19 ms·

Doctor-prescribed videogame for ADHD

136 points by wdh505 2y ago

crustaceansoup 2y ago
This looks like something you could game jam with a 4 person crew in a couple days (being really generous). $99 a month, seriously?
pyridines 2y ago
A shame there's only one doctor left :(
deleted 2y ago
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the_gipsy 2y ago
$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?
- mattgreenrocks 2y ago
  If it works, then that’s not a bad price at all. ADHD attentional issues will suck orders of magnitude more money out of your life if left untreated in some people.
  - TeMPOraL 2y ago
    If it works. If it doesn't, then that's just another $99/month money hole that people with ADHD have a particular difficulty digging themselves out of - subscriptions are like a kryptonite to them.
    - FrustratedMonky 2y ago
      Hence the studies? /sarcasm. And, can't you cancel the subscription?
      - TeMPOraL 2y ago
        Most people can. People with ADHD usually can, eventually.
    - mattgreenrocks 2y ago
      So long as cancellation is as easy signing up, I think they’ll be okay.
      - TeMPOraL 2y ago
        Not really - cancellation being objectively as easy as signing up is still much harder to actually do for people with ADHD. Signing up is something exciting and fun and something such person may do impulsively in a moment of weakness. Cancelling is boring and scary (what if dark patterns?) and a chore you don't look forward to, but rather try to not forget. It's not positively rewarding, but merely stops a penalty. This might seem like an exaggerated difference, but it actually hits the exact points that are affected by executive dysfunction.
- gjsman-1000 2y ago
  On one hand, this isn’t a drug, so it would probably be much cheaper to test and verify. On the other hand, the average cost for drug R&D, testing, and approval was $2.87 billion each… in 2016. That’s going to take serious cash to break even on.
- coderc 2y ago
  Will insurance lower the cost in the case that this is a prescribed treatment?
- stevebmark 2y ago
  There is high corruption at every level of healthcare, from ambulance companies to prosthetists to local doctors to hospitals to pharmacies to insurance to government. $99/month is pure corruption, and they get away with it because insurance can help cover it. In healthcare, "Economies of scale don’t lower prices", and "prices rise to what the market will bear" - An American Sickness. Very much what you're seeing here for this price tag.
  - antisthenes 2y ago
    Well said. This corruption costs Americans hundreds of billions of dollars every year.
  - resource_waste 2y ago
    As a healthcare clinic owner: ITS SO EASY TO MAKE MONEY! Like, my wife with 0 business experience, is able to profit 6 figs off her workers and 6 figs off her labor. She completely failed to train new/bad people and multiple patients left her clinic because of the poor quality labor. Doesnt matter, all those patients paid and she is slammed busy. Limiting licenses is an excuse for quality. These doctors are so absurdly low quality and getting paid for treatment that doesnt work. I propose a science based medical system as an alternative to the Authority based healthcare system. Never going to happen because clinic owners like myself lobby, but it would be better.
- simonlc 2y ago
  I guarantee they didn't invent anything new to gaming. It's just like all those studies that claim tetris helps with ptsd, stress, lazy eye, postpartum depression, etc. It's just a game. There's nothing that makes this game, or tetris specifically special.
  - FrustratedMonky 2y ago
    Even though there were a lot of studies on other existing games helping "ptsd, stress, lazy eye, postpartum depression, etc.". I wonder if they were to be used in some treatment, they would also need to be approved? So Tetris itself wouldn't cost, but the doctor administering treatment gets approval to use the game, and that overall treatment costs the money. I'm little unsure if any joe blow psychologist is allowed to makeup treatments, or if they go through an approval process also.
- guidedlight 2y ago
  Just saying there are heaps of free apps that monitor and manage insulin dosing without FDA approval. I don't see why you need FDA approval for a video game, or even make medical claims about a video game.
  - jpeggtulsa 2y ago
    Because you can buy it using FSA/HSA. There are very strict laws against what is considered purchasable on those plans.
- gcheong 2y ago
  FDA did not approve it, that is the highest level and requires proof that it is more effective than placebo I believe. The FDA only looked for adverse events in the data and granted authorization to market it as they determined it is very low risk for adverse events. But people will be mislead by the FDA-authorized status as some kind of FDA blessing that it works: https://www.fda.gov/news-events/press-announcements/fda-permits-marketing-first-game-based-digital-therapeutic-improve-attention-function-children-adhd https://www.fda.gov/news-events/press-announcements/fda-perm...
  - ProjectArcturis 2y ago
    This is false. The FDA does not grant approval to market anything solely on the basis of "low risk for adverse events." The game makers had to run studies demonstrating that it improved ADHD measures. The link you provided says that as well: "The FDA reviewed data from multiple studies in more than 600 children, including studies that evaluated, among other things, whether participants demonstrated improvements in attention function, as measured by the Test of Variables of Attention (TOVA), academic performance measures, and other assessment tools."
    - gcheong 2y ago
      Fair enough, I think I came to that conclusion because reading the next statement was just that they determined there were no major adverse events. But I think it still stands that this is only a marketing authorization, the FDA isn't saying it works, so really the company shouldn't be mentioning the FDA at this point unless they go for a stronger classification.
