A Game of Concentration: Videogames and ADHD

Bill Loguidice's picture

Author: Patty McCabe-Remmell
Editing: Bill Loguidice, Cecil Casey
Web Layout: Cecil Casey

When all is said and done, and the future reveals that all the bogeymen of technology have not created a society full of violent idiots, as the fear-mongers predict we will, I will look down from on high and have a good laugh. Just like the adage that television would rot one's brain, the notion that videogames are at the root of the demise of America's children will be dismissed with a laugh and a "yeah right, as if."

Since the advent of video gaming, reports in the media have attempted to tie the use of videogames to all sorts of bad things, not the least of which is a rising penchant for violence among school children. Indeed, ever since television entered the scene, video violence has been blamed for decades of school bullying and other aggressive behavior1. The shootings at Columbine High School and other schools during the closing years of the 1990s were held up by media and self-help pundits as proof. Parents were aghast and games like Mortal Kombat which displayed gory fight scenes. This spawned a movement of self-help gurus who, via the Internet, began advising parents the evils of too much gaming, especially if the child in question was "at risk" in any way. Because children with ADD are often seen as impulsive, and sometimes even violent, the question of the correlation between videogames and the acquisition or acceleration of attention Deficit/Hyperactivity Disorder (ADD or ADHD2) is begged. The reason for this is mostly because of the frustration that is attendant with a disorder that manifests itself in the sufferer as a feeling that the brain is rapidly changing channels, as if on television. It is difficult or impossible to focus when one's attention is constantly being drawn to other things. Even as I write this, I struggle to stay on task and keep my paragraphs flowing smoothly, but then again, writing was my way of coping with ADD as a child.

I was diagnosed with ADD as an adult. There was no such convenient diagnosis back in the 1950s and 1960s when I was being labeled as "difficult," "moody," or "impulsive." "Your daughter is very smart but she just doesn't apply herself" is the line my mother would hear over and over again.

My reactions to being misunderstood for all those years manifested themselves through rage and outbursts. To this day, my mother remembers me as being difficult to live with. Imagine my disappointment when, at school age, my son began to exhibit the exact same symptoms. Luckily, by the 1990's, there was a name for it.

AD/HD guru Dr. Edward M. Hallowell says, "The diagnosis can be liberating, particularly for people who have been stuck with labels like 'lazy,' 'stubborn,' 'willful,' 'disruptive,' 'impossible,' 'tyrannical,' 'a space shot,' 'brain damaged,' 'stupid,' or just plain 'bad.' 3" What remains, however, is the question of whether one should simply learn to cope, as generations before had done, or whether one should medicate. Schools are all for medication because it's easier than dealing with a child who is struggling to cope, but there are drawbacks to starting children on a pill-popping habit early. One is that it sets the stage for drug dependency. The other is that the ADD label can hastily be applied to any child by overworked and harried teachers who simply wish to request a chemical babysitter.

CHADD (Children and Adults with Attention Deficit Disorder), an organization founded to champion the cause of children and adults who suffer from AD/HD, explains:

Children with AD/HD are "at-risk" for potentially serious problems: academic underachievement, school failure, difficulty getting along with peers, and problems dealing with authority. Furthermore, up to 67 percent of children will continue to experience symptoms of AD/HD in adulthood. However, with early identification and treatment, children and adults can be successful. Studies show that children who receive adequate treatment for AD/HD have fewer problems with school, peers and substance abuse, and show improved overall functioning, compared to those who do not receive treatment. In adulthood, roughly one third of individuals with AD/HD lead fairly normal lives while half still have symptoms that may interfere with their family relationships or job performance. However, severe problems persist in about ten percent of adults.4

Zelda Logo.

I decided to be one of those parents who chose to teach my child how to cope and while the road has been hard, I see the benefits as he gets older. He has learned how to control his aggression and has become more socially adjusted than other children who, in my view, are warehoused in a chemical haze. One of the things I chose for my son as an outlet is videogames. The reason is probably because I was fascinated by videogames from the time I saw my first Space Invaders console in a college bar back in the 80s. I found Pacman to be strangely soothing and frustrating at the same time. Nintendo was even better. I would lose myself in The Legend of Zelda for hours. Gaming allowed me to focus for once, and gave me ample practice in channeling and focusing thoughts in order to complete a task. As I got to know other gamers, I began to see a relationship between videogames and people who exhibited all the signs of attention deficit. This is probably because my friends who are extremely passionate about video gaming were also considered "eccentric" as children. We were the kids who daydreamed during classes. We've been called weirdoes, social outcasts, geeks: the very people who invented video gaming in the first place.

