In America, 6.4 million children have been given diagnoses of attention disorders. That’s 11 percent of the school-age population. Annual production of Ritalin-like drugs has quadrupled since the 1960s, and millions of children are taking these powerful stimulants every day.
Some argue that this “epidemic” is in fact an artifact of a test-driven, high-stakes, high-pressure school culture. Parents are eager to diagnose kids to get them extra resources, extra time to take tests, or simply an educational edge, and schools can exempt themselves from test targets if they have more kids classified as “disabled.” A.D.H.D. diagnoses spiked 22 percent in the first four years after No Child Left Behind.
Regardless of the broader context, kids and families are clearly suffering. Sandra lives in Newton, Massachusetts and is the mother of a 9 year old boy who’s had trouble in school, both with behavior and grades, since kindergarten.
“It’s painful when your kid comes home and says, I feel like the dumbest kid in the class because all the other kids know the answers,” she says. “He tells me, Mom, when I’m in school I have a really hard time paying attention. I go into the clouds and I miss what the teacher said and I have to ask my friends to tell me what just happened.” Despite these problems, Sandra has been reluctant to medicate her son. She was happy to have the opportunity to enroll him in a clinical trial of a new technological solution, Atentiv.
Atentiv is, essentially, a video game with a brain-computer interface component. To play the game, children strap a headband around the forehead that uses an EEG to measure the brain’s pattern of electrical signals and transmits them wirelessly to the computer via Bluetooth. First, the player goes through a calibration process that measures the unique “signature” of the individual’s brainwaves in concentrating and distracted conditions while completing the Stroop Task, a common test of concentration.(Previous studies support the presence of unique EEG patterns for children diagnosed with ADD).
Once the system is calibrated the user plays a game that involves a character running through a landscape to complete tasks. When the player is distracted, the character slows down; the more she concentrates the faster the character moves. The result is something like a form of biofeedback–young children get an object demonstration of “growth mindset.” They grow in awareness of what distraction and concentration feels like, and they also grow in their sense of being able to control their mental state for better performance.
For Hayden, Sandra’s son, who took part in the clinical trial three times a week for 8 weeks, the results were dramatic. “I really saw a tremendous difference both at home and at school. I was thrilled.” Hayden’s handwriting got neater. His sleeping habits improved. His homework got better. His teacher was no longer calling with discipline problems. He got along better with his sister and with friends. He was easier to get out of the house in the morning.
Hayden is not alone. Trials of the Atentiv System have shown sustained improvements in 75-85% of children, as rated by parents, standardized tests, and direct measures of the brain waves. In this study, parents noticed significant improvement in inattentive and hyperactive-impulsive symptoms six months after the treatment began.
It’s hard to say how much of this is due to the futuristic wonders of neurofeedback technology, and how much of it is a placebo effect. The researchers in this independent study noted that the study did not have a control group that, say, played a regular video game, and the parents all knew that their kids were in the treatment condition, which may have caused them to exaggerate the positive effects.
Atentiv’s founders are not initially seeking FDA approval for their technology, so they can’t make outright claims about ADHD. Instead they are launching early next year with a consumer product aimed at parents who want a solution for their kids without drugs. CEO Eric Gordon is confident that the technology will eventually lead to clinical products for treating not just ADHD but memory and abstract reasoning, in children, adults and the elderly.
Sandra’s explanation for her son’s improvement is not about the technology itself, but about the broader message of the game.
“It’s all about self-esteem,” she says. “For Hayden, it helped him realize he was capable. And also, just the way the game and training materials talked to him about it: saying there’s nothing wrong with you, you’re not dumb. Look, your brain is like a Ferrari and we’re going to teach you to look at the green and red light.”