imagery, fantasy, and violent action. I’m afraid the genie is out of the bottle. Whether you’re concerned about TV or video games, it is vital to first screen what your child is watching or playing.  Watching TV with them or watching them play their video games gives you the opportunity to discuss offensive, sexual, or violent material. You may object and censor their use or viewing of this material.

As a parent, you set the example as well. If you are sedentary, your child will likely be sedentary (as well as your pet). Play with your child, take them outdoors.

Treat video games like dessert. Dessert is given as a reward, and it is given in highly limited quantity.

So, even if research says correlations exist, you mustn’t dismiss the impact that you impart as parent. Study of study correlations often result in generalizations which may or may not be significant to your family.  As parent you are the decider – provided that you accept that role and are proactive. 

From Delta Sky Magazine, November 2007

Attention, not Detention

THE DOORBELL RINGS and Stacey Morrison greets the arrival: Bobby, the seventh-grade son of family friends. She offers him an after-school snack, which he declines, and they both head to the small sunroom of the Morrisons’ house in the central New Jersey town of Metuchen. As Bobby takes a seat in front of a computer, Morrison (at her request, the family name has been changed) reaches for a red bicycle helmet and a spray bottle containing a saline solution. Both bear the words “Play Attention.”

Three contact pads in the helmet receive a quick, enabling spritz. Bobby dons the helmet, which is wired through a Play Attention control unit to the computer. He’s now ready for another half-hour session of computer games and mental exercises that its creator calls a revolutionary breakthrough in treating a widespread disorder. It’s not the games themselves that are so unusual, but the way that Bobby and other players control much of the activity. For instance, players make a frog hop on a lily pad, keep a bird aloft or build a tower using only their brainwaves, by focusing intently on the task at hand. That is to say, they’re paying attention—a problem for Bobby and, according to various estimates, anywhere from 1.4 million to 3.5 million school-age children who struggle with ADHD (Attention Deficient Hyperactivity Disorder).

After a short procedure to establish a baseline attention level, Bobby selects Mind Maze for the first of his five-minute challenges. “Remember,” says Morrison, who has taken a seat beside him to serve as his Play Attention coach, “you want to get less than two errors.” Responding to brainwave patterns indicating that he’s focused, the software empowering this short-term memory challenge—something like the 1980s game Simon—sets four colored blocks in a circle blinking in a sequence. Bobby repeats each sequence, in this case using the up, down and sideways arrows on the keyboard. In his 35 hours of Play Attention sessions to date, he has gone from three-block sequences to recalling the order of as many as seven blinking boxes. He has NASA, a boy named John and a former teacher named Peter Freer to thank for his progress.

Freer, founder of a company called Unique Logic + Technology, located in Asheville, North Carolina, invented Play Attention out of frustration. In the early 1990s, teaching fourth grade in a pod-style open classroom, he was assigned a notorious student named John. John’s problems stemmed from ADHD and parents with an eighth-grade education who were even less able to cope with his behavior than the schools were. “I felt for John,” says Freer. “He was not intentionally trying to act out or misbehave. He was just not wired the same as his peers.”

Freer sat John at a desk right next to his own. Simplified instructions for him. Used behavioral shaping rewards. John made incremental progress at school, but not at home. “The parents are frustrated. Dad’s hitting him. They medicate him. Some days he comes in so sleepy he just lays his head on the desk,” Freer recalls. “Some days he’s fairly normal. But it disturbed me—disturbed me that I was totally underequipped to help him.”

Freer, whose graduate work included writing educational software programs, began what he now terms his “crusade” to devise a way to teach children with ADHD how to pay attention to classroom lessons, take tests and do homework. Also driving his quest: indications that as many as 60 percent of children with ADHD carry their condition into adulthood. Freer discovered that NASA, eager to keep pilots and astronauts focused on eye-glazing, low-stimulation control panels, had devised a brainwave biofeedback training system. So he hired an engineer and programmer, and the team made some enhancements to the apparatus to create Play Attention.

The noninvasive sensors in the helmet, he explains, “listen to what the brain is doing in real time. It’s a physiological monitor, like grabbing a bar on a treadmill at the gym that displays your heart rate. When the neurons fire in the brain, they produce small electrical bursts. That’s what’s picked up.”