Detractors say that videogames, because of their interactive nature, are stimuli for already overworked brains, but there is no conclusive evidence that this is true. On one hand, according to the Journal of Personality and Social Psychology, some studies suggest that "real-life violent video game play [is] positively related to aggressive behavior and delinquency." On the flip side, however, the article goes on to state:

"The research to date on video game effects is sparse and weak in a number of ways. Indeed, one reviewer (and many video game creators) has espoused the belief that "video game playing may be a useful means of coping with pent-up and aggressive energies" (Emes, p. 413). In brief, what is needed is basic theory-guided research on the effects of playing violent videogames."5

There is something about the rapid-response demand of most videogames that helps someone with AD/HD focus -- a rarity in the AD/HD world of any child or adult who suffers from it. Some have said this is because of a correlation between the brain's ability to produce dopamine and AD/HD:

The increase in dopamine production in the brain during video game play is no different than smoking marijuana, or a person being injected with amphetamines, or the ADD drug Ritalin. The change in brain chemistry is the first hard evidence that video game playing is addictive, like a dose of speed. Accordingly, these kids are addicted to raised dopamine levels, and can't concentrate on anything without them.5

Addiction to videogames themselves plays a very small part of a larger neurological picture. It may explain why those diagnosed with adult ADD are usually those with some type of addiction, whether it be to "legal" drugs like alcohol or illegal ones like marijuana. Stimulus addiction is a factor in the argument against videogames: the child become addicted to the stimulus rather than the play itself. Speaking from the position "inside" an ADD brain, however, I can argue that it is not so much the dopamine or the stimulus but the fact that games are havens from the incessant chaos of our thoughts. This is what makes it difficult to get us to leave that comfortable space for another which might be even more frenzied, especially if it means having to go out in public where the world is as frenetic as our own thoughts. One begins to see, then, that what makes videogames so enticing to a kid with ADD is that it is an escape from the world -- but not necessarily a bad escape. Rather than sucking the child out of reality and into some cyber-coma, the act of gaming allows him or her to focus a million thoughts into about a hundred or even ten. It's a break. It's a calming of the mind after a day of brain-bombardment. I have watched my son relax in this manner, and, when he is finished, is able to take up the task of homework or dinner or emptying the dishwasher with relative calm (emphasis on relative). The difficulty in tearing him away without a tantrum disappeared when I learned different approaches to separating him from something in which he was intensely absorbed. This is all part of strategies learned as a parent of an AD/HD child and has nothing to do with the "doping" factor of a video game.

I sit here now and watch my son as he creates a new football character on the Sony PlayStation 2 (PS2). He is god of his own little world in which he can design a football player as well as a stadium or an entire NFL team. He can virtually play an entire NFL season and has -- winning the Super Bowl several times already, never seeming to tire of the game..

I was talking to him just the other day about why he hasn't "gone Columbine," since he has been playing videogames since he discovered my old Nintendo at age four or five. He scoffed at me, and started to protest and I said, "Well you know, behavioral scientists have been saying for years that violent videogames produce violent children." This was met with a derisive laugh and the usual look that said "mom, you are SO uncool" and I dropped the subject.

So here is my son: a typical American teenager except for the daily dance with ADD. Yes, he was exposed to violent videogames via the other kids around him: his cousins, schoolmates, friends. Why, then, has he not become violent? Indeed, why does he purposely not choose violent games? He has a propensity for aggression, yet he has no desire to play Halo unless friends are playing and then he will join in.

Madden 2005 screen

Madden 2005.
© 2004 Electronic Arts.

Beyond his PS2, he enjoys Flash games on Web-based sites such as Newgrounds (http://www.newgrounds.com/), and PC games such as Hot Wheels Stunt Track Driver and Rollercoaster Tycoon, but he draws the line at Sims, which he feels is too slow-moving. (To my eternal chagrin, I do not have a PC dedicated to games.) PS2 is his favorite system, although he would give his right arm for a new Nintendo handheld to carry around. His primary choices for games are sports games, such as EA Games' Madden and Tiger Woods offerings, but he has had the most fun and spent the most time with the Tony Hawke series from Activision. There are also all sorts of other games available to him including war and shoot-em-up games such as Medal of Honor and fantasy games such as Final Fantasy and Return of the King[/i], but he always goes back to games where he can create and build, if not ex nihilo, then from some fantastic ground constructed by some far-off Japanese developer.

So, essentially, to say that videogames are a cause of AD/HD is absurd. To say that violent videogames produce violent children is absurd. I watched The Three Stooges for years and never poked anyone in the eye. Behavioral problems, by and large, point to bad parenting rather than bad genes, and I am loath to say that bad parenting may be becoming so prevalent, it may indeed evolve into a part of our DNA, but that's too scary even for the SCI FI channel to consider. A Google search reveals articles supporting the idea that videogames cause AD/HD are mostly published by drug and attention-monitoring device companies. There may be something to my theory that videogames might be beneficial, however. Science is, in fact, revealing that videogames, despite the tolling of the doomsayers' litany about their propensity for making future juvenile delinquents, may be useful in terms of biofeedback.