      - ProjectArcturis 2y ago
        "When the facts change, I don't change my opinion."
        gcheong 2y ago
        Which facts? I was wrong about the evidence needed for marketing authorization but, if I’m not mistaken, they would need that authorization in order to market the product in the first place so mentioning the FDA authorization would, in my opinion, potentially give people the wrong impression that the FDA has endorsed the product at a level (e.g. approval) which I don’t believe the FDA has done at this point.
- danielfoster 2y ago
  Getting any kind of drug or medical therapy approval is extremely risky and expensive.
- ossobuco 2y ago
  Genius move, take a crappy mobile game, call it a medical device and sell it for a price not even the best AAA games would ever dream to ask. Only the USA healthcare system could give life to such an abomination.
  - WA 2y ago
    Nope, we have the same in Germany (and in the EU), called "digital health applications" (DiGA in German). These are smartphone apps with some medical claims, certified as medical devices and prescribed by doctors. They make about €120-€500 for 90 days. In some cases, these apps might be useful. But I think there are quite a few cash grabs in there, too.
    - ossobuco 2y ago
      Germany is the first country, in 2019, to have introduced a pathway for DiGA to be prescribed and reimbursed by health insurance. But in 2017 the FDA launched the Digital Health Innovation Action Plan. So arguably the concept was born in the USA.
umbra07 2y ago
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.
- readthenotes1 2y ago
  Heh Maybe reading a good physical book for the same time would work as well??
  - acchow 2y ago
    If you do find a book which manages to totally captivate you, then you’d just rather read that instead of returning to normal life. Not sure if this really counts as helping ADHD
    - bitwize 2y ago
      The key is to find a hard, less captivating book and just power your way through it. Crime and Punishment may be this for some. You could also try learning X11 programming with the famous wall-o'-manuals that entails.
      - 01HNNWZ0MV43FF 2y ago
        My productive habit is that every morning I wake up, eat a healthy breakfast, and pop a couple Atomoxetine
      - RoyalHenOil 2y ago
        >The key is to find a hard, less captivating book and just power your way through it... This is a lot like saying that the way to treat a broken leg is to just start running on it and not have it be broken anymore.
fn-mote 2y ago
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.
- lewispollard 2y ago
  ADHD and other neurodevelopmental disorders are all typically assessed based on self report (via standardised questionnaires).
diob 2y ago
You know when they don't say actual numbers that it doesn't work much better than a placebo.
- ryanwhitney 2y ago
  They include some clinical research info at the end of the usage instructions PDF[0]. One says results were not statistically significant and the other has a warning that it may be placebo effect since they didn’t have a “sham control group”. (I don't have enough stats knowledge to know what any of this actually means though.) 0: https://www.endeavorrx.com/wp-content/uploads/2024/01/EndeavorRx-IFU5011-Commercial-RevU.pdf https://www.endeavorrx.com/wp-content/uploads/2024/01/Endeav... (pdf)
  - odo1242 2y ago
    As a person who did study statistics, they found absolutely nothing useful, for the most part, if what you say is correct. (Basically, everything they found can be attributed to random chance, and there’s no proof their game is anything special compared to other games)
    - ProjectArcturis 2y ago
      Did we read the same thing? "The primary endpoint was achieved, mean change from baseline on the TOVA API was 0.93 in the EndeavorRx group versus 0.03 in the control group (p=0.006). "
      - diob 2y ago
        I couldn't find anything incredibly definitive on TOVA, but based on https://www.queensu.ca/rarc/sites/rarcwww/files/uploaded_files/Research/what%20can%20we%20learn%20about%20TOVA%20profiles%20Pollock%20Harrison%20Armstrong%202021.pdf https://www.queensu.ca/rarc/sites/rarcwww/files/uploaded_fil... it does seem incredibly useless / statistically insignificant.
        2y ago
boomskats 2y ago
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.
umvi 2y ago
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.
- AILU77 2y ago
  You don't need to put in efforts, I offer with ADHOCON.COM a contract legal manufacturer, we do all the paperwork incl. clinical evaluation for the developer and register the product with our QMS and Documentation for you
- zeristor 2y ago
  Tetris has been used to reduce PTSD: “Can playing Tetris help prevent PTSD if you’ve witnessed something traumatic?” https://theconversation.com/can-playing-tetris-help-prevent-ptsd-if-youve-witnessed-something-traumatic-226736 https://theconversation.com/can-playing-tetris-help-prevent-...
- fragmede 2y ago
  equally seriously, if you ran proper scientific studies showing actual improvements with tetris because it's a very rules oriented game, vs something more abstract, like Stardew valley, isn't that actually a treatment?
  - TeMPOraL 2y ago
    If you ran them, and they did show actual improvement, and demonstrated the causal connection, then yes, it would be a treatment. That is not what happened here, though.
jagged-chisel 2y ago
doctor-prescribed TFA’s title is to blame. This hyphen makes the title read correctly.
- deleted 2y ago
  [deleted]
sneed_chucker 2y ago
$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.
autoexec 2y ago
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.
- superb_dev 2y ago
  Wait, how isnt that privacy policy terrible? No medical treatment should also be selling your behavior to advertisers.
  - phito 2y ago
    Yeah, sad to see the standards are set so low
- evrimoztamur 2y ago
  They do have the 'adult version' at https://www.endeavorotc.com/ https://www.endeavorotc.com/
