The FDA just approved the first prescription video game for ADHD
June 17, 2020 12:18 PM Subscribe
After seven years of clinical trials, the United States FDA has approved the EndeavorRX mobile video game as a prescription-only neurofeedback alternative therapeutic treatment for children (ages 8-12) diagnosed with ADHD. But is neurofeedback therapy a reliable alternative method for treating ADHD?
The FDA just approved the first prescription video game — it’s for kids with ADHD
2014: "This video game might be the future of ADHD and Alzheimer's treatment"
2017: "Prescription Video Games May Be The Future of Medicine"
Therapists are using neurofeedback to treat ADHD, PTSD and other conditions
Here's what EndeavorRX claims in their Privacy Policy.
Spain and Singapore, respectively, are also in the development phase for two similar mobile apps.
The FDA just approved the first prescription video game — it’s for kids with ADHD
According to [video game developer Akili Interactive]'s favorite of the five studies, the answer is yes: one-third of kids treated “no longer had a measurable attention deficit on at least one measure of objective attention” after playing the obstacle-dodging, target-collecting game for 25 minutes a day, five days a week for four weeks.Previous coverage of EndeavorRX (aka ProjectEVO) in The Verge:
“Improvements in ADHD impairments following a month of treatment with EndeavorRx were maintained for up to a month,” the company cites, with the most common side effects being frustration and headache — seemingly mild compared to traditional drugs, as you’d hope from so-called virtual medicine.
That said, we are talking about a study by doctors who work for the game’s developer, according to disclosures at the bottom of the study, and even their conclusion is that the results “are not sufficient to suggest that AKL-T01 should be used as an alternative to established and recommended treatments for ADHD.
[The Verge]
2014: "This video game might be the future of ADHD and Alzheimer's treatment"
2017: "Prescription Video Games May Be The Future of Medicine"
Therapists are using neurofeedback to treat ADHD, PTSD and other conditions
Neurofeedback, which is also used for post-traumatic stress disorder and attention-deficit hyperactivity disorder, has been around since the 1960s. Some research has found it promising. Other studies have been inconclusive, and some have shown no positive outcomes.Concerned about what this means for patient privacy and the collection of user data from apps alleging to treat mental health?
The most solid data concern ADHD, especially a recent trial involving 104 children published in March in the Journal of Pediatrics. Those who received neurofeedback had improvements in attention and impulse control, while those who did not receive the therapy did not. These improvements persisted after six months. The authors concluded that neurofeedback may be a “promising attention training treatment for children with ADHD.”
...Deborah Stokes, an Alexandria psychologist, compares neurofeedback to riding a bike: It’s non-conscious learning, based on the feedback, that, with repetition, can be long-lasting, she said.
“We don’t know exactly how neurofeedback works,” she said. “It’s a process where if clients get out of their own way, they relax. Over time, they get the desired brain pattern, feel calm and function better. This encourages them to stay with it.” Her team sees 30 patients a week.
...Silver Spring psychologist Robb Mapou is among the skeptics.
“I have not seen enough well-controlled, rigorous studies in most conditions for which it is recommended to show, definitively, that neurofeedback is effective. I also think there are other therapeutic factors that can contribute to an individual’s outcome, such as discussing their problems with a therapist.”
Michelle Harris-Love, a neuroscience researcher at the MedStar National Rehabilitation Network in Washington, agrees.
“I believe it is applied in some situations where we do not have enough information on the cause of a disorder or how recovery happens,” she said.
But Rex Cannon, past president of the International Society for Neurofeedback and Research, based in McLean, Va., cited nearly 200 peer-reviewed published articles that indicate neurofeedback’s effectiveness. This includes a meta-analysis of 10 studies on epilepsy patients: Although they had not responded to medications, they had a significant reduction in seizures after neurofeedback treatment. And a study on migraine patients reported, “Neurofeedback appears to be dramatically effective in abolishing or significantly reducing migraine frequency in the great majority of patients.”
[PW: WaPo]
Here's what EndeavorRX claims in their Privacy Policy.
Spain and Singapore, respectively, are also in the development phase for two similar mobile apps.
This is super cool, and I absolutely have high hopes for the future of this kind of tech, but...
As a "gamer" this looks like they hired the lowest bidder to actually make the game itself. It's a game where you dodge obstacles and pick up specific colored "fish," which strikes me as neither very engaging nor able to keep my attention for very long.
But I don't have ADHD so maybe what I think is "engaging" doesn't matter. *shrugs
posted by deadaluspark at 12:23 PM on June 17, 2020 [1 favorite]
As a "gamer" this looks like they hired the lowest bidder to actually make the game itself. It's a game where you dodge obstacles and pick up specific colored "fish," which strikes me as neither very engaging nor able to keep my attention for very long.
But I don't have ADHD so maybe what I think is "engaging" doesn't matter. *shrugs
posted by deadaluspark at 12:23 PM on June 17, 2020 [1 favorite]
One additional concern I have about this "app as neurofeedback therapy" issue is whether or not it solves what is perhaps the biggest barrier to even accessing neurofeedback: cost. Most neurofeedback treatments for ADHD (in an office, with a medical practitioner) require upwards of 30 sessions with a patient; each of those sessions may cost upwards of $200. Health insurance in the U.S. may or may not cover it.
I could not yet find any information on the price of EndeavorRX and whether or not U.S. health insurance companeis are covering the cost. Is it subscription based? Is it a one-time purchase? How do the costs compare to clinician-setting neurofeedback treatment?
posted by nightrecordings at 12:23 PM on June 17, 2020 [4 favorites]
I could not yet find any information on the price of EndeavorRX and whether or not U.S. health insurance companeis are covering the cost. Is it subscription based? Is it a one-time purchase? How do the costs compare to clinician-setting neurofeedback treatment?
posted by nightrecordings at 12:23 PM on June 17, 2020 [4 favorites]
My biggest fear is that the puritanical side will seize on this to take other drug based solutions like Adderall and Vynase away from mental health patients that use them quite successfully. Schedule II medications are already a giant pain in the ass.
IAWTC from a personal standpoint, as someone with ADHD who has seen their own executive functioning and lifestyle benefit greatly from access to Vyvanse, but I'm not sure which puritanical boogie man we should be worried about. ADHD medication-skeptical psychiatrists? Health insurance companies? Lobbyists for the companies developing these neurofeedback tools? Perhaps all of them.
At the same time, pharmaceutical companies still have a great deal of lobbying power and investment capital, and I doubt they want to be shoved aside in favor of neurofeedback video game mobile applications. Just saying. That doesn't mean Big Pharma companies are good. The enemy of my enemy is not my friend.
posted by nightrecordings at 12:28 PM on June 17, 2020 [4 favorites]
IAWTC from a personal standpoint, as someone with ADHD who has seen their own executive functioning and lifestyle benefit greatly from access to Vyvanse, but I'm not sure which puritanical boogie man we should be worried about. ADHD medication-skeptical psychiatrists? Health insurance companies? Lobbyists for the companies developing these neurofeedback tools? Perhaps all of them.
