A presentation given by LearningWorks for Kids at a 2013 conference.

1. Games and Apps for Improving
Executive Functions in Children
with ADHD
Presentation at CHADD 2013 Annual International
Conference on ADHD
Randy Kulman, Ph.D.
President, Learning Works for Kids

2. Disclaimer
Randy Kulman is President of LearningWorks for
Kids, Inc. and a Cogmed provider.

3. Take-Aways
• Brief review of Executive Functions (EFs) / Thinking
Skills
• Why EFs are crucial, particularly to kids with ADHD
• How EFs are used in video games and apps
• Why we want to use technology to teach EFs for
ADHD
• How games and apps can support, practice, and
help acquire EFs
• Why games and apps are not enough
• How to transfer game –based skills to real world
activities

4. Finding Angry Birds
• How to find Angry Birds on your device:
• iPhone, iPad: Go to App store, search on
bottom of screen, type Angry Birds, go to
Free version, tap free and then download
• Android Phone/ Tablets:
Go to Google Play, search
Angry Birds go to Free
version, tap free and then
download

5. What are Executive Functions?
• Cognitive capacities that enable independent,
purposeful, goal-directed behavior
• The CEO or the conductor of
the brain
• A collection of brain processes
that guide thought and behavior
• Located primarily in the prefrontal
cortex but involving other neural
networks

6. Executive Functions
Development
• Infancy; when a child can keep an object in
mind while playing hide-and-seek
• Preschoolers; learning to inhibit behavior such
as not touching a hot stove and developing
basic social skills
• Adolescence; learning to develop planning,
emotional regulation, and organizational skills
• EFs develop slowly in many psychiatric
disorders, and in particular ADHD
• Teens, Tweens need EF “support”, scaffolding

7. Evernote

8. Evernote

9. LiveScribe
• A smartpen that records voice notes that is connected to
written notes
• Child takes notes on digitally-equipped paper and when
going over those notes can listen to
• Recordings of lectures
• Helps with children who
struggle with working
memory
• Very helpful for children who
process information or have
slow clerical motor speed

10. LiveScribe

11. Dawson and Guare Model of
Executive/Thinking Skills
Focus
Task Persistence
Sustained attention
Task initiation
Self-Awareness
Metacognition
Social thinking
Self-Control
Regulation of affect
Response inhibition
Working Memory
Organization
Planning
Flexibility
Time Management

12. The Importance of Teaching
Thinking and Executive Skills
• Preschoolers who learn EF’s perform better
academically (Diamond, McClelland)
• Improving working memory enhances
reading, reduces ADHD symptoms (Cogmed
research)
• Self Control enhances future life success
(Marshmallow test)
• Protects children from mental health issues

13. Executive/Thinking Skills
in Daily Life
• Assembling a toy - planning and organization,
focus
• Cleaning one’s room - focus, organization
• Getting ready for school
in the morning: planning,
time management
• Completing chores:
focus, time management,
working memory

14. Executive/Thinking Skills
in School
• Doing homework - organization, planning, focus,
time management
• Phonological awareness - working memory
• Written language:
organization, focus,
planning
• Math word problems:
working memory, focus,
planning

15. Train Your Brain for Success

16. Research on Thinking/Executive
Skills and Video Games
• Games (non video) that increase cognitive load and
used as a teaching tool by parents reduce ADHD
symptoms in Preschoolers (Halperin, 2012)
• Combination of board and video games improve
fluid reasoning and processing speed (Mackey,
2011)
• Working memory video games improve WM, fluid
reasoning skills (Cogmed studies)
• Computer-based training improves executive
attention in preschoolers (Rueda, 2005)
• LW4K pilot study

17. Research based technologies to
improve executive skills
• Improves processing speed and time
management (Green and Bevalier, 2009)
• Improves working memory (Klingberg, et al,
2007)
• Increases pro-social behaviors (Gentile et al,
2009)
• Improves problem solving skills (Gee, 2007)
• Enhances social involvement (Ferguson, 2010)

18. Angry Birds
• Birds are used as
projectiles to hit pigs that
are protected by
structures.
• Players plan out each shot
and predict the
consequences of his shot.
• Each level is set out
uniquely so the player to
flexibly change strategies.

19. Angry Birds

20. Cautions
Solutions
Children with ADHD or attention problems
may become “hyper-focused” on video games
and other digital media, neglecting other
important responsibilities.
Require that your child complete all of her
homework, chores, or other responsibilities
before being allowed some digital play time. By
making him put-off these fun activities until
after her work is done, he won’t be able to use
digital play as a means of procrastination.
Kids with ADHD or attention problems often
become so absorbed with activities they find
interesting, that they may lose track of how
much time they have spent on their digital
play.
Use a timer if you need to limit your child with
ADHD. Time management and having a sense
of time are often significant deficits for children
with attention problems. You can use online
timers such as TabTimer.com or even an
everyday kitchen timer to keep your child on
track.
Kids with ADHD or attention problems may
choose to engage with digital play instead of
the physical activities that are part of a
healthy treatment process.
Exercise has been shown to improve Focus and
learning in children with attentional problems.
Tell your child to go out and run around before
playing video games, and to play active games
such as Wii Tennis or Kinect Adventures.

