Games and Learning

In her pitch to convince potential IndieGogo backers to support her new racing game, Candice Hughes sketched out her now 17-year-old son’s dream: to study computer programing in the hallowed halls of the Massachusetts Institute of Technology — “the temple of geekdom.”

“He’d be a perfect fit,” she said, sounding like the proud mom she is. “He loves sci-fi and ‘Magic: The Gathering,’ and he has honors in English and math. But I don’t think he’ll be admitted, not because he isn’t smart enough, but like 10 percent of U.S. kids today he has ADHD.”

Psychiatrists started diagnosing the disorder in 1960s, and students with Attention Deficit Hyperactivity Disorder — or ADHD — often have trouble focusing in school, completing homework and staying dialed-in to social cues.

Hughes, who earned her doctorate in anatomy and neuroscience from Boston University School of Medicine in 1991, wanted to make a video game “so kids can learn to surpass their ADHD limitations.”

“Just like learning to play baseball,” she said, “kids with ADHD need to practice their attention and planning skills.”

If the personal motivation of a highly educated mother with a background in gaming — how many neuroscientists do you know who can claim both old-school Dungeons & Dragons cred and stick-time with Skyrim, Bethesda’s gigantic role-playing game — can’t elicit empathy for children with ADHD, perhaps this data will. Roughly 6 million children, their parents, guardians and their teachers deal with symptoms of ADHD. Two-thirds of those children take medication to help, and many carry their symptoms into adulthood. Recent studies show that number grows by at least 5% percent every year.

Two years ago, Hughes assembled a small team of designers and consultants, and founded a game company, AdapTac Games LLC, to build a tool to help her son and others.

The new firm knew who they would target with their games — parents.

“Schools are not the ideal partner. Not to knock the schools. They certainly try to help. There are many caring individuals and special education programs, but I think they’re a little bit overwhelmed and find it difficult to support the parents in many cases,” she said. “But the burden is mostly on you. You have to take charge, because it’s your child, and other people aren’t going to care as much as you care.”

That’s a sentiment shared by the app’s lead game designer, Rey Samonte, who brought his experience working for big companies like Activision to the AdapTac fold.

From the beginning of Samonte’s career, he really wanted to be a part of something big — a smash hit game.

But over the years, Samonte started to feel unfulfilled by these big commercial projects. Like so many other developers, when Samonte had a family of his own — and some of his kids experienced test anxiety and learning challenges of their own — the lack of substance became very personal.

“In my mind, I felt like there’s something I can do as a parent to help them out in this area. When Candice [Hughes] approached me with the idea for this game, it was a great opportunity for me to take my background in game development, and really be a part of something beneficial,” he said.

AdapTac’s first offering is a relatively simple racer that is part steampunk and part World of Warcraft.

The racer bears the truly unique title Intergalactic Aetherial Hurtle, which is even harder to say than it is to type. But don’t type all that in at the App Store because there she markets the game as ADHD Skills Booster. The game is currently only available for iPad and costs $34.99. Purchasers also get access to Hughes’ password-protected ADHD community website entitled Own Proud, which purports to include various forms of advice and support for parents.

“As a parent looking at it,” Hughes said, “compared to what I’m paying for all these other kinds of things I could be buying for my child, $34.99 is not really that much money. Honestly, every time I take [my son] to the clinician it’s $250 an hour.” Hughes also pointed to neurofeedback systems like Play Attention which measure brainwaves by requiring users with ADHD to paste sensors to their head, and can cost roughly $200 per month.

“So when you start looking at these numbers, our price doesn’t seem like a big cost,” Hughes said.

Players progress through three phases of gameplay: car part collection, the build and the actual race, in which kids can use missiles and other types of weapons in conjunction with their custom car to win races, badges and points.

“Every single part of the game is designed from the ground up to focus on ADHD, and we buried a lot of the analytics in the back end. We’re always measuring, analyzing and monitoring what the player is doing,” Hughes explains, and parents are able to access this information to track their child’s progress towards improving focus and attention skills.

Many gamers are familiar with the general gameplay mechanics of a battle-style racer. Massive commercial titles like Gran Turismo, Forza and even old school titles like R.C. Pro-Am and Rock ’n Roll Racing all laid the groundwork as far back as the mid-80s. Designing your own slick ride with custom parts and paints, launching a missile up your opponent’s tail pipe and leaving them in your dust were usually more entertaining than getting the checkered flag.

A Help, Not a Cure

But what’s not so clear is whether these kinds of games can actually affect something as complicated as a behavioral disorder. Hughes is very clear about one point: her game is not a cure for ADHD.