At the same time, pharmaceutical companies still have a great deal of lobbying power and investment capital, and I doubt they want to be shoved aside in favor of neurofeedback video game mobile applications. Just saying. That doesn't mean Big Pharma companies are good. The enemy of my enemy is not my friend.
posted by nightrecordings at 12:28 PM on June 17, 2020 [4 favorites]
As a "gamer" this looks like they hired the lowest bidder to actually make the game itself. It's a game where you dodge obstacles and pick up specific colored "fish," which strikes me as neither very engaging nor able to keep my attention for very long.
IIRC this is sort of the whole point. I have ADHD, and lots of video games are tailored to reward that in various ways. But that's not the goal here. It's not meant to force engagement, it's meant to notice when you're not engaged and then do something that requires you to re-engage (the example I've seen IRL had the user controlling an airplane flying through the sky, which would dip when you lost focus). Over time this is meant to train your brain to re-engage with tasks in real life, even when your brain doesn't want to.
posted by showbiz_liz at 12:29 PM on June 17, 2020 [13 favorites]
IIRC this is sort of the whole point. I have ADHD, and lots of video games are tailored to reward that in various ways. But that's not the goal here. It's not meant to force engagement, it's meant to notice when you're not engaged and then do something that requires you to re-engage (the example I've seen IRL had the user controlling an airplane flying through the sky, which would dip when you lost focus). Over time this is meant to train your brain to re-engage with tasks in real life, even when your brain doesn't want to.
posted by showbiz_liz at 12:29 PM on June 17, 2020 [13 favorites]
To be clear, EndeavorRX is striking in its similarities to once popular "brain games" apps like Lumosity. Yeah, remember Lumosity? Both Lumosity and EndeavorRX are based on neurofeedback techniques. Both based their alleged effectiveness on studies financed by the app-creators themselves (paywalled Fortune Magazine article, apologies). Here's a similar article in the Chicago Tribune.
posted by nightrecordings at 12:34 PM on June 17, 2020 [4 favorites]
posted by nightrecordings at 12:34 PM on June 17, 2020 [4 favorites]
Here's another from Wired: Brain training apps don't really work. So why do we love them?
posted by nightrecordings at 12:36 PM on June 17, 2020 [4 favorites]
posted by nightrecordings at 12:36 PM on June 17, 2020 [4 favorites]
ADHD medication-skeptical psychiatrists? Health insurance companies? Lobbyists for the companies developing these neurofeedback tools?
Honestly my fear is some anti-psych Republican lobbied by pharma companies to have generic amphetamine salts moved to Schedule I under the guise of "we have apps for that now we don't need these drugs in our community."
They slightly change the Adderall XR formulation to make sure they have a patent on it and generic lisdexamfetamine gets the same treatment in 2023.
posted by Your Childhood Pet Rock at 12:46 PM on June 17, 2020 [3 favorites]
Honestly my fear is some anti-psych Republican lobbied by pharma companies to have generic amphetamine salts moved to Schedule I under the guise of "we have apps for that now we don't need these drugs in our community."
They slightly change the Adderall XR formulation to make sure they have a patent on it and generic lisdexamfetamine gets the same treatment in 2023.
posted by Your Childhood Pet Rock at 12:46 PM on June 17, 2020 [3 favorites]
I'm going to respond to one last comment and then step away from this post for a while so that I don't continue to suck up all of the oxygen in the room.
As a "gamer" this looks like they hired the lowest bidder to actually make the game itself. It's a game where you dodge obstacles and pick up specific colored "fish," which strikes me as neither very engaging nor able to keep my attention for very long.
But I don't have ADHD so maybe what I think is "engaging" doesn't matter.
While I am still skeptical (skeptical but open, mind you) to neurofeedback as a therapy for ADHD, please be mindful that this is an app for children. Neurodivergent children. I don't think it is helpful, nor kind, to mock the apparent mechanics of a tool that may have the potential to help neurodivergent children achieve certain skills and therapeutic goals. I understand that you're pointing your criticism at the game manufacturer and that you mean well, but for a moment, let's just posit that the game could actually work. In this hypothetical world where the game with dodging and picking up different colored fish actually helps neurodivergent children achieve executive functioning and other goals, thus improving their symptoms and making their life better, it sounds cruel to mock the game's apparent sophistication when one is neither a person with ADHD nor a person - as far as I know - trained in ADHD clinical treatment. The game's "game appeal", broadly, is of less concern here than its effectiveness as a tool for treating children's ADHD.
It's neurofeedback therapy repackaged as a game. It's prescription-only. It's not for neurotypical gamers. You are not the target audience. Kids with ADHD are the target audience.
I'll also reiterate one last time: I understand that this may not have been your intention, but it's the impact that it had. Even as an adult with ADHD, I felt hurt (and honestly felt hurt on behalf of kids struggling with ADHD) to hear the game dismissed based on the appearance of its mechanics in the eyes of a neurotypical or at least not-ADHD diagnosed person.
posted by nightrecordings at 12:51 PM on June 17, 2020 [17 favorites]
As a "gamer" this looks like they hired the lowest bidder to actually make the game itself. It's a game where you dodge obstacles and pick up specific colored "fish," which strikes me as neither very engaging nor able to keep my attention for very long.
But I don't have ADHD so maybe what I think is "engaging" doesn't matter.
While I am still skeptical (skeptical but open, mind you) to neurofeedback as a therapy for ADHD, please be mindful that this is an app for children. Neurodivergent children. I don't think it is helpful, nor kind, to mock the apparent mechanics of a tool that may have the potential to help neurodivergent children achieve certain skills and therapeutic goals. I understand that you're pointing your criticism at the game manufacturer and that you mean well, but for a moment, let's just posit that the game could actually work. In this hypothetical world where the game with dodging and picking up different colored fish actually helps neurodivergent children achieve executive functioning and other goals, thus improving their symptoms and making their life better, it sounds cruel to mock the game's apparent sophistication when one is neither a person with ADHD nor a person - as far as I know - trained in ADHD clinical treatment. The game's "game appeal", broadly, is of less concern here than its effectiveness as a tool for treating children's ADHD.
It's neurofeedback therapy repackaged as a game. It's prescription-only. It's not for neurotypical gamers. You are not the target audience. Kids with ADHD are the target audience.
I'll also reiterate one last time: I understand that this may not have been your intention, but it's the impact that it had. Even as an adult with ADHD, I felt hurt (and honestly felt hurt on behalf of kids struggling with ADHD) to hear the game dismissed based on the appearance of its mechanics in the eyes of a neurotypical or at least not-ADHD diagnosed person.
posted by nightrecordings at 12:51 PM on June 17, 2020 [17 favorites]
Can someone please give me an honest, non-snarky reason why this is prescription-only? Are there any potential ill effects if played by a neuro-typical person? If not, then why not make it broadly available, with potential cost-offsets by insurance companies if a child is so diagnosed?
posted by Silvery Fish at 1:03 PM on June 17, 2020 [2 favorites]
posted by Silvery Fish at 1:03 PM on June 17, 2020 [2 favorites]
Can someone please give me an honest, non-snarky reason why this is prescription-only? Are there any potential ill effects if played by a neuro-typical person?
