Understanding video game play and parent perceptions in children with ADHD
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The document discusses research on video game play in children with ADHD, finding that while they spend significant time playing video games, this alone does not improve academic skills; however, video games can effectively train executive functions when used as part of a structured program with coaching that emphasizes skill-building and transferring skills to other contexts. The document provides recommendations for parents to make video games a more productive learning tool for children with ADHD through differentiated instruction, teaching skills both in and out of games, and focusing on generalization of skills.
Understanding video game play and parent perceptions in children with ADHD
- 1. Understanding Video Game Play and Parent Perceptions in Children with ADHD Randy Kulman, Ph.D. randy@learningworksforkids.com @rkulman Lara J. Kaplan Goodrich, PhD Uchenna Enah Monica Mabe, MA LearningWorks for kids Eastern Psychological Association www.learningworksforkids.com Annual Meeting March1-4, 2013 @lw4k New York, N.Y.
- 2. Presentation Disclosure Randy Kulman, Ph.D. commercial interests: • President, Majority Stockholder, LearningWorks for Kids, Inc. • Cogmed Working Memory provider
- 3. 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?
- 4. 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
- 5. 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)
- 6. 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
- 7. 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
- 8. Children, parents, and video game play 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
- 9. 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
- 10. 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.
- 11. Why use video games and digital media to help kids with ADHD? Kids with ADHD or Video Games and Digital Media Attention Difficulties May become easily bored and • Require ever-changing skills unable to sustain attention • Employ video, sounds, words, and actions • Multi-modal Often require immediate • Provide clear and immediate feedback reinforcement or consequence • Constantly let player know what he is to stay focused on a task. doing wrong and right Often require that their body or • Extremely engaging mind to be actively engaged. • Many require physical and cognitive involvement
- 12. Why use video games and digital media to help kids with ADHD? Kids with ADHD or Attention Video Games and Digital Media Difficulties Usually have problems with • Teach by trial and error or following directions. guided discovery • Require that the player understand the instructions in order to succeed May struggle to learn new • Most negative feed back from information and experience video games and other digital frustration or low self-esteem as a media occurs privately. result. • Causes less embarrassment and frustration • Teaches the player how to handle these emotions
- 13. 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
- 14. Why do children with ADHD not become scholars after playing video games? • Existing games are generally not designed to promote skills in children with ADHD. • 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.
- 15. 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
- 16. 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
- 17. 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
- 18. What can we do to make video games a more productive learning experience for children with ADHD? • 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 • Build generalization strategies, practice skills outside of the game • Consider duration and intensity of game play to practice skills • Mediated learning, including parents, psychologists, educat ors, and peers
- 19. 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
- 20. 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
- 22. Prescription of Games, Technologies, and Recommendations
Editor's Notes
- #4: My own interest- 27 years of child clinical practice“what do you like to do, your strengths?”- Video games, TV, and Legos
- #6: Bioulac (2012) ADHD kids look very similar to TD peers on video game performanceComparing computer as opposed to analog technologies on neuropsychological testing -compared typically-developing children with atypically-developing children on theWisconsin Card Sorting Test computerized version versus deck of cards, and there was a smaller difference on the computerized version (Oznoff 1995).Lingineri (2012) data, ADHD kids 90% spend more than 1 hr per day on computer, TD kids 80% spend more than 1 hr per day on computerSouth County dataVideo games are second most used technology after TV, not 3rd as in national surveys (after music)Have 125 families in initial study, have revised questionnaire.Alos have child questionnaire, looing for other sites
- #7: Much less than Kaiser Foundation Study 2010 – 7 hours 38 minutes per day of time with digital mediaOur numbers much lower- due to estimates rather than diariesIs it an issue of social desirability?
- #8: Kaiser and other data suggest that about 30% of parents play video games with their kidsParents who reported themselves as more active participants in their child’s video game play reported a greater belief that video games could help their child with planning, time management, understanding themselves/others, and overall performance in school.
- #9: Increasing numbers of educators, parents, clinicians are seeing game-based learning as a legitimate approach.There are real concerns re. addiction, more so seen in data from other countries such as South Korea.
- #14: General strategies that work with ADHD children… something to do, to be able to move, to be able to talk , or to be able to fidget when concentratingResearch on ADHD and vigorous exercise (Verret et al 2010, Ratey in Spark)…what about exergames as a tool for increasing focusing skillsBest (2011) Exergaming immediately enhance EFs
- #16: LWK pilot research (N=10) that targeted areas of specific EF weakness resulted in gains in these areas, not in others, similar to what Mackey found where they targeted sollely by the games played, =rather than by child’s needs and games/playbooks selectedOther studies support targeted approaches, the use of mediators, the importance of intensity and duration (5-6 weeks 40 minutes per day)Clarfield and Stoner; early reading skill development--HeadsproutOta and DuPaul; math skills practice—Math BlasterMautone, DuPaul, Jitendra; math skillsDovis study- video games enhance motivation which improves WM
- #18: Games as a teaching tool,Building metacognition and generalization into processTargeting skills individuallyHot vs. cold Efs, games seem to be better for cognitive than self control skills ( eg planning, cognitive flexibility, organization, time management, task initiation…than regulation of affect, response inhibition)
- #20: Mediation, metacognition, goal setting, FUN!
- #21: Far transfer and metacognitionPractice across settingsExpand the skill sets to other similar skills