“Play Attention made sense to me,” says Morrison, who’d consulted with numerous doctors and tried various treatments and mental exercises for her own son Jack, who was the same age as Bobby and suffering from ADHD. (Bobby himself has not received a formal diagnosis of ADHD.) “It’s like having a weak muscle in your body and they send you to physical therapy and you gradually strengthen that muscle. Except, when you tell a kid, ‘Pay attention. Pay attention,’ what does that mean? Attention is not something you can hold in your hand and see.”

That, she stresses, is the beauty of Play Attention. It shows you instantly when your attention begins to waver. “You have to pay attention,” Morrison says. “You can’t just stare at what’s on the screen. It knows the difference. You really have to be concentrating on that bird [to make it fly]. If you stop concentrating, the bird starts to drop.”

Morrison started her son Jack on Play Attention at the very end of his fifth-grade year, continuing his twice-weekly sessions throughout the summer. (Full-featured, professionally supported home versions of the program start at $100 a month. Open-site licenses for schools and organizations are also available.) In early September, Jack’s sixth-grade math teacher, who’d taught him the year before, called Morrison. “He’s like a different kid,” said the teacher. “He’s participating. He’s taking notes. He’s paying attention.”

One strength of Play Attention, explains Morrison, is its ability to target unwanted behaviors. Sitting beside Jack, she noticed that his eyes wandered all over when he first started playing Play Attention. “There’s chair-tipping or, like we’re working with Bobby now, fiddling with things on the desk,” she says. Now, with visible manifestations of behavioral drags on performance appearing on-screen, and with cues from the coach as well, Play Attention users can more easily understand the roots of inattention and begin to rewire their brains. “I know I’m just a mom, and I sound like an infomercial,” says Morrison, “but I’d like to see Play Attention in the school system.”

According to Freer (whose small business received a badly needed $100,000 in 1998 from an “angel” investor who herself suffered from ADHD), Play Attention is being used by some 450 American school systems and in various learning centers in England, Saudi Arabia, China and other countries. It’s also being used to address attention issues beyond ADHD.

While looking on with interest, some professionals remain cautious about Play Attention’s claims. “I think the jury is still out,” says Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Schneider Children’s Hospital in New Hyde Park, New York, who notes that the promise of Play Attention still awaits the critical eye of scientifically designed studies.

One such study is being conducted under Dr. Ellen Perrin and Dr. Naomi Steiner at The Floating Hospital for Children at Tufts–New England Medical Center in Boston. “We’re intrigued that [Play Attention] could be a helpful treatment for children with ADHD, either by itself or in conjunction with medication,” says Perrin, director of the hospital’s Division of Developmental-Behavioral Pediatrics and The Center for Children with Special Needs. The pilot study, which followed about 50 Boston area middle-school students through the 2006-07 school year, randomly assigned each child to one of three groups: those attending Play Attention sessions in school, those using another computer-based program and those receiving no special in-school program. The data collected laid the groundwork for the second phase of the study, now in progress.

By the time you read this, Bobby will have been weaned off his twice-weekly sessions at the Morrison house. Stacey Morrison, who is not being paid to coach Bobby, describes him as a bright kid who was getting B’s in his accelerated math class when he could have earned A’s: “His mother told me whenever he’d take a test, he’d always get the first problem wrong even though it was invariably the easiest question. I said, ‘Aha!’ Because when he first sat down to do Play Attention, whatever game he chose to do, at first he would always have trouble. But once he got started, he was fine.

“When Bobby started with me and I asked him for his goals, he told me, ‘I don’t want to spend so much time doing homework and getting yelled at all the time.’ He’s now getting A’s in that math class, stopped getting those first problems wrong, and his mother tells me, ‘You know what, Bobby is doing his homework on his own. He’s getting it done, and he’s having more free time.’”

Bobby’s mother has noticed something else, too—something that would please Peter Freer just as much, and an added benefit of Play Attention. “Bobby now looks people in the eye when he talks to them,” Morrison says. “He never used to do that before.”

Not Just for Kids

Other groups and individuals with interests beyond ADHD (Attention Deficient Hyperactivity Disorder) are also getting good results from Play Attention (800-788-6786 or 828-225-5522; www.playattention.com).