21. Play Diet
• Social Play, Active Play, Creative Play, and
Free Play.
• Digital Play is just one part of a balanced
Play Diet.
• Neglecting digital play is just
as bad as allowing too
much digital play.
• Digital Play can be active,
social, creative, and free.

22. Why use video games and digital media to help
kids with ADHD?
Kids with ADHD or Attention
Difficulties
Video Games and Digital Media
May become easily bored and unable
to sustain attention
Good video games and digital media are often
multi modal, requiring ever-changing skills and
employing video, sounds, words, and actions that
help keep kids interested and engaged.
Often require immediate
reinforcement or consequence to
stay focused on a task.
Video games provide clear and immediate
feedback, constantly letting the player know
what he is doing wrong, and what he is doing
right.
Often require that their body or mind
to be actively engaged.
Video games and digital media are extremely
engaging and many require physical and cognitive
involvement.

23. Why use video games and digital media to help
kids with ADHD?
Kids with ADHD or Attention Difficulties
Video Games and Digital Media
Usually have problems with following
directions.
Video games teach by trial and error or
through guided discovery, requiring that the
player understand the instructions in order to
succeed.
May struggle to learn new information and
experience frustration or low self-esteem as a
result.
Most negative feed back from video games
and other digital media occurs privately. This
causes less embarrassment and frustration,
while teaching the player how to handle
these emotions

24. What are the characteristics of interventions that
work best with children With ADHD?
• Point of performance interventions
• Immediacy of feedback
• Powerful and engaging feedback and
meaningful consequences
• Multimodal presentations and multiple
intervention agents
• Individualized to child’s capacities
• Strategic teaching principles including:
previewing, setting explicit goals,
partnering, metacognition, and
generalization strategies

25. How do games, apps, and digital
media improve executive functions?
• Great variation in how they may or may not help,
similar to physical exercise
• Effectiveness is determined in part by level of
stimulation and engagement
• Support—provides external structure to help
regulate or scaffold skills
• Practice—guided rehearsals in repeatedly using a
new executive skill
• Master—the child “owns the skill” and is motivated
and knowledgeable about where and when to apply
it

26. How do digital technologies
teach executive functions?
The LearningWorks for Kids model:
•Games as a vehicle for "engaging the gears" of a child's
brain
•Opportunities for children to practice an executive skill in
a fun and engaging fashion
•A teaching opportunity for parents, teachers, and
clinicians
•An opportunity to detect, reflect, and connect on the use
of executive skills
•A "new literacy," an understanding of ways of doing,
thinking, and valuing things in the context of relationships
and school practices (James Paul Gee)

27. How well do game based skills
transfer to the real world?
• Game play alone results in modest
improvements in real-world executive skills
• Children with learning and attention problems
have problems in generalizing strategies
• Kids like to talk about playing video games and
may be willing to learn from that
• Games prompt partnering and motivation to
learn executive skills
• Practice and rehearsal of executive skills

28. BUT…games are not enough!!!
• The key to success is effective teaching
• Teachers (including peers, parents, and imbedded
instruction) make the
connection between gamebased learning and real-world
skills
•Actual learning requires
knowledge of the skill,
understanding how and when to
use it, and practice across many
situations

29. Effective teaching with digital
technologies:
• Goals need to be explicit and shared
• "It's not about the game.”
• Finding other teaching opportunities for
developing executive skills
• Limiting video game-play
• Getting peers, siblings, or other family
members involved
• Noticing and reinforcing improvements in the
use of executive skills

30. Conditions in which “Brain Training” or
Technology Work Effectively
(From the Sharpbrains Guide to Brain Fitness, assumes direct
connection of brain training to skills)
• Training exercises core brain-based capacity
• Training connects to real-life outcomes such as
executive functions or working memory
• Training targets an area of weakness
• Dosage is important, with a minimum of 15 hours
performed over 8 weeks or less
• Intensity is important, as training must be adapted
to performance and requires increasing effort
• Continued practice is necessary to see continued
benefits

31. Executive Skills Questionnaire

32. Prescription of Games, Technologies,
and Recommendations

33. Quizzes and Assessments

34. Advice for Parents

35. Where’s My Water?

36. Where’s My Water?

37. Planning in
Where’s My Water?
Planning skills are used when the player:
•assesses the level.
•thinks out steps before moving water.
•considers different options for reaching the
goal.
•decides on a course of action.
•carries out a course of action based on a
predetermined plan.

38. Planning in Life
Planning skills are used when a child:
•reads directions prior to starting a task.
•determines the steps necessary to complete
complex math problems.
•engages in pre-writing tasks such as
brainstorming, outlining, and using graphic
organizers.
•decides which materials to pack in a backpack.
•prioritizes homework and extracurricular tasks.

39. Thank You
Randy Kulman, Ph.D
randy@learningworksforkids.com
@lw4k on Twitter
www.pinterest.com/lw4k
www.learningworksforkids.com