Because this isn't targeting gamers, its' targeting children who are neurodivergent.
As Nightrecordings put it so well up above:
posted by Fizz at 1:22 PM on June 17, 2020 [4 favorites]
Because this isn't targeting gamers, its' targeting children who are neurodivergent.
As Nightrecordings put it so well up above:
The game's "game appeal", broadly, is of less concern here than its effectiveness as a tool for treating children's ADHD.Some things are just not for certain people and that's ok, this includes gamers at large. This is a medical tool to help certain individuals at very specific things related to their health.
posted by Fizz at 1:22 PM on June 17, 2020 [4 favorites]
Therapeutic games often look boring AF to gamers. This is because the repetition, metrics and outcomes are the key points, not any playability or world creation. The vendors certainly can't claim that "playing this game 30 minutes a day will give your kid the attention span of an oyster".
I'm on team amphetamines for better living for life, but any other useful therapies are good.
posted by scruss at 1:38 PM on June 17, 2020 [1 favorite]
I'm on team amphetamines for better living for life, but any other useful therapies are good.
posted by scruss at 1:38 PM on June 17, 2020 [1 favorite]
Fizz - with absolute respect to you - I am not convinced it is a ‘medical tool’ just because the manufacturer says it is. Is it like a catheter or x-ray machine, that can cause infection or damage if not used by a trained professional? Is it like crutches or a splint - both medical tools that can be used safely by most people? Is it like Flonase, that was a (prescription only) medical tool until the patent was up and then it wasn’t? Even some generally available tv shows and games have epilepsy warnings for flashing lights and still do not require a prescription to view. I honestly cannot think of any reason besides money that a video game would require a prescription. Usually, prescriptions are issued because of potential harmful side effects if personal health history and current medications profile are not considered: that is, a person could cause damage to themself if the product is not used according to clearly defined guidelines. I am not seeing that here.
posted by Silvery Fish at 1:43 PM on June 17, 2020 [9 favorites]
posted by Silvery Fish at 1:43 PM on June 17, 2020 [9 favorites]
As a game developer (albeit on outside of this space), it may be prescription-only because the game is not designed to compete with mainstream games on their terms: if they're all-in on some specific kind of play, it may well be incompatible with many of the tricks we use lure you in and keep you playing. It may be that it's really designed to be a tool, not a "game" in the sense that Fornite is a "game."
If it's out there on Steam and gets trashed because it's a "boring game," it'll be a harder sell to kids and parents who may benefit from it. If you doctor recommended something that had a 1-star rating and a bunch of negative reviews, would you really push your kid to try it?
Also, by making it prescription, you can ensure the kids have been coached about the proper way to play (or at least, the doctor had an opportunity to do so).
Speculative analogy: imagine if iPhone games were all also available on Steam. Most would get bad reviews, and rightly so, because on PC they would deliver a bad experience.
As for the graphics: yeah, it doesn't sound like their focus was graphics. Graphics (and good aesthetics) are *expensive*. That doesn't necessarily mean this was a "lowest bidder" situation (though it very well could be).
I've only seen the trailer, but I'd be interested to try it.
posted by ®@ at 1:46 PM on June 17, 2020 [7 favorites]
If it's out there on Steam and gets trashed because it's a "boring game," it'll be a harder sell to kids and parents who may benefit from it. If you doctor recommended something that had a 1-star rating and a bunch of negative reviews, would you really push your kid to try it?
Also, by making it prescription, you can ensure the kids have been coached about the proper way to play (or at least, the doctor had an opportunity to do so).
Speculative analogy: imagine if iPhone games were all also available on Steam. Most would get bad reviews, and rightly so, because on PC they would deliver a bad experience.
As for the graphics: yeah, it doesn't sound like their focus was graphics. Graphics (and good aesthetics) are *expensive*. That doesn't necessarily mean this was a "lowest bidder" situation (though it very well could be).
I've only seen the trailer, but I'd be interested to try it.
posted by ®@ at 1:46 PM on June 17, 2020 [7 favorites]
Do they ever require a prescription just to ensure that you've consulted with a doctor who would have the chance to recommend more suitable treatment?
Like, are they just worried if they market it for children with ADHD, parents will use it instead of seeing a doctor, who might have recommended medication or something instead or in addition to this?
posted by RobotHero at 1:48 PM on June 17, 2020 [1 favorite]
Like, are they just worried if they market it for children with ADHD, parents will use it instead of seeing a doctor, who might have recommended medication or something instead or in addition to this?
posted by RobotHero at 1:48 PM on June 17, 2020 [1 favorite]
It is prescription only because it is a form of ADHD therapeutic treatment called neurofeedback, which is a specific subset of biofeedback medical treatment. These treatments are inappropriate when not administered under the care of a licensed physician or therapist. (Especially since neurofeedback is still a contested form of therapy.) I'm not sure I understand the overstated concern here with being able to play it without a prescription? Do gamers not like being told "No, sorry, you can't play this one"?
All of this - about the fact that it's neurofeedback packaged in the format of a "game", to make it perhaps more attractive and fun for the neurodivergent kids who will be using it, among other reasons - was already stated in the post; it's also stated in several comments upthread.
Neurotypical folks: this is a great example of a thread to comment less, read more. If you have that many questions, those of us who have the spoons to reply to you may reply, but Google is your friend. Please don't ask us to keep doing the emotional labor of researching and explaining it for you. We will do that if and when we want to and have the spoons/energy for it.
There are too many other fascinating points to discuss here: the cost prohibitive nature of neurofeedback treatment, whether or not neurofeedback is a useful therapeutic tool, data/privacy concerns with patient health information and how these companies intend to use it. It would be a shame for the comments to derail into explaining to non-ADHD folks why this ADHD-therapeutic-treatment-in-the-form-of-a-game is prescription only.
Thanks,
a Mefite with ADHD
posted by nightrecordings at 1:58 PM on June 17, 2020 [23 favorites]
All of this - about the fact that it's neurofeedback packaged in the format of a "game", to make it perhaps more attractive and fun for the neurodivergent kids who will be using it, among other reasons - was already stated in the post; it's also stated in several comments upthread.
Neurotypical folks: this is a great example of a thread to comment less, read more. If you have that many questions, those of us who have the spoons to reply to you may reply, but Google is your friend. Please don't ask us to keep doing the emotional labor of researching and explaining it for you. We will do that if and when we want to and have the spoons/energy for it.
There are too many other fascinating points to discuss here: the cost prohibitive nature of neurofeedback treatment, whether or not neurofeedback is a useful therapeutic tool, data/privacy concerns with patient health information and how these companies intend to use it. It would be a shame for the comments to derail into explaining to non-ADHD folks why this ADHD-therapeutic-treatment-in-the-form-of-a-game is prescription only.