Harriet Eskildsen, director of the High Tech Center for the Disabled at the College of Marin, in Kentfield, California, has found it has helped adult stroke victims regain lost quality of life. “My students tell me it’s helped them remain focused for a longer period of time,” she says. “They can go to the movies again and follow a story line. They can return to reading books, and can again take part in conversations, which requires listening skills we take for granted.”

Among those looking to Play Attention for an edge in athletic performance is Bill Tavares, coach of the U.S. Women’s Olympic Bobsled Team. Not only is Tavares impressed by the early improvements made by some of his bobsled drivers, for whom focus on the proper line down the course is paramount, he’s also enthusiastic about what his own Play Attention sessions have done for his golf game—helping him lower his handicap from 9 to a 4 or 5.—J.G.

An article from the October 6, 2005 issue of  MONiTOR TODAY!, Ottawa’s Technology Information portal:

Technology Showing Promise in Treating Attention and Behavioral Problems in Children and Adults.

Asheville, North Carolina – It’s a patented technology that is similar to that used by NASA astronauts and U.S. Air Force pilots to stay attentive in the cockpit. An innovative product called the Play Attention Learning System is using similar space-age technology that can now be used on home/school computers to help minimize attention, concentration and focus challenges in children and adults. Through the use of new computer technology, unique one-on-one support and a dynamic training program, Play Attention’s innovative learning system actually trains the brain to pay attention and focus better.

“NASA has proven that attention can be improved through feedback training. Play Attention is actually an enhancement to their technology which is successfully impacting the lives of children and adults worldwide,” says Peter Freer, Play Attention Founder and CEO. The results have been powerful throughout the United States, Europe, China, Canada, Singapore, Puerto Rico, South America, Taiwan, and Australia.

What is Play Attention? The Play Attention Learning System consists of a unique computer software program, a sensor-lined helmet similar to one used for bicycling and an interface unit that connects the helmet sensors to the computer. These sensors monitor the user’s attentive state and cognitive process while he/she interacts with the characters on the computer screen. Users complete a series of video game-like exercises that are controlled, not by joysticks or controllers, but by the brain alone. Through a process called Edufeedback, Play Attention users can see and hear real-time feedback of how they’re progressing in focusing, finishing tasks, increasing memory, and filtering out distractions.

Within a short time of using Play Attention, behavior can be modified to reduce or eliminate disruptive calling out, fidgeting, and impulsivity, all while improving time-on-task, focus, comprehension and more. The system helps reduce the effects of distraction at! home, school and the workplace, bringing life into focus. Play Attention encourages practice of key cognitive and attention skills that, in a relatively short amount of time, retrains the brain how to think more clearly, more attentively and with more focus.

The Play Attention Learning System is much more than computers and technology. In addition to the hardware & software a user receives personalized one-on-one support, motivation and guidance with Play Attention staff members, typically holding a master’s degree or higher. A mentor program for children and adults to insure goals are set and being reached. And free access to www.playattention.net, a support site loaded with newsletters, information about the rewards program, latest software downloads, coaching resources, interactive advice from the Play Attention staff.

The entire Play Attention Learning System sells for $1,795, which includes all equipment, materials and training. Complete information is available online: www.playattention.com or by calling (800) 788-6786 for a FREE demonstration CD.

As many as three million children in the United States are being treated for Attention Deficit Disorder. And they’re not the only ones. 4.4 percent of the adult population have A.D.D. or a related disorder, making it the second most common psychological problem in adults after depression. VOA’s Paige Kollock reports on a new ‘game’ that might be able to help them.

New Video Game Shows Promise In Treatment of Attention Deficit Disorder

By Paige Kollock
Washington, DC
29 August 2005

Medical studies have shown that television and video games may contribute to the rise in Attention Deficit Disorder, especially in children.

Doctor Stephen Hinshaw of the University of California researches children with attention deficit hyperactivity disorder. He says, “Very fast paced media are in some ways overwhelming the young brains.”

Now a company called Unique Logic and Technology has created a video game that helps re-train those young brains. It’s called “Play Attention,” and the company claims it can teach your brain how to pay attention. It works by using a helmet that has sensors.