ben_sisko 2y ago
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.
- api 2y ago
  Our stupid phobia of stimulants is a major blocker too. Making it hard to get ADD drugs does nothing to address abuse of street drugs like meth. Unlike opiates there is no evidence they lead people toward street drugs. I’m personally in favor of OTC availability of some kind of safe abuse resistant mild stimulant. Sure there are a few people who would try to get high with it but hard liquor and weed are legal.
  - ProjectArcturis 2y ago
    >I’m personally in favor of OTC availability of some kind of safe abuse resistant mild stimulant. Sure there are a few people who would try to get high with it but hard liquor and weed are legal. Like caffeine?
    - piperswe 2y ago
      Caffeine builds physical dependence easier than amphetamine, AFAIK
      - qingcharles 2y ago
        Is caffeine strong enough to have any serious effect on ADHD? It barely touches my concentration difficulties.
        bluefirebrand 2y ago
        I don't know if it actually helps, but for a while I was drinking so much coffee I gave myself ulcers. I eventually got diagnosed ADHD in my 30s, and my doctor suggested that my coffee problem was a subconscious effort to self-medicate. I've been on stimulants for a few years and quit coffee easily (with some nasty headaches and such, but no real cravings) I do still have coffee now and then, but only occasionally and only because I like the taste. I often stick to decaf when I do have it, too
citizenpaul 2y ago
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.
quink 2y ago
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.
superb_dev 2y ago
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.
AzzyHN 2y ago
Spend $99/mo on some meds instead. Much more effective.
pogue 2y ago
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 https://youtube.com/watch?v=qkhSLr6DlWc
- contravert 2y ago
  Watching the video, it's not really clear how this game is substantially different than a normal mobile game. What is the actual mechanism here for treating ADHD?
  - romwell 2y ago
    Placebo effect for parents who pay money for this, I assume.
  - lewispollard 2y ago
    If the gameplay amounts to what's in the video, it seems to be based on a poor or at least vastly simplified understanding of what ADHD is, seems to be training some a simple kind of multimodal attention and context switching between simultaneous things, but pretty much any complex video game will do that. Being designed around that premise seems to be taking the name "attention deficit" a bit too literally given the wide array of symptoms that have little to do with that kind of skill. Anecdotally, as someone with ADHD, I seem to be naturally better at that kind of "doing 2 things at once" skill than my peers anyway. Perhaps we're just seeing a tiny slice of the game and there's a lot more to it, but my experience of healthcare software and startup culture makes me think no, that's probably the entirety of the game, dressed up in some technobabble and references to medical journals/papers without much actual evidence-based efficacy.
kinos 2y ago
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.
vrighter 2y ago
$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.
aaron695 2y ago
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jacknews 2y ago
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'.
lackoftactics 2y ago
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
alfiedotwtf 2y ago
Who knew all this time I was self-medicating
- FrustratedMonky 2y ago
  Not sure this even joking really. ADHD people often self medicate with alcohol or coffee. Video Games have definitely been in the mix for 'self-medicating'. That is why I'm wondering why so many people in this thread say 'just play such and such game X'. Games can be addicting, to be addicted to a game isn't necessarily helping the person. But games can also help. So there has to be some mechanism, some particular game play mechanism that is helping. That is what needs to be studied. Then we could pick the ones already on the market with that mechanism.
  - alfiedotwtf 2y ago
    I'm on 40mg Vyvanse daily, so it was a self-depricating joke... but as for me, replace games with programming - like many here, I was fortunate enough to turn my hyper-hyper-focus in a paid career. I don't know how many people with ADHD are as lucky.
xlii 2y ago
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.
- latentsea 2y ago
  >Would it be possible that ANY video game has a positive effect on ADHD? Some have very detrimental effects. Games are inherently interesting. Usually much more interesting than homework and/or housework. So, you start playing video games and all of a sudden you can't switch your attention back to the homework or housework when you need to. This causes lots of friction between you and the other people in your life that expect things of you. It's a fundamental difficulty of regulating attention, not staying focused. That means either keeping it on something when you need to OR switching it away from something when you need to. In my experience an enormous class of problems stems from being unable to switch your attention away from something that has just absolutely grabbed a hold of you and that causing you to be scolded by those around you day in day out for not meeting expectations.
louiechristie 2y ago
“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/Adults-with-ADHD-See-Significant-Improvements-in-Attention-ADHD-Symptoms-and-Quality-of-Life-in-Clinical-Trial-of-Akili%E2%80%99s-EndeavorRx%C2%AE-Video-Game-Based-Therapeutic 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 https://en.wikipedia.org/wiki/Placebo
- romwell 2y ago
  Not to mention, TOVA scores are pure blocks that don't even claim to correlate with ADHD traits.
dailykoder 2y ago
>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
- close04 2y ago
