The video game prescribed by doctors to treat ADHD

While many parents worry that their children spend too much time playing computer games, Kelcey Sihanourath is pleased to see her son Owain pick up his tablet.

Now aged 13, he was diagnosed with ADHD (attention deficit hyperactivity disorder) in pre-school.

Since then, the family, who live in the US city of Savannah, Georgia, have taken Owain to see occupational therapists to help him better cope with everyday life tasks.

They also tried the medication route, but had to stop after the prescribed drugs exacerbated the boy’s regular migraines, and made him sick.

With ADHD continuing to affect Owain’s school performance over the years, Kelcey says she was “hoping for something more, for any other option”.

“I could see him struggling to understand why he was not able to focus, and the frustration he had when he tried so hard and would still get distracted,” she says. “It broke my heart, but I felt trapped and completely useless.”

Help came in the end from what initially seems very incongruous – a computer game called EndeavorRx.

In 2020 it became the first such game to be approved by the US Food and Drug Administration (FDA) for use in the treatment of ADHD in children.

Currently only available on prescription from doctors in the US, EndeavorRx at first glance looks very similar to countless other games. You control a little alien that races on a spaceship through different worlds having to collect things.

But the app-based game was developed in conjunction with neuroscientists, and is designed to stimulate and improve areas of the brain that play a key role in attention function.

The idea is that it trains a child with ADHD to both better multitask and ignore distractions, with a computer algorithm measuring his or her performance and customising the difficulty of the game in real time.

When doctors prescribe it, the child’s parents get sent an activation link that is needed before the game will play.

Kelcey says she was “a little sceptical”, but at the end of 2020 Owain started a three-month programme, playing the game for 25 minutes a day. He then did another round last year.

“He admitted it was a little harder than he expected,” she says. “But he understood that he was doing it to help improve his focus. He remained super motivated despite the difficulties and frustrations that came along with it.”

After each of Owain’s sessions she noted his daily behaviour in the app, and tracked his progress.

Soon she started to see small, positive changes in his behaviour. For example, getting ready for school had become smoother, and there were no negative messages from teachers.

And after failing fifth grade, Owain subsequently shot up to getting As and Bs for his work.

“It has been amazing to see my son so successful, but more so, seeing him have confidence in himself,” Kelcey says. “He is no longer upset and confused about why he just does not get it.”

Eddie Martucci, chief executive of Akili, the Boston-based tech firm behind EndeavorRx, says the game has been designed to boost cognitive progressing.

“It is something that’s very difficult to get through molecular means, like taking a pill. But it turns out that sensory stimuli can actually directly stimulate parts of the brain controlling cognitive function.”

His company now plans to launch the game in Europe in the next few years.

In London, UK app Thymia is using computer games to help doctors and other medical professionals detect and diagnose mental health issues, particularly depression.

One game sees the user have to try to memorise moving objects, while another is a card game that also tests his or her memory.

In addition to how well the patient performs in the game, their comments and facial expressions are also monitored and evaluated by the app, which accesses their computer or mobile phone’s camera and microphone.

Thymia has been launched by Dr Emilia Molimpakis, who has a doctorate in linguistics, cognitive neuroscience and experimental psychology from University College London (UCL). She runs the business with co-founder Dr Stefano Goria, who has a doctorate in theoretical physics from the University of Turin.

Dr Goria says the app “gathers and extracts biomarkers that are relevant for understanding depression symptoms… in a useable and engaging way”.

Both Akili and Thymia say that their apps should be used in addition to existing doctor-led monitoring and treatments, and not as a replacement. UK-based adolescent psychologist Angela Karanja agrees.

“While these are… effective inventions, they should be used alongside current existing [patient evaluation] questionnaires, which have been tested and accepted for reliability and validity, as well as doctors’ input, and also alongside other treatments, not in isolation,” says Ms Karanja.

Fellow UK psychologist Lee Chambers says that while the use of such video games in the diagnosis, monitoring and treatment of mental health conditions is still in the early stages, it appears to have “potential”.

“Engaging with a game has the ability to remove aspects of feeling like we are being tested and measured,” he says. “These types of mental health games have an ability to widen access, and track variations in the baseline data that they collect over time.

“Given this, it has the potential to be an early indicator and show patterns in a way we don’t currently have access to.”(BBC)