The sensors can tell whether or not the user is paying attention. In conjunction with computer software, the sensors teach the user what it feels like to pay attention and reward them for paying attention for longer periods. Over time, the user acquires the skill of concentration.

Former Principal Pat Faulkner says the $1,795 program is worth the money. “I think Play Attention was worth every penny they ever spent on it, and all the time that was spent on it, because it has the power to change a child’s life. When a child can learn to participate in class, then he can learn, and that’s a life changing experience.”

Adults are using Play Attention too. While the U.S. Women’s Olympic bobsled team may not have A.D.D, using Play Attention helps them increase their focus, which gives them a competitive edge.

Educators say the game takes between eight and 12 months to become permanently effective. From that point on, they say, users can fall back on the skill for the rest of their lives.

From the  Berkeley Medical Journal:

y Attention!

Can custom-made video games help kids with attention deficit disorder?

By Gordon Kwan

For children with Attention Deficit Hyperactivity Disorder (ADHD), life can feel like a never-ending video game. They are wired–restless, impulsive, and easily distracted. Their minds are constantly bombarded with different elements of reality that compete for their attention.

So far, the most popular treatment for ADHD has been Ritalin, a rapid-acting stimulant for adults that has the opposite effect in children, calming the jitters associated with the disorder. According to the National Institute of Mental Health, about three percent of American school children take stimulants like Ritalin regularly. However current research suggests a surprising new strategy for treating this disorder: video games linked to brain-wave biofeedback that can help kids with ADHD train their minds to tune in and settle down.

It is difficult for a child with ADHD to learn how to self-regulate and know what it feels like to concentrate. Biofeedback teaches patients to control normally involuntary body functions such as heart rate by providing real-time monitoring of such responses. More than 15 years of studies show that with the aid of a computer display and an EEG sensor attached to the scalp, ADHD patients can learn to modulate brain waves associated with focusing. Increasing the strength of high-frequency beta waves and decreasing the strength of low-frequency theta waves, for example, creates a more attentive state of mind. With enough training, changes become automatic and lead to improvements in grades, sociability, and organizational skills.

Despite its proven success, the technique has not become a mainstream treatment for several good reasons. First, unlike drug therapy, which can have immediate results, a typical course of biofeedback treatment takes a series of about 40 one-hour sessions over a span of several months before benefits become apparent. Second, it is more expensive than drugs. Costs range from $3,000 to $4,000 for these treatments, so insurance companies tend to pick the less expensive option. Finally, biofeedback training requires the very kind of prolonged concentration that patients with ADHD struggle to attain.

Alan Pope, a behavioral scientist at NASA Langley Research Center in Hampton, Virginia, came up with a more engaging approach through work with NASA flight simulators. He was determining the degree of interaction with cockpit controls necessary to help pilots stay attentive during routine flights. In an experiment, he linked the level of automation in the cockpit to the pilots’ brain-wave signals, so that some controls switched from autopilot to manual when the pilot started to lose focus. He found that with practice the pilots could begin to adjust the controls to the level of automation that felt most comfortable by regulating their own brain waves.

Pope applied his findings to help ADHD patients stay focused by rewarding an attentive state of mind. He realized, however, that the simple displays that were already part of biofeedback treatment may not be enough to hold the interest of restless youngsters. He then chose several common video games and linked the biofeedback signal from the player’s brain waves to the handheld controller that guides the games’ actions. “In one auto-racing game, a car’s maximum speed increases if the player’s ratio of beta to theta waves improves. The same sort of feedback also controls the steering,” Pope says.

In the test, six Sony PlayStation games were used with 22 boys and girls between the ages of nine and thirteen who had ADHD. Half the group received traditional biofeedback training; the other half played the modified video games. After 40 one-hour sessions, both groups showed substantial improvements in everyday brain-wave patterns as well as in tests of measuring attention span, impulsiveness, and hyperactivity. Parents in both groups also reported that their children were doing better in school.

The difference between the two groups was motivation. “In the video-game group, there were fewer no-shows and no dropouts,” according to Pope. The parents were more satisfied with the results of the training, and the kids seemed to have more fun.