The spring 2002 edition of the Berkeley Medical Journal states:

More than 15 years of studies show that with the aid of a computer display and an EEG sensor attached to the scalp, ADHD patients can learn to modulate brain waves associated with focusing. Increasing the strength of high-frequency beta waves and decreasing the strength of low-frequency theta waves, for example, creates a more attentive state of mind. With enough training, changes become automatic and lead to improvements in grades, sociability, and organizational skills.

Biofeedback, however, is much too costly a treatment, requiring up to forty sessions over several months at a cost of $3,000 to $4,000. Insurance companies, therefore, will opt to cover drug therapy rather than the more expensive but less invasive alternative. NASA, however, has funded a study by Alan Pope, a behavioral scientist, at NASA's Langley Research Center in Langley, Virginia, and inventor of virtual reality biofeedback. Pope had been researching the level of interaction between cockpit controls and pilots in an attempt to design controls that monitor the brain waves of pilots and automatically switch to "auto" if a pilot began to get drowsy or lose consciousness. This type of study is beneficial for those who are looking for non-prescription treatment of AD/HD.

According to the BMJ:

Pope applied his findings to help AD/HD patients stay focused by rewarding an attentive state of mind. He realized, however, that the simple displays that were already part of biofeedback treatment may not be enough to hold the interest of restless youngsters. He then chose several common videogames and linked the biofeedback signal from the player's brain waves to the handheld controller that guides the games' actions. "In one auto-racing game, a car's maximum speed increases if the player's ratio of beta to theta waves improves. The same sort of feedback also controls the steering," Pope says.

The test groups, utilizing 22 children between the ages of nine and 13, had "fewer no-shows and no drop-outs " according to Pope, who also noted that "both groups showed substantial improvements in everyday brain-wave patterns as well as in tests of measuring attention span, impulsiveness, and hyperactivity. Parents in both groups also reported that their children were doing better in school." The article goes on to say that this type of biofeedback can be self-taught since children are already familiar with video gaming and systems are already being marketed. There is a caveat, however: only specifically developed systems should be used and no other videogames should be substituted, but this comes from the company marketing the system. Another warning, from Professor Stephen Hinshaw, a clinical psychologist at UC Berkeley: "Biofeedback is a promising potential alternative, but unfortunately the kinds of really well-controlled studies that might support its clinical benefits have yet to be performed." What is promising is that biofeedback, while requiring a longer period of time to learn (as opposed to quick-acting drugs such as Ritalin), "has the potential for longer-lasting effects."6

Videogames have other potential benefits. There is evidence that they can also be used for treatment of phobias. According to Game Industry News7, "Researchers at the University of Quebec in Outaouais found that videogames can be more effective in treating patients with phobias than commercially developed virtual environments costing as much as $10,000, and the games do it at a fraction of the cost." The GIN goes on to say:

"Patients were given a chance to get used to the environments without anything to trigger phobias, and then exposed to the stimulus. The researchers found there was little simulator sickness, which can be common in virtual realities, and that the programs stimulated the right level of anxieties for use in therapy. The modified therapeutic environments, which under the game licenses must be distributed for free, can be downloaded from the University of Quebec at Outaouais's Cyberpsychology Laboratory Website.".

Ultimately, videogames are not the "Big Bad Wolf" that a lot of self-help and behavioral gurus would have us believe, and, of course, moderation is the key to success with anything. Overindulgence can only be achieved if we allow it -- both in ourselves and in our children. As human beings, we are endowed with free will and the power to make good or bad choices. The prevailing trend of blaming external causes for our own bad habits is merely the result of decades of self-indulgence and self-absorption. At least in my own household, with a little time management and a lot of behavior modification, videogames do not seem to be taking over our minds, making us prone to violence at the drop of a hat. Quite the contrary: video gaming has offered a safe haven from a world of stimuli and another triumph against a society that would have us medicated and complacent.


1 "Violent Video Games Under Attack." Wired News.
2 The common acronym is AD/HD according to the Children and Adults with ADD organization (CHADD).
3 Ibid.
4 Anderson, Craig A. and Karen E. Dill. "Video Games and Aggressive Thoughts, Feelings, Behavior in the Laboratory and in Life." Journal of Personality and Social Psychology. American Psychological Association. Vol. 78 No. 4. pp 772-790. April 2000.
5 ""Disorders: ADD/ADHD". Accu-Cell 12/04/04.
6 Kwan, Gordon. "http://www.ocf.berkeley.edu /~issues/spring02/ADDplay.html>Play Attention! Can custom-made video games help kids with attention deficit disorder?" Berkeley Medical Journal Issues 2002. 16 Dec., 2004.
7 Game Industry News.