1. Generalization of Game-BasedLearning for Children with ADHDRandy Kulman, Ph.D. randy@learningworksforkids.com @rkulmanLearningWorks for kids2012 APA Conventionwww.learningworksforkids.com www.apa.org/convention @lw4k@APAConvention

2. Presentation DisclosureRandy Kulman, Ph.D. commercial interests: President, Majority Stockholder, LearningWorks forKids, Inc. Cogmed Working Memory provider 3. Overview What do we know about children with ADHD andvideo games? Why use video games and digital media to helpchildren with ADHD? What are the characteristics of interventions proven towork with children with ADHD? Why do children with ADHD not become scholarsafter playing video games? What can we do to make video games a moreproductive 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 primaryADHD diagnosis based upon a fullneuropsychological evaluation) Survey asks parents to describe their ownmedia usage to see if it is correlated toattitudes regarding video games Also asks them to describe their concernsand hopes for benefits of video games andother digital media Digital media use of ADHD kids- Most timetelevision, video games, music (different fromwhat is seen in national studies of typicallydeveloping kids) 6. Children, parents, and video game playHow many hours a week does your child spendplaying video games?34% Less than 1 hour per32% 2-4 hours20% 5-7 hours13% 8+ hoursHow many hours per week do you spendobserving or interacting with your child when theyplay video games?23% no time46% less than 1 hour27% 1-5 hours4% 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. Why use video games and digital media tohelp children with ADHD? Video game play requires the use of executivefunctioning skills. Other skills such as organization and metacognitiveskills are required for success. Both simple and complex videogames regularly use skills suchas planning, cognitiveflexibility, self-control, and timemanagement. Many games specifically taxworking memory skills andattentional skills. 9. Why use video games and digitalmedia to help kids with ADHD?Kids with ADHD orVideo Games and Digital Media Attention DifficultiesMay become easily bored and Require ever-changing skills unable to sustain attention Employ video, sounds, words, and actions Multi-modalOften require immediate Provide clear and immediate feedbackreinforcement or consequence Constantly let player know what he is to stay focused on a task.doing wrong and rightOften require that their body or Extremely engaging mind to be actively engaged. Many require physical and cognitive involvement 10. Why use video games and digitalmedia to help kids with ADHD? Kids with ADHD or AttentionVideo Games and Digital MediaDifficulties Usually have problems with Teach by trial and error orfollowing directions.guided discoveryRequire that the player understand the instructions in order to succeed May struggle to learn newMost negative feed back frominformation and experience video games and other digitalfrustration or low self-esteem as amedia occurs privately.result. Causes less embarrassment and frustrationTeaches the player how to handle these emotions 11. What are the characteristics of interventions that work best with children With ADHD?Point of performance interventionsImmediacy of feedbackPowerful and engaging feedback and meaningful consequences Multimodal presentations andmultiple intervention agents Individualized to childscapacities Strategic teaching principlesincluding: previewing, settingexplicitgoals, partnering, metacognition,and generalization strategies 12. Why do children with ADHD not become scholars after playing video games? Existing games are generally not designed to promoteskills in children with ADHD. Existing games focus onother things, while usingimportant thinking skills. Metacognitive skills are notbuilt into existing videogames. Generalization and strategicteaching skills are not builtinto existing game. 13. Research on Executive/Thinking Skills and Video Games LWK pilot research on differentiatedinstruction, targeting areas of EF weakness withvideo games Combination of board and video games improvefluid reasoning and processing speed(Mackey, 2011) Working memory video games improve WM, fluidreasoning skills (Cogmed ) Intensity/duration Computer-based training improves executiveattention in preschoolers (Rueda, 2005) Video game like math and reading programsimproves learning, reduces attention symptoms Games (non video) that increase cognitive loadand used as a teaching tool by parents reduceADHD symptoms in Preschoolers(Halperin, 2012) 14. How well do game based skills transfer to the real world? Game play alone results in modestimprovements in real-world executiveskills Children with learning and attentionproblems have problems ingeneralizing strategies Kids like to talk about playing videogames and may be willing to learnfrom that Games prompt partnering andmotivation to learn executive skills Practice and rehearsal of executiveskills 15. BUTgames are not enough!!! The key to success is effectiveteaching or mediation (can be done inthe game) Teachers (includingpeers, parents, and imbeddedinstruction) make the connectionbetween game-based learning andreal-world skills Actual learning requires knowledge ofthe skill, understanding how and whento use it, and practice across manysituations 16. What can we do to make video games a moreproductive learning experience for children withADHD? 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 17. Play Together Talk before, during, and aftergameplay. Choose gameplay goalswith your child. Have fun playing the game with yourchild! Reflect on gameplay, emphasizing theuse of the targeted thinking oracademic skills. Direct your discussion to how thesesame skills are useful in dailyactivities. 18. Make it Work Explain the benefits of digitalplay, and introduce the skills beingexercised in the game. Encourage non-digital activities thatuse the same skills. Regularly connect game-basedskills to things your child isstruggling with in the real-world. Try different games and skills 19. Executive Skills Questionnaire 20. Prescription ofGames, Technologies, and Recommendations 21. Gardens of Time: Video PlayBook 22. Thank You!Randy Kulman, Ph.D. randy@learningworksforkids.com @rkulmanLearningWorks for kids2012 APA Conventionwww.learningworksforkids.com www.apa.org/convention @lw4k@APAConvention