LearningWorks for kidswww.learningworksforkids.com

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Understanding Video Game Play and Parent Perceptions in Children

with ADHDRandy Kulman, Ph.D.

randy@learningworksforkids.com@rkulman

Lara J. Kaplan Goodrich, PhDUchenna Enah

Monica Mabe, MA

Eastern Psychological Association Annual Meeting March1-4, 2013

New York, N.Y.

Presentation Disclosure

Randy Kulman, Ph.D. commercial interests:

• President, Majority Stockholder, LearningWorks for Kids, Inc.

• Cogmed Working Memory provider

Overview• What do we know about children with ADHD and

video games?

• Why use video games and digital media to help children with ADHD?

• What are the characteristics of interventions proven to work with children with ADHD?

• Why do children with ADHD not become scholars after playing video games?

• What can we do to make video games a more productive learning tool for children with ADHD?

What do we know about ADHD kids and video games?

• Clinical and anecdotal observations - too much and often too intensely! (but this is exactly why we need to use this behavior)

• No research evidence of difference concerning frequency or duration of play between ADHD and typically-developing children ages 10 to 12.

• Similar enjoyment for the same types of games (Bioulac 2008).

• South County Child and Family Consultants Data

LWK study of ADHD kids and parents on video game play

• (Current sample of 60 children with a primary ADHD diagnosis based upon a full neuropsychological evaluation)

• Survey asks parents to describe their own media usage to see if it is correlated to attitudes regarding video games

• Also asks them to describe their concerns and hopes for benefits of video games and other digital media

• Digital media use of ADHD kids- Most time television, video games, music (different from what is seen in national studies of typically developing kids)

Children, parents, and video game play

How many hours a week does your child spend playing video games?

• 34% Less than 1 hour per

• 32% 2-4 hours

• 20% 5-7 hours

• 13% 8+ hours

How many hours per week do you spend observing or interacting with your child when they play video games?

• 23% no time

• 46% less than 1 hour

• 27% 1-5 hours

• 4% 6+ hours

Children, parents, and video game play

Do you play video games with your child?

• 25% Never

• 57% Sometimes

• 14% Often

• 3% Always

How much do you believe that video games can help your child with problem solving?

• 34% Somewhat

• 25% Quite a bit

• 19% A little bit

• 13% A great deal

• 8% Not at all

Describe the level of concern you have about your child’s video game play leading to video game addiction.

• 66% Not at all concerned

• 29% Concerned

• 5% Extremely concerned

Do you monitor the length of time your child plays video games?

• 8% Never

• 20% Sometimes

• 27% Often

• 45% Always

Children, parents, and video game play

Do you believe that video game play can benefit your child?

• 40% Somewhat

• 21% Quite a bit

• 13% A little bit

• 12% A great deal

• 14% Not at all

Children, parents, and video game play

Why use video games and digital media to help children with ADHD?

• Video game play requires the use of executive

functioning skills.

• Other skills such as organization and metacognitive

skills are required for success.

• Both simple and complex video

games regularly use skills such

as planning, cognitive flexibility,

self-control, and time

management.

• Many games specifically tax

working memory skills and

attentional skills.

Why use video games and digital media to help kids with ADHD?

Kids with ADHD or Attention Difficulties

Video Games and Digital Media

May become easily bored and unable to sustain attention

• Require ever-changing skills • Employ video, sounds, words, and

actions • Multi-modal

Often require immediate reinforcement or consequence

to stay focused on a task.

• Provide clear and immediate feedback• Constantly let player know what he is

doing wrong and right

Often require that their body or mind to be actively engaged.

• Extremely engaging • Many require physical and cognitive

involvement

Why use video games and digital media to help kids with ADHD?

Kids with ADHD or Attention Difficulties

Video Games and Digital Media

Usually have problems with following directions.

• Teach by trial and error or guided discovery

• Require that the player understand the instructions in order to succeed

May struggle to learn new information and experience

frustration or low self-esteem as a result.

• Most negative feed back from video games and other digital media occurs privately.

• Causes less embarrassment and frustration

• Teaches the player how to handle these emotions

What are the characteristics of interventions that work best with children With ADHD?

• Point of performance interventions

• Immediacy of feedback

• Powerful and engaging feedback and meaningful consequences

• Multimodal presentations and multiple intervention agents

• Individualized to child’s capacities

• Strategic teaching principles including: previewing, setting explicit goals, partnering, metacognition, and generalization strategies

Why do children with ADHD not become scholars after playing video games?

• Existing games focus on other things, while using important thinking skills.

• Metacognitive skills are not built into existing video games.

• Generalization and strategic teaching skills are not built into existing game.

• Existing games are generally not designed to promote skills in children with ADHD.

Research on Executive/Thinking Skills and Video Games

• LWK pilot research on differentiated instruction, targeting areas of EF weakness with video games

• Combination of board and video games improve fluid reasoning and processing speed (Mackey, 2011)

• Working memory video games improve WM, fluid reasoning skills (Cogmed ) Intensity/duration

• Computer-based training improves executive attention in preschoolers (Rueda, 2005)

• Video game like math and reading programs improves learning, reduces attention symptoms

• Games that increase cognitive load and used as a teaching tool by parents reduce ADHD symptoms in Preschoolers (Halperin, 2012)

• Dovis et al, 2011-Motivation from games and WM

How well do game based skills transfer to the real world?

• Game play alone results in modest improvements in real-world executive skills

• Children with learning and attention problems have problems in generalizing strategies

• Kids like to talk about playing video games and may be willing to learn from that

• Games prompt partnering and motivation to learn executive skills

• Practice and rehearsal of executive skills

BUT…games are not enough!!!

• The key to success is effective teaching or mediation (can be done in the game)

• Teachers (including peers, parents, and imbedded instruction) make the connection between game-based learning and real-world skills

• Actual learning requires knowledge of the skill, understanding how and when to use it, and practice across many situations…generalization and strategic teaching approaches

What can we do to make video games a more productive learning experience for children with

ADHD?

• Build generalization strategies, practice skills outside of the game

• Consider duration and intensity of game play to practice skills

• Mediated learning, including parents, psychologists, educators, and peers

• Utilize a differentiated instructional model that identifies the specific skills that a child with ADHD needs to improve

• Teach skills and then practice them in game and technology play

• Talk about gameplay and skills, metacognitive approaches

Play Together

• Talk before, during, and after gameplay. Choose gameplay goals with your child.

• Have fun playing the game with your child!

• Reflect on gameplay, emphasizing the use of the targeted thinking or academic skills.

• Direct your discussion to how these same skills are useful in daily activities.

• http://www.learningworksforkids.com

Make it Work

• Explain the benefits of digital play, and introduce the skills being exercised in the game.

• Encourage non-digital activities that use the same skills.

• Regularly connect game-based skills to things your child is struggling with in the real-world.

• Try different games and skills

Executive Skills Questionnaire

Prescription of Games, Technologies, and Recommendations