Many children play video games. In fact, it’s estimated that 91 percent of children between the ages of 2 and 17 play them. However, some people are concerned about the effects video games have on children, and whether they can cause Attention Deficit Hyperactivity Disorder (ADHD).
ADHD is a neurodevelopmental disorder that can cause inattention, impulsive behaviors, and hyperactivity. While video games may appeal to children with ADHD due to their fast-paced nature and the feeling of accomplishment, there is no research that supports that they cause ADHD.
In this article, I will discuss the perceived connection between ADHD and video games. I’ll also outline the potential benefits, and why children with ADHD are drawn to these digital games. I’ll also touch on how much is too much, and if they’re addictive.
What Research Says About ADHD and Video Games
There has been extensive research surrounding the link between ADHD and video games. A study conducted by Iowa State University found that children who spent more time playing video games were more impulsive and had more difficulty paying attention. It was done over the course of 3 years and involved 3,000 children and adolescents.
The findings of the study suggest that video game playing can intensify existing attention problems. However, the study lacks supporting evidence that the games cause or worsen the attention problems, they suggest that kids who play the most have more severe ADHD symptoms.
A recent study in 2021 showed that excessive video game play was correlated with more severe ADHD symptoms. However, the study also notes that more research should be done surrounding the benefits.
Another study conducted in 2018 analyzed video game use in children with ADHD. The study involved 80 children with ADHD and 120 without ADHD who played video games. There was a significant difference between the groups when it came to compulsive video game use, 37.5 and 11.8 percent. The study found more problematic use of video games among children with ADHD where it interfered with homework completion. Problematic ADHD video gamers were hypothesized to be more prone to video game addiction.
While there might be a higher risk of video game addiction in children with ADHD, excessive video game use was observed in both groups.
Why Children with ADHD are Drawn to Video Games
There are a few reasons why children with ADHD are drawn to video games:
Video games offer constant stimulation. They provide instant rewards, they are usually fast-paced, and they’re colorful and exciting.
Video games and other digital media oftentimes require ever-changing skills and employ a variety of stimuli including video, sounds, words, and actions that help keep kids interested and engaged. They also provide clear and immediate feedback, constantly letting the player know what they are doing right and wrong.
Video games tend to give constant achievements, goals, rewards, and praise to the user. This can feel very exciting for a child with ADHD since they can find tasks more difficult than others, especially if they required intense focus and attention.
Children with ADHD may find it difficult to focus; especially on things that they are not interested in. Conversely, many kids with ADHD are able to hyperfocus.
However, your child might have the ability to hyperfocus on video games because of the fixation and satisfaction that it’s bringing them. Digital games tend to be highly engaging and many require physical and cognitive involvement.
The release of dopamine
Children with ADHD naturally produce less dopamine than those who don’t have ADHD. Dopamine is a neurotransmitter that responds to pleasurable experiences. When a person enjoys playing video games, the brain begins to associate the activity with dopamine production and seeks that experience again.
Even though many focus on the negative effects of video games, research shows how they can be therapeutic and provide positive benefits for children with ADHD.
In 2020 a study was conducted that analyzed children ages 8-12. A therapeutic video game was examined in addition to the current standard of care. The goal was to explore further options that may help to alleviate symptoms such as improved attention and cognitive control.
The participants were to play video-game-like designs for 25 minutes per day, 5 days per week for 1 month. Parents of the children noted improvements in inattention and a lower risk of side effects, compared to other ADHD treatments.
Executive control is a collection of higher-order cognitive functions that allows individuals to flexibly regulate their thoughts and actions in the service of adaptive, goal-directed behavior. Video games can also help children build important skills.
These may include:
- Visual-spatial skills
- Hand-eye coordination
- Strategy and problem-solving
- Planning, sequencing, and prioritizing
- Collaboration and teamwork
- Time management
In June 2020, the Food and Drug Administration (FDA) cleared a video game treatment for ADHD. While it’s not to be used as a stand-alone treatment for ADHD, it can help to improve attention skills.
Similarly, Joon is an app that uses gamification to encourage children to complete daily tasks. A parent manages the app and assigns the child a virtual pet to take care of. The child feeds, washes, and watches the pet grow, but can only do so by completing the tasks set for them by their parent. Once they complete a task, they’re able to level up in the game.