  > 30 day prescription > Why is everything subscription based nowadays? It's a prescription (written note from the doctor) but this looks like a long term regimen so you could call it a subscription too. The reason is almost definitely profit. As a game there's no reason for it to be this expensive. As a medical treatment I doubt the R&D justifies the cost.
  - dailykoder 2y ago
    Oh woopsie, Thanks for the clarification.
- poulpy123 2y ago
  It's because it makes more money and is more stable than once time buy. And it's especially expensive because it's "medical": both because it is more expensive to have a medical stamps of approval (although I'm not sure here) and because people don't have many alternatives
- fleischhauf 2y ago
  everything is subscription based, because companies have a continuous income stream (as opposed to one time large payment). With an continuous income stream you can plan better.
  - richrichie 2y ago
    Well, one time payment can be turned into an income stream by investing the amount in treasuries or a time deposit account. That is the whole purpose of existence of financial markets.
hawski 2y ago
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.
Cloudef 2y ago
> 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.
helloplanets 2y ago
Now I'm interested in a proper study that compares different popular video games across various genres, for treating ADHD.
deleted 2y ago
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andrewqa 2y ago
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eleveriven 2y ago
I think it is a promising advancement in ADHD treatment
niemandhier 2y ago
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.
thih9 2y ago
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?
Lockal 2y ago
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.
dkga 2y ago
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.
fxtentacle 2y ago
In case anyone is curious, this is the actual study: https://www.nature.com/articles/s44184-024-00075-w.pdf 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/ 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".
- resource_waste 2y ago
  "Nature" used to be well respected according to academics. However, Academia isnt science, its authority. I've now seen 2 studies that should never have been published in Nature in the last year. I am science based, so I never really cared about what organization published, look to the data. However, if you hang out with academics, they unanimously read the journal + abstract. Its so weird. I feel like there is some sort of Dunning Kruger where I'm the idiot... But really... I know the scientific method. I know the quality of the people I'm talking to. Happy to see you didn't just accept it like my academia pals!
Eumenes 2y ago
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.
davikr 2y ago
> 73% of children reported an improvement in their attention. What kind of study outcome is this?
- nusl 2y ago
  The kind of study outcome that tries to get people to buy the product.
pgcudahy 2y ago
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.
fredgrott 2y ago
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.
devcil 2y ago
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.
- khaki54 2y ago
  > please don't speculate about ADHD, especially about people who suspect they might have it. Is this a joke? This is a discussion platform for speculating. Plus half the people on HN probably have ADD or ADHD
  - segfaltnh 2y ago
    Love this comment. As someone with ADHD, I am drawn to technology and made a career out of it. I suspect many people here are the same, diagnosed or not. By the way, the "ADD" diagnosis has been removed from the DSM, there's no longer a medical distinction between the two.
  - Eumenes 2y ago
    > Plus half the people on HN probably have ADD or ADHD They've convinced themselves they have it. Please ignore the prevalence of obesity, lack of exercise, poor diet, and anti-social nature of tech workers plz. They are suffering from a natural affliction.
- Mo3 2y ago
  I have ADHD-PI and am medicated. I too believe this cannot substitute medication in anything but less severe cases (if that even exists), but I cannot overstate the importance and usefulness of coping mechanisms and attention training. It really defines to some extent whether medication is necessary and in which form (only working hours, all waking hours, etc). Now, granted, for some even building habits and a routine is impossible (like me sometimes too), and then medication fixes some issues and one starts to almost automagically create habits and routines. I've gone years unmedicated when I had a less demanding and more lax work environment and daily focus meditation has helped a great deal. If I'm not mistaken some video games have also vastly improved and kept alive quick reaction times and delayed reward mindset - stuff that this game seemingly also does - training being less impulsive and overriding other, negative habits. It makes perfect sense - video games can release high amounts of dopamine on demand, while in our daily lives we lack release in key moments. Synaptic plasticity, learning and memory is dopamine dependent. In a dopamine deprived brain, if timed correctly, these sudden releases can be extremely habit-forming and beneficial. I've read through their whole website and nowhere is mentioned that this is supposed to replace necessary medication. It's simply another tool in the toolbox, and as such should absolutely not be disregarded. I can 100% see this being extremely helpful and would love to try it out - unfortunately the apps are only available in US app stores.
sam_goody 2y ago
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?
zelias 2y ago
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.
k__ 2y ago
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.
shadowtree 2y ago
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.
- regfault 2y ago
  Really fascinating. Do you remember the name of the app or the kind of sound therapy? Sounds like it might work wonders.
deleted 2y ago
[deleted]

