Those of you who regularly visit our website already know about our approach to make game-based learning into real-world skills. The LearningWorks for Kids method is based on children’s cognitive engagement while playing complex, popular video games. Game play that challenges brains, requires problem-solving, and practices executive-functioning skills is viewed as an opportunity for learning. While some of these skills may transfer more readily to other parts of children’s lives, our approach is that they need assistance to make game-based learning into something that helps them in their daily activities. We provide parents, clinicians, and teachers with guides to use popular games to improve executive skills, along with small group, online game-based classes on Outschool.com, where we teach kids to connect skills they practice in games to real-world activities. But what if there were a video game that was both fun and helpful to children with ADHD and directly taught executive skills without any need for help from parents or teachers?
This past week, the FDA approved the first digital medicine to treat ADHD, a video game titled Endeavor. The research behind this game has been ongoing for more than a decade and has found two consistent components of video games that improve attention skills beyond game play : go no go tasks and action games. Go no go tasks require intense concentration and the use of working-memory skills, while action games demand flexible thinking, quick decision-making, and selective attention.
There have been previous efforts to create game-like tools to help with Attention-Deficit/Hyperactivity Disorder. Working-memory programs such as Cogmed and executive-functioning programs such as Lumocity demonstrate modest impact on attention and cognitive skills but are often limited by their generalizability to other situations, in part because they were limited to a narrow skill. Maybe more importantly, these games were not engaging, so players did not maintain their level of effort, persistence, and sustained attention.
In contrast, Endeavor was built on a video game platform. Prior to designing the game mechanic and storyboard, the developers recognized that without the full attention, focus, and effort of players, there would be little chance of making sustainable change. Endeavor has enough complexity and excitement to keep kids engaged in playing it. In the recent study demonstrating its effectiveness, children played the game 5 times a week for 25 minutes a day over the course of 4 weeks.
While the game demonstrated significant improvement in attention based on the neuropsychological measures that were used, parent report data did not describe it as being any more effective than a control video game described as engaging and focused on academic skills. This suggests that the benefits of improved attention were not as readily transferred to real-world situations such as schoolwork, inhibition of responses, use of metacognitive skills, or working-memory capacities. However, Endeavor is not designed as a stand-alone activity, with the Endeavor Care Package including an app to monitor children’s attention and strategies for parenting. We suggest that parents treat ADHD as a multi-dimensional set of symptoms and use a variety of behavioral, cognitive, medical, physical, and educational strategies to address it.
From our perspective at LearningWorks for Kids, the FDA approval of Endeavor is a significant step forward in the use of technologies to help kids with ADHD, executive-function difficulties, Autism Spectrum Disorder, and a variety of other social-emotional difficulties. Given the accessibility of technologies, low cost, and engagement and interest of children in using them, this is a fertile area for further development. At the present time, most games and technologies designed for these kids or suitable to help them don’t do a great job in connecting the skills used in game play to the real world. As we move forward, LearningWorks for Kids hopes that game publishers will begin to consider strategies that can improve and enhance the generalization of skills. Newer technology such as virtual reality and artificial intelligence may help in this area.
We encourage parents who want to learn more about Endeavor to visit their website. You can also speak to your pediatrician about the use of this technology.