1. Generalization of Game-BasedLearning for Children with ADHD Randy Kulman, Ph.D. randy@learningworksforkids.com @rkulman LearningWorks for kids 2012 APA Conventionwww.learningworksforkids.com www.apa.org/convention @lw4k @APAConvention

2. Presentation DisclosureRandy Kulman, Ph.D. commercial interests: President, Majority Stockholder, LearningWorks for Kids, Inc. Cogmed Working Memory provider

3. Overview What do we know about children with ADHD and video games? Why use video games and digital media to help children with ADHD? What are the characteristics of interventions proven to work with children with ADHD? Why do children with ADHD not become scholars after playing video games? What can we do to make video games a more productive 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 primary ADHD diagnosis based upon a full neuropsychological evaluation) Survey asks parents to describe their own media usage to see if it is correlated to attitudes regarding video games Also asks them to describe their concerns and hopes for benefits of video games and other digital media Digital media use of ADHD kids- Most time television, video games, music (different from what is seen in national studies of typically developing kids)

6. Children, parents, and video game playHow many hours a week does your child spendplaying video games? 34% Less than 1 hour per 32% 2-4 hours 20% 5-7 hours 13% 8+ hoursHow many hours per week do you spendobserving or interacting with your child when theyplay video games? 23% no time 46% less than 1 hour 27% 1-5 hours 4% 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 to help children with ADHD? Video game play requires the use of executive functioning skills. Other skills such as organization and metacognitive skills are required for success. Both simple and complex video games regularly use skills such as planning, cognitive flexibility, self-control, and time management. Many games specifically tax working memory skills and attentional skills.

9. Why use video games and digital media to help kids with ADHD? Kids with ADHD or Video 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-modal Often 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 digital media to help kids with ADHD? Kids with ADHD or Attention Video Games and Digital Media Difficulties Usually have problems with Teach by trial and error or following directions. guided discovery Require that the player understand the instructions in order to succeed May struggle to learn new Most negative feed back from information and experience video games and other digitalfrustration or low self-esteem as a media occurs privately. result. Causes less embarrassment and frustration Teaches the player how to handle these emotions

11. What are the characteristics of interventions that work best with children With ADHD? Point of performance interventions Immediacy of feedback Powerful and engaging feedback and meaningful consequences Multimodal presentations and multiple intervention agents Individualized to childs capacities Strategic teaching principles including: previewing, setting explicit goals, 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 promote skills in children with ADHD. Existing games focus on other things, while using important thinking skills. Metacognitive skills are not built into existing video games. Generalization and strategic teaching skills are not built into existing game.

13. Research on Executive/Thinking Skills and Video Games LWK pilot research on differentiated instruction, targeting areas of EF weakness with video games Combination of board and video games improve fluid reasoning and processing speed (Mackey, 2011) Working memory video games improve WM, fluid reasoning skills (Cogmed ) Intensity/duration Computer-based training improves executive attention in preschoolers (Rueda, 2005) Video game like math and reading programs improves learning, reduces attention symptoms Games (non video) that increase cognitive load and used as a teaching tool by parents reduce ADHD symptoms in Preschoolers (Halperin, 2012)

14. How well do game based skills transfer to the real world? Game play alone results in modest improvements in real-world executive skills Children with learning and attention problems have problems in generalizing strategies Kids like to talk about playing video games and may be willing to learn from that Games prompt partnering and motivation to learn executive skills Practice and rehearsal of executive skills

15. BUTgames are not enough!!! The key to success is effective teaching or mediation (can be done in the game) Teachers (including peers, parents, and imbedded instruction) make the connection between game-based learning and real-world skills Actual learning requires knowledge of the skill, understanding how and when to use it, and practice across many situations

16. What can we do to make video games a moreproductive learning experience for children with ADHD? 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, educators, and peers

17. Play Together Talk before, during, and after gameplay. Choose gameplay goals with your child. Have fun playing the game with your child! Reflect on gameplay, emphasizing the use of the targeted thinking or academic skills. Direct your discussion to how these same skills are useful in daily activities.

18. Make it Work Explain the benefits of digital play, and introduce the skills being exercised in the game. Encourage non-digital activities that use the same skills. Regularly connect game-based skills to things your child is struggling with in the real-world. Try different games and skills

19. Executive Skills Questionnaire

20. Prescription of Games, Technologies, and Recommendations

21. Gardens of Time: Video PlayBook

22. Thank You! Randy Kulman, Ph.D. randy@learningworksforkids.com @rkulman LearningWorks for kids 2012 APA Conventionwww.learningworksforkids.com www.apa.org/convention @lw4k @APAConvention