Nate is like a lot of kids who have ADHD. Time management and organization skills are a challenge. He has trouble focusing on humdrum tasks like homework, especially math. But when it comes to video games that are full of combat, its mission accomplished for Nate, a 17-year-old high school student in Cleveland, GA.
"He has no problem concentrating when he's playing a game," says Nate's mom, Christine, a 911 dispatcher. "I try to play with him, but I can't keep up with him. He's too good for me!" She wishes her son had the same ease with everyday activities that he has with the digital world. But then, video games are more exciting for kids with ADHD than for the average person.
It's a toxic loop: Kids with attention problems already are prone to being sucked into the action-packed world of video games, and that makes their attention problems worse. That doesn't mean video games cause ADHD, as some studies have suggested. In some cases, they might even be helpful.
"There's no evidence whatsoever that something like video games causes ADHD," says David Anderson, PhD, clinical psychologist with the Child Mind Institute. "But there definitely are some important connections we need to think about when it comes to video games and ADHD."
No Single Cause
Doctors aren't sure why people develop ADHD. But the number of people who are diagnosed with it keeps going up. Nate is part of the 11% of kids ages 4 through 17 who have been diagnosed with it. He's also part of the 84% of boys his age who play video games.
The appeal for a boy like Nate is obvious: The pace of play leaves little time for his mind to wander, and the reward is instant. It's so unlike the challenges of everyday life.
"A child with ADHD may be easily distracted or easily bored and have difficulty sustaining attention," Anderson says. "But video games are constructed differently." They require short bursts of attention and fast responses. But that doesn't do much good for the child when taken to excess.
Everything in Moderation
"Too much of anything isn't good for you," says Eugene Arnold, MD, child psychiatrist at Ohio State.
Video games take away the need for what Arnold calls, "effortful attention." According to Arnold, "the game controls what you pay attention to. But kids with ADHD need practice in controlling their attention." So, he stresses restraint. "There's nothing wrong with video games in moderation," Arnold says.
In his practice, he's actually using screen technology that looks a lot like a video game to see if kids with the disorder can increase their concentration. Test subjects control space ships on a screen using their brainwaves. When the mind wanders, the ships go off course. When there's concentration, the ships stay on course.
The experiment is designed to teach kids how to control their brain function. The goal is to reduce the need for medication, which, right now, more than half of all kids diagnosed with ADHD take.
"Practice makes perfect," says Arnold, who stresses that they're not just playing video games. "This is not entertainment," he says. "This is hard work for these kids, who are learning how to take charge of paying attention."
He calls it "brain exercise."
Be Clear With Your Kids
Even without an experiment like Arnold's, video games already are one of the few areas where kids with ADHD can exercise cognitive skills. Games demand that they pay attention, even for a short time. Players must focus in order to achieve the goals of the game. Along the way, there are consequences, both good and bad. This is a concept that works well within the game, and in the real world.
"Whatever the issue is, there are consequences for good and bad behavior. That's what I try to stress to parents," says Larry Rosen, MD, author and research psychologist. He says you must be clear with your kids about the rules when it comes to time spent on video games. "I tell them to negotiate with their kids, make the child part of all decisions on behavior and consequences," Rosen says. He suggests setting caps on the amount of time your child can play video games. "And there should be a break between games," he adds. "Something that doesn't require a screen."
Here's a good example for setting limits on game time for kids with ADHD:
- Preschoolers: Limited and supervised time only
- Elementary school: 1 to 1.5 hours a day, including television time
- Middle school: 1.5-2 hours a day, including TV and cell-phone time
- High school: 2 to 2.5 hours a day (negotiable, depending on academic needs)
Rosen says it's a good idea to be flexible. Reward good behavior in everyday life with some extra video game time.
But be careful and pay attention to how your child uses their game. "Where we get into trouble is when kids use games to replace other things that are important for emotional development," Anderson says.
The fact is, we live in a society that's increasingly using screens for everyday needs. So it's almost inevitable that a child with ADHD is going to spend some time in front of video technology, whether it's a game or a computer.
Even the American Academy of Pediatrics (AAP) is taking another look at its recommendations. Previously, it established well-known guidelines that prescribe (or discourage) screen time. AAP now recognizes that it must rethink its policies in order to keep up in an ever-more digital society.
There's no cookie-cutter solution to managing your child with ADHD and their love of video games. Ultimately, it comes down to what works best for your kid and you. In Nate's case, his video game time is limited to weekends. The rest of the week is supposed to be dedicated to schoolwork.
"He was diagnosed with ADHD when he was 6, years before he became interested in video games," says his mom, Christine. "So far, they haven't affected him in a negative way. But every kid is so different from the next."