136 points by wdh505 2y ago

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

pyridines 2y ago

A shame there's only one doctor left :(

deleted 2y ago

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the_gipsy 2y ago

$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?

mattgreenrocks 2y ago
If it works, then that’s not a bad price at all. ADHD attentional issues will suck orders of magnitude more money out of your life if left untreated in some people.
- TeMPOraL 2y ago
  If it works. If it doesn't, then that's just another $99/month money hole that people with ADHD have a particular difficulty digging themselves out of - subscriptions are like a kryptonite to them.
  - FrustratedMonky 2y ago
    Hence the studies? /sarcasm. And, can't you cancel the subscription?
    - TeMPOraL 2y ago
      Most people can. People with ADHD usually can, eventually.
  - mattgreenrocks 2y ago
    So long as cancellation is as easy signing up, I think they’ll be okay.
    - TeMPOraL 2y ago
      Not really - cancellation being objectively as easy as signing up is still much harder to actually do for people with ADHD. Signing up is something exciting and fun and something such person may do impulsively in a moment of weakness. Cancelling is boring and scary (what if dark patterns?) and a chore you don't look forward to, but rather try to not forget. It's not positively rewarding, but merely stops a penalty. This might seem like an exaggerated difference, but it actually hits the exact points that are affected by executive dysfunction.
gjsman-1000 2y ago
On one hand, this isn’t a drug, so it would probably be much cheaper to test and verify. On the other hand, the average cost for drug R&D, testing, and approval was $2.87 billion each… in 2016. That’s going to take serious cash to break even on.
coderc 2y ago
Will insurance lower the cost in the case that this is a prescribed treatment?
stevebmark 2y ago
There is high corruption at every level of healthcare, from ambulance companies to prosthetists to local doctors to hospitals to pharmacies to insurance to government. $99/month is pure corruption, and they get away with it because insurance can help cover it. In healthcare, "Economies of scale don’t lower prices", and "prices rise to what the market will bear" - An American Sickness. Very much what you're seeing here for this price tag.
- antisthenes 2y ago
  Well said. This corruption costs Americans hundreds of billions of dollars every year.
- resource_waste 2y ago
  As a healthcare clinic owner: ITS SO EASY TO MAKE MONEY! Like, my wife with 0 business experience, is able to profit 6 figs off her workers and 6 figs off her labor. She completely failed to train new/bad people and multiple patients left her clinic because of the poor quality labor. Doesnt matter, all those patients paid and she is slammed busy. Limiting licenses is an excuse for quality. These doctors are so absurdly low quality and getting paid for treatment that doesnt work. I propose a science based medical system as an alternative to the Authority based healthcare system. Never going to happen because clinic owners like myself lobby, but it would be better.
simonlc 2y ago
I guarantee they didn't invent anything new to gaming. It's just like all those studies that claim tetris helps with ptsd, stress, lazy eye, postpartum depression, etc. It's just a game. There's nothing that makes this game, or tetris specifically special.
- FrustratedMonky 2y ago
  Even though there were a lot of studies on other existing games helping "ptsd, stress, lazy eye, postpartum depression, etc.". I wonder if they were to be used in some treatment, they would also need to be approved? So Tetris itself wouldn't cost, but the doctor administering treatment gets approval to use the game, and that overall treatment costs the money. I'm little unsure if any joe blow psychologist is allowed to makeup treatments, or if they go through an approval process also.
guidedlight 2y ago
Just saying there are heaps of free apps that monitor and manage insulin dosing without FDA approval. I don't see why you need FDA approval for a video game, or even make medical claims about a video game.
- jpeggtulsa 2y ago
  Because you can buy it using FSA/HSA. There are very strict laws against what is considered purchasable on those plans.
gcheong 2y ago
FDA did not approve it, that is the highest level and requires proof that it is more effective than placebo I believe. The FDA only looked for adverse events in the data and granted authorization to market it as they determined it is very low risk for adverse events. But people will be mislead by the FDA-authorized status as some kind of FDA blessing that it works: https://www.fda.gov/news-events/press-announcements/fda-permits-marketing-first-game-based-digital-therapeutic-improve-attention-function-children-adhd https://www.fda.gov/news-events/press-announcements/fda-perm...
- ProjectArcturis 2y ago
  This is false. The FDA does not grant approval to market anything solely on the basis of "low risk for adverse events." The game makers had to run studies demonstrating that it improved ADHD measures. The link you provided says that as well: "The FDA reviewed data from multiple studies in more than 600 children, including studies that evaluated, among other things, whether participants demonstrated improvements in attention function, as measured by the Test of Variables of Attention (TOVA), academic performance measures, and other assessment tools."
  - gcheong 2y ago
    Fair enough, I think I came to that conclusion because reading the next statement was just that they determined there were no major adverse events. But I think it still stands that this is only a marketing authorization, the FDA isn't saying it works, so really the company shouldn't be mentioning the FDA at this point unless they go for a stronger classification.
    - ProjectArcturis 2y ago
      "When the facts change, I don't change my opinion."
      - gcheong 2y ago
        Which facts? I was wrong about the evidence needed for marketing authorization but, if I’m not mistaken, they would need that authorization in order to market the product in the first place so mentioning the FDA authorization would, in my opinion, potentially give people the wrong impression that the FDA has endorsed the product at a level (e.g. approval) which I don’t believe the FDA has done at this point.
danielfoster 2y ago
Getting any kind of drug or medical therapy approval is extremely risky and expensive.
ossobuco 2y ago
Genius move, take a crappy mobile game, call it a medical device and sell it for a price not even the best AAA games would ever dream to ask. Only the USA healthcare system could give life to such an abomination.
- WA 2y ago
  Nope, we have the same in Germany (and in the EU), called "digital health applications" (DiGA in German). These are smartphone apps with some medical claims, certified as medical devices and prescribed by doctors. They make about €120-€500 for 90 days. In some cases, these apps might be useful. But I think there are quite a few cash grabs in there, too.
  - ossobuco 2y ago
    Germany is the first country, in 2019, to have introduced a pathway for DiGA to be prescribed and reimbursed by health insurance. But in 2017 the FDA launched the Digital Health Innovation Action Plan. So arguably the concept was born in the USA.

