FDA Permits Marketing of Digital Game to Improve Attention in ADHD Children (2020)

It looks like the adult version which doesn't require a prescription has in-game purchases (Google Play subscription?), so assuming it was bought that way, it seems like it wouldn't be restricted to one device. I can see the kid version being restricted if they only sell prescriptions outside of the Play Store.

I wonder what the difference is between the adult and kid versions, just the prescription requirement maybe?

Well, in this case the control does not really match the treatment group at all, so I would suggest that may be a serious flaw. If the hypothesis is that the proprietary algorithm is responsible for the change in the treatment group, it is an odd choice to use an entirely different game as a control, rather than the same game with the proprietary adaptive algorithm removed. (Evidently it is possible to remove just the algorithm, as the demo version lacks the treatment algorithm.) I'm a bit skeptical of the utility of the study.

(I also take minor issue with a study "sponsored by Alkili" being reasonably construed as independent, given that "the funder had a role in study conception and design, confirming data and statistical analyses, and conducting the study." But this of course does not necessarily invalidate the underlying science.)

>AKL-T01 is an investigational digital therapeutic that uses a proprietary algorithm designed to improve attention and related cognitive control processes, by training interference management at an adaptive and personalised high degree of difficulty. Interference is instantiated through a video game-like interface displaying two tasks that are to be done in parallel (multitasking): a perceptual discrimination targeting task in which users respond to the instructed stimulus targets and ignore the stimulus distractors (similar to a Go–No-Go task) and a sensory motor navigation task in which users continuously adjust their location to interact with or avoid positional targets.

It seems the crux of their "tech" is simply a game that tries to get you to balance your focus between two tasks and punish/reward you for performance on that. Reviews claim the game feels like it was thrown together in a couple weeks because it probably was, because "multitask two different things and train yourself to manage the distractions they produce" is such a trivial concept that it already exists as at least one video game I know of (https://store.steampowered.com/app/640290/Super_Multitasking...) and it's been a genre for at least decades, and the only novelty they have introduced is an "algorithm" that is most likely "as they succeed at managing the distractions, make it harder", otherwise known as "dynamic difficulty" which goes back to at least the mid-2000s.

People rarely play these games for fun because practicing managing your attention is really hard and stressful and is basically the opposite of what most people are doing video games for. The reviews for example point out that the game is extremely hard very quickly, and they don't seem to realize that's the point: To explicitly challenge your ability to respond to distractions as practice.

Most games IMO do not fit this pattern enough to help ADHD. Further looking, I see their entire test of outcomes was a singular ADHD test called "TOVA", which primarily tests reaction time to a stimulus.

So, their paper (not an independent study BTW) says that if you play a game that challenges your reaction time for 20 minutes every day, you will do better on a test that asks you to have good reaction time for 21.6 (why) minutes.

Wow

IMO selling such a game as a subscription and "medicine" is pretty abhorrent. The only reason to do so is to charge absurd prices for a very simple game.

I posted elsewhere an excerpt from their paper. Their game looks like a demo you'd create following a tutorial because it basically is.

The crux of their tech is just a game where you juggle two tasks and get distractions thrown at you, and the better you do, the more it tries to distract you. They probably barely modified a few stock assets and added a single chunk of code to implement that dynamic difficulty.

It really makes me want to re-implement this exact project. It's literally a weekend thing.

Of note, their test they supposedly improved on was TOVA, "Test of variable attention", and anecdotally more so tests your ability to stay focused on a response time test.

That is not confidence inspiring. Being able to do better on a response time test after playing a game that challenges your response time at higher difficulties is not new science. This also does nothing for those like me with utterly broken executive functioning.