Abstract

BackgroundThe need for accessible and motivating treatment approaches within mental health has led to the development of an Internet-based serious game intervention (called “Plan-It Commander”) as an adjunct to treatment as usual for children with attention-deficit/hyperactivity disorder (ADHD).ObjectiveThe aim was to determine the effects of Plan-It Commander on daily life skills of children with ADHD in a multisite randomized controlled crossover open-label trial.MethodsParticipants (N=170) in this 20-week trial had a diagnosis of ADHD and ranged in age from 8 to 12 years (male: 80.6%, 137/170; female: 19.4%, 33/170). They were randomized to a serious game intervention group (group 1; n=88) or a treatment-as-usual crossover group (group 2; n=82). Participants randomized to group 1 received a serious game intervention in addition to treatment as usual for the first 10 weeks and then received treatment as usual for the next 10 weeks. Participants randomized to group 2 received treatment as usual for the first 10 weeks and crossed over to the serious game intervention in addition to treatment as usual for the subsequent 10 weeks. Primary (parent report) and secondary (parent, teacher, and child self-report) outcome measures were administered at baseline, 10 weeks, and 10-week follow-up.ResultsAfter 10 weeks, participants in group 1 compared to group 2 achieved significantly greater improvements on the primary outcome of time management skills (parent-reported; P=.004) and on secondary outcomes of the social skill of responsibility (parent-reported; P=.04), and working memory (parent-reported; P=.02). Parents and teachers reported that total social skills improved over time within groups, whereas effects on total social skills and teacher-reported planning/organizing skills were nonsignificant between groups. Within group 1, positive effects were maintained or further improved in the last 10 weeks of the study. Participants in group 2, who played the serious game during the second period of the study (weeks 10 to 20), improved on comparable domains of daily life functioning over time.ConclusionsPlan-It Commander offers an effective therapeutic approach as an adjunct intervention to traditional therapeutic ADHD approaches that improve functional outcomes in daily life.Trial RegistrationInternational Standard Randomized Controlled Trial Number (ISRCTN): 62056259; http://www.controlled-trials.com/ISRCTN62056259 (Archived by WebCite at http://www.webcitation.org/6eNsiTDJV).

Highlights

  • Attention-deficit/hyperactivity disorder (ADHD) is the most common childhood neurodevelopmental disorder with young patients experiencing functional impairments in different areas of daily life [1,2,3,4,5]

  • Participants in group 2, who played the serious game during the second period of the study, improved on comparable domains of daily life functioning over time

  • Children from group 2, who played the serious game during the second period of the study, improved on comparable domains of daily life functioning over time

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Summary

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is the most common childhood neurodevelopmental disorder with young patients experiencing functional impairments in different areas of daily life [1,2,3,4,5]. Understudied, impaired social functioning in children with ADHD has serious long-term consequences for the development of conduct disorder and even some substance use disorders [10]. Functional impairments in the areas of time management, planning/organizing, and prosocial behavior skills often endure and escalate into adolescence and adulthood [6,7,11,12,13,14]. The need for accessible and motivating treatment approaches within mental health has led to the development of an Internet-based serious game intervention (called “Plan-It Commander”) as an adjunct to treatment as usual for children with attention-deficit/hyperactivity disorder (ADHD)

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