The Use of Mobile Games in the Management of Patients With Attention Deficit Hyperactive Disorder: A Scoping Review

Abstract

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder associated with significant morbidity. Current treatment approaches consist of a mixture of pharmacological and psychological approaches. The emergence of digital technology, and mobile gaming applications, represents a promising novel method in potentially augmenting existing interventions for ADHD. In this review, we will map out the use of mobile gaming applications in the management of ADHD and evaluate the effectiveness of these technologies and any areas for future research. Four electronic databases were searched for relevant articles. All articles were screened for abstract and full text by two independent reviewers, and data extracted onto a common data extraction sheet. The data was narratively synthesized and reported in line with the PRISMA-ScR guidelines. A total of 19 studies were included. Studies mostly evaluated the effectiveness of games on male children with ADHD. Most games were focused on the treatment of ADHD, while a minority were focused on the diagnosis and monitoring of ADHD. Some of the common gaming mechanisms employed in games included having participants responding to cures, remembering details, and making associations between different entities. The studies generally showed an improvement in performance of children as they played the games, but evidence for the effectiveness of these modalities remains scarce and mixed. While it is exciting that there is such a wide variety of games available currently in the diagnosis, treatment, and monitoring of ADHD, many of the games lack clinical evidence to prove their effectiveness. Furthermore, most studies contain several limitations including small sample size, limited ages of participants, lack of control group, and lack of comprehensive outcomes. To promote the application of these games to clinical practice, robust clinical trials, collaboration between stakeholders and using a comprehensive set of outcome measurements is essential.

Adjuvant Therapy for Attention in Children with ADHD Using Game-Type Digital Therapy

“…It is also very effective as a home treatment tool or learning material in the case of exceptional social circumstances, such as the isolation due to the COVID-19 pandemic. Existing studies indicate that providing digital treatment interventions through mobile devices can increase the access to treatment and reduce treatment costs, which, in turn, can help improve compliance [ 44 ]. NeuroWorld DTx research offers the advantage of improving the objectively measured inattentiveness of pediatric ADHD patients and increasing compliance through greater motivation and the active participation of children, including those refusing to participate in the study, or not giving up or missing out on participants.…”

Integrating reinforcement learning and serious games to support people with rare genetic diseases and neurodevelopmental disorders: outcomes on parents and caregivers

“…By providing a gamified environment for therapeutic exercises, these games increase the engagement and motivation of rehabilitation. Active engagement is facilitated by the immersive qualities of serious games, which enhances the efficacy of rehabilitation interventions (Bukovšek et al, 2020;Jiang et al, 2022;Cervantes et al, 2023). Concurrently with the development of serious games, the incorporation of reinforcement learning, a form of artificial intelligence (AI), enhances the capabilities of technological interventions in this field.…”

An Emotional Bias Modification for Children With Attention-Deficit/Hyperactivity Disorder: Co-design Study

“…More recently, regarding ADHD, there have been further studies examining the evidence base of existing games for individuals with ADHD and the potential of gamification for serious games targeting individuals with ADHD. Jiang et al [ 10 ] conducted a scoping review of the currently available mobile games on several databases, and they reported that most of the existing games were focused on managing individuals with symptoms and less so on symptoms and diagnosis. Although the studies have shown an improvement in the performance of the children across the interventions, these studies were limited in several aspects, such as the inclusion of a small sample size and lack of a control group for comparison, and these factors influence the overall effectiveness of the study [ 10 ].…”

“…Jiang et al [ 10 ] conducted a scoping review of the currently available mobile games on several databases, and they reported that most of the existing games were focused on managing individuals with symptoms and less so on symptoms and diagnosis. Although the studies have shown an improvement in the performance of the children across the interventions, these studies were limited in several aspects, such as the inclusion of a small sample size and lack of a control group for comparison, and these factors influence the overall effectiveness of the study [ 10 ]. Nonetheless, the 19 studies highlighted the potential of considering a serious game approach when conceptualizing new interventions, and they also revealed that the most common techniques were that of having participants to respond to various cues, remembering details, or making association between different entities [ 10 ].…”

“…Although the studies have shown an improvement in the performance of the children across the interventions, these studies were limited in several aspects, such as the inclusion of a small sample size and lack of a control group for comparison, and these factors influence the overall effectiveness of the study [ 10 ]. Nonetheless, the 19 studies highlighted the potential of considering a serious game approach when conceptualizing new interventions, and they also revealed that the most common techniques were that of having participants to respond to various cues, remembering details, or making association between different entities [ 10 ]. In another recent study by Sujar et al [ 11 ], the authors, having synthesized the evidence from literature, reported that future games that are designed for individuals with ADHD ought to consider the following aspects: the underlying mechanics of the game ought to be based on some form of cognitive exercise and therapeutic strategies that may be helpful include having levels of difficulties, a motivational element, time constraint for the task one has to undertake, and some form of reinforcement [ 11 ].…”