Since children are more motivated toward video-game biofeedback and may already be familiar with video games, they will not need one-on-one coaching to master the technique. As a result, the cost of the treatment should be reduced and maybe even permit “do-it-yourself” biofeedback. One North Carolina company markets their Play Attention system as a fun bike helmet and game-like video exercises that work on almost any computer. The helmet is lined with sensors that monitor the child’s brain waves, and the child actually controls the computer video exercises by mind alone. Parents should not expect regular video games to help their children. The wrong kinds of video games might actually hurt children with attention disorders.

Parents, however, may be hesitant to switch from traditional treatment programs. One parent whose child currently takes drugs to control ADHD says, “Our son is using drugs to control his attention problems and although we don’t like giving him the pills, he is no longer causing problems at school. We try to keep our son away from things that might make him hyperactive. Unless our doctor tells us to do this brain wave training in a hospital, we are not going to buy a machine to do our own treatment at home.”

Brain-wave biofeedback alone may not be a substitute for drug therapy. Professor Stephen Hinshaw, an expert in the field of child clinical psychology at UC Berkeley, gives a reserved opinion about biofeedback treatment. “Biofeedback is a promising potential alternative, but unfortunately the kinds of really well-controlled studies that might support its clinical benefits have yet to be performed.” The two treatments have complementary aspects that make them effective as adjuncts. A single dose of Ritalin, for example, acts quickly but only for a few hours, and most patients take it only on school days. Brain-wave regulation takes a long time to learn but has the potential for longer-lasting effects.

Researchers and clinicians are realizing that ADHD is not easily outgrown. Most doctors support an approach that combines good nutrition, sleep, exercise, and learning strategies as well as biofeedback and drug therapy. The possibilities for brain-wave biofeedback are very promising since its benefits could last a lifetime. Video game biofeedback therapy may provide a more tolerable and long-lasting form of treatment for children through a medium they are more likely to enjoy.

An Innovative Technology for Individuals with Autism Spectrum Disorders

By Linda Creamer Aug 1, 2005

Parents and teachers commonly encourage children to “pay attention.” But what does pay attention mean? What does it physically feel like? When you instruct a child to pay attention, typically their perception is that they are already paying attention! Obviously, attention is an abstract, subjective concept, and one that is incredibly difficult to manage for children with attention problems and autism. Its abstract and subjective nature also makes it difficult to teach. Special needs children would directly benefit from a program that would allow them to control their attention and establish a relationship between attention and behavior.

Years ago a local psychologist hired me to initiate a special program at his office. It was called Play Attention. Play Attention is a feedback-based program that enables individuals to control a series of computerized cognitive tasks by attention alone. Through a sensor loaded helmet, the student can actually control computer screen characters — make them fly, swim, etc. — simply by focusing on them. If the student loses focus because of fidgeting, being off-task, or some other self-distracting behavior, the characters go the wrong direction. This allows the student to actually see a direct correlation between behavior and attention. This program enables the individual to understand the concept of paying attention with concrete visual stimulation as well as understanding the way his/her body is physically feeling and reacting. It shifts attention from an abstract concept to a concrete, controllable reality. It is a tremendously powerful teaching tool.

The producers of Play Attention call its training technique Edufeedback, the combination of feedback with a behavior modification program that enables adults and children to improve attention and decrease their impulsive behaviors. Edufeedback is based on neuroplasticity, defined as the brain’s ability to restructure, reorganize, and rewire when properly challenged and stimulated. Play Attention uses EEG neurofeedback in the background to allow the monitoring of concentration. It couples this with five different cognitive tasks including attention stamina, visual tracking, time on-task, short-term-memory sequencing, and discriminatory processing. Impulsivity is measured as well during the tasks.

I worked with the psychologist for two years and achieved many successes using Play Attention with ADHD individuals. It increased their increased ability to focus and attend to details and it decreased their levels of impulsivity. Although Play Attention was developed for individuals with attention problems, I have helped many students with varying levels of autism achieve amazing results in an after-school tutoring program. Play Attention is also offered during schools hours to children who are diagnosed Autistic and in the full inclusion program.

