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Games, apps and new tools for ADHD
Virtual reality game with stimuli to hit or avoid. Video game that requires problem-solving strategies to save the galaxy from a meteor storm. A chore app developed to help children follow routines. These are some of the new technology-based tools – some of which are considered digital therapies – that promise to help patients with ADHD and related conditions such as anxiety and depression.
Most emerging digital therapy companies emphasize the power of technology to engage patients and maintain treatment adherence. This is especially true for technologies that use video game-like interfaces, including wearable technologies and virtual reality (VR), as a mode of delivery. Industry leaders say digital therapy should be seen as “a tool in the toolbox”, alongside clinician visits, ADHD medication and psychoeducation, to maximize its impact.
Some of these interventions require a prescription and are supervised by doctors or other clinicians. Read on to learn about the most promising tools to date.
NOTE: All product/service names, models, prices, links and specifications were accurate at the time of this article’s publication.
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Akili Interactive touts its product, EndeavorRx, as “the only prescription video game treatment for children with ADHD” to receive FDA approval. In a company-funded study published in 2020, data showed that the video game improved ADHD symptoms in children when used at home for four weeks.
EndeavorRx is prescribed by a doctor and then downloaded to a mobile device. In the game, players chase mysterious creatures through different worlds and must solve problems to unlock new characters and build their own universe. It is fast moving and designed to offer increasingly difficult challenges. Players must multitask and avoid distractions and obstacles to advance through all levels of the game.
- Age group: 8-12
- Goal: Inattentive and combined subtypes, selective and sustained attention
- How it works: Children play a game that requires them to use problem-solving skills to promote and maintain focus to avoid obstacles. Real-time algorithms adjust difficulty based on player performance.
- Cost: $99 for a three month subscription. Some insurance plans may cover the cost.
- Usage time: 25 minutes per day, 5 days per week, for 4 or more weeks
- Website: www.endeavorrx.com
[Read: Video Games Can Help Kids with ADHD – If You Choose Wisely]
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XRHealth is a VR telehealth clinic offering physical, occupational, speech language and mental health therapy; cognitive training; and support groups for a variety of conditions. Patients begin by meeting with a therapist, who conducts an assessment, determines the safety of VR for the individual, and develops a treatment plan. VR allows the therapist to measure how the patient reacts and adjust as needed. Applications for children with ADHD include a boxing-like game in which players choose which stimuli to hit, which to avoid, and which distractions to ignore.
- Age group: 10-17 for children with ADHD; adult applications too
- Goal: Concentration, attention and hyperactivity
- How it works: Virtual reality presents a go/no-go task that allows users to practice selective attention and avoid distraction. The immersive nature increases attention and the will to practice.
- Cost: Three levels of care for $276, $356 or $476 per month, including online therapy sessions that vary in length. Some insurance plans may cover the cost.
- Usage time: Once or twice a week for 3 to 6 months
- Website: www.xr.health
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Joon is a downloadable app designed to make tasks, or “quests”, fun for children to complete. Parents and children both need access to a mobile device where they can keep track of their assignments. First, parents select from a small list of recommended assignments (ie, chores, homework) for their child. Then the child chooses a virtual pet that requires their care. As they complete the tasks assigned to their parents, the child can raise their pet and explore new worlds in the game. Joon says it can help children complete tasks more efficiently and without the hassle that often comes with homework and chores.
- Age group: 8-12
- Goal: Task initiation, motivation, focus, task persistence
- How it works: Joon rewards children with coins and points to motivate them to complete routine tasks and develop new skills. Parents can change expectations and rewards.
- Cost: $89.99 per year, or $18.99 month-to-month
- Usage time: Ongoing
- Website: www.joonapp.io
[Read: 10 Behavior Chart Rewards to Motivate Your Child]
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Calmsie has developed a video game that incorporates real-time elements of cognitive behavioral therapy (CBT) to help with anxiety, depression and emotional challenges. Avatars guide children through conversational CBT sessions designed to help them gain better control over their thoughts, feelings and actions. Players must use these skills to “save the galaxy from a meteor storm.”
The game is seen as a supplement to medical and therapeutic treatment of anxiety and depression.
- Age group: 8-12
- Goal: Depression, anxiety and emotional challenges
- How it works: Calmsie uses a daily CBT session with a video bot. Through real-time conversations, the child learns effective ways to cope with challenging emotions.
- Cost: Not available yet
- Usage time: 17 to 25 minutes per day for 28 consecutive days
- Website: calmsie.ai
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Mightier offers more than 30 engaging video games designed to help children build emotional regulation skills. The patient has a wireless heart rate monitor on their arm and can see their heart rate in a box on the screen while they play. When a child’s heart rate rises due to excitement or anxiety, the toys become more difficult. The player must then bring their heart rate down using various calming exercises taught in the game. The idea is that these skills can be used in real-life situations.
- Age group: 8-12
- Goal: Frustration, anger, oppositional behaviour, anxiety, emotional dysregulation, inattention and hyperactivity
- How it works: The games offer direct instruction in breathing and relaxation techniques. The system encourages continuous practice of the skills and monitors their effectiveness via the heart rate monitor.
- Cost: $336 per year, or $40 month-to-month
- Usage time: Ongoing; recommended use 15 minutes per day, three times per week.
- Website: www.mightier.com
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Revibe Technologies released the Revibe Connect, a watch-like wearable device, in 2018. The device sends vibration reminders to redirect kids to stay on task or get back to work. Parents and teachers set the initial schedule for notifications (can be 15 minutes of work time with reminders every 5 minutes). They can also program custom text messages to appear at set times, such as “write down your homework.” Revibe Connect was designed to track attention span, focus frequency, motor activity and movement, and generate reports on a child’s progress.
The company announced in 2022 that it was discontinuing sales of Revibe Connect to focus on newer products, including “FokusRx,” an investigational SaMD (software as a medical device) for ADHD that is still in early development.
Digital Therapeutics for ADHD: Next Steps
Randy Kulman, Ph.D., is the founder and president of LearningWorks for Kids, an educational technology company that specializes in using video games and interactive digital media to teach leadership and academic skills.
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