“Anyone who tells you that is being dishonest, because that’s not where the science is right now,” Hughes said.

Which is probably an important point to stress. If you design an educational game with claims it helps kids with ADHD, you’d better be prepared to back them up.

At the beginning of 2015, the Federal Trade Commission slapped down Focus Education LLC after the federal watchdog found the company’s Jungle Ranger brain-training game absolutely whiffed on its claim it could help 6- to 12-year-old kids, including children with ADHD symptoms, improve self-regulation, focus, attention and memory skills.

Before the sanctions, Focus Education’s ifocus System, which included Jungle Rangers, posted a $4.5 million profit in just under two years. Their website still flashes a host of awards from more than a dozen national educational organizations, including the Association of Educational Publishers, the National Parenting Center and the Mom’s Choice Awards program, along with accolades from nearly 15 different parenting blogs.

But the FTC wasn’t impressed. The agency said Focus Education’s 45-person study was sloppy, wasn’t “randomized, blinded or controlled,” lacked proper follow-up testing and didn’t even measure the skills and emotional conditions they purported to improve.

All of which adds a lot of weight to the question: Does AdapTac’s first app actually help kids with ADHD symptoms?

Skeptics will likely point their finger at the low number of kids involved in ADHD Skills Booster’s pilot study. Similar studies from other games can include hundreds of participants spread across several groups. AdapTac’s ADHD test group included only six children with ADHD symptoms — one of whom had already played the game prior to testing — and compared them to a control group of nine kids without symptoms.

It’s a criticism Hughes readily acknowledges, but the neuroscientist said she’s comfortable with the results nonetheless.

“Once you get a larger number of kids, you’re unlikely to see the opposite happen. You usually don’t see a reversal. We think we had a pretty good study design for our test, but when you go to the real world, you’ll encounter a number of roadblocks. That’s the challenge of being a small independent developer. But we were very happy to get that result. All the kids, except for the one who already played, improved. It means they were learning,” Hughes said.

After eight rounds of play, Hughes says the ADHD group increased their focus scores to levels very close to a group of nine children without ADHD, and her company plans to conduct a larger study with a university partner or land SBIR funding from the U.S. Department of Education so they can complete a more statistically significant test.

As a pharmaceutical consultant, Hughes is used to the hundreds of thousands, or even millions, of dollars drug companies sometimes spend to study the results of a single medication. That’s money she did not have as she started this project. AdapTac funded their more modest trial with significant portions of Hughes’ own money and a $10,000 grant from CTNext’s Entrepreneur Innovation Awards. They analyzed the data using expertise from Hughes, along with a biostatistician and a behavioral analyst. They also received business mentoring from The Refinery accelerator in Connecticut. Most recently the Milken-Penn GSE Education Business Plan Competition awarded AdapTac Games a $20,000 venture prize as a “research-based game app to help children with ADHD improve attention and planning skills.”

Hughes says the app should be seen as an education tool.

“I purposely designed the game to parallel experiences they might have in the real world, and the way they would have to study in school,” she said, adding, the challenge isn’t so much staying focused – everybody gets distracted from time to time — but snapping back to the task at hand.

That’s why Hughes and her team included elements like “The Trickster” into the game, a character designed to distract kids from selecting parts and putting together their car.

“I wanted to put in The Trickster because I knew that’s something that’s really hard for them. It’s something they could encounter in the classroom. Maybe a bell rings or somebody drops a book or some other kinds of loud noise. I wanted them to be able to learn not to focus strongly on those things,” she said.

Although it’s clear AdapTac needs to do more research to bolster its claims that their racing game improves focus, Hughes said she and her designers took the mission to heart. For example, instead of using the same shapes and colors for certain car parts, Hughes had Samonte switch them up in order to force the player to concentrate harder, which is essentially the opposite of how Samonte learned to communicate with players through game design.

“Trying to find that balance was very different. But when you step back and see the bigger changes you tend to agree with them,” Samonte said. “For me, the interesting part is learning new approaches to game design, and seeing it benefit players.”

Skill-based learning isn’t without its critics, but AdapTac hopes their racing game will kickstart an entire series of apps — up to four per year — that focus on other learning difficulties and social skills.

“We don’t want to just end with one game, we want to keep developing behavioral health tools and fill a good niche that’s not really out there right now,” Hughes said.

But before they start peering over the next horizon, AdapTac Games must clear a big hurdle just as critical as sound science, if not more so: will kids with ADHD actually play.