from Hacker News

Doctor-prescribed videogame for ADHD

by wdh505 on 7/21/24, 10:29 PM with 234 comments

• by umbra07 on 7/21/24, 11:52 PM

  I've been on this for about a month and a half now.

  The game itself isn't engaging at all. It was a struggle to get myself to actually play the game regularly, for the allotted time (30 minutes, 5 days a week). It feels like a pretty big flaw with the game - after all, one of the challenges that people with ADHD face is forcing themselves to do things they don't want to do. This game is a complete bore, and I can't imagine anyone over, idk, 10 feeling differently.

  It's also an incredibly frustrating game, and for the first couple of weeks I was fairly irritated after each 30 minute session.

  I haven't noticed any improvement yet.

• by dailykoder on 7/22/24, 6:27 AM

  >The current cost for EndeavorRx is $99 for a 30 day prescription.

  Why is everything subscription based nowadays? Even without a subscription $99 would seem a lot to me. I guess because something something server costs and update development? Or is it just plain greed?

  PS: Programming is absolutely fantastic, too, when you have ADHD (an probably even if you don't have it). It also doesn't cost a dime and there is plenty of content available for free. Might give that one a shot! Works wonders for me

• by the_gipsy on 7/21/24, 11:44 PM

  $99 a month subscription, because they're FDA or whatever approved.

  Is there corruption with these kind of things, or did they just hit jackpot?

• by ben_sisko on 7/22/24, 12:16 AM

  Stimulant medication for ADHD has the highest effect size in all of psychiatry. ADHD is highly treatable, when people are properly treated. This just feels like something that somebody made for the parents who are pathologically drug averse at the expense of their children. Of course, the parents don’t realize that their kids don’t get that development time back, so the longer they wait, the harder things can get for their kids.

• by louiechristie on 7/22/24, 6:18 AM

  “More than one-third (36.6%) of adults with ADHD moved into the non-clinical, or normative, range (TOVA ACS score of >0)”- https://www.businesswire.com/news/home/20230503005295/en/Adu...

  So about as effective as a placebo or sugar pill https://en.wikipedia.org/wiki/Placebo

• by autoexec on 7/22/24, 12:15 AM

  I'm extremely skeptical. I've yet to see a treatment for ADHD that is only effective on children 8-17. If their product actually worked, I'm sure they wouldn't want to exclude the massive market of adults with ADHD.

  I'm also opposed to any medical device that uses a cell phone or requires a download from an app store. At that point you're handing over at least some amount of medical information to an ad company, using a device that's entirely controlled by that same ad company, who would be all to happy to use that information against you.

  That said, Their privacy policy isn't too terrible. They do sell your data to third parties for advertising (including cross-context behavioral advertising) and they're handing data over to "service providers", some of which are also ad companies. A lot of their data collection does seem to be opt-in at the moment which is nice. They say that they "seek to link only to [social media] sites that share our high standards and respect for privacy", but because they link to facebook it makes their "standards and respect for privacy" seem very questionable.

  Video games in general are already known to help people with ADHD focus, the problem is that while it can greatly improve the ability to focus on the game while it's being played the effect doesn't seem to hold up for very long after the game is turned off. I suspect that the very slight improvements their own research shows could be gained by playing many other games.

• by Lockal on 7/22/24, 11:06 AM

  This game is "Endless Running And Jumping Game" clone, similar to those typically placed in YouTube Shorts to hold visual attention. But how one of these games - completely blank in terms of novelty and unreasonably expensive for its quality - could start being used as a cure is beyond me. It is an absolute discredit to both doctors and the FDA as a whole.

• by xlii on 7/22/24, 6:14 AM

  I think this is a snake oil, but since (as other commenters mentioned) it seems to bring benefits even though it’s mediocre game I have another question.

  Would it be possible that ANY video game has a positive effect on ADHD?

  I’m wondering because usually games reward focus and provide plethora of stimulus both visually and auditory.

• by quink on 7/22/24, 12:30 AM

  Base building, collectathons, grand strategy, delivery simulators there’s plenty out there to get ADHD kids into a flow state where their brains start wiring towards sustaining focus. While avoiding hyper focus through gameplay mechanics. This, at $99 a month being more expensive than anything else, doesn’t seem to do any of that.

• by Cloudef on 7/22/24, 6:59 AM

  > Kids are challenged to multitask and ignore distractions by navigating courses, collecting targets, and avoiding obstacles.

  You could pick something like path of exile for free.

• by shadowtree on 7/22/24, 1:22 PM

  My daughter was prescribed an audio therapy that worked wonders.

