A Systematic Review and Content Analysis of Serious Video Games for Children with ADHD

Our systematic review and content analysis of ADHD games was published (open access) in Frontiers in Psychiatry and is available now. Link here.

We believe this study provides the most comprehensive overview to date of how therapeutic video games are being used to support children and adolescents with attention-deficit/hyperactivity disorder (ADHD). We systematically reviewed published studies and analyzed the content of the games to understand the content, whether that content is intended to improve attention or behavior, and how effective the content appears to be at reducing ADHD symptoms in real-world settings (based on parent ratings).

Our review identified 37 studies published between 2005 and 2021 that evaluated 22 distinct serious games targeting ADHD. These games were created for therapeutic purposes—often aiming to improve cognitive functions such as working memory, attention, and impulse control. More than half of the games relied on cognitive training paradigms, similar to laboratory tasks like go/no-go or continuous performance tests, which challenge players to selectively respond to stimuli. About 18% of the games used EEG-based neurofeedback, where players learn to control brainwave patterns (specifically the theta/beta ratio) associated with attention. The remaining games employed more novel or mixed approaches, such as physical activity or eye-gaze training.

Across studies, the effects on parent ratings of ADHD symptoms varied widely, with reported effect sizes ranging from roughly d = –0.55 (i.e., moderate negative effect) to 1.26 (i.e., large postive effect). Importantly, no single type of game content was consistently linked to greater improvement. Cognitive training games did not outperform neurofeedback or novel content in any systematic way. Instead, the largest outcomes were associated with assessment procedures that had the higher risk of bias, such as unblinded raters, suggesting that some of the most optimistic results may be misleading.

Overall, the findings highlight the limitations of serious video games as interventions for ADHD. Although serious games can be engaging, there is still no clear evidence that any particular game feature or therapeutic mechanism is reliably effective in improving ADHD symptoms. Our review also underscores the heterogeneity of this research area: studies differ widely in design, duration, outcome measures, and methodological rigor, making comparisons difficult.

In short, the field is still in an early developmental stage. Future research should focus on improving study quality, using more consistent outcome measures, and exploring innovative game elements based on proven psychosocial treatments. By strengthening methodological standards and testing for real-world behavior change, researchers might still develop serious games that truly help children with ADHD.