Behavioral Outcome Effects of Serious Gaming as an Adjunct to Treatment for Children With Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Trial

Kim Bul, Pamela Kato, Saskia Van der Oord, Marina Danckaerts , Leonie Vreeke, Annik Willems, Helga van Oers, Ria van den Heuvel, Derk Birnie, Therese van Amelsvoort, Ingmar Franken, Athanasios Maras

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Abstract

Background: The need for accessible and motivating treatment approaches within mentalhealth has led to the development of an Internet-based serious game intervention (called Plan-ItCommander) as an adjunct to treatment as usual for children with attention-deficit/hyperactivitydisorder (ADHD).Objectives: To determine the effects of Plan-It Commander on daily life skills of children withADHD in a multisite randomized controlled crossover open-label trial.Methods: Participants (N=170) in this 20-week trial had a diagnosis of ADHD and ranged inage from 8 to 12 years (male: 80.6%, 137/170; female: 19.4%, 33/170). They were randomizedto 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 inaddition to treatment as usual for the first 10 weeks and then received treatment as usual for thenext 10 weeks. Participants randomized to group 2 received treatment as usual for the first 10weeks and crossed over to the serious game intervention in addition to treatment as usual forthe subsequent 10 weeks. Primary (parent report) and secondary (parent, teacher, and childself-report) outcome measures were administered at baseline, 10 weeks, and 10-week followup.Results: After 10 weeks, participants in group 1 group compared to group 2 achievedsignificantly greater improvements on the primary outcome of time management skills (parentreported; P=.004) and on secondary outcomes of time management (teacher reported; P=.09),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 werenonsignificant between groups. Within group 1, positive effects were maintained or furtherimproved in the last 10 weeks of the study. Participants in group 2, who played the seriousgame during the second period of the study (weeks 10 to 20), improved on comparable domainsof daily life functioning over time.Conclusions: Plan-It Commander offers an effective therapeutic approach as an adjunctintervention to traditional therapeutic ADHD approaches that improve functional outcomes indaily life.TrialRegistrationInternational Standard Randomized Controlled Trial Number (ISRCTN): 62056259;http://www.group 2led-trials.com/ISRCTN62056259 (Archived by WebCite® athttp://www.webcitation.org/6eNsiTDJV)

Publisher Statement: This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.
Original languageEnglish
Article numbere26
Number of pages19
JournalJournal of Medical Internet Research
Volume18
Issue number2
DOIs
Publication statusPublished - 16 Feb 2016

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Attention Deficit Disorder with Hyperactivity
Randomized Controlled Trials
Time Management
Therapeutics
Licensure
Internet
Short-Term Memory
Reproduction
Publications
Biomedical Research
Parents
Outcome Assessment (Health Care)

Keywords

  • Attention Deficit-Hyperactivity Disorder
  • Randomized Controlled Trial
  • Treatment
  • Children
  • Internet
  • Serious Game

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Behavioral Outcome Effects of Serious Gaming as an Adjunct to Treatment for Children With Attention-Deficit/Hyperactivity Disorder : A Randomized Controlled Trial. / Bul, Kim; Kato, Pamela; Van der Oord, Saskia ; Danckaerts , Marina ; Vreeke, Leonie; Willems, Annik; van Oers, Helga ; van den Heuvel, Ria; Birnie, Derk; van Amelsvoort, Therese; Franken, Ingmar ; Maras, Athanasios.

In: Journal of Medical Internet Research, Vol. 18, No. 2, e26, 16.02.2016.