  An app plays something akin to channel surfing on steroids, at a high initial switching frequency. Patient is to watch their favorite Youtube vids, play a video game - for 30 min while this cacophony slams their ears. Then gradually, day after day, the frequency is lowered to "humane" levels.

  Totally worked, no meds involved.

  I think it simply flooded her CNS and trained it to focus, without conscious effort. Might only work in 8 year olds, I don't know.

  A lot of sound therapy we saw initially tried the opposite, calm stuff like classical music - feels clear why this can't work on a ADHD brain that runs in circles.

• by diob on 7/21/24, 11:54 PM

  You know when they don't say actual numbers that it doesn't work much better than a placebo.

• by kinos on 7/22/24, 1:58 AM

  I played a game pretty similar to this when I was a kid. It was a Game and Watch style game with two buttons on a simple LCD screen. I got it for free with a happy meal. Bull.

• by fxtentacle on 7/22/24, 11:27 AM

  In case anyone is curious, this is the actual study: https://www.nature.com/articles/s44184-024-00075-w.pdf

  "AKL-T01 was linked with improvements on the Test of Variables of Attention (TOVA®) Attention Comparison Score (ACS) of 2.6 (95% CI: 2.02, 3.26; p < 0.0001) in adolescents and 6.5 in adults (95% CI: 5.35, 7.57; p < 0.0001)"

  I would read that as: Focusing on this specific video game helps you to learn how to focus on things in general.

  But "Mean overall compliance in the Efficacy Population was 72.4%", which kind of suggests that this game isn't that much fun to play. Or else, why would 1 out of 4 kids not play the mandatory 25 minutes per day?

  What I find a bit shady, though is that https://www.endeavorrx.com/the-research/ says "There were no serious adverse events seen in any clinical trials of EndeavorRx" with a big 0% above it, but the study did have adverse events, like headache and nausea, they just didn't classify those as "serious".

• by devcil on 7/22/24, 12:29 PM

  To acquire strategies to alleviate some problems, this might be helpful, similar to coaching and therapy.

  I have, however, serious doubts that it can be a substitute for stimulants. ADHD affects so many parts of one's life such that attention sometimes seem a very small part of the disorder. Miraculously, at least for some people, stimulants create a kind of automatic improvement in other areas too. I hope that general discourse about ADHD moves towards easier access to those drugs, not replacing them.

  Also, please don't speculate about ADHD, especially about people who suspect they might have it.

  ADHD experience differ a lot among people and even in different situations for an individual. Because of this aspect, a lot of people have complicated relationships with their diagnoses.

  Self-doubt, for various reasons, is a very common trait of people with ADHD. Strongly worded claims about ADHD might be very harmful to people who plan to seek help or struggle to follow their treatments.

• by pogue on 7/22/24, 12:58 AM

  Here's a video of a doctor playing the game along with sort of an explanation of how it works and is meant to do.

  I'd be curious to know how much this costs for patients. I'm guessing it's some type of a subscription model.

  https://youtube.com/watch?v=qkhSLr6DlWc

• by AzzyHN on 7/22/24, 12:43 AM

  Spend $99/mo on some meds instead. Much more effective.

• by umvi on 7/22/24, 12:01 AM

  FDA approves all sorts of software as a medical device that it doesn't rigorously test or understand.

  Completely serious - I bet Tetris could be approved by the FDA for ADHD treatment if The Tetris Company were willing to put in the effort for all the paperwork and fees.

• by Eumenes on 7/22/24, 11:35 AM

  I almost spit out my coffee when I saw this. The ADHD industrial complex steams on I guess. If doctors can "prescribe" video games, can prescribe time playing outside or away from technology? I suspect that doesn't get the user on a monthly subscription plan. Soon we'll have the government subsidizing video games in the name of "digital therapeutics". Nothing says mental well-being like playing video games.

  I know this is for children, but anecdotally, the number of 30 somethings I know IRL who are now discovering they have "ADHD" is comically high. Social media has truly been a disaster for the human race.

• by sam_goody on 7/22/24, 12:34 PM

  I was just speaking to a parent who, several years ago, sent their (very ADHD) kids through biofeedback, and were really impressed by the results.

  I mentioned it to the school psychologist, who told me that biofeedback is not considered legit, but that it does seem to work for some kids.

  My first thoughts when trying to figure out how biofeedback works is that it could easily be turned onto a game, even a good game, and it would help at least those that it helps.

  Is that right? Thoughts from those here with experience or domain knowledge?

• by jacknews on 7/22/24, 5:12 AM

  video game 'prescription'? lol

  The game doesn't look anything special to me, what are the key traits that make it suited as a treatment?

  Or did they simply run a clinical trial and get FDA approval as a treatment because of that?