Thanks,
a Mefite with ADHD
posted by nightrecordings at 1:58 PM on June 17, 2020 [23 favorites]
Mod note: Couple of comments deleted. This is a new kind of product, so it's understandable that people have questions, but at the same time, please don't ask them in an insistent this-must-be-a-scam way, since that can land for some readers as being skeptical about the need for treatments. Thanks.
posted by LobsterMitten (staff) at 2:03 PM on June 17, 2020 [8 favorites]
posted by LobsterMitten (staff) at 2:03 PM on June 17, 2020 [8 favorites]
Y'all... those are actually amazing graphics for a therapeutic intervention. Like, I was expecting something really bad from these comments. Those graphics are fine. It's not AAA quality but it's there's plenty of small indie games that look like that (and plenty of bigger games--Star Stable, which was posted about previously, doesn't look much better). Trust me, I have seen much, much worse graphics for therapeutic intervention.
Because... yeah, the graphics aren't the point. Why spend your money on graphics when you can spend it on making sure the mechanics--the part actually delivering therapeutic intervention--are as flawless and effective as possible? The games that engage people with ADHD aren't the ones that are the most visually interesting. It's the ones in which do a thing --> immediate reward. So even if the point were to keep kids engaged, that wouldn't be where I'd put my money. I know a lot of people with ADHD that play games with shitty, shitty graphics, because the mechanics have hit that action --> reward sweet spot so well. I mean, case in point, my partner has ADHD and since Bella Donna posted that Star Stable article, they've been playing nonstop. Despite the graphics looking like... this. Kids with ADHD are not you and what you're looking for in a game is 1) not what the therapeutic intervention is about, and 2) likely not even what they're looking for in a game anyway.
Also, the point of approving it for prescription is so that insurance will cover it. Is there anything suggesting it will be prescription only? Because you can get a prescription for compression stockings, but that doesn't stop people from buying it without a prescription. They just have to pay full price.
THAT SAID. I looked at the study itself and I'm a little skeptical. For context, I've given the TOVA (although, I will admit I have probably more often failed to give the TOVA because kids with attention issues absolutely hate it, for good reason). The range on the TOVA Attention Performance Index is -10 to 10, with negative meaning more ADHD-like and positive meaning more normative. A mean change of 0.93 is... not a lot. There's unfortunately a difference between statistical significance and clinical significance, and that's made clear in the fact that none of the rating scales suggest any improvements--if there was a change, it wasn't noticeable by anyone around the kids (I personally would have added in a self report measure to see if kids noticed changes in themselves, though 9 is a little young to get super valid introspective info). So, while it may have had some effect, is it going to significantly improve kid's lives? Not necessarily.
However, this research area is new, there's lots to be tweaked, and maybe it would be more effective over time (kids played for 25 minutes a day, 5 days per week, for 4 weeks, which isn't actually that much time). I think it's definitely promising, and insurance covering it means more kids can try and it and more research can be done. Whether or not this particular intervention is effective, I'm excited to see us exploring these options. Medication is great and should still be the frontline treatment, but many people don't tolerate it, and even those that do don't get as much benefit as they need. So having other options is good too.
posted by brook horse at 2:56 PM on June 17, 2020 [12 favorites]
Because... yeah, the graphics aren't the point. Why spend your money on graphics when you can spend it on making sure the mechanics--the part actually delivering therapeutic intervention--are as flawless and effective as possible? The games that engage people with ADHD aren't the ones that are the most visually interesting. It's the ones in which do a thing --> immediate reward. So even if the point were to keep kids engaged, that wouldn't be where I'd put my money. I know a lot of people with ADHD that play games with shitty, shitty graphics, because the mechanics have hit that action --> reward sweet spot so well. I mean, case in point, my partner has ADHD and since Bella Donna posted that Star Stable article, they've been playing nonstop. Despite the graphics looking like... this. Kids with ADHD are not you and what you're looking for in a game is 1) not what the therapeutic intervention is about, and 2) likely not even what they're looking for in a game anyway.
Also, the point of approving it for prescription is so that insurance will cover it. Is there anything suggesting it will be prescription only? Because you can get a prescription for compression stockings, but that doesn't stop people from buying it without a prescription. They just have to pay full price.
THAT SAID. I looked at the study itself and I'm a little skeptical. For context, I've given the TOVA (although, I will admit I have probably more often failed to give the TOVA because kids with attention issues absolutely hate it, for good reason). The range on the TOVA Attention Performance Index is -10 to 10, with negative meaning more ADHD-like and positive meaning more normative. A mean change of 0.93 is... not a lot. There's unfortunately a difference between statistical significance and clinical significance, and that's made clear in the fact that none of the rating scales suggest any improvements--if there was a change, it wasn't noticeable by anyone around the kids (I personally would have added in a self report measure to see if kids noticed changes in themselves, though 9 is a little young to get super valid introspective info). So, while it may have had some effect, is it going to significantly improve kid's lives? Not necessarily.
However, this research area is new, there's lots to be tweaked, and maybe it would be more effective over time (kids played for 25 minutes a day, 5 days per week, for 4 weeks, which isn't actually that much time). I think it's definitely promising, and insurance covering it means more kids can try and it and more research can be done. Whether or not this particular intervention is effective, I'm excited to see us exploring these options. Medication is great and should still be the frontline treatment, but many people don't tolerate it, and even those that do don't get as much benefit as they need. So having other options is good too.
posted by brook horse at 2:56 PM on June 17, 2020 [12 favorites]
This is cool.
I had a short-lived experience with biofeedback in 2008(I think?) when I was just a bit older than that target age group. I wish I could have continued that treatment. I think it was called Brainmaster?
The graphics were terrible. I didn't care. The "game" I remember most was something like "keep this little thing about half-way full." With your brain. No controls, just electrodes on my scalp. It wasn't enjoyable like a game. It was challenging and frustrating and it made me feel like I could improve the way my brain works without the terrible come-down from Concerta or losing my appetite or feeling like a zombie.
It looked more like a bar graph than anything else and it was definitely more medication than game.
Anyway, I'm really excited about neurofeedback and I hope it becomes an option for me (and others) again, hopefully with more conclusive research behind it.
Thanks for posting this, nightrecordings. I wouldn't have seen it otherwise.
posted by meemzi at 3:07 PM on June 17, 2020 [8 favorites]
I had a short-lived experience with biofeedback in 2008(I think?) when I was just a bit older than that target age group. I wish I could have continued that treatment. I think it was called Brainmaster?
The graphics were terrible. I didn't care. The "game" I remember most was something like "keep this little thing about half-way full." With your brain. No controls, just electrodes on my scalp. It wasn't enjoyable like a game. It was challenging and frustrating and it made me feel like I could improve the way my brain works without the terrible come-down from Concerta or losing my appetite or feeling like a zombie.
It looked more like a bar graph than anything else and it was definitely more medication than game.
Anyway, I'm really excited about neurofeedback and I hope it becomes an option for me (and others) again, hopefully with more conclusive research behind it.
