Are these games addictive for children with ADHD, since presumably they trigger the release of dopamine? "Only in the sense that any pleasure is addictive," Dr. Steingard says. "Anything that makes you feel good drives the same circuit path—movies, books, red velvet chocolate cake—although some you have to work at harder than others."
Paying attention in school is one of those things that takes a lot more work to generate rewards, and the claim has been made by some researchers that ADHD symptoms in school—inattention, hyperactivity, and impulsivity—are actually exacerbated in kids who are exposed to a lot of TV and video games. The notion is that the constant stimulation and instant rewards of games raise the bar for kids to pay attention in normal, less stimulating situations.
An Iowa State University study of some 3,000 children and adolescents from Singapore, measured over three years, found that children who spent more time playing video games were more impulsive and had more attention problems. Researchers interpreted the findings to suggest that video game playing can "compound kids’ existing attention problems."
"Our data suggest that the children who already are most at risk for attention problems play the most games, which becomes a vicious cycle," says Douglas Gentile, an associate professor of psychology at Iowa State. But the study results don’t offer supporting evidence that there’s anything more than a link. Dr. Steingard says there’s no evidence of causality here.
That isn’t to say that kids spending an unlimited amount of time playing these games isn’t harmful, but it’s a different kind of harm. The problem is that all that screen time means time not spent doing other things more valuable for their development. "It takes time away from doing more creative or more learning-based activities," Dr. Weder says. "It takes time away from interaction with family and friends that helps them with their social skills."
Since social skills are a challenge for many kids with ADHD, who have trouble paying attention and reining in their impulsivity, the cost can be high. "It’s not healthy socially to spend a lot of time by yourself playing games in lieu of doing something with people," Dr. Steingard says. But he adds that this is a global concern—and not just for kids with ADHD. "No kid should spend unlimited time sitting in front of a screen in lieu of playing with other kids."
The American Academy of Pediatrics recommends an hour per day of total media screen time for elementary school children, and two hours for kids in secondary school. American children, Gentile says, currently average more than six hours of screen time per day.
Caroline Miller, mother of three, is the editorial director of Childmind.org, the website of Child Mind Institute in NYC. Access the full research report, “Video Game Playing, Attention Problems, and Impulsiveness: Evidence of Bidirectional Causality,” from the journal “Psychology of Popular Media Culture,” at nyspecialparent.com/video-report.