Presently, some researchers and experts recognize that there is a correlation between Attention Deficit / Hyperactivity Disorder (AD/HD) and Autism Spectrum Disorders. Some believe that ADHD is closely related to Asperger’s Syndrome. Autism Spectrum Disorders and ADHD are developmental disorders that affect the areas of social skills, behavior, and communication. Sensory oversensitivity is also recognized in both developmental disorders. There are several website links to various articles and information from the PlayAttention website that further explain this relationship in detail. Every child with Autism requires different types of strategies and program interventions due to individual behaviors and level of understanding. The following are strategies and results used with different Play Attention clients with Autism and behavior difficulties. These are the findings of a teacher who is presently using the program with clients’ on the Autism Spectrum. I am not a researcher. Therefore, the following should be considered case studies and not controlled studies. The student’s names have been changed to protect their anonymity.

Summary

When combined with special strategies as well as transfer and generalization techniques, Play Attention has produced remarkable results for students with Autism and ADHD. The core Play Attention system allows the teacher to modify and adjust it curriculum to accommodate the special needs of these children.

I have used the combination of biofeedback and behavior modification, known as edufeedback, as an effective strategy to produce positive results with the performance of people with ADHD and Autism Spectrum Disorders.

The increased ability to attend, reduced impulsivity, development of cause/effect relationships, expanded communication abilities, social skills, sensory integration, and development of positive behaviors are observable and measurable with each student. Academic skills in reading comprehension and math concepts have improved due to the students’ ability to attend for longer periods of time. Again, these changes are actual and quantifiable. Please see the Case Studies below.

These results have been documented by a special educator who is tutoring her students with Play Attention and not by a research team or an employee of Play Attention.

Read the Case Studies

Recently, Scott Bauer of the Associated Press (July 27, 2005) released an article entitled: Blind Teen Amazes With Video-Game Skills.

In it, Bauer writes of super video game whiz, Brice Mellen. Brice is super proficient in games such as Mortal Kombat and others. The only difference between Brice and his peers is that Brice is blind. The following excerpt is from the article and is an exceptional example of neuroplasticity or Brice’s ability (his brain’s ability) to compensate for his loss of sight.

And as he easily dispatched foes who took him on recently at a Lincoln gaming center, the affable and smiling Mellen remained humble.

“I can’t say that I’m a superpro,” he said, working the controller like an extension of his body. “I can be beat.”

Those bold enough to challenge him weren’t so lucky. One by one, while playing “Soul Caliber 2,” their video characters were decapitated, eviscerated and gutted without mercy by Mellen’s on-screen alter ego.

“I’m getting bored,” Mellen said in jest as he won game after game.

Blind since birth when his optic nerve didn’t connect because of Leber’s disease, Mellen honed his video game skills over the years through patient and not-so-patient playing, memorizing key joystick operations and moves in certain games, asking lots of questions and paying particular attention to audio cues. He worked his way up from games such as “Space Invaders” and “Asteroid,” onto the modern combat games.

“I guess I don’t know how I do it, really,” Mellen said, as he continued playing while facing away from the screen. “It’s beyond me.”

Mellen knows this much: He started playing at home when he was about 7.”

Brice has learned how to control play through adaptation. He can play with his back to the screen and use finely tuned listening skills to calculate distance and position. Applying this with exquisitely tuned kinesthetic skills on the joystick, and he has a powerful combination that few can beat.

His mastery is a mystery; however, it is a true example of the human brain’s ability to adapt when given the correct stimulation and learning environment. It remains unfortunate, at the time of this blog, that science has yet to catch up or tap into the immense innate capacity of the human brain.

When I developed Play Attention, I was acutely aware that cognitive training/development through video game usage was an incredibly motivating discipline. The intrinsic interest in computer video gaming provides a tremendous teaching environment.

Off-the-shelf commercial video games provide little cognitive improvement, if any according to recent research. They do teach the user to identify screen objects quickly and accurately. They may quite likely decrease one’s ability to control sustained attention, impulsivity, and aggression as well.

Thus, it is imperative to provide specific goals for game play. Play Attention teaches and increases specific cognitive skills typically deficit in persons with attention problems. I systematically structure the teaching/learning process to produce cognitive and behavioral changes. This, of course, does not happen in off-the-shelf games where violence is the objective. It is important to remember that our brains are ALWAYS affected by what we input into them.