Thanks for posting this, nightrecordings. I wouldn't have seen it otherwise.
posted by meemzi at 3:07 PM on June 17, 2020 [8 favorites]
Usually, prescriptions are issued because of potential harmful side effects if personal health history and current medications profile are not considered: that is, a person could cause damage to themself if the product is not used according to clearly defined guidelines. I am not seeing that here.
One thing that many people with ADHD have a tendency to do is excessively focus on things that stop our brains telling us that we're definitely in the wrong place, doing the wrong thing and should immediately start doing something else, up to and beyond the point that they don't work effectively anymore, or where they actively start causing harm. Hyperfocus is a real thing, and it isn't necessarily the wonderful "flow" state that people image. More often, for me, it results in a complete inability to understand where the hell an entire day went while I was obsessively fussing at something I didn't enjoy anyway.
One reason it may be prescription only, I would suggest, is because not all brains are alike, and what may be fine for most neurotypical people to pick up and play without medical supervision may risk harm to those of us whose brains don't work like that.
posted by howfar at 3:07 PM on June 17, 2020 [12 favorites]
One thing that many people with ADHD have a tendency to do is excessively focus on things that stop our brains telling us that we're definitely in the wrong place, doing the wrong thing and should immediately start doing something else, up to and beyond the point that they don't work effectively anymore, or where they actively start causing harm. Hyperfocus is a real thing, and it isn't necessarily the wonderful "flow" state that people image. More often, for me, it results in a complete inability to understand where the hell an entire day went while I was obsessively fussing at something I didn't enjoy anyway.
One reason it may be prescription only, I would suggest, is because not all brains are alike, and what may be fine for most neurotypical people to pick up and play without medical supervision may risk harm to those of us whose brains don't work like that.
posted by howfar at 3:07 PM on June 17, 2020 [12 favorites]
I recall reading a study that showed music lessons were similarly successful in teaching concentration and patience to children with add and adhd. This seems to be a similar type of concentrated skill-building practice.
posted by ShakeyJake at 3:07 PM on June 17, 2020
posted by ShakeyJake at 3:07 PM on June 17, 2020
What I'm not clear on is how, exactly, this involves neurofeedback. Where's the feedback coming from? The form of neurofeedback I'm familiar with involves sensors that track your brain waves, whereas I read through the FAQ for this game and didn't see anything about sensors at all. Maybe it uses some sort of eye-tracking tech?
I first heard of this whole concept in the early 2000s because a school friend's mom had a biofeedback clinic. She definitely had a video game system in her office which, from what I could tell, was "played" hands-free, with the goal being to achieve and maintain a particular brainwave pattern. Essentially the vibe I got was "tech-assisted meditation training." Two of her biggest client bases were kids with ADHD and adults with insomnia.
So since biofeedback video games meant to train kids with ADHD existed 20 years ago, my question is, what's new about this specific game? The answer may be "not much, but they played the FDA game right." Or it may be "something valid, but we don't want to blow our patent by telling you."
posted by showbiz_liz at 3:08 PM on June 17, 2020 [3 favorites]
I first heard of this whole concept in the early 2000s because a school friend's mom had a biofeedback clinic. She definitely had a video game system in her office which, from what I could tell, was "played" hands-free, with the goal being to achieve and maintain a particular brainwave pattern. Essentially the vibe I got was "tech-assisted meditation training." Two of her biggest client bases were kids with ADHD and adults with insomnia.
So since biofeedback video games meant to train kids with ADHD existed 20 years ago, my question is, what's new about this specific game? The answer may be "not much, but they played the FDA game right." Or it may be "something valid, but we don't want to blow our patent by telling you."
posted by showbiz_liz at 3:08 PM on June 17, 2020 [3 favorites]
The graphics were terrible. I didn't care. The "game" I remember most was something like "keep this little thing about half-way full." With your brain. No controls, just electrodes on my scalp. It wasn't enjoyable like a game. It was challenging and frustrating and it made me feel like I could improve the way my brain works without the terrible come-down from Concerta or losing my appetite or feeling like a zombie.
It looked more like a bar graph than anything else and it was definitely more medication than game.
I experienced that too--mine was a little yellow bar on a graph and I was asked to think the bar down using the EEG electrodes on my scalp. I haaaaaated it, but it was also really helpful for me and my executive function, too. Like physical therapy more than medication, really.
I'm also very curious about where the neurofeedback aspect of this game is. Is it a game designed to help practice focusing even when bored, or does it come with some sort of EEG-like peripheral?
posted by sciatrix at 3:37 PM on June 17, 2020 [2 favorites]
It looked more like a bar graph than anything else and it was definitely more medication than game.
I experienced that too--mine was a little yellow bar on a graph and I was asked to think the bar down using the EEG electrodes on my scalp. I haaaaaated it, but it was also really helpful for me and my executive function, too. Like physical therapy more than medication, really.
I'm also very curious about where the neurofeedback aspect of this game is. Is it a game designed to help practice focusing even when bored, or does it come with some sort of EEG-like peripheral?
posted by sciatrix at 3:37 PM on June 17, 2020 [2 favorites]
I can't see the WaPo article, but I don't actually see the term neurofeedback in any of the other articles or on EndeavorRx's website. While this was developed by a neuroscience lab and provides feedback (in the form of scores) I don't think it actually provides what we traditionally call neurofeedback. I think it's just a digital intervention. That doesn't make it less interesting, though, IMHO.
Also, full disclosure, clinicians use a lot of techniques before they research has fully validated them. It's not actually always research --> application. Often, clinicians notice something seems to work, try it out, see improvements (in their clinical judgement), and researchers go, "Huh, we should check that out." Research is, unfortunately, often pretty slow, and clinicians often know/utilize things decades before research catches up to it (see: sensory processing as a symptom of autism). Particularly for things that require a lot of equipment, getting funding for a large enough sample to conduct a randomized controlled trial is... hard, to put it mildly. It took seven years of clinical trials for this program. And you're not going to get that funding without other, smaller studies coming first to prove to your funding sources this is a viable path of interest. So, putting aside this not actually being biofeedback--I'm not surprised that techniques clinicians were using 20 years ago are just now being approved by the FDA.
posted by brook horse at 3:52 PM on June 17, 2020 [6 favorites]
Also, full disclosure, clinicians use a lot of techniques before they research has fully validated them. It's not actually always research --> application. Often, clinicians notice something seems to work, try it out, see improvements (in their clinical judgement), and researchers go, "Huh, we should check that out." Research is, unfortunately, often pretty slow, and clinicians often know/utilize things decades before research catches up to it (see: sensory processing as a symptom of autism). Particularly for things that require a lot of equipment, getting funding for a large enough sample to conduct a randomized controlled trial is... hard, to put it mildly. It took seven years of clinical trials for this program. And you're not going to get that funding without other, smaller studies coming first to prove to your funding sources this is a viable path of interest. So, putting aside this not actually being biofeedback--I'm not surprised that techniques clinicians were using 20 years ago are just now being approved by the FDA.
posted by brook horse at 3:52 PM on June 17, 2020 [6 favorites]
I did a lot of training some years back to become a neurofeedback provider (I'm a psychologist, psychotherapist) but I never got "good enough" to actually practice neurofeedback. This was because: I never got reliable signals on my machines (too much "noise," often, probably from not being too great at attaching the electrodes to the scalp); and, mostly, I just didn't Believe enough to follow through (and with this stuff, you gotta believe, because there are so few controlled studies). The field was very hard to attach oneself to because there are mostly True Believers who get involved with it.
