ADHD, FDA, and Video Games

Recently the Food and Drug Administration approved a video game that is purported to be helpful as a treatment for attention deficit hyperactivity disorder (ADHD). Parents and teachers are often concerned about kids whose behavior indicates ADHD, as their inattentiveness and high activity level combine to cause problems for their learning at school and at home, and serves as distractions to their teachers and parents as well as to other kids. The adults are bound to find attractive the idea that having the children play a video game can help improve their focus and self-control.

I’m not going to state the manufacturer or name of the specific game that was approved by the FDA. It doesn’t really matter, and I’m not in the business of telling people what to buy or not to buy. What is important is that people always need to find out certain things before they decide to put their resources into a treatment.

An important question is, who paid for the research? Obviously, research funding can come from neutral, objective sources who have no reason to want one outcome or another. But it can also come from highly interested parties—and in this case that’s what happened. The manufacturer paid for the research and got the outcome they wanted. When we say that a treatment is evidence-based, however, we ask for two independent researchers both to show the beneficial effects of the treatment. If someone unconnected with the manufacturer got the same results as the people funded by the manufacturer, that would be something to encourage us to use the treatment.

A second important question is, what does the outcome have to do with the original problem? Lots of treatments have effects, and it can be seen that they make a difference of some kind. The question is whether the difference they make is relevant to the problem everyone was worried about. In this case, that has not happened. The kids played one video game and their attentiveness was measured. Then they played another game 100 times, went back to the first one, and their attentiveness had improved—voila, a desirable outcome. However, none of the ratings by their parents, of attentiveness and so on, were improved. If the wish had been to create a treatment that would help the kids play video games better, this one would be good, but of course that was not the point of treating ADHD.

Just because we (in general) always hope for a pill or a potion to “fix” problems of development and behavior, rather than to have to do any difficult work, there will always be offerings of this kind. I mentioned one a while ago: “Forbrain” , which according to its website “energizes” the brain when you speak using a bone conduction headset. How you know whether your brain has or has not been energized is not mentioned. That’s typical of devices offered to treat autism, speech and hearing problems, and attention difficulties—even some that seem highly plausible and were created by very knowledgeable people.

The difference between the ADHD video game and the others is that in the ADHD case the FDA has approved, suggesting that the game has been found both safe for use and effective. That last part is questionable, as I have pointed out. And this is a prescription game, sounding very impressive and encouraging parents and teachers to see it as worth a try, whatever it costs.

It all amounts to caveat emptor. Ask the right questions!