Research output: Contribution to journalArticle

Bul, K, Kato, P, Van der Oord, S, Danckaerts , M, Vreeke, L, Willems, A, van Oers, H, van den Heuvel, R, Birnie, D, van Amelsvoort, T, Franken, I & Maras, A 2016, 'Behavioral Outcome Effects of Serious Gaming as an Adjunct to Treatment for Children With Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Trial' Journal of Medical Internet Research, vol. 18, no. 2, e26. https://doi.org/10.2196/jmir.5173
Bul, Kim ; Kato, Pamela ; Van der Oord, Saskia ; Danckaerts , Marina ; Vreeke, Leonie ; Willems, Annik ; van Oers, Helga ; van den Heuvel, Ria ; Birnie, Derk ; van Amelsvoort, Therese ; Franken, Ingmar ; Maras, Athanasios. / Behavioral Outcome Effects of Serious Gaming as an Adjunct to Treatment for Children With Attention-Deficit/Hyperactivity Disorder : A Randomized Controlled Trial. In: Journal of Medical Internet Research. 2016 ; Vol. 18, No. 2.
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abstract = "Background: The need for accessible and motivating treatment approaches within mentalhealth has led to the development of an Internet-based serious game intervention (called Plan-ItCommander) as an adjunct to treatment as usual for children with attention-deficit/hyperactivitydisorder (ADHD).Objectives: To determine the effects of Plan-It Commander on daily life skills of children withADHD in a multisite randomized controlled crossover open-label trial.Methods: Participants (N=170) in this 20-week trial had a diagnosis of ADHD and ranged inage from 8 to 12 years (male: 80.6{\%}, 137/170; female: 19.4{\%}, 33/170). They were randomizedto 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 inaddition to treatment as usual for the first 10 weeks and then received treatment as usual for thenext 10 weeks. Participants randomized to group 2 received treatment as usual for the first 10weeks and crossed over to the serious game intervention in addition to treatment as usual forthe subsequent 10 weeks. Primary (parent report) and secondary (parent, teacher, and childself-report) outcome measures were administered at baseline, 10 weeks, and 10-week followup.Results: After 10 weeks, participants in group 1 group compared to group 2 achievedsignificantly greater improvements on the primary outcome of time management skills (parentreported; P=.004) and on secondary outcomes of time management (teacher reported; P=.09),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 werenonsignificant between groups. Within group 1, positive effects were maintained or furtherimproved in the last 10 weeks of the study. Participants in group 2, who played the seriousgame during the second period of the study (weeks 10 to 20), improved on comparable domainsof daily life functioning over time.Conclusions: Plan-It Commander offers an effective therapeutic approach as an adjunctintervention to traditional therapeutic ADHD approaches that improve functional outcomes indaily life.TrialRegistrationInternational Standard Randomized Controlled Trial Number (ISRCTN): 62056259;http://www.group 2led-trials.com/ISRCTN62056259 (Archived by WebCite{\circledR} athttp://www.webcitation.org/6eNsiTDJV)Publisher Statement: This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.",
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author = "Kim Bul and Pamela Kato and {Van der Oord}, Saskia and Marina Danckaerts and Leonie Vreeke and Annik Willems and {van Oers}, Helga and {van den Heuvel}, Ria and Derk Birnie and {van Amelsvoort}, Therese and Ingmar Franken and Athanasios Maras",
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T1 - Behavioral Outcome Effects of Serious Gaming as an Adjunct to Treatment for Children With Attention-Deficit/Hyperactivity Disorder

