From Dr. Karnik's Desk, 6/30/2020

Many of you by now may already know that there is a new therapy approved by the FDA for ADHD that is not another medication. For those who are reluctant to start a pill for your child, this may feel like a great relief. Of course, the question is whether this is for your child?

What is this video game all about?

Before I answer that, let me give you the information about this video game. This product, EndeavorRX, is developed by Akili Interactive after seven years of research on children with ADHD between ages eight and twelve years. This video involves playing the obstacle dodging, target-collecting game for 25 minutes a day, five days a week, for four weeks. Once a child plays for 25 minutes, the game shuts off till the next day which prevents children from playing for a longer time. The game is also designed to challenge the child’s attention by performing multiple tasks.

How does the research back it?

This program is available only with a doctor’s prescription.  Once you have it, the program can be downloaded on a mobile device. This is the only time you need the internet. For playing the video game, you do not need it. Though the studies were done on children who were not on any medication, this mode of therapy can be used along with other conventional therapies. A child will go through one-month treatment and if needed, it can be repeated again for another month after a few weeks break for added benefit.  

This video game therapy was approved by the FDA after reviewing the data from various studies conducted by the company on 600 children by the investigators involved in developing the product.  The improvement is primarily seen in attention and not with hyperactivity. Parents can track the child’s improvement by reviewing the summary screen which is displayed while playing. The parent does not have to sit with the child.

This approval is a great relief for many parents who are reluctant to put a child on medication and looking for alternative therapies. However, there are many concerns raised about the product

Should I ask my doctor for a Digital Medicine prescription?

Almost all pediatric professionals are worried that ADHD children do use screen much more, rather than doing homework or other important physically and socially beneficial activities. They are trying to cut screen time for this reason and are concerned if this therapy will create more problems. The other concern is that the studies are done by researchers who developed the product and not vetted by unbiased studies. Time will answer these concerns.

My personal take on this is that I want to keep an open mind, and with caution, try it on children with mild cases who have only attention issues and not hyperactivity, and especially where parents are reluctant to use medication as an option.

I also want the parents to know that this a new therapy, and not many things are known about it at this time. We have been through many other therapies like neurofeedback, Cogmed, Lumosity, and Play Attention in the past; they really did not replace all time-proven modalities. I do not see this as a great breakthrough that will replace what we are currently doing, but it could be an option for a mild case to try out.

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