Tablets, computers, consoles, phones have infiltrated every part of our lives, and brought a greater ease of access to video games. A once small industry started by a pixelated ball bouncing between two paddles has grown into what is expected to be a $300 billion dollar industry by 2025. This once small niche hobby now has a competitive sports league and celebrity streamers. It is rare to find a student in the hallways of any school that does not know about the latest Fortnite skins or Call of Duty update. It is just as rare to find a parent that has not grappled with knowing how to balance the amount of time their child visits these virtual worlds.
Parents of children with ADHD-like behaviors are often very perplexed how their child can sit and focus on the sights and sounds of these games for hours but cannot sit still long enough to finish a ten-problem math worksheet. It seems counterintuitive, but a child that is able to focus on a video game, but not much else, could still have ADHD.
This discrepancy further explained below.
If you were to design a non-medication treatment for ADHD you would externalize important information at key points of performance; externalize time, reduce cognitive load, provide increasing rewards, make it interesting, immediate rewards, immediate feedback, and externalize all important information (e.g., reminders, tracking, visible indicators).
When you look at this photo from the popular video game, Super Mario Bros. for Nintendo it looks remarkably similar to the elements described above.
- externalize time (timer) √
- reduce cognitive load (only focused on small portion of level) √
- increasing rewards (gain new abilities with success) √
- make it interesting (lots of action) √
- immediate rewards (moving further in the level) √
- immediate feedback (mess up and the game immediately restarts) √
- externalize all important information (tracking of coins, world, points) √
This can help to explain the discrepancy between why most ADHD children can focus on video games. In the classroom rewards are often delayed, it is not always interesting, and there is minimal feedback. The classroom can be unpredictable and has lots of distractions (other children, commotion outside the classroom, etc.)
Understanding how a video game can hold a child’s attention is not meant to excuse problematic behaviors. It is to offer some insight into how a child can perform so differently under seemingly similar environments that appear to require the same skill, sitting in place for a long time. This understanding is meant to help show how implementation of some of the similar tools employed by video games to produce entertainment can be implemented in the home or classroom. Video games are very good at one of the most recommended treatments for ADHD, behavior modification.
Behavior modification is focused on if it increases or decreases the likelihood of the behavior to recur and completes this through external means. It can include both reinforcement and punishment, which may work independently, as well as together, as part of a behavior plan.
