Exergaming intervention to foster executive functions in children with attention deficit hyperactivity disorder: preliminary results from a clinical trial.

In childhood and adolescence Attention Deficit Hyperactivity Disorder (ADHD) is one of the most frequent mental disorders. Reduced attention, poor control of impulses, as well as increased motor activity are its key symptoms, which seem to be associated with decreased performance in Executive Functions (EF), finally affecting academic achievement. Although medication usually has some effect on symptoms, concerns about regular drug intake and possible side effects result in a need for alternative treatments. For this purpose, sedentary cognitive trainings are frequently used, although transfer effects seem to be limited. To increase potential effects, interventions combining physical and cognitive demands targeting a broader range of cognitive processes are called for. Therefore, the aim of the current study was to examine the effects of cognitively and physically demanding exergaming on EF of children with ADHD. In total, 36 children between 8-12 years (M = 10.63; SD = 1.32) diagnosed with ADHD were assigned either to an 8-week exergame intervention group (three training sessions per week à 30 min) or to a waiting-list control group. The EF performance in updating (color span backwards), inhibition and shifting (Simon task; Flanker task) was assessed before and after the interventional period using computer-based tests. On average children trained 2-3 times a week. Manipulation checks indicate that exergaming were physically and cognitively challenging to the participants. With regard to interventional effects, ANCOVAs (one-tailed; pre-test values as covariates) revealed that children in the exergame group improved their inhibition and shifting performance significantly (ps < .05). In the current study, positive effects of a combination of cognitive and physical training in children with ADHD could be revealed. Results indicate that, in future, exergaming might serve as promising tool to improve the EF in children with ADHD. However, further improvements with regard to child appropriateness, cognitive as well as physical challenge are warranted.