A new study evaluates the feasibility, safety, and benefit potential of video game-based ‘digital medicine’ to help children with autism and co-occurring ADHD.

Counter-intuitively, a new study has found that a digital tool could improve attention span and other metrics in a population of children with autism and ADHD.

The presence of attention deficit/hyperactivity disorder (ADHD) symptoms in children with autism spectrum disorder (ASD) is associated with worse cognitive control. Children with ASD and ADHD often respond poorly to medications, necessitating the need for alternative treatments.

Researchers at Children’s Hospital of Philadelphia (CHOP) evaluated a digital medicine tool (Project Evo) designed as an investigational treatment for children with ASD and co-occurring ADHD. Results of the study, published in the Journal of Autism and Developmental Disorders, confirmed the acceptability, feasibility, and safety of Project: EVO, which delivers sensory and motor stimuli through an action video game experience. It was designed by Akili Interactive, a prescription digital medicine company.

As many as 50% of children with ASD have some ADHD symptoms, with roughly 30% receiving a secondary diagnosis of ADHD. However, since ADHD medications are less effective in children with both disorders than in those with only ADHD, researchers are exploring alternative treatments.

“Children with ASD and ADHD symptoms are also at high risk for impaired ‘cognitive function’, including the brain’s ability to maintain attention and focus on goals while ignoring distractions,” said Dr Benjamin Yerys, a child psychologist at CHOP’s Center for Autism Research (CAR) and first and corresponding author on the study. “As children reach school age and beyond, these cognitive impairments make it more difficult for them to set and achieve goals, as well as successfully navigate the demands of day-to-day life in the community.

“Our study showed that children engaged with the Project: EVO treatment for the recommended amount of time, and that parents and children reported high rates of satisfaction with the treatment,” said Dr Yerys. “Based on the promising study results, we look forward to continuing to evaluate the potential for Project: EVO as a new treatment option for children with ASD and ADHD.”

Nineteen children aged 9-13 with ASD and co-occurring ADHD symptoms completed this app-based treatment that targets multi-tasking through gameplay versus a comparison educational treatment. The study found that children adhered to the treatment protocol by engaging with the treatment for 95% or more of the recommended treatment sessions.

“Both parents and children reported that the treatment had value for improving a child’s ability to pay attention and served as a worthwhile approach for treatment,” said Dr Yerys. “Within-group analyses suggest the multi-tasking but not the educational treatment may improve cognitive control.” Though the sample size of the study was small, the study showed that using Project: EVO was feasible and acceptable with potentially therapeutic effects. The research team is planning a larger follow-up study for continued evaluation of Project: EVO’s potential efficacy.