As for this game: as other posters have pointed out, this isn't really neurofeedback, as I know it, because in neurofeedback, you train your brain waves to "do the work." This is why it's "no hands." You're not looking to train your hands! even as mediators of what your brain wants to do. In the neurofeedback I know, there is no or little *conscious* effort to make something happen. Your brain just kind of learns how to make it happen ("it" = raising a bar on a screen or something -- whatever you have told the machine to correlate with raising that bar -- for ADHD, it's usually raising beta waves (I think; now I can't remember; I seem to remember that a lot of the ADHD kids also had high theta --i.e. were in a kind of cloudy state -- honestly this is so basic but -- my poor memory --- I guess I need neurofeedback).
But all that aside (maybe this game IS some form of neurofeedback, more broadly defined) -- what are the controls? Did they give a group of ADHD kids some NON-"prescription" game for the same time period to see if their test scores changed similarly? Because ADHD kids CAN focus -- just not on what you want them to focus on, for the time period that you want them to focus. A psychiatrisI knew defined ADHD as "the inability to pay attention to things that you don't want to pay attention to." So then we would have to see if the gains in this study transferred to e.g, schoolwork. There is problem when ANY game-like activity is used to "treat" ADHD. Kids like games, even if they're not their favorite games. But they don't necessarily "like" sitting still in a classroom, listening to a teacher, or doing their homework.
So -- all this is said by somebody who has not read any of the research involved with this game.
posted by DMelanogaster at 4:21 PM on June 17, 2020 [2 favorites]
As for this game: as other posters have pointed out, this isn't really neurofeedback, as I know it, because in neurofeedback, you train your brain waves to "do the work." This is why it's "no hands." You're not looking to train your hands! even as mediators of what your brain wants to do. In the neurofeedback I know, there is no or little *conscious* effort to make something happen. Your brain just kind of learns how to make it happen ("it" = raising a bar on a screen or something -- whatever you have told the machine to correlate with raising that bar -- for ADHD, it's usually raising beta waves (I think; now I can't remember; I seem to remember that a lot of the ADHD kids also had high theta --i.e. were in a kind of cloudy state -- honestly this is so basic but -- my poor memory --- I guess I need neurofeedback).
But all that aside (maybe this game IS some form of neurofeedback, more broadly defined) -- what are the controls? Did they give a group of ADHD kids some NON-"prescription" game for the same time period to see if their test scores changed similarly? Because ADHD kids CAN focus -- just not on what you want them to focus on, for the time period that you want them to focus. A psychiatrisI knew defined ADHD as "the inability to pay attention to things that you don't want to pay attention to." So then we would have to see if the gains in this study transferred to e.g, schoolwork. There is problem when ANY game-like activity is used to "treat" ADHD. Kids like games, even if they're not their favorite games. But they don't necessarily "like" sitting still in a classroom, listening to a teacher, or doing their homework.
So -- all this is said by somebody who has not read any of the research involved with this game.
posted by DMelanogaster at 4:21 PM on June 17, 2020 [2 favorites]
DMelanogaster (study here):
posted by brook horse at 4:31 PM on June 17, 2020 [1 favorite]
The control was designed to match AKL-T01 on expectancy, engagement, and time on task in the form of a challenging and engaging digital word game, targeting cognitive domains not targeted by the AKL-T01 intervention and not primarily associated with ADHD.21 The user was instructed to find and connect letters on a grid to spell words; points are awarded on the basis of number of words formed, word length, and the use of unusual letters. There is progression in difficulty to maintain engagement and expectation of benefit from patients and their caregivers.No statistically significant changes in the control group. In regards to whether the skills transfer, improvements were seen on the TOVA. My experience is that the TOVA does not really replicate the classroom environment, but it is not a game and people with ADHD generally hate it and don't find it fun at all, so it does indicate the skills may transfer to some degree to things they don't like.
posted by brook horse at 4:31 PM on June 17, 2020 [1 favorite]
nightrecordings, LobsterMitten - I am an adult with physician diagnosed ADD who cannot get the medications that work for me because like so many others I lost my job recently, am now on Medicaid, and no Medicaid-accepting doctors in my area will prescribe Schedule II medications because evidently Medicaid recipients are as a class untrustworthy, even though I have a treatment record going back a decade. I appreciate the desire to maintain focus and decorum in this and every conversation here on MeFi. I feel equally strongly about feeling like I have to disclose deeply person information to be allowed to participate meaningfully. This is definitely one of those areas that I prefer to hold as private space. If there is question of my intent or interest in the questions I presented - can y’all please just ask first? Not just to me, but to anyone? Ask why the particular points seem important?
I HAVE done my research. Been researching the hell out of this for 10 years. I also personally understand the barriers and costs associated with so many doctors visits and uncomfortable conversations about time taken off work monthly just to get the medications needed to be functional. I also know the battle to even GET Schedule II medications as an adult because insurance companies argue that ADD is a juvenile ailment only.
I would have been more than happy to share parts of this - the context and concerns surrounding my questions, if someone asked where my concerns were coming from.
I have not assumed this was a scam - I’ve been assuming that this is an actually effective alternative to drug therapies. If this is a viable treatment, my hope would be that it would be made available widely and to all populations. My fear is - continues to be - that the decision to market under the aegis of medical device is a revenue-based decision, which (if so) makes me sad and angry because it puts so many steps between the good people who need it and relief. Nuff said.
posted by Silvery Fish at 5:41 PM on June 17, 2020 [10 favorites]
I HAVE done my research. Been researching the hell out of this for 10 years. I also personally understand the barriers and costs associated with so many doctors visits and uncomfortable conversations about time taken off work monthly just to get the medications needed to be functional. I also know the battle to even GET Schedule II medications as an adult because insurance companies argue that ADD is a juvenile ailment only.
I would have been more than happy to share parts of this - the context and concerns surrounding my questions, if someone asked where my concerns were coming from.
I have not assumed this was a scam - I’ve been assuming that this is an actually effective alternative to drug therapies. If this is a viable treatment, my hope would be that it would be made available widely and to all populations. My fear is - continues to be - that the decision to market under the aegis of medical device is a revenue-based decision, which (if so) makes me sad and angry because it puts so many steps between the good people who need it and relief. Nuff said.
posted by Silvery Fish at 5:41 PM on June 17, 2020 [10 favorites]
I'm an adult with ADD who's never been medicated or gotten any kind of mental health care past the initial assessment 23 years ago, & I'm currently operating entirely off of whatever coping mechanisms I can get by myself without interfacing with a doctor (lists & routines, time-waster-blocker scripts for the internet, deleting Burrito Bison off my phone, deleting Burrito Bison off my phone again...)