umbra07 2y ago

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.

readthenotes1 2y ago
Heh Maybe reading a good physical book for the same time would work as well??
- acchow 2y ago
  If you do find a book which manages to totally captivate you, then you’d just rather read that instead of returning to normal life. Not sure if this really counts as helping ADHD
  - bitwize 2y ago
    The key is to find a hard, less captivating book and just power your way through it. Crime and Punishment may be this for some. You could also try learning X11 programming with the famous wall-o'-manuals that entails.
    - 01HNNWZ0MV43FF 2y ago
      My productive habit is that every morning I wake up, eat a healthy breakfast, and pop a couple Atomoxetine
    - RoyalHenOil 2y ago
      >The key is to find a hard, less captivating book and just power your way through it... This is a lot like saying that the way to treat a broken leg is to just start running on it and not have it be broken anymore.

fn-mote 2y ago

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.

lewispollard 2y ago
ADHD and other neurodevelopmental disorders are all typically assessed based on self report (via standardised questionnaires).

diob 2y ago

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

ryanwhitney 2y ago
They include some clinical research info at the end of the usage instructions PDF[0]. One says results were not statistically significant and the other has a warning that it may be placebo effect since they didn’t have a “sham control group”. (I don't have enough stats knowledge to know what any of this actually means though.) 0: https://www.endeavorrx.com/wp-content/uploads/2024/01/EndeavorRx-IFU5011-Commercial-RevU.pdf https://www.endeavorrx.com/wp-content/uploads/2024/01/Endeav... (pdf)
- odo1242 2y ago
  As a person who did study statistics, they found absolutely nothing useful, for the most part, if what you say is correct. (Basically, everything they found can be attributed to random chance, and there’s no proof their game is anything special compared to other games)
  - ProjectArcturis 2y ago
    Did we read the same thing? "The primary endpoint was achieved, mean change from baseline on the TOVA API was 0.93 in the EndeavorRx group versus 0.03 in the control group (p=0.006). "
    - diob 2y ago
      I couldn't find anything incredibly definitive on TOVA, but based on https://www.queensu.ca/rarc/sites/rarcwww/files/uploaded_files/Research/what%20can%20we%20learn%20about%20TOVA%20profiles%20Pollock%20Harrison%20Armstrong%202021.pdf https://www.queensu.ca/rarc/sites/rarcwww/files/uploaded_fil... it does seem incredibly useless / statistically insignificant.
      - 2y ago

boomskats 2y ago

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.

umvi 2y ago

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.