The game helps the child build a sense of intrinsic motivation by caring for the pet as extrinsic rewards are not included inside the app. The overarching goal is to help the child eventually develop important executive functioning skills that will serve the child well as they become older and develop a stronger need for these skills.
Monitoring Video Game Play
It’s important to monitor video gameplay. It can be helpful to talk with your child and set appropriate boundaries for when and how long they can play online games.
To establish a structured plan for appropriate screen time and video gameplay at home, consider:
- Setting a schedule so your child knows when they can play video games
- Using tools to monitor or limit screen usage
- Promoting time spent with others that aren’t just virtual (in-person)
- Working with your doctor or a mental health professional to address concerns around screen time and digital gameplay
- Encouraging play that the child enjoys that’s both indoors and outdoors
You may want to use video gameplay as a reward for completing chores, doing homework, etc. However, playing video games should not replace other important activities like going outside, spending time with family and friends, or other social interactions.
Keep an eye out for these behaviors, they can be signs that your child should play video games less often:
- Throwing fits or tantrums when they’re asked to stop playing
- Staying up all night or very late playing
- Outbursts and uncontrolled behaviors when losing
- Lying about how much time is spent using video games
If your child is struggling, you may want to consider behavioral therapy. It will be important to find a clinician who has some expertise with children's gameplay and technology engagement.
You should also make sure your child is playing appropriate games for their age. Some of the most popular video games have sexual content or violence that’s meant for people ages 18+. The rating categories range from E (everyone) to AO (adults only, 18 years and older).
Some games that might be a good choice for your child include games that improve organizational skills. Animal Crossings, Roblox, and Minecraft could be some good video game choices for your child with ADHD.
Problematic digital media use (PDMU)
A recent study researched the digital media use of children with ADHD during the COVID-19 pandemic. The study found that children with ADHD show greater signs of problematic digital media use (PDMU).
Some of these signs include inattention, lack of motivation, anxiety, defiant behaviors, and difficulty with executive function. Increased adult supervision over media use can help the child reduce PDMU.
Parents may want to consider playing the games with their kids or observing them. This can create a space to talk to the child about the game and be able to set more effective limits.
Video game addiction and internet gaming disorder
People with ADHD are at a higher risk of addictive behavior. A 2018 review estimated that 2 to 5.5 percent of adolescents and young adults may have a video game addiction. The DSM-5 currently recognizes internet gaming disorder, in which gaming causes “significant impairment or distress” in everyday life as warranting further research, not as an established diagnosis.
Similar to tobacco, alcohol, or drugs, screen time or video games can become an addiction if it damages your health and relationships, and it’s unable to be controlled.
Some symptoms of video game addiction could include:
- Having intense urges for screen time or to play video games, and these urges block out other thoughts
- Spending money on games or screens, even though you can't afford it
- Cutting back on social or recreational activities because of preference for screen time or video games
- Continuing to play them or participate in screen time, even though you know it's causing problems in your life, such as poor performance at school or work, or letting household responsibilities go
- Displaying signs of irritability, anxiety, or anger when forced to stop playing, even for brief periods of time
- Hyperactivity symptoms
- Lying to others about the extent of your use
- Needing more screen time over time to get the same level of enjoyment
- Neglecting your appearance, including lack of interest in grooming or clothing
How Much is Too Much?
The American Academy of Pediatrics suggests children play video games for under 30 to 60 minutes per day on school days and 2 hours or less on non-school days.
The group recommends even lower limits of under 1 hour of total screen time per day for children under 6 years old, and they encourage parents to determine the appropriate amount of time for video games and other electronic media use for children over the age of 6.
Regardless of what limits you think are appropriate, some days each week should involve no gaming. This is to ensure that your child develops, maintains, and enjoys other, non-screen time activities. It’s suggested that children between the ages of 6 and 9 spend 90 minutes or less per day using screens, and parents should choose the technology and provide guidance.
The current research about ADHD and video game use does not suggest people with ADHD should avoid playing them entirely. Instead, video game use should be monitored. If you or your child has ADHD, it’s also important to watch for signs of worsening symptoms.