Why the FDA Approved a Video Game—Yes, a Video Game!—as an Official Treatment for ADHD

Photo: Stocksy/Victor Bordera
Neurodivergent folks nationwide have been struggling to treat their attention-deficit/hyperactivity disorder (ADHD) in recent months due to a national medication shortage. Without their regular access to Adderall, many have been trying to figure out other ways to manage symptoms.

Andrew Kahn, PsyD, associate director of behavior change and expertise at Understood.org, points out that medication is just one tool in the toolbox you should have to combat your (and work with) ADHD symptoms. But when thinking about other ways of coping, a video game is not likely to come to mind. Heck, it might even be a source of distraction.

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Yet the Food and Drug Administration (FDA) recently greenlit EndeavourRx to treat symptoms of ADHD, via prescription, specifically in kids 8- to 12-years-old. No, the date is not April 1, and this is not a prank. Instead, the move is a creative and innovative way to treat symptoms of ADHD.

Video games are not new in medicine

Even though this idea seems novel, this is far from the first time video games have been used to improve our health. Dr. Kahn stresses that games have a long history in medical and therapeutic settings.

For instance, physical therapy has taken advantage of the power of games like RehabMaster, an interactive VR game which encourages rehabilitation of the upper body after a stroke. A 2015 study on the game Mindlight showed it successfully lowered anxiety symptoms in children diagnosed with autism spectrum disorder. The VR immersion game Snowworld has been used to support burn victims, and brain scans have shown it to actually lower the amount of pain patients are experiencing.

And this approach isn't just for patients: There are even games like Underground and Super Monkey Ball that have been shown to help surgeons perform better.

What is the new game for ADHD?

EndeavorRx is an "immersive video game experience" that's quite similar to many games that children already play for, your know, fun. On an iPhone, iPad, or Android device, the user plays the game while receiving a variety of sensory and attentional cues via movement of their character through a multi-level sensory experience, Dr. Kahn says. The game developer says that the system measures the areas that the child struggles with while they're playing. The software then tailors future gaming sessions to address those specific areas of attention or focus.

Unlike recreational games, the therapeutic gameplay in EndeavorRx is only to be played on a prescriptive schedule (25 minutes, five times a week). The system will not allow access to more time on the game.

"The game developers hypothesize that the targeted tasks and skills used during the play sessions activate key brain areas associated with attention and focus," says Dr. Kahn. "The research has indicated evidence of statistically significant improvements in attention and focus on the TOVA (Test of Variables of Attention)." However, he stresses that statistical positives don't always translate to noticeable changes in one's life.

Still, products like EndeavorRx offer a promising way to engage children in activities that could benefit their daily functioning. Because let's face it: Kids are far more likely to be interested in doing something that involve a game than they would be in traditional therapy sessions or classroom lessons. Using forms of play to encourage kids to develop key skills is an exciting option in a field that doesn't always entice children to participate.

Are there downsides?

Dr. Kahn points out that the study noted some users reported a headache. Still, unlike with medication, there's no risk of allergic reaction.

The most notable drawback is the cost. At $99 a month, EndeavorRx is available by prescription only, and most insurance plans are unlikely to pay for it. Currently, there are no payment plans available. Which means families that can't afford it are unlikely to get access to the game.

What does EndeavorRx say about the future of ADHD treatment?

'The best psychological treatments should 'meet the client where they're at' and provide meaningful support to help the client thrive," says Dr. Kahn. A game like EndeavorRx is an exciting example of the creative use of technology that is likely to drive ADHD treatments down the road. Right now, we've got a video game, but who knows what could be next.

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