2
Jan

ADHD and the X-Box

Often, towards the end of an ADHD assessment when it is clear a child meets criteria for the disorder, I will ask parents, “How many hours does your child play video games?  How do you think they will react to limiting their game time?” Parents sometimes seem shocked that I would know this is issue number one at home, or that this is even an issue at all if it was not previously disclosed.  In some cases the child is playing hours upon hours of video games, and is sometimes the only means of social connection with others via collaborative play of war games on the X-Box or role playing games on the personal computer.

The question parents ask is, “How in the world did you know that our child is obsessed with video games!?!”

I think I can address this question by citing a research study I recently came across.  According to research in Pediatrics, teens and young adults who play a lot of video games are more likely to have Attention Deficit Hyperactivity Disorder (ADHD). Does that mean it's time to confiscate your child’s video game system?  It’s possible, but you need to see the complete picture, and understand how you might use video games as an incentive.

The research in Pediatrics which appears here was based on sample of 1,323 students assessed over 13 months by parent and child reported television and video game exposure as well as teacher-reported attention problems. Another sample of 210 late adolescent and early adult participants provided additional self-reports of television exposure, video game exposure, and attention problems.

The study found that exposure to television and video games was associated with greater attention problems. The association of television and video games to attention problems in the middle childhood sample remained significant when earlier attention problems and gender were statistically controlled. The associations of screen media and attention problems were similar across media type (television or video games) and age (middle childhood or late adolescent and early adult).

Among the middle childhood cohort, those who spent a median of 3.86 hours in front of a screen had an odds ratio for developing attention problems of 1.81.  Among the sample of late adolescents and young adults, those with a median of 4.36 hours of total screen time, the odds ratio for attention problems was 2.04.  Among the children, they found the median daily exposure to television was 2.99 hours and to video games was 0.66 hours, for a total of 3.86 hours a day of screen time. Those who were above the medians were significantly also more likely to have attention problems:  The study concluded that viewing television and playing video games each are associated with increased subsequent attention problems in childhood.

There have been several studies which show that preschoolers who watch a lot of television are more likely to have ADHD, but a direct correlation has not been proven.  In other words, these have been correlational studies, not causal studies, such as the research study referenced above.

Mindless television (non-educational television) such as Sponge Bob, The Simpsons, etc doesn't help young children, and may be distracting them from what they really should be doing such as reading, studying, playing and interacting with people.  Despite all the research and common sense objections to hours upon hours of video game playing, I have had parents tell me, “I don’t want to limit my child’s video game time, because it is the only time they interact with their peers!” or “This is my child’s only pleasure in life, and I won’t take that way!”  My response to that is usually, “Your child is playing 4 hours of video games every day.  When do they have time to go outside, play, and have normal interactions?  When do they have the opportunity to find other pleasures in life, or to get other skills they can take pride in like riding a bike or throwing a ball?  You’ve got to start limiting their video game time.”

ADHD Interventions:

Here are some straightforward suggestions to start limiting your child’s video game time, and using it in a positive way:

  • Adopt the 2 hour per day limit on screen time (all television, computer, handheld games combined) suggested by the American Academy of Pediatrics.  Two hours per day is the daily maximum, and not the baseline or average time.
  • Treat screen time as a privilege, not a right.  Some parents reward good behavior with a small dose of television time or video games.  Your child can earn screen time privileges by doing chores or reading books.  Track your child’s screen time by using a kitchen timer.  Then the timer goes off, so does the television.
  • Consider what your children are watching in terms of content.  Many video games such as “Modern Warfare” or “Grand Theft Auto” are both violent and sexually explicit, even more so than late night shows on HBO or Showtime. There is plenty of research that these violent and sexually explicit shows have a bad influence on children's behavior and self-image.
  • When your child has earned video game privileges, play the games your children play, and watch their shows.  Not only will you be better equipped to make decisions on whether the content is appropriate, you can discuss it with them. Additionally, if you can explain to your children why you are bothered by violence on television it helps them understand why you're imposing rules, it helps them learn how to set limits of their own.
  • Set a rule in your house that homework must be done before the television goes on.  If your child is getting bad grades, the television does not go on until grades are lifted.

It is possible to use video games in a positive manner.  I personally have used Leapster Learning System games with my own children.  There are games such as Math Blaster and several typing instruction games that we use in our home, and we currently are using Rosetta Stone software to learn a new language (not a game, but still a fun program).  It is suggested that games for pure fun should be used as rewards for completing other behaviors.