AILU77 2y ago
You don't need to put in efforts, I offer with ADHOCON.COM a contract legal manufacturer, we do all the paperwork incl. clinical evaluation for the developer and register the product with our QMS and Documentation for you
zeristor 2y ago
Tetris has been used to reduce PTSD: “Can playing Tetris help prevent PTSD if you’ve witnessed something traumatic?” https://theconversation.com/can-playing-tetris-help-prevent-ptsd-if-youve-witnessed-something-traumatic-226736 https://theconversation.com/can-playing-tetris-help-prevent-...
fragmede 2y ago
equally seriously, if you ran proper scientific studies showing actual improvements with tetris because it's a very rules oriented game, vs something more abstract, like Stardew valley, isn't that actually a treatment?
- TeMPOraL 2y ago
  If you ran them, and they did show actual improvement, and demonstrated the causal connection, then yes, it would be a treatment. That is not what happened here, though.

jagged-chisel 2y ago

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

deleted 2y ago
[deleted]

sneed_chucker 2y ago

$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.

autoexec 2y ago

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.

superb_dev 2y ago
Wait, how isnt that privacy policy terrible? No medical treatment should also be selling your behavior to advertisers.
- phito 2y ago
  Yeah, sad to see the standards are set so low
evrimoztamur 2y ago
They do have the 'adult version' at https://www.endeavorotc.com/ https://www.endeavorotc.com/

ben_sisko 2y ago

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.

api 2y ago
Our stupid phobia of stimulants is a major blocker too. Making it hard to get ADD drugs does nothing to address abuse of street drugs like meth. Unlike opiates there is no evidence they lead people toward street drugs. I’m personally in favor of OTC availability of some kind of safe abuse resistant mild stimulant. Sure there are a few people who would try to get high with it but hard liquor and weed are legal.
- ProjectArcturis 2y ago
  >I’m personally in favor of OTC availability of some kind of safe abuse resistant mild stimulant. Sure there are a few people who would try to get high with it but hard liquor and weed are legal. Like caffeine?
  - piperswe 2y ago
    Caffeine builds physical dependence easier than amphetamine, AFAIK
    - qingcharles 2y ago
      Is caffeine strong enough to have any serious effect on ADHD? It barely touches my concentration difficulties.
      - bluefirebrand 2y ago
        I don't know if it actually helps, but for a while I was drinking so much coffee I gave myself ulcers. I eventually got diagnosed ADHD in my 30s, and my doctor suggested that my coffee problem was a subconscious effort to self-medicate. I've been on stimulants for a few years and quit coffee easily (with some nasty headaches and such, but no real cravings) I do still have coffee now and then, but only occasionally and only because I like the taste. I often stick to decaf when I do have it, too

citizenpaul 2y ago

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.

quink 2y ago

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.

superb_dev 2y ago

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.

AzzyHN 2y ago

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

pogue 2y ago

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

contravert 2y ago
Watching the video, it's not really clear how this game is substantially different than a normal mobile game. What is the actual mechanism here for treating ADHD?
- romwell 2y ago
  Placebo effect for parents who pay money for this, I assume.
- lewispollard 2y ago
  If the gameplay amounts to what's in the video, it seems to be based on a poor or at least vastly simplified understanding of what ADHD is, seems to be training some a simple kind of multimodal attention and context switching between simultaneous things, but pretty much any complex video game will do that. Being designed around that premise seems to be taking the name "attention deficit" a bit too literally given the wide array of symptoms that have little to do with that kind of skill. Anecdotally, as someone with ADHD, I seem to be naturally better at that kind of "doing 2 things at once" skill than my peers anyway. Perhaps we're just seeing a tiny slice of the game and there's a lot more to it, but my experience of healthcare software and startup culture makes me think no, that's probably the entirety of the game, dressed up in some technobabble and references to medical journals/papers without much actual evidence-based efficacy.

kinos 2y ago

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.

vrighter 2y ago

$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.

aaron695 2y ago

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jacknews 2y ago

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'.

lackoftactics 2y ago

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

alfiedotwtf 2y ago

Who knew all this time I was self-medicating

FrustratedMonky 2y ago
Not sure this even joking really. ADHD people often self medicate with alcohol or coffee. Video Games have definitely been in the mix for 'self-medicating'. That is why I'm wondering why so many people in this thread say 'just play such and such game X'. Games can be addicting, to be addicted to a game isn't necessarily helping the person. But games can also help. So there has to be some mechanism, some particular game play mechanism that is helping. That is what needs to be studied. Then we could pick the ones already on the market with that mechanism.
- alfiedotwtf 2y ago
  I'm on 40mg Vyvanse daily, so it was a self-depricating joke... but as for me, replace games with programming - like many here, I was fortunate enough to turn my hyper-hyper-focus in a paid career. I don't know how many people with ADHD are as lucky.

xlii 2y ago

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.

latentsea 2y ago
>Would it be possible that ANY video game has a positive effect on ADHD? Some have very detrimental effects. Games are inherently interesting. Usually much more interesting than homework and/or housework. So, you start playing video games and all of a sudden you can't switch your attention back to the homework or housework when you need to. This causes lots of friction between you and the other people in your life that expect things of you. It's a fundamental difficulty of regulating attention, not staying focused. That means either keeping it on something when you need to OR switching it away from something when you need to. In my experience an enormous class of problems stems from being unable to switch your attention away from something that has just absolutely grabbed a hold of you and that causing you to be scolded by those around you day in day out for not meeting expectations.