T2 - A Randomized Controlled Trial

AU - Bul, Kim

AU - Kato, Pamela

AU - Van der Oord, Saskia

AU - Danckaerts , Marina

AU - Vreeke, Leonie

AU - Willems, Annik

AU - van Oers, Helga

AU - van den Heuvel, Ria

AU - Birnie, Derk

AU - van Amelsvoort, Therese

AU - Franken, Ingmar

AU - Maras, Athanasios

PY - 2016/2/16

Y1 - 2016/2/16

N2 - Background: The need for accessible and motivating treatment approaches within mentalhealth has led to the development of an Internet-based serious game intervention (called Plan-ItCommander) as an adjunct to treatment as usual for children with attention-deficit/hyperactivitydisorder (ADHD).Objectives: To determine the effects of Plan-It Commander on daily life skills of children withADHD in a multisite randomized controlled crossover open-label trial.Methods: Participants (N=170) in this 20-week trial had a diagnosis of ADHD and ranged inage from 8 to 12 years (male: 80.6%, 137/170; female: 19.4%, 33/170). They were randomizedto 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 inaddition to treatment as usual for the first 10 weeks and then received treatment as usual for thenext 10 weeks. Participants randomized to group 2 received treatment as usual for the first 10weeks and crossed over to the serious game intervention in addition to treatment as usual forthe subsequent 10 weeks. Primary (parent report) and secondary (parent, teacher, and childself-report) outcome measures were administered at baseline, 10 weeks, and 10-week followup.Results: After 10 weeks, participants in group 1 group compared to group 2 achievedsignificantly greater improvements on the primary outcome of time management skills (parentreported; P=.004) and on secondary outcomes of time management (teacher reported; P=.09),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 werenonsignificant between groups. Within group 1, positive effects were maintained or furtherimproved in the last 10 weeks of the study. Participants in group 2, who played the seriousgame during the second period of the study (weeks 10 to 20), improved on comparable domainsof daily life functioning over time.Conclusions: Plan-It Commander offers an effective therapeutic approach as an adjunctintervention to traditional therapeutic ADHD approaches that improve functional outcomes indaily life.TrialRegistrationInternational Standard Randomized Controlled Trial Number (ISRCTN): 62056259;http://www.group 2led-trials.com/ISRCTN62056259 (Archived by WebCite® athttp://www.webcitation.org/6eNsiTDJV)Publisher Statement: This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

AB - Background: The need for accessible and motivating treatment approaches within mentalhealth has led to the development of an Internet-based serious game intervention (called Plan-ItCommander) as an adjunct to treatment as usual for children with attention-deficit/hyperactivitydisorder (ADHD).Objectives: To determine the effects of Plan-It Commander on daily life skills of children withADHD in a multisite randomized controlled crossover open-label trial.Methods: Participants (N=170) in this 20-week trial had a diagnosis of ADHD and ranged inage from 8 to 12 years (male: 80.6%, 137/170; female: 19.4%, 33/170). They were randomizedto 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 inaddition to treatment as usual for the first 10 weeks and then received treatment as usual for thenext 10 weeks. Participants randomized to group 2 received treatment as usual for the first 10weeks and crossed over to the serious game intervention in addition to treatment as usual forthe subsequent 10 weeks. Primary (parent report) and secondary (parent, teacher, and childself-report) outcome measures were administered at baseline, 10 weeks, and 10-week followup.Results: After 10 weeks, participants in group 1 group compared to group 2 achievedsignificantly greater improvements on the primary outcome of time management skills (parentreported; P=.004) and on secondary outcomes of time management (teacher reported; P=.09),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 werenonsignificant between groups. Within group 1, positive effects were maintained or furtherimproved in the last 10 weeks of the study. Participants in group 2, who played the seriousgame during the second period of the study (weeks 10 to 20), improved on comparable domainsof daily life functioning over time.Conclusions: Plan-It Commander offers an effective therapeutic approach as an adjunctintervention to traditional therapeutic ADHD approaches that improve functional outcomes indaily life.TrialRegistrationInternational Standard Randomized Controlled Trial Number (ISRCTN): 62056259;http://www.group 2led-trials.com/ISRCTN62056259 (Archived by WebCite® athttp://www.webcitation.org/6eNsiTDJV)Publisher Statement: This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

KW - Attention Deficit-Hyperactivity Disorder

KW - Randomized Controlled Trial

KW - Treatment

KW - Children

KW - Internet

KW - Serious Game

U2 - 10.2196/jmir.5173

DO - 10.2196/jmir.5173

M3 - Article

VL - 18

JO - Journal of Medical Internet Research

JF - Journal of Medical Internet Research

SN - 1439-4456

IS - 2

M1 - e26

ER -