Can video games cause ADHD?


(This is part two
of a series that examines ADHD in the digital world, in honor of CHADD’s Annual International Conference on ADHD, at which my colleague, Dr. Gary Stoner and I will be guest presenters)

In a recent and highly recommended article in The New York Times, Dr. Richard Friedman, a professor of clinical psychiatry at Cornell Medical College, puts forth a theory to explain the increase in the rates of ADHD diagnoses. He writes that a lifetime prevalence of ADHD in children has increased from 7.8% in 2003 to 11% in 2011. His explanation for this 41% increase: video games cause ADHD.

Well, not really.

Friedman’s analysis is more nuanced. He describes “the increasingly stark contrast between the regimented and demanding school environment and the highly stimulating digital world” as making it more difficult for kids with ADHD to pay attention in a dull and boring academic environment. Friedman essentially describes ADHD as a disorder in the reward systems of the brain. We can take from this the logical explanation that a kid with attentional issues may be attentive in the digital world where most everything is immediate, highly stimulating, interactive, and rewarding to their brain. The slower paced, mundane world of school, home, and accompanying responsibilities, however, may “seem even duller to a novelty-seeking kid living in the early 21st century.”

So, while video games are not the cause of ADHD, it may well be that the highly stimulating digital environment that today’s kids are growing up in is so much more engaging than traditional school settings that it becomes difficult for students to “light up” the reward centers of their brain when challenged with classwork, homework, and household chores.

Other experts in the world of games and learning have similarly detailed concerns that video game play impacts attentional skills. Daphne Bavelier, who has published dozens of studies about on the ways that action games can improve selective attention and reasoning skills, reports that selective attention may improve from playing video games, while the slow streams of information in a classroom setting may fail to attract attention. Michael Merzenich, a pioneer in the use of technology to enhance brain plasticity, notes that the time spent playing video games is time spent away from schoolwork or other social activities, reducing engagement and attention to school. Douglas Gentile, an expert in games and learning, notes that game-based attentional skills may be a liability in the classroom when a child is supposed to ignore distractions and focus on just one thing at a time.

One solution to help kids with ADHD pay attention in the boring, mundane classrooms of today is to medicate them. I think that a far better solution is to bring their classrooms into the 21st digital century by making them more engaging, stimulating, and interactive. Bringing video games, apps, and other technologies into the classroom, the therapists office, or a tutoring session makes sense for kids with ADHD because these tools light up the reward circuits in kids’ brains. Video games and other technologies are multimodal, require ever-changing skills, and employ a variety of stimuli — including video, sounds, words, and actions — that help keep kids interested and engaged. Video games encourage physical and cognitive involvement and provide clear and immediate feedback, constantly letting the player know what she is doing wrong and what she is doing right. Video games provide negative feedback privately, and as a result may have less of an impact upon the already low self-esteem of many children with ADHD.

While it might be impossible and inadvisable to attempt to make children’s life into one big video game, integrating games and technology into the classroom will be a very powerful tool for children with ADHD. Fortunately, this is already begun as schools are now using games such as Minecraft and Angry Birds to teach a variety of lessons. In addition, schools are encouraging children to use website such as iXLMath and Khan Academy to develop their mathematical skills. Strategies that “gamify” classrooms, or encourage users to complete chores or increase exercise are powerful tools for children with ADHD.

As Friedman notes, the rate of ADHD in adults is much lower than for children. He suggests that adults may have more freedom to choose their working environment than kids do and readily self-select activities that engage their brains. It is hoped that as more children are provided with an environment that stimulates their brains we will see a reduction in the diagnoses of ADHD, and that, in the future, video games, rather than being seen as the cause of the disorder, will be the reason for fewer diagnoses.

Read the first part of this series, “She can’t have ADHD, she can play video games all day long!

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