louiechristie 2y ago

“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/Adults-with-ADHD-See-Significant-Improvements-in-Attention-ADHD-Symptoms-and-Quality-of-Life-in-Clinical-Trial-of-Akili%E2%80%99s-EndeavorRx%C2%AE-Video-Game-Based-Therapeutic 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 https://en.wikipedia.org/wiki/Placebo

romwell 2y ago
Not to mention, TOVA scores are pure blocks that don't even claim to correlate with ADHD traits.

dailykoder 2y ago

>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

close04 2y ago
> 30 day prescription > Why is everything subscription based nowadays? It's a prescription (written note from the doctor) but this looks like a long term regimen so you could call it a subscription too. The reason is almost definitely profit. As a game there's no reason for it to be this expensive. As a medical treatment I doubt the R&D justifies the cost.
- dailykoder 2y ago
  Oh woopsie, Thanks for the clarification.
poulpy123 2y ago
It's because it makes more money and is more stable than once time buy. And it's especially expensive because it's "medical": both because it is more expensive to have a medical stamps of approval (although I'm not sure here) and because people don't have many alternatives
fleischhauf 2y ago
everything is subscription based, because companies have a continuous income stream (as opposed to one time large payment). With an continuous income stream you can plan better.
- richrichie 2y ago
  Well, one time payment can be turned into an income stream by investing the amount in treasuries or a time deposit account. That is the whole purpose of existence of financial markets.

hawski 2y ago

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.

Cloudef 2y ago

> 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.

helloplanets 2y ago

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

deleted 2y ago

[deleted]

andrewqa 2y ago

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eleveriven 2y ago

I think it is a promising advancement in ADHD treatment

niemandhier 2y ago

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.

thih9 2y ago

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?

Lockal 2y ago

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.

dkga 2y ago

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.

fxtentacle 2y ago

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

resource_waste 2y ago
"Nature" used to be well respected according to academics. However, Academia isnt science, its authority. I've now seen 2 studies that should never have been published in Nature in the last year. I am science based, so I never really cared about what organization published, look to the data. However, if you hang out with academics, they unanimously read the journal + abstract. Its so weird. I feel like there is some sort of Dunning Kruger where I'm the idiot... But really... I know the scientific method. I know the quality of the people I'm talking to. Happy to see you didn't just accept it like my academia pals!

Eumenes 2y ago

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.

davikr 2y ago

> 73% of children reported an improvement in their attention. What kind of study outcome is this?

nusl 2y ago
The kind of study outcome that tries to get people to buy the product.

pgcudahy 2y ago

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.

fredgrott 2y ago

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.

devcil 2y ago

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.

khaki54 2y ago
> please don't speculate about ADHD, especially about people who suspect they might have it. Is this a joke? This is a discussion platform for speculating. Plus half the people on HN probably have ADD or ADHD
- segfaltnh 2y ago
  Love this comment. As someone with ADHD, I am drawn to technology and made a career out of it. I suspect many people here are the same, diagnosed or not. By the way, the "ADD" diagnosis has been removed from the DSM, there's no longer a medical distinction between the two.
- Eumenes 2y ago
  > Plus half the people on HN probably have ADD or ADHD They've convinced themselves they have it. Please ignore the prevalence of obesity, lack of exercise, poor diet, and anti-social nature of tech workers plz. They are suffering from a natural affliction.
Mo3 2y ago
I have ADHD-PI and am medicated. I too believe this cannot substitute medication in anything but less severe cases (if that even exists), but I cannot overstate the importance and usefulness of coping mechanisms and attention training. It really defines to some extent whether medication is necessary and in which form (only working hours, all waking hours, etc). Now, granted, for some even building habits and a routine is impossible (like me sometimes too), and then medication fixes some issues and one starts to almost automagically create habits and routines. I've gone years unmedicated when I had a less demanding and more lax work environment and daily focus meditation has helped a great deal. If I'm not mistaken some video games have also vastly improved and kept alive quick reaction times and delayed reward mindset - stuff that this game seemingly also does - training being less impulsive and overriding other, negative habits. It makes perfect sense - video games can release high amounts of dopamine on demand, while in our daily lives we lack release in key moments. Synaptic plasticity, learning and memory is dopamine dependent. In a dopamine deprived brain, if timed correctly, these sudden releases can be extremely habit-forming and beneficial. I've read through their whole website and nowhere is mentioned that this is supposed to replace necessary medication. It's simply another tool in the toolbox, and as such should absolutely not be disregarded. I can 100% see this being extremely helpful and would love to try it out - unfortunately the apps are only available in US app stores.

sam_goody 2y ago

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?

zelias 2y ago

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.

k__ 2y ago

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.

shadowtree 2y ago

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.

regfault 2y ago
Really fascinating. Do you remember the name of the app or the kind of sound therapy? Sounds like it might work wonders.

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