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Visual Performance Today	 61	 Volume 2 | Issue 1
Play Attention is a computerized train­
ing program for those 5 years of ...
Visual Performance Today	 62	 Volume 2 | Issue 1
along the way. Your task is to
improve upon this over time.
In Visual Tra...
Visual Performance Today	 64	 Volume 2 | Issue 1
I usually read all instruc­
tions before start­ing a new
computer program...
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Play Attention: A Computerized Training Program for ADHD Reviewed by Dominick Maino


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This is a review of a computerized training program for those with ADHD using neuro-bio-feedback in a game-like format.

Published in: Health & Medicine, Education
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Play Attention: A Computerized Training Program for ADHD Reviewed by Dominick Maino

  1. 1. Visual Performance Today 61 Volume 2 | Issue 1 Play Attention is a computerized train­ ing program for those 5 years of age or old- er who have been diagnosed with attention deficit hyperactivity disorder. This program uses task-based neurofeedback (NF) that reinforces correct responses to various stim- uli in game-like format. This results in train- ing attention and working memory while simultaneously decreasing impulsivity. Inter- ventions of NF have been found to improve working memory and decrease parent- and teacher-rated symptoms of ADHD.1 You must supply the computer, but they provide all other software, a manual, and equipment, including the Body Wave device that fits on your arm or leg. There are six games that are included: Attention Stamina, Visual Tracking, Time on Task, Discriminatory Processing, Short Term Memory, and Finishing Tasks. The program notes what the player has achieved and then sets the next goal level automatically, or if you prefer, you can do this manually. (Before I begin this review I should note that I had an opportunity to actually use this program and that my review is based on that use and current research involving its application. Philip Brotman, PhD of Biofeedback Instrument Corporation was kind enough to send me a unit so that I could experience it in a personal manner. I did not use this with any patients, but rather on myself. I have no personal financial interest in Biofeedback Instrumentation Corporation or in the Play Attention system). The Games In Attention Stamina you control a compu­ ter avatar’s dive depth in the ocean by your concentration and attention. At the beginning of the game you can choose who will represent you: a diver, dolphin, whale, or submarine. When you maintain attention, your avatar swims in a straight line at a certain depth. When you lose attention, the avatar rises. The goal is to avoid fish and other objects and to finish the dive in an appropriate manner. I personally used this multiple times. This is not an easy task even for an adult with a relatively normal level of attention, but if mastered will give the desired result. The initial goal is to pay attention for at least 2% of the time and to pick up gold coins Play Attention: A Computerized Training Program for ADHD Dominick M. Maino, OD, MEd • Illinois College of Optometry • Chicago, Illinois
  2. 2. Visual Performance Today 62 Volume 2 | Issue 1 along the way. Your task is to improve upon this over time. In Visual Tracking you begin by seeing 25 blocks arranged in a square five blocks tall by five blocks wide where random blocks will light up and beep in quick succession. The patient’s task is to click on these blocks using the computer mouse as they light up and beep. Time on Task trains the patient on how to start and finish an assignment on time. The game starts with a warehouse scene. There is a truck, a stack of wooden crates, and a man on a yellow fork­lift.  The task is to load twelve crates onto the truck bed in five minutes or less using sustained attention on the task.  Discriminatory Processing teaches the patient to filter out unwanted distractions and attend to the task at hand. At the beginner level you are in a spaceship cockpit. The only way to move the spaceship is to attend appropriately. You also must protect yourself against various asteroids along the way by hitting the space bar. Timing is important because if the space bar is hit too early, the protective shields will go back down before the asteroid makes contact. If the space bar is hit too late, the ship takes damage. If you lose attention, the ship will stop moving, and the patient hears, “Focus to refuel.” As the patient gets better in concentration and attention, the tasks become more varied and difficult. Short Term Memory teaches you how to process visual and auditory information and hold that information in short term memory so you can recall it later when needed. The first part is similar to the game Simon. Sustained attention is required to activate the game. Finishing Tasks monitors your attention when you’re doing an actual task (your homework for example). The Attention Monitor shows you how much attention you’re paying to the task. If the patient becomes distracted, the program will tell the patient to attend to the chosen task. A video that reviews Play Attention is available here. Add on Games There are several additional games you can purchase that include auditory processing, hand-eye coordination, spatial memory, social skills, working memory, and motor skills. Play Attention will even customize a game for you as well. Other Important Things to Know What You Will Receive Play Attention includes the software, the BodyWave® armband, interface box, Bluetooth dongle, user manual, behavior shaping charts, and all behavioral management materials. You will also receive free and unlimited technical and educational support, a phone call supported introductory tutorial, an interactive manual with audio and video clips, and an unlimited user-license. The Cost The cost can be as little as $100 per month for home use, but there is a variety of flexible
  3. 3. Visual Performance Today 64 Volume 2 | Issue 1 I usually read all instruc­ tions before start­ing a new computer program or using new instrumentation, but for the first part of this review, I wanted not only to evaluate the program for effectiveness, but intuitiveness as well. I started Attention Stamina without reading the instructions. It took me about 20 minutes to figure out what I needed to do and to accomplish the task. I also learned that it is important to read the instructions before using this program to reduce any initial frustrations that might otherwise occur! After reading the instruc­tions, I then worked on the other “games.” With a clear idea of how to accomplish the tasks set before me (I read the instructions this time), I managed to complete the beginner levels for all the games. With effort and a bit of self-coaching, I found all the tasks doable. As Play Attention and current research notes, this is not a quick fix, but requires both a serious fiscal and time commitment. There are many things to like about this program and a few that require a deeper understanding of neuro-feedback and patient manage­ment. Like vision therapy, there must be a total commitment by the doctors, staff, families, and patients involved. All should understand the fiscal and personal commitments needed to be successful. I suggest that if you are going to incorporate this into your practice, that you do it separately from your regular vision therapy program. You may want to consider using Play Attention’s iLab program to facilitate this therapy as an at-home program. I would also suggest, though, that if you do this the first few sessions be conducted in-office. In this way you can make sure your patient and their family understand how to do the program to maximize the individual’s chance of success. Final Recommendation This is a research supported tool to improve attention and other attention-related areas when deficits in attention are diagnosed. If used in combination with optometric vision therapy, not only should attention improve, but all symptoms associated with learning related vision problems can be eliminated as well. Using the Play Attention “Finishing Tasks” program while simultaneously conducting active therapy should also improve vision therapy outcomes. A combined program of Play Attention and optometric vision therapy may help us all improve the academic outcomes and quality of life of our patients. As a private practitioner (Lyons Family Eye Care), I am going to seriously consider this adjunct intervention as a part of the many services I provide for my patients. As an academic, I can see multiple Play Attention and vision therapy research projects already being considered in the future. I would suggest that all who are reading this review take a moment to consider using this within your patient care regimen for attention anomalies as well.