5 - (IOP 15) A Pilot Study of a Video Game-based Organization and Planning Skills Intervention for Young Adolescents with ADHD

Serious games are designed to alter player knowledge, abilities, or behavior, rather than to simply entertain. In recent decades, serious video games have been designed to evaluate and treat mental illnesses, with emerging research showing some clinical benefits. A subset of mental health games is targeted to the symptoms, impairments, and/or neurocognitive deficits of individuals with attention-deficit/hyperactivity disorder (ADHD). To date, research on ADHD games has been mixed, with little evidence for behavior change beyond computer-based laboratory tasks. In the present study, we piloted a novel computer-assisted behavior intervention (CABI) using a serious game designed to teach the organization and planning skills taught within evidence-based psychosocial treatments for ADHD. Previous research on the game, called ATHEMOS, suggests that it is highly engaging, with player satisfaction comparable to purely recreational games.

Thirty-one middle school students with ADHD and their teachers were randomly assigned to either receive the novel CABI or the Challenging Horizons Program - Mentoring model (CHP-M), an established school-based psychosocial treatment for ADHD. All teachers in both conditions provided supportive mentoring for up to 24-weeks of intervention. We evaluated our results using parent and teacher ratings of child behavior at home and school and analyzed those data using both Bayesian and frequentist modeling. Results suggest that the Time × Condition interactions were generally small (ηp2 = 0.00 to 0.11) and inconclusive. The CABI approach performed comparably (or inconclusively) to the CHP-M on both parent (BF10 = 0.40 to 1.15) and teacher behavior ratings (BF10 = 0.34 to 0.57), with credible and significant main effects of time on ADHD-related impairments (ηp2 = 0.09 to 0.59). In other words, both treatments appeared to be equally beneficial. Our findings suggest that the CABI innovation is a reasonable modification to traditional school-based approaches and might be used to engage adolescents who are otherwise unmotivated to accept intervention.

It is noteworthy that both treatments resulted in equally strong outcomes on ecologically valid measures of child behavior, with effects that appear to meet or exceed those for other game-based interventions already in use by teachers and parents. With additional revisions, the CABI could potentially provide added benefit in terms of the working alliance with teachers and perhaps academic achievement, although the current findings suggest that extensive revisions might be needed to achieve those aims. Still, our findings support a new direction in computer-assisted interventions that might rival the results of established, evidence-based psychosocial interventions and be selected depending on student or teacher preferences.