Schools are on the front lines in coping with attention deficit hyperactivity disorder (ADHD). More school-age kids are getting diagnosed with it each year (more than one in 10, according to the most recent National Survey of Children’s Health) and the classroom is where kids often have their biggest problems with impulse control and an inability to sit still and focus.
Some kids take medicine to control these symptoms, but many do not. And so principals and teachers are tremendously interested in non-medical therapies they can use at school to help children. Fortunately, it’s an exciting time in ADHD research, thanks to developments in neuroscience, and psychologists hope they will find new tools for schools.
It’s hard to know how much stock to put in the new research studies. Some studies find short-term benefits from physical exercise, according to a synthesis of findings from 10 major studies in a paper published online in February, 2016, in the Journal of Attention Disorders. Others have shown improvements in certain brain functions from regularly playing specially designed video games, some of which are already being sold in the education market. And just last week, a startup company, C8 Sciences, issued a press release touting its new physical exercise and video game therapy for children with ADHD as showing promising, short-term results. C8’s study is still unpublished and not reviewed by outside scientists, but the company is already marketing its $5,000 program to schools.
I talked with Jeffrey M. Halperin, a leading ADHD researcher and professor at Queens College of the City University of New York, who has helped develop some of the new theories and tools. He advises school leaders to be cautious before investing any time or money in them.
“Buyer beware,” Halperin said. “I think personally it’s premature to be marketing these things at this point, because I don’t think evidence is there yet.”
Halperin cited Cogmed as an example. Pearson sells this computer program to schools, and advertises that kids’ concentration and time spent on task improve from playing its memory games. Halperin says the research literature does show that the Cogmed games improve a child’s working memory, but that they don’t help with ADHD symptoms. “It doesn’t translate into improved behavior,” he said. “That’s the challenge.”
There are two types of new therapies that Halperin and many other researchers are focused on right now: physical exercise and cognitive brain games. They’re both based on neuroscience findings that children with ADHD have had delayed brain growth or insufficient brain development. So they theorize that, just as you go to the gym to build muscles, exercises can help build up the brain. One route is through aerobic exercise, which has been shown to promote brain growth in animals and geriatric patients. The other is through cognitive games. The C8 Sciences company is cleverly combining the two.
“There are a number of good theoretical reasons why it might work,” said Halperin. “But there are good theoretical reasons why a lot of things should work that end up not working.”
In Halperin’s recent research, he initially found terrific results from using physical exercise games, from Simon Says to old-fashioned ball games. But that was with a small group of students in an “open” clinical trial, in which he relied on parent and teacher surveys to measure results. Parents knew who was getting treated and who wasn’t. When he repeated the experiment on a larger group of students in a randomized control trial, he said, the results weren’t so strong.
Halperin says there hasn’t yet been a large scale, well-designed scientific study of whether physical exercise is an effective treatment for ADHD. Even the February 2016 meta-analysis relied mostly on small studies. And the studies measured how well exercise increased certain brain functions, such as working memory or motor skills, not how well it reduced ADHD symptoms, such as classroom outbursts or inability to complete school work.
And no one has yet shown long-term benefits from the exercises and games. Once you stop doing them intensively, three to five times a week or more, it’s possible that the brain benefits would disappear.
Halperin is now turning his research focus to developing new cognitive games, played with other kids in a real world social setting, and not administered through a computer screen.
Fortunately, exercise and game therapies aren’t harmful. They’re just a big time commitment, and a potentially expensive one, depending on which program you buy.
“Would I say to schools that recess, exercise and more gym for kids is a good thing? Yes, I think it really is,” said Halperin. “Is it going to fix ADHD? That’s a tougher question.”