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ADHD patients play video games as part of treatment By Susan Jenks ,
Florida Today A generation raised on video games is inspiring
researchers' efforts to unlock the mysteries of a puzzling learning
disorder that afflicts millions of school-age children and even some
adults.

Whether speeding down a virtual street in Sony's Gran Turismo or
slaying Spyro the Dragon, researchers hope games such as these will
improve the lives of those with attention-deficit hyperactivity
disorder, commonly known as ADHD, or cognitive-processing
difficulties.

People with these disorders experience "constant frustration," says
Henry Owens, a Melbourne, Fla., clinical psychologist who recently
began offering a patented video game system, which evolved from NASA
technology, to some of his patients.

"If they just play video games on their own, they will zone out," he
says. "When they play on this system, if they zone out, the video game
doesn't respond any more," acting as an incentive to improve focus and
concentration.

That comes through controlling brain-wave activity, which some
researchers say is too slow or too fast in certain areas of the brain
when patients have ADHD.

Video game play is a form of neuro-feedback, Owens says, which teaches
patients to self-regulate brain-wave patterns to improve learning.

But some researchers remain cautious.

"It's still controversial," says Dr. Andrew Adesman, chief of
developmental and behavioral pediatrics at Schneider Children's
Hospital in New Hyde Park, N.Y.

He says studies have yet to show video game play with a neuro-feedback
component has either a short-term or long-term benefit, despite
parents' desire to explore other options in the wake of recent
concerns about Ritalin and other stimulants used to treat ADHD.

They need to ask, "Does it help, and is it the best treatment
available?" says Adesman, a spokesman for Children and Adults with
Attention-Deficit/Hyperactivity Disorder, a non-profit education,
advocacy and support group in Maryland.

The concern, he adds, is parents might abandon mainstay treatments — a
combination of pharmacological and educational interventions that have
been tested and proved over time.

Owens, however, says some patients have been using the video game
system, developed by the San Diego company CyberLearning Technology,
in combination with medications, while others want to try the non-drug
alternative first, before turning to drug therapy.

Owens says he has four patients playing Smart Brain Games (www.smartbraingames.com),
as the system is known, at home — a recent alternative to in-office
sessions, which began about a year ago.

Of the home training, he says, "Its advantage is intensity," although
he advises against playing more than 20 minutes a day for children
younger than 10, and no more than a half-hour daily for everyone else.

And while the company makes the system available directly to consumers
— and it is compatible with any Sony off-the-shelf video game — Owens
says that without an initial evaluation with an electroencephalogram
or EEG, to map brain activity, "how would you know what's being
treated?"

"Because this is so new and such a commitment," he says, "we don't
want parents to do it lightly."

FDA approved

In Florida, Owens is one of only five practitioners authorized by the
company to offer its gaming system.

Lindsay Greco, a co-founder of CyberLearning, says the company has 54
providers Nationwide, identified by "licensure and their expertise in
neuro-feedback."

She says the system has approval from the U.S. Food and Drug
Administration, and that by mid-2003 the company had acquired an
exclusive license from NASA to take Langley Research Center's
technology, enabling researchers to measure the brain waves of pilots
during flight simulations, into the gaming arena.

The device works through a specially designed helmet, with built-in
sensors that monitor a player's brain waves. Signals from the sensors
are fed through a signal-processing unit and then to a video
controller as a game is played.

"There are other systems with computer-based technologies where the
bar goes up and down," Greco says. "But these are rudimentary. Our
games empower you to change your own brain's physiology."

Like Owens, she says the best games are jumping and racing games that
provide consistent movement and a better ability to measure feedback
response.

Also, where there is a diagnosis of ADHD, she says, patients should
seek providers' expertise on how best to use the system.

Of the roughly 700 systems sold, she says, about 70% have gone to
patients using them under the supervision of a health care
professional, while 30% have been bought by people for entertainment
or those "simply wanting to sharpen their attention or memory."

Greco says in-office neuro-feedback programs normally cost from $4,000
to $5,000, while their system costs $584, with in-office network
provider supervision running less than $2,000.

Insurance typically does not cover any of these expenses.

"Cost has been a huge challenge for many consumers," she says.

'Quite helpful'

Although he has not worked with the video game system, Thomas Peake,
another Melbourne clinical psychologist, supports the concept "in the
right hands."

"If it's done right, these things, in and of themselves, can be quite
helpful," Peake says. "And kids are used to playing games and like
them."

He says he used to do biofeedback to help patients control pain and
has seen it used in major medical centers to help speed recovery in
stroke patients.

"Most people off the street would not know how to use these devices,
however," he cautions. "But, to me, the principle is a good one."



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