Can Playing Video Games Improve ADHD?

If your child has attention-deficit/hyperactivity disorder (ADHD), video games can be a tricky issue. Kids with ADHD tend to love them, while parents worry that gaming can make a bad condition worse. With their fast pace and tendency toward sensory overload, video games seem sure to exacerbate attention problems, pushing schoolwork and "real life" into the background.

Game proponents make the opposite claim. They say that video games provide a sense of accomplishment that can be rare in the lives of kids suffering from this disorder. And now, some research suggests that certain video games may even treat ADHD.

Neurofeedback, not Super Mario

Sadly, there's no evidence that Super Mario Galaxy or other mass market video games improve ADHD. But a growing body of research suggests that neurofeedback—in this case, using a technique that involves a video game–like computer interface—may be helpful.

Ute Strehl, Ph.D., of the University of Tübingen in Germany, who has published several studies on neurofeedback, says, "There is growing evidence from good scientific data that neurofeedback is a viable option for ... therapy [for] ADHD."

Most studies so far have been small. Many also lack the random assignment to treatment needed to definitively prove an effect, but they do suggest that neurofeedback could have some positive effects on both IQ and attention span, as measured in the laboratory. One study even found that it was as effective as medication.

One company, SmartBrain Technologies, of San Marcos, Calif., makes a system that can be used at home, but it's expensive, and there's no clear proof yet whether it is effective.

"The research is promising but not conclusive," says L. Eugene Arnold, M.D., professor emeritus of psychiatry at Ohio State University, who is starting a controlled study of the SmartBrain Technologies system over the next few months. (Parents in the Columbus area who are interested in enrolling their children can contact sarah.hersch@osumc.edu). The research is being funded by the National Institute of Mental Health, not the manufacturer.

Theories behind how neurofeedback helps

"The theory behind it is reasonable," says Arnold, explaining that people with ADHD have been found to have brainwaves that are slower than what's considered normal. "Contrary to popular belief, if someone is over-active, they may still actually be under-aroused," he says.

The brain waves of ADHD kids tend to spend too little time in the beta frequency and too much in the theta frequency. Beta waves are associated with a calm state of focus, while theta is where the brain tends to be when "tuning out."

When children play the neurofeedback game, painless electrodes are attached to their scalp to measure their brainwaves. Onscreen, the game looks like an ordinary car race, with many different tracks to explore so that it doesn't become boring.

However, the car can't accelerate and will crash if the child's brain waves are in the wrong frequency when he or she "drives." The more beta brain waves, the faster the car goes. And, in successive rounds, the child's opponent in the race becomes a car representing his or her previous performance. This ramps up the challenge and increases the child's ability to stay in the right range.

To let the child know how he's doing, the game controller vibrates and "rumbles" to signal when the child is using more theta waves rather than beta ones. "To be able to steer, you have to keep the frequency up away from theta," says Arnold. "I've played it myself and it's interesting because you have to get calm and relaxed to get rid of the rumble."

"Medications like [Ritalin] make the same sort of changes [in brain waves], so it fits together," says Arnold.

The gaming system and a visor that includes the electrodes are currently available from SmartBrain Technologies for $500-$1,000, for the Xbox and Playstation game consoles.

The bottom line

So, should parents just shell out the money? Arnold advises this only for wealthy parents. "If you have plenty of money, you may as well spend it on that as on unneeded luxuries, but I don't think the evidence is quite there yet to justify ordinary families making sacrifices to pay for it."

And what about time spent on other games? Arnold counsels limiting, but not eliminating, it. "Like other things, in moderation, video games are not actually harmful and might do some good. But in excess, almost anything is bad."

Arnold suggests that game time should probably come in the evening, though. During the day, he says, "[Children] would probably benefit more from going outside and playing." More and more research suggests that physical activity such as outdoor play is good for brain function, and one study reported that exposure to nature reduced ADHD symptoms in children.

This could be one reason that another study found a connection between more than an hour of video game play a day and worsened ADHD "inattention" symptoms—the kids may have been playing video games instead of playing outside.

More on ADHD on MSN Health & Fitness:

• Treating ADHD in Children and Adolescents
• Does Hyperfocus Suggest ADHD?
• Helping Kids with ADHD Handle Difficulties with Inhibition

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Maia Szalavitz is a journalist and author who covers the intersection between mind, brain and behavior. She is a senior fellow at Stats.org , a media watchdog organization, which investigates coverage of science and statistics. Her own experience as a former heroin and cocaine addict brings a unique perspective to her work. She's a regular contributor to Brain & Body. Her most recent book, co-written with leading child trauma expert Bruce D. Perry, M.D., Ph.D., is The Boy Who Was Raised as a Dog and Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing (Basic, 2007).