  It seems to me many other games would also be effective, especially building games, Factorio, Minecraft, etc, and which don't require a $99/month 'prescription'.

• by jagged-chisel on 7/22/24, 12:10 AM

  doctor-prescribed

  TFA’s title is to blame. This hyphen makes the title read correctly.

• by pgcudahy on 7/22/24, 11:49 AM

  This is frustrating that it's marketed as FDA approved but people won't recognize that it is regulated as a medical device, which have to only show safety, rather than as a drug, which have to show safety *and* efficacy.

• by citizenpaul on 7/22/24, 12:27 AM

  Cost for EndeavorRx

  The current cost for EndeavorRx is $99 for a 30 day prescription. EndeavorRx is FSA/HSA eligible. You can pay for EndeavorRx by using your FSA/HSA card during checkout or by submitting the cost to your FSA/HSA after purchase.

• by niemandhier on 7/22/24, 10:24 AM

  as a treatment the product probably has some form of patent like protection, BUT as with all kind of games nothing keeps someone from just building a clone, and malet as „attention improving“ without the fda stamp.

• by thih9 on 7/22/24, 10:49 AM

  They also offer an OTC version.

  > EndeavorOTC is the only FDA-authorized digital therapeutic for ADHD available without a prescription.

  I wish there was a comparison between the two - or is the age requirement (18+ for otc) the only difference?

• by hawski on 7/22/24, 6:37 AM

  Just yesterday I read about Interactive Metronome and thought how it could easily model to various games. I am now quite sure that many games, especially classic ones, could try to get some sort of certification.

• by fn-mote on 7/21/24, 11:50 PM

  The results footnoted on the web site are underwhelming. Kids report they can pay better attention? If you weren’t trying to sell a product you would make up a better metric.

  Maybe the real papers are more legit.

• by sneed_chucker on 7/22/24, 12:12 AM

  $99 a month for a 30 day "prescription" of a game.

  Really obscene. The healthcare industry is such a sickness in this country, I hope we get a populist one day who completely guts it.

• by k__ on 7/22/24, 1:11 PM

  Half-OT: I played Balatro.

  It eats hours.

  However!

  It drastically cut down on my doom scrolling.

  Would be cool to see if someone could design a game that was addictive, but also fade you out of this addiction natively.

• by lackoftactics on 7/22/24, 6:13 AM

  Any plans for opening video game to Europe? I once wrote to you about availability for individuals to purchase it in Europe, but didn’t get any answer

• by vrighter on 7/22/24, 3:38 AM

  $99 for a 30 month prescription.

  So it's priced way higher than a full AAA game, but you only keep it for a month. So even worse than a digital purchase.

• by pyridines on 7/22/24, 12:18 AM

  A shame there's only one doctor left :(

• by davikr on 7/22/24, 11:39 AM

  > 73% of children reported an improvement in their attention.

  What kind of study outcome is this?

• by fredgrott on 7/22/24, 12:04 PM

  the designer of the UX of the website needs to be freaking slapped with wet noodles...poor text contrast even by WWW3 own text contrast measuring tools.

• by crustaceansoup on 7/22/24, 12:18 AM

  This looks like something you could game jam with a 4 person crew in a couple days (being really generous). $99 a month, seriously?

• by eleveriven on 7/22/24, 9:43 AM

  I think it is a promising advancement in ADHD treatment

• by boomskats on 7/22/24, 12:01 AM

  I wouldn't be at all surprised if this turned out to be some kind of exposé on FDA corruption and the farcical levels of blatant pisstaking within the US medical insurance system. Brilliant work.

• by alfiedotwtf on 7/22/24, 6:10 AM

  Who knew all this time I was self-medicating

• by superb_dev on 7/22/24, 12:35 AM

  From the website, I’m not clear on how this is actually working. (On the assumption it’s working at all, I have not read the research)

  The FAQ says “EndeavorRx uses sensory stimuli and simultaneous motor challenges designed to target areas of the brain that play a key role in attention function.”

  So is it just meant to exercise those areas? “Uses sensory stimuli and simultaneous motor challenges” could describe a million other games.

• by helloplanets on 7/22/24, 7:25 AM

  Now I'm interested in a proper study that compares different popular video games across various genres, for treating ADHD.

• by zelias on 7/22/24, 12:52 PM

  Difficult to say for sure without the ability to try a demo (seriously??), but I'd bet there are at least fifty games on Steam that "address" ADHD along the same pathways as this one, with the added benefit of actually being fun.

• by dkga on 7/22/24, 11:13 AM

  Now I know for certain that all that N64 Star Fox has clinically helped me :)

  To this day when I need to focus on an issue I often say “Location confirmed, sending supplies” or some other SF sentence.