It... hasn't been going great lately vis a vis the ol' productivity, being a (nominally) self-directed remote employee in a surging coronavirus hotspot who's been burned out since last November. Trying to put the news or the Animal Crossing down and do actual work makes me feel like my brain is being stabbed through with knives made out of galvanized boredom & all of my neurons are screaming. It's real hard to push through.
If this software helps adults train their brains to return focus to whatever they're doing -- and I understand that no one knows yet whether it actually does or not -- I'd like to be able to purchase it over the counter & try it out without getting a doctor involved, because it would be really helpful to me if my brain could just do that.
posted by taquito sunrise at 6:50 PM on June 17, 2020 [7 favorites]
It... hasn't been going great lately vis a vis the ol' productivity, being a (nominally) self-directed remote employee in a surging coronavirus hotspot who's been burned out since last November. Trying to put the news or the Animal Crossing down and do actual work makes me feel like my brain is being stabbed through with knives made out of galvanized boredom & all of my neurons are screaming. It's real hard to push through.
If this software helps adults train their brains to return focus to whatever they're doing -- and I understand that no one knows yet whether it actually does or not -- I'd like to be able to purchase it over the counter & try it out without getting a doctor involved, because it would be really helpful to me if my brain could just do that.
posted by taquito sunrise at 6:50 PM on June 17, 2020 [7 favorites]
If it's out there on Steam and gets trashed because it's a "boring game," it'll be a harder sell to kids and parents who may benefit from it. If you doctor recommended something that had a 1-star rating and a bunch of negative reviews, would you really push your kid to try it?
I don't think this is the reason. (Although it's not even confirmed you *need* a prescription to get it. I think brook horse is right that the FDA approval allows insurance to cover it). There are tons of games on the market which are aimed at a more meditative experience. Games with titles like "Meditative Journey" and "House Painter 20." Games don't have to be in-your-face-action to get good reviews. If the game's stated objective is to help attention span in individuals with ADHD, then that's why people would play and review it for.
I'm not sure I understand the overstated concern here with being able to play it without a prescription? Do gamers not like being told "No, sorry, you can't play this one"?
There's not really any reason to presume people who want to play this 'game' without a prescription are just "gamers" (whatever that means, are there people under 70 who don't play computer/phone games?) out for the latest thrill. I would presume anyone who wants to play this game without a prescription wants to treat either diagnosed/undiagnosed ADHD/ADD/other attention problem without the need to visit a doctor.
posted by Stargazey at 9:01 PM on June 17, 2020 [3 favorites]
I don't think this is the reason. (Although it's not even confirmed you *need* a prescription to get it. I think brook horse is right that the FDA approval allows insurance to cover it). There are tons of games on the market which are aimed at a more meditative experience. Games with titles like "Meditative Journey" and "House Painter 20." Games don't have to be in-your-face-action to get good reviews. If the game's stated objective is to help attention span in individuals with ADHD, then that's why people would play and review it for.
I'm not sure I understand the overstated concern here with being able to play it without a prescription? Do gamers not like being told "No, sorry, you can't play this one"?
There's not really any reason to presume people who want to play this 'game' without a prescription are just "gamers" (whatever that means, are there people under 70 who don't play computer/phone games?) out for the latest thrill. I would presume anyone who wants to play this game without a prescription wants to treat either diagnosed/undiagnosed ADHD/ADD/other attention problem without the need to visit a doctor.
posted by Stargazey at 9:01 PM on June 17, 2020 [3 favorites]
Thanks for the post, I'm really curious to hear DrMsEld's opinion on this and/or introduce her to it for more information gathering. I didn't see links to the actual study/abstract/whatever that has the hard data (and it may be paywalled) but if anyone could link the actual video game study/studies (and not just ADHD or more generalized neurofeedback studies) and/or provide the text of the same that would be wonderful. Apologies if I missed the same above.
Edit: nevermind found it in brook horse's comment above. thanks!
posted by RolandOfEld at 9:22 PM on June 17, 2020
Edit: nevermind found it in brook horse's comment above. thanks!
posted by RolandOfEld at 9:22 PM on June 17, 2020
You know how there are those "training" modules you can do to get better at aptitude tests that employers give new candidates?
Your IQ isn't going up, you're just getting better at doing the test.
The patients are seeing improvement in their TOVA API score... which is tested on a computer, where patients have to respond to stimuli. The control was specifically set up to challenge different cognitive domains.
I mean, all we can really say now is that if you play this game you'll improve your TOVA API score, it would be interesting to know if anyone can shed some light as to how impactful this really is.
posted by xdvesper at 12:17 AM on June 18, 2020
Your IQ isn't going up, you're just getting better at doing the test.
The patients are seeing improvement in their TOVA API score... which is tested on a computer, where patients have to respond to stimuli. The control was specifically set up to challenge different cognitive domains.
I mean, all we can really say now is that if you play this game you'll improve your TOVA API score, it would be interesting to know if anyone can shed some light as to how impactful this really is.
posted by xdvesper at 12:17 AM on June 18, 2020
Oh god, Silvery Fish, I'm so sorry to hear that. Job hunting while medicated is hard enough, doing it without treatment is an executive function-taxing slog of managing follow-ups, searching for paperwork, trying to remember to record contact information and in a way that you can find it again, scheduling meetings, remembering you scheduled a meeting, the actual process of searching which is such a rumination trigger.. heck, even driving to interviews is more dangerous without meds.
It's exactly the wrong time to take away meds and I've seen it so often with my friends in the states who also have ADHD: they're all smart, capable, and hard-working, but some of them are between jobs, doing internships, or marginally employeed and so they're struggling without medication at exactly the time they really need it.
Re: attention mechanisms speculated about by others in the thread, if you're curious about how it works I can highly recommend A New Understanding of ADHD in Children and Adults by Thomas E. Brown. It's like a textbook of the neurobiology behind ADHD. It's also priced like a textbook, so here's a relevant nugget from my reading of it: you can measure activity in the "default mode network" (interconnected brain regions that fire during mind-wandering and rumination), and what we see is that with ADHD there is an impairment in suppressing the DMN. Two people can sit with the intention to do a task, but the one with ADHD will be less successful at suppressing the DMN from turning on, and with medication they normalize. This matches my personal experience. I can be highly motivated to do something and feel it is extremely important that I do the task, but my brain fails to be a team player. I suddenly find myself doing something entirely different trying to remember what that thing was I wanted to get done. It's miserable.
Like if you've just fallen in love or someone close to you died, and right now you really just need to get some work done or you're trying to have an unrelated conversation with a friend, but thoughts about the emotional event keep interrupting you over and over again? It's like that but our brains just find random stuff to interrupt us with, spiked with that high level of salience so we don't immediately recognize the random thing is not important, and it does this throughout the day every day.
posted by antinomia at 4:25 AM on June 18, 2020 [11 favorites]
It's exactly the wrong time to take away meds and I've seen it so often with my friends in the states who also have ADHD: they're all smart, capable, and hard-working, but some of them are between jobs, doing internships, or marginally employeed and so they're struggling without medication at exactly the time they really need it.
Re: attention mechanisms speculated about by others in the thread, if you're curious about how it works I can highly recommend A New Understanding of ADHD in Children and Adults by Thomas E. Brown. It's like a textbook of the neurobiology behind ADHD. It's also priced like a textbook, so here's a relevant nugget from my reading of it: you can measure activity in the "default mode network" (interconnected brain regions that fire during mind-wandering and rumination), and what we see is that with ADHD there is an impairment in suppressing the DMN. Two people can sit with the intention to do a task, but the one with ADHD will be less successful at suppressing the DMN from turning on, and with medication they normalize. This matches my personal experience. I can be highly motivated to do something and feel it is extremely important that I do the task, but my brain fails to be a team player. I suddenly find myself doing something entirely different trying to remember what that thing was I wanted to get done. It's miserable.
Like if you've just fallen in love or someone close to you died, and right now you really just need to get some work done or you're trying to have an unrelated conversation with a friend, but thoughts about the emotional event keep interrupting you over and over again? It's like that but our brains just find random stuff to interrupt us with, spiked with that high level of salience so we don't immediately recognize the random thing is not important, and it does this throughout the day every day.
posted by antinomia at 4:25 AM on June 18, 2020 [11 favorites]
I'm sorry, I didn't mean to be dismissive and derail the conversation yesterday. I was frustrated that this is prescription only. My daughter has ADHD and I got excited and wanted to try it right away. I wonder if I too might had ADHD but can't get my doctor to take my concerns seriously, so I wanted to try it myself first. Also, I'm in Canada and when the FDA approves a treatment it's often like - great, so this will be approved in Canada in maybe a year, if ever? It's like, here's this great promising thing that might help (on top of the medication in my child's case), but you can't have it.
It's interesting and I hope people can get access to it easily and quickly.
posted by kitcat at 9:37 AM on June 18, 2020 [2 favorites]
It's interesting and I hope people can get access to it easily and quickly.
posted by kitcat at 9:37 AM on June 18, 2020 [2 favorites]
We make some very popular games/apps that some people with ADHD find useful. This looks way more slick! Grin.
posted by alasdair at 2:36 PM on June 18, 2020 [1 favorite]
posted by alasdair at 2:36 PM on June 18, 2020 [1 favorite]
I just went to their website. I am sickened. Unfortunately, I don't have the narrative energy to explain this feeling fully at this time. The medicalization of this game, using the word "medicine" over and over and over again when it is,okay, a "therapy," perhaps; perhaps a helpful way to train your mind (yeah, there are still minds - want to call it a "neural interface" or some other fancy term? fine) == but is it "medicine"? really? what IS medicine? is physical therapy "medicine"? I feel this is a VAST stretch of the word "medicine" purely to capitalize (not using that word loosely!) on people who are searching for treatments. So I am immediately turned off and skeptical. and then you go to the "cutting edge" or whatever "neuroscience" and yeah, you see THE BRAIN! and some models that sound so fancy and smart but are really very very basic -- but I want to see some CITATIONS, please. I want to see HOW *this* particular game, and not *other* games, is tapping into the regions and functions of the brain that it says it is tapping into.
I've read a lot of ads and literature about a LOT of games (as I said in my previous post, I studied neurofeedback for several years, with several experienced practitioners/teachers) and MOST of these websites DO have studies cited. I understand that, for patent reasons, they're not going to give all their information away. But I would never think that this game is going to do anything that a ton of other games might also be doing without being shown that this is in some way true.
But also the homepage is just GROSS.
posted by DMelanogaster at 4:52 PM on June 18, 2020 [2 favorites]
I've read a lot of ads and literature about a LOT of games (as I said in my previous post, I studied neurofeedback for several years, with several experienced practitioners/teachers) and MOST of these websites DO have studies cited. I understand that, for patent reasons, they're not going to give all their information away. But I would never think that this game is going to do anything that a ton of other games might also be doing without being shown that this is in some way true.
But also the homepage is just GROSS.
posted by DMelanogaster at 4:52 PM on June 18, 2020 [2 favorites]
This is a little hidden on the site, but goes into more detail about the mechanics of it, as well as the studies behind it at the end of the document.
posted by brook horse at 5:01 PM on June 18, 2020 [1 favorite]
posted by brook horse at 5:01 PM on June 18, 2020 [1 favorite]
So since biofeedback video games meant to train kids with ADHD existed 20 years ago, my question is, what's new about this specific game? The answer may be "not much, but they played the FDA game right." Or it may be "something valid, but we don't want to blow our patent by telling you."
posted by showbiz_liz
EXACTLY -- but it's not necessarily "new," that's not the point. What they're saying is that they have CORRELATED what's required to play this game successfully with certain ways that the brain acts when the brain-owner is playing the game successfully, AND they have determined that whatever that is that they believe is going on in the brain at that time is GOOD for the ADHD brain. ARE they really correlated? And is "whatever it is that's changing" REALLY good for the ADHD brain? LOADS of assumptions there, and no evidence that they're willing to talk about on that elaborate website.
To somebody else's question of "where's the feedback"? The feedback would be, I imagine, that you "win" in some way, or get "points," or keep some creature alive, or don't crash something, or whatever thing that is very similar to other video games -- and THAT is what, presumably, is correlated with whatever thing they think they're changing in your brain.
Biofeedback of any kind is a very general term. You can get "biofeedback" when you're on a reducing diet, for example, by weighing yourself. OR by watching your clothing get looser. They are all measures of changing "bio," but weighing is more direct, and clothing size is more indirect.
posted by DMelanogaster at 5:21 PM on June 18, 2020 [1 favorite]
posted by showbiz_liz
EXACTLY -- but it's not necessarily "new," that's not the point. What they're saying is that they have CORRELATED what's required to play this game successfully with certain ways that the brain acts when the brain-owner is playing the game successfully, AND they have determined that whatever that is that they believe is going on in the brain at that time is GOOD for the ADHD brain. ARE they really correlated? And is "whatever it is that's changing" REALLY good for the ADHD brain? LOADS of assumptions there, and no evidence that they're willing to talk about on that elaborate website.
To somebody else's question of "where's the feedback"? The feedback would be, I imagine, that you "win" in some way, or get "points," or keep some creature alive, or don't crash something, or whatever thing that is very similar to other video games -- and THAT is what, presumably, is correlated with whatever thing they think they're changing in your brain.
Biofeedback of any kind is a very general term. You can get "biofeedback" when you're on a reducing diet, for example, by weighing yourself. OR by watching your clothing get looser. They are all measures of changing "bio," but weighing is more direct, and clothing size is more indirect.
posted by DMelanogaster at 5:21 PM on June 18